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Objective: Focusing on body functionality – what the body can do – may benefit women's body image. This pilot study examined the effects of focusing on body functionality appreciation during an audio-guided mirror gazing task (F-MGT). Participants: 101 college women, M(SD)AGE = 19.49(1.31), were alternately assigned to F-MGT or a comparison with no guidance on how to examine the body, directed attention mirror gazing task (DA-MGT). Methods: Participants self-reported pre- and post-MGT body appreciation, state appearance satisfaction, and orientation to and satisfaction with physical functionality. Results: Group interactions were significant for body appreciation and functionality orientation. DA-MGT decreased body appreciation from pre- to post-MGT; F-MGT did not change. There were no significant interactions in post-MGT state appearance satisfaction or functionality satisfaction, though state appearance satisfaction increased significantly in F-MGT. Conclusions: Integrating body functionality may buffer against harmful effects of mirror gazing. Given F-MGT's brevity, additional work must assess its potential as an intervention technique. [ABSTRACT FROM AUTHOR]

Background: Adults with conditions that affect their appearance, known as visible differences, can experience appearance concerns, social anxiety, and depression. Interventions have been developed for this population to facilitate adjustment and coping skills; however, they have limited evidence of efficacy. The Expand Your Horizon [Alleva, J. M., Martijn, C., Van Breukelen, G. J., Jansen, A., & Karos, K. (2015). Expand Your Horizon: A programme that improves body image and reduces self-objectification by training women to focus on body functionality. Body Image, 15, 81–89. ] online functionality-based writing programme was adapted for adults with visible differences. Method: A pilot randomised controlled trial with a wait-list control group was carried out to assess preliminary intervention efficacy and gain information about the acceptability and feasibility of the programme. Forty-four adults aged 21–63 years (M = 40.21; SD = 12.05) with visible differences took part. Various facets of body image (i.e. functionality appreciation and body appreciation) as well as depression and anxiety were assessed immediately pre- and post-intervention and at three-months. Results: Participants reported enjoying the programme, felt that the format was acceptable, and it significantly increased functionality appreciation, which was maintained at three-months. However, there were no improvements in body appreciation, depression, and anxiety. Conclusions: In future, a full trial should be carried out with an active control group. [ABSTRACT FROM AUTHOR]

Background Adults with conditions that affect their appearance, known as visible differences, can experience appearance concerns, social anxiety, and depression. Interventions have been developed for this population to facilitate adjustment and coping skills; however, they have limited evidence of efficacy. The Expand Your Horizon [Alleva, J. M., Martijn, C., Van Breukelen, G. J., Jansen, A., & Karos, K. (2015). Expand Your Horizon: A programme that improves body image and reduces self-objectification by training women to focus on body functionality. Body Image, 15, 81–89. https://doi.org/10.1016/j.bodyim.2015.07.001] online functionality-based writing programme was adapted for adults with visible differences.Method A pilot randomised controlled trial with a wait-list control group was carried out to assess preliminary intervention efficacy and gain information about the acceptability and feasibility of the programme. Forty-four adults aged 21–63 years (M = 40.21; SD = 12.05) with visible differences took part. Various facets of body image (i.e. functionality appreciation and body appreciation) as well as depression and anxiety were assessed immediately pre- and post-intervention and at three-months.Results Participants reported enjoying the programme, felt that the format was acceptable, and it significantly increased functionality appreciation, which was maintained at three-months. However, there were no improvements in body appreciation, depression, and anxiety.Conclusions In future, a full trial should be carried out with an active control group.

This study aimed to examine the mediating role of body image coping strategies in the relationship between positive body image and wellbeing. Three hundred and seventy-two women and three hundred and seventy-seven men completed a questionnaire assessing body appreciation, body appreciation functionality, body compassion, body image coping strategies (appearance fixing, avoidance, positive rational acceptance), self-acceptance and overall psychological wellbeing. Path analysis showed that avoidance significantly mediated the relationship between body appreciation and overall psychological wellbeing among both women and men; its mediating role was confirmed for men's but not for women's self-acceptance. Positive rational acceptance was a significant mediator of the relationship between body compassion and both psychological wellbeing and self-acceptance among men but not among women. These findings show that higher body appreciation is associated with a lower tendency to avoid appearance-related cognitions or thoughts that are interpreted as threatening, with an indirect effect on women's and men's psychological wellbeing. Analogously, but only for men, body compassion is associated with mental activities and self-care behaviors that foster rational self-talk and the acceptance of one's experiences, which, in turn, are linked to higher wellbeing. These findings can help to plan programs aimed at fostering individuals' wellbeing by focusing on their positive body image considering gender differences. [ABSTRACT FROM AUTHOR]

Abstract Background Recent evidence supports the use of immersive virtual reality (VR) as a means of delivering bodily illusions that may have therapeutic potential for the treatment of musculoskeletal conditions. We wanted to investigate whether a single session of an embodiment-based immersive VR training program influences pain-free range of motion in patients with shoulder pain. Methods We designed a rehabilitation program based on developing ownership over a virtual body and then “exercising” the upper limb in immersive VR, while the real arm remains static. We then carried out a single-arm pre-post experiment in which 21 patients with movement-related musculoskeletal shoulder pain were exposed to the 15-min VR program and measured their active pain-free range of motion immediately before and afterwards. Results We found that shoulder abduction and hand-behind-back movements, but not shoulder flexion, were significantly and clinically improved post-intervention and that the level of improvement correlated with the level of embodiment. Following this one session, at 1-week follow-up the improvements were not maintained. Conclusions Virtual embodiment may be a useful therapeutic tool to help improve range of motion in patients with movement-related shoulder pain in the short term, which in turn could expedite rehabilitation and recovery in these conditions.

• Functionality-focused mirror exposure (FME) improved four patients' body image. • All patients showed improved body satisfaction, body checking, and body avoidance. • Patients' maintained gains at varied (3-, 9-, and 11-month) follow-up durations. Body dissatisfaction is a robust risk factor for eating disorders (EDs) and body dysmorphic disorder (BDD) and is associated with decreased quality of life. Current gold-standard ED treatments often do not fully address body dissatisfaction, which may leave patients vulnerable to relapse following treatment. Mirror exposure (ME) is one evidence-based strategy shown to reduce body dissatisfaction in EDs and BDD. However, the potential of integrating this strategy with other interventions demonstrated to reduce body dissatisfaction, such as focusing on the body's functionality, remains unexplored in ED samples. This article describes the development of a novel body functionality-focused ME (FME). We describe the development and structure of the novel ME, and a pilot test for its benefits in treatment through a clinical case series of four individuals with clinically elevated body dissatisfaction and/or EDs who were receiving concurrent cognitive behavioral therapy. All four patients demonstrated clinically meaningful improvements in state body satisfaction, body checking, and body image avoidance from pretreatment to posttreatment, with nonsignificant improvements evident at longer follow-up durations (which varied across patients). Additional randomized controlled treatment research is needed to determine whether FME may improve efficacy or reduce relapse rates compared to traditional cognitive behavior therapy for body dissatisfaction and EDs. [ABSTRACT FROM AUTHOR]

Background: Recent evidence supports the use of immersive virtual reality (VR) as a means of delivering bodily illusions that may have therapeutic potential for the treatment of musculoskeletal conditions. We wanted to investigate whether a single session of an embodiment-based immersive VR training program influences pain-free range of motion in patients with shoulder pain. Methods: We designed a rehabilitation program based on developing ownership over a virtual body and then "exercising" the upper limb in immersive VR, while the real arm remains static. We then carried out a single-arm pre-post experiment in which 21 patients with movement-related musculoskeletal shoulder pain were exposed to the 15-min VR program and measured their active pain-free range of motion immediately before and afterwards. Results: We found that shoulder abduction and hand-behind-back movements, but not shoulder flexion, were significantly and clinically improved post-intervention and that the level of improvement correlated with the level of embodiment. Following this one session, at 1-week follow-up the improvements were not maintained. Conclusions: Virtual embodiment may be a useful therapeutic tool to help improve range of motion in patients with movement-related shoulder pain in the short term, which in turn could expedite rehabilitation and recovery in these conditions. [ABSTRACT FROM AUTHOR]

• Investigated a body image program for women who have undergone bariatric surgery. • Experimental and wait-list groups experienced quantitative improvements in body image. • Qualitative analyses showed the experimental group experienced positive body image. • Qualitative analyses also revealed challenges to women's body image. This study investigated a novel technique to improve body image among women who have undergone bariatric surgery—namely, by having them focus on their body functionality (everything the body can do , rather than how it looks). Participants were 103 women (M age = 46.61) who had undergone bariatric surgery 5–7 months prior to the study. They were randomized to the 1-week online intervention, comprising three functionality-focused writing exercises (Expand Your Horizon; Alleva et al., 2015), or to a wait-list control group. Body appreciation, appearance and functionality satisfaction, body awareness, self-objectification, self-esteem, and self-kindness were assessed at pretest, posttest, and at 1-week and 3-month follow-up. Multilevel modeling analyses showed that, compared to the control, the intervention group experienced improved body appreciation at posttest, and these improvements persisted at both follow-ups. These findings were nonsignificant when intent-to-treat analyses were performed. Both available case and intent-to-treat analyses showed that all participants experienced improvements in facets of body image across time. Qualitative analyses of participants' responses to the intervention writing exercises provided more insight. Via coding reliability thematic analysis, we identified 11 themes that together provide evidence that intervention participants experienced facets of a more positive body image, while also facing challenges to their body image and well-being. Together, findings suggest that focusing on body functionality may contribute to improved body image among women who have undergone bariatric surgery, but effects may be nuanced compared to prior functionality research among general samples of women. The study was registered retrospectively (ClinicalTrials.gov; identifier NCT04883268). [ABSTRACT FROM AUTHOR]

Body functionality is an emerging positive body image construct which may help women value what their body can do, rather than how it looks. In this online experimental study, we examined women's responses to functionality content on Instagram. Young women (N = 318, M ag e =22.19) viewed one of four types of Instagram posts: functionality text and images, functionality text overlaid on fitspiration images, standard fitspiration images, or cityscapes. They completed pre- and post-test state measures of appearance and functionality satisfaction and self-care intent, and post-test social comparison. Familiarity with contemporary social media trends and interest in functionality content were also assessed. Surprisingly, appearance and functionality satisfaction were highest after viewing the functionality and functionality with fitspiration images. Social comparison did not differ between conditions. Women were familiar with body positive concepts, except body functionality, although they expressed interest in this content. We conclude body functionality content would be useful to include in women's social media feeds. • Women viewed quotes and illustrations relating to body functionality. • These quotes were also overlaid on fitspiration images. • State satisfaction high for these two conditions; higher than plain fitspiration. • Women were familiar with positive body image concepts but not body functionality. • Women expressed interest in seeing functionality content in their social media feed. [ABSTRACT FROM AUTHOR]

• Compared a body gratitude intervention to an active control to lower weight bias. • Functionality appreciation, self-compassion, and healthcare stress were also tested. • Both conditions demonstrated improvements on study variables. • The effects over time were stronger for intervention participants. • Body gratitude journaling has promise in improving body-related esteem. Weight bias internalization (WBI) is associated with a myriad of negative health outcomes, but there are few effective treatments that address this concern. This randomized controlled trial examined the preliminary effectiveness of a previously developed body gratitude journaling intervention (i.e., Expand Your Horizon) compared with an active control writing condition (i.e., expressive writing) in emerging adult women with WBI. Participants (N = 135) completed baseline measures and were then randomized to either Expand Your Horizon (n = 72) or the active control condition (n = 63). Participants in both conditions completed three writing tasks over one week. Assessments occurred at baseline, post-test, and follow-up (one-week). Participants in both conditions experienced improvements in WBI, functionality appreciation, and self-compassion at follow-up, though improvements were greater in the Expand Your Horizon condition. Further, participants in the Expand Your Horizon had greater improvement in healthcare stress at follow-up. In sum, Expand Your Horizon appeared accessible and demonstrated preliminary effectiveness in a sample of emerging adult women with WBI. Avenues for future research include evaluating this intervention in more diverse populations with a longer follow-up. [ABSTRACT FROM AUTHOR]

• The Japanese FAS is unidimensional and invariant across sex. • The Japanese FAS showed good test-retest reliability over a three-week period. • The Japanese FAS showed good internal consistency reliability estimates. • The Japanese FAS also showed good construct and incremental validities. The Functionality Appreciation Scale (FAS; Alleva et al., 2017) is a widely adopted measure to assess appreciation for one's body and its capacity. In this study, we performed a psychometric validation of the Japanese translation of the FAS. Participants included an online sample of 750 Japanese individuals (20–70 years old), who completed the FAS and other previously validated measures of body appreciation, intuitive eating, gratitude, self-esteem, and life satisfaction. Moreover, the survey was conducted twice, 3 weeks apart, to determine test–retest reliability. Exploratory factor analyses replicated the unidimensional factor structure of the FAS, which was also verified by the confirmatory factor analysis. FAS scores had gender invariance, and demonstrated good internal consistency and test-retest reliability over the 3-week period. In addition, further analyzes indicated adequate construct, and incremental validity. These findings indicate that the Japanese version of FAS demonstrates good psychometric properties, and can be used to examine the importance of functionality appreciation for enhancing positive body image and healthy eating. [ABSTRACT FROM AUTHOR]

Negative body experience is a core characteristic of eating disorders, and poses a serious risk factor for its development, maintenance and relapse. This underlines the importance of specific therapeutic attention to body experience. In the past ten years a body-oriented treatment protocol with the focus on positive body exposure, called 'Protocol Positive body experience' has been developed. The aim of this paper is to describe the scientific basis of the protocol and to give an impression of its content and structure, illustrated by clinical case vignettes. An important and innovative aspect of the protocol is to enhance not only aesthetic, but also functional and tactile body experience. The protocol enables body-oriented therapists and psychomotor therapists to treat negative body experience in an evidence-based way and facilitates further research to validate the effect of positive body exposure. [ABSTRACT FROM AUTHOR]

• We introduce feminist materialist disability theory to rethink body functionality. • Feminist disability theory reimagines difference through an affirmative lens. • This approach has important implications for theory, research, and practice. • We advocate for engagement with this theory base to advance functionality research. A burgeoning body of literature shows a positive relationship between body functionality and positive body image. Although still nascent, research centring experiences of people with disabilities and bodily differences develops this literature. In this article, we offer directions for this research, bringing body functionality into dialogue with feminist materialist disability theory to examine relations between people's bodily perceptions and the socio-material worlds they occupy. Feminist disability theory re-imagines difference through an affirmative lens, conceptualising body image as relational and processual, and approaching difference through four orientations: difference is basic to the world; difference is not deficiency; difference is not the problem, our inhospitable and ableist world is; and centring difference exposes the mythical norm. We apply this lens to body functionality research, and outline implications for research, practice, and theory, arguing that building a bridge between these frameworks offers a stepping off point for exciting directions for body image research. [ABSTRACT FROM AUTHOR]

The present study examined the impact of writing different types of comments in response to fitspiration (fitness inspiration) images on women's body dissatisfaction and negative affect. Women (N = 256) from the general population (age range: 18 to 49) were randomized to write one of three types of comments on the same fitspiration images: appearance (comment on the woman's appearance), functionality (comment on what the woman's body can do), or background (comment on the image background). Participants completed measures of state body dissatisfaction and negative affect pre- and post-exposure and measures of appearance comparison and functionality appreciation post-exposure. After controlling for pre-body dissatisfaction due to a baseline difference among groups, there was no difference among groups in body dissatisfaction at post-exposure. Negative affect decreased from pre- to post-exposure across all groups, but there was no difference by group or interaction by time and group. The background group reported lower state appearance comparison than the appearance group. There were no group differences in functionality appreciation. Our results suggest that commenting on image backgrounds might decrease appearance comparison relative to making appearance comments and that writing comments on appearance, functionality, or the background in response to fitspiration may be beneficial for mood. • An experiment comparing the impact of different fitspiration comments on women. • There was no difference among groups in body dissatisfaction at post-exposure. • Negative affect decreased from pre- to post-exposure across all groups. • The background group had lower appearance comparison than the appearance group. • There were no group differences in functionality appreciation. [ABSTRACT FROM AUTHOR]

Few studies have investigated community knowledge and beliefs about negative body image. Yet, low rates of recognition and help-seeking for body image concerns have been reported. Given the prevalence of body image problems and associated mental health risks in women, the current online study investigated negative body image mental health literacy in 260 women aged 18 to 64 years recruited via Prolific. The mental health literacy paradigm was employed in a 2 × 2 experimental design in which the effect of a target's domain of body image concern (appearance versus body functionality) and weight status ("normal weight" versus "overweight") was assessed on problem recognition, beliefs, and help-seeking recommendations. Overall, low symptom recognition was observed, and ratings for beliefs and help-seeking suggested low levels of stigma. However, significantly greater sympathy and lifestyle support recommendations were observed in the overweight compared to normal weight condition, and a domain × weight interaction suggested significantly fewer negative emotional reactions in the appearance overweight condition compared to appearance normal weight, and functionality overweight, conditions. The findings suggest a need for education about body image independent of weight status in women. Future research would benefit from examining diverse samples, broader functionality concerns, and stigma. • Symptom recognition of negative body image was poor in women. • Body image problems were perceived as distressing and warranting help. • Greater sympathy and fewer negative emotional reactions in 'overweight' condition. • Greater lifestyle support recommended in 'overweight' condition. • Weight stigma inversely associated with negative body image mental health literacy. [ABSTRACT FROM AUTHOR]

The study aimed to investigate the influence that recreation center promotional messaging had on college females’ body perceptions. Female participants 18 to 25 years of age (N = 137, Mage = 20.41) from a mid-sized, Midwestern university completed two separate body perception questionnaires. These questionnaires assessed body appreciation (functionality) and body shame (appearance). Participants were divided into three groups and shown a collage of recreation center messages that were portraying one of three conditions: (a) body functionality, (b) body appearance, or (c) neutral images. Participants then completed post-collage surveys to capture acute responses in body perceptions based on the collage that was viewed. Results indicated that those who viewed the body functionality collage had a significant decrease in body shame scores from pre- to post-survey completion, but those who viewed the body appearance collage had no significant change in body perception. This study provides preliminary work for researchers to expand upon in order to enhance recreation center usage among female students. [ABSTRACT FROM AUTHOR]

• Scores on Romanian Functionality Appreciation Scale (FAS) are 1-dimensional. • Romanian FAS scores have adequate test-retest reliability and construct validity. • Romanian FAS scores are invariant across sex, but sex difference in latent scores were null. The Functionality Appreciation Scale (FAS; Alleva et al., 2017) is a 7-item measure of an individual's appreciation of their body for what it can do and is capable of doing. Although the instrument is increasingly used in interventionist studies, its psychometric properties have been infrequently investigated outside Anglophone populations. Here, we examined psychometric properties of a novel Romanian translation of the FAS. An online sample of 959 Romanian adults (18–73 years old) completed the Romanian FAS, and validated measures of positive body image (body appreciation), negative body image (weight discrepancy in women, drive for muscularity in men), eating disorder symptomatology, and psychological well-being (self-esteem, gratitude). Exploratory factor analyses led to the extraction of a 1-dimensional model of FAS scores, which we confirmed using confirmatory factor analysis. FAS scores achieved scalar invariance across sex, but the sex difference in latent FAS scores did not reach significance (d = 0.15). FAS scores had adequate internal consistency and test-retest reliability up to four weeks, and further analyses provided evidence of convergent, construct, and incremental validity. These results support the psychometric properties of the Romanian FAS and present evidence of the importance of functionality appreciation in relation to healthier body image and psychological well-being. [ABSTRACT FROM AUTHOR]

• Body functionality is valuable with respect to positive body image and well-being. • Beyond functionality awareness, functionality appreciation is particularly important. • A multifaceted and holistic conceptualisation of body functionality is also important. • The experience of body functionality is nuanced across social identities. Body functionality describes everything that the body is able to do, across diverse domains (e.g., bodily senses, creative endeavours). Nearly a decade ago, leading scholars identified research on body functionality as a priority for the body image field. The field has responded, as shown by the recent rise of body functionality research. We considered this an opportune time to (a) define body functionality (what it is and is not); (b) present theoretical frameworks of body functionality; (c) articulate first-generation and current measures relating to body functionality; (d) offer functionality-focused body image interventions that can improve appreciation for one's body functionality (and body image more broadly); (e) summarise additional areas of research related to body functionality and positive body image; and (f) provide considerations and directions for future research and interventions incorporating body functionality. Research has underscored body functionality as a valuable construct with respect to positive body image and well-being, particularly when individuals appreciate what their bodies can do and conceptualise their body functionality holistically. Yet, the experience of body functionality is nuanced across social identities. Overall, the field has greatly advanced knowledge about body functionality, and we are excited to see the next generation of research that emerges. [ABSTRACT FROM AUTHOR]

The appreciation of body functionality refers to the extent to which an individual appreciates what his body does or is capable of doing. It represents a facet of positive body image that has recently gained significant attention in research in the area. The Functionality Appreciation Scale (FAS) is an instrument created to measure this construct. However, so far, the use of FAS has been limited to a few languages. To partially overcome this limitation, the present study aimed to carry out a cross-cultural adaptation of FAS and assess the psychometric properties of the developed version. A sample of 157 Brazilian young university students (mean age = 23.41, SD = 4.21; 84 men, 73 women) completed the Brazilian Portuguese version of the FAS online, plus additional measures. A Confirmatory Factor Analysis demonstrated a one-dimensional structure for the version (factorial loads > 0.50). Evidence of convergent validity was provided through significant and positive correlations of FAS with measures of body appreciation, self-compassion, and self-esteem, plus significant and negative correlations with measures of anxiety and depression (r > 0.5 e p < 0.0001). The internal consistency of FAS was satisfactory (a = 0.90). The availability of the Brazilian version of FAS may be useful for use in clinical and research settings. Future studies may provide additional evidence of validity, including use with other populations. [ABSTRACT FROM AUTHOR]

• This research explores positive body image among people with chronic pain. • Pain management and acceptance were associated with all assessments of body image. • Controlling pain may be less relevant to body image than is coping with pain. Although body image research has recently begun to examine positive body image and ways to improve body image, it remains unclear the extent to which these findings generalize to individuals who experience chronic pain. With this in mind, this study examined individuals with chronic pain conditions (N = 278, M age = 36.75, SD = 11.56), including their reports of their ability to control, manage, and accept their pain. Participants also completed assessments of four facets of body image: perceptions of body functionality, body appreciation, appearance evaluation, and body satisfaction. Results indicated that pain acceptance was the most consistent, unique predictor of these body image constructs, after controlling for the other pain facets, as well as body mass index, gender, and age. These findings have implications for improving body image among people with chronic pain; it appears that controlling or altering pain may be less relevant to body image than is how individuals cope with pain. [ABSTRACT FROM AUTHOR]

Despite its high prevalence in women, few studies have examined lay knowledge and beliefs about negative body image. Yet, studies applying mental health literacy to body image problems suggest recognition of appearance concerns is poor, which could impede help-seeking. The present study extended previous work by investigating problem recognition, beliefs and help-seeking for aesthetic and functional (physical ability focused) body image concerns in women, and the role of self-objectification in help-seeking. A within-subjects online survey design employing the mental health literacy paradigm was undertaken in a sample of 210 female-identifying adults residing in Australia (M age = 31.25, SD = 12.76). Overall, results indicated that recognition of body image problems depicted via fictional text vignettes was limited. Moreover, recognition, as well as ratings of perceived prevalence, distress, sympathy, affective reactions, and help-seeking recommendations and intentions, were significantly greater for aesthetic compared to functional body image concerns. Self-objectification displayed significant negative associations with help-seeking recommendations for aesthetic (but not functional) concerns, and was not associated with help-seeking intentions. Findings suggest that negative body image mental health literacy is poor in women, particularly in relation to body functionality. More research is needed to facilitate help-seeking and reduce the impact of body image concerns in women. • Recognition of negative body image symptoms is poor among women. • Aesthetic body concerns were better recognised than functional body concerns. • Functional body concerns were perceived as a less serious and prevalent problem. • Different help sources were recommended for aesthetic vs. functional body concerns. • Self-objectification was linked to fewer help recommendations for aesthetic concerns. [ABSTRACT FROM AUTHOR]

Pregnancy and the postpartum period have been identified as times when women experience important changes in their physical bodies. Yet, little is known about the ways in which these experiences may be related to positive embodiment, or in contrast experienced as restricting and objectifying. Thus, the aim of this study was to qualitatively examine the way in which women experienced embodiment during the course of pregnancy and the postpartum period. Twenty women, mean age (SD) = 31.85, (2.3) years, 95 % White, participated in individual interviews and completed online surveys. Findings revealed that women described experiencing both aspects of positive embodiment including body connection and comfort, agency and functionality, attuned self-care, connection to appetite, and inhabiting the body as a subjective site. Findings also revealed negative aspects including body disconnection and discomfort, disrupted functionality, challenged self-care, appetite suppression, and the body as a public and objectified site. Findings highlight the potential for the pregnancy and postpartum periods to be important times for positive embodiment in women, and a source of appreciation of the body and its functionality. However, social pressures may also constrain embodiment during this period. These findings have implications for identifying pathways to positive embodiment in pregnancy and postpartum. • The peripregnancy period (pregnancy and postpartum) is a unique time for embodiment. • Women described experiencing positive embodiment across the different facets. • Women also described negative aspects of embodiment. • Social context influences body appearance and functionality in peripregnancy. [ABSTRACT FROM AUTHOR]

• Women completed online positive self, appearance, functionality tasks. • Control group completed online tasks about stress management. • Both groups improved across measures with larger effects in body image group. • Idealised media exposure only reduced functionality satisfaction. • Reflections on appearance, functionality and self can help with positive body image. Women's relationship with their bodies may be improved through activities which encourage them to focus on the positive elements of their appearance, the functional qualities of their body, and positive aspects of themselves in general. This study examined the effectiveness a multi-session program addressing these elements. Across two online sessions, 117 Australian women (M age = 23.48) completed writing tasks about the positive elements of their appearance, body functionality, and who they are as a person, as well as engaging with functionality-focused public health campaigns. A control group completed matched tasks on stress management. Results showed that both groups had improvements across trait body appreciation, self-objectification, and weight concern across the program. Within-session state improvements were found across stress, body appreciation, appearance and functionality satisfaction for both groups. An online media exposure task was used one week post-program completion (n = 81). Idealised media exposure reduced functionality satisfaction in both groups but did not impact any other outcome measure. Findings suggest that tasks encouraging positive reflections on appearance, functionality, and self are useful in improving women's body satisfaction. Issues around choice of control group are discussed. [ABSTRACT FROM AUTHOR]

• Describing one's functionality vs. appearance generated distinct thoughts. • The functionality group described positive body-self connection and resilience. • Both groups evaluated their bodies and described them in relation to a social norm. • The appearance group described their body as a 'project' to be worked on. • More men expressed appearance appreciation compared to women. The aim of this study was to explore the themes that emerge when individuals are asked to describe their body functionality, and those that emerge when individuals are asked to describe their physical appearance. Data were gathered from undergraduate women and men's (N = 75, M age = 20.66) responses to a writing exercise (Alleva et al., 2014), wherein they were either asked to describe their body functionality or their physical appearance. Through thematic analysis, six themes were identified from participants' descriptions of their body functionality (ordered by frequency): (a) evaluating the functionality of the body, (b) positive body-self connection, (c) resilient body, (d) comparisons to the norm, (e) body behind the scenes, and (f) enjoyment of body functions. Five themes were identified from participants' descriptions of their physical appearance (ordered by frequency): (a) comparisons to the norm, (b) evaluating the appearance of the body – own evaluations, (c) evaluating the appearance of the body – other people's evaluations, (d) the body project, and (e) appearance appreciation. Overall, the findings suggest that the themes that emerge when people are asked to reflect on their body functionality tend to be more positive, as they can be linked to positive embodiment, gratitude, and less self-objectification. [ABSTRACT FROM AUTHOR]

• Positive body image interventions improve aspects of health and well-being. • Fifteen studies, evaluating 13 interventions, were eligible for inclusion. • The two interventions for men, rated as weak, did not improve positive body image. • Strong and moderate quality interventions improved positive body image in women. • Future interventions should target multiple components of positive body image. Theory suggests promoting positive body image (PBI) through interventions would have a significant impact on health and well-being. However, little is known about the effectiveness of existing interventions. This review aimed to identify and assess the evidence of effectiveness of interventions to increase PBI in adults. Database searches were conducted using CINAHL Plus, Medline, PsychINFO, Wiley Online Library, and SCOPUS. Application of inclusion criteria and data extraction were conducted by two reviewers. Methodological quality was assessed using the Effective Public Health Practice Project Quality Assessment Tool, and narrative synthesis was conducted. Fifteen studies, evaluating 13 interventions, were included. Three studies, evaluating one online writing-based functionality intervention, were judged to have strong methodological quality and had evidence of improving body appreciation, body esteem, and functionality satisfaction. Six moderate quality studies found interventions using intuitive eating, CBT, self-compassion, and exercise improved PBI. There was limited evidence of effectiveness of interventions for men, suggesting future research is needed to better understand PBI mechanisms in men. Lack of heterogeneity of outcome measures is discussed as a limitation. Findings suggest existing interventions are effective at increasing aspects of PBI among women and support the development of interventions that target multiple components of PBI. [ABSTRACT FROM AUTHOR]

• Women with visible physical disabilities (WPD) define body image holistically. • In WPD, body functionality includes what bodies cannot do & what they do differently. • Body image among WPD fluctuates with mental and physical health symptoms. • Functional-aesthetic body image emerged as an influential body image concept. A current hypothesis is that women who learn to focus on their body's functionality versus appearance may experience improved body image outcomes. This research is underdeveloped in considering the perspectives of women with visible physical disabilities (WPD), who have differences in body functionality and appearance that influence their body image. Our study aimed to understand how WPD conceptualize body image and body functionality and to clarify relationships between these constructs. We conducted semi-structured interviews with 15 women representing a range of ages (21–53 years) and disabilities. We used a constructivist grounded theory approach, applying the constant comparative method and engaging in reflexivity throughout the research process. We interpreted themes and subthemes based on their emergence across and explanatory value within cases to develop a conceptual model of the findings. Four major themes emerged: meanings and definitions, body image stability, factors that influence body image, and the interaction of appearance and body functionality. A new concept, "functional-aesthetic body image," emerged describing women's perceptions about the appearance of their body when engaged in functions or activities. Results may stimulate advancements in body image theory and measurement, and guide further exploration of the complex appearance-functionality relationship and its links with holistic health outcomes. [ABSTRACT FROM AUTHOR]

Motherhood can increase vulnerability to body dissatisfaction, but positive body image interventions may mitigate this. Expand Your Horizon (Alleva et al., 2015), an online writing intervention, enhances functionality appreciation, an aspect of positive body image. The intervention's demonstrated efficacy and focus on body functionality indicate its potential use among mothers. However, its original 3-session format may be unfeasible for mothers alongside other commitments. Thus, we tested the impact of a single 15-minute Expand Your Horizon session on state body appreciation and functionality appreciation. Mothers (N = 143) of 0–10-year-olds were randomly allocated to either the intervention group, or an active control group. State body appreciation and functionality appreciation were assessed pre- and post-intervention. Trait self-compassion was tested as a potential moderator. Participants who completed Expand Your Horizon reported greater state body appreciation and functionality appreciation post-intervention than those in the control group. Self-compassion moderated the intervention's effect on state functionality appreciation, with effects strongest for those with lower levels of self-compassion. Overall, findings support the intervention's suitability for mothers, particularly those with low self-compassion. Practical implications include possibly tailoring Expand Your Horizon and similar interventions to benefit all mothers. Future research directions include longitudinal and qualitative designs, and extension to other specific populations. • Mothers completed either a body or item functionality writing task. • Both tasks improved body image, with larger effects for the body functionality task. • Body functionality writing is most effective for mothers low in self-compassion. • Findings point to a time-efficient intervention format for mothers. [ABSTRACT FROM AUTHOR]

Viewing body-positive content on social media can benefit women's body image. Previous research has conceptualised body positivity broadly, and therefore it remains unclear whether some components are more useful than others. This study examined the impact of body appreciation or body functionality messages (in addition to a mixed condition) overlaid across different image types to influence women's body image. Young women (17–30 years, M age = 21.53, N = 308) completed an online survey in which they were randomised to view either fitspiration or diverse images overlaid with messaging focusing on body appreciation, body functionality, or a combination. Participants completed pre- and post-test measures of appearance and functionality satisfaction, body appreciation, and body objectification / conceptualisation. Post-test measures of social comparison and perceptions of models were also taken. Results showed that message type did not interact with image type. Rather, exposure to diverse images increased appearance satisfaction and body appreciation, with no changes to functionality satisfaction (vs a decrease for the fitspiration condition). All conditions improved in self-objectification. Further, diverse images resulted in more favourable social comparisons. Our findings consider body positive content in a controlled way and show no differences across body appreciation or body functionality themes. • Women viewed diverse or fitspo images overlaid with body positive messaging. • Messaging focused on body functionality, body appreciation, or a combination. • No interactive effects; diverse imagery improved, and fitspo worsened, state body image. • Greater social comparison to fitspo images, although models rated negatively. [ABSTRACT FROM AUTHOR]

The Functionality Appreciation Scale (FAS; Alleva et al., 2017) measures functionality appreciation , the extent to which people appreciate their body for what it is able to do. We translated the FAS to Dutch and evaluated its factor structure and psychometric properties among 471 native Dutch speakers in the Netherlands (255 cisgender women, 204 cisgender men, 8 nonbinary, 1 "other," 3 "rather not say") who were between 18 and 85 years old. Participants completed the Dutch translation of the FAS, followed by questionnaires to assess additional variables of interest (body appreciation, appearance satisfaction, self-esteem, and gratitude). Exploratory factor analysis showed that Dutch FAS scores demonstrated a unidimensional factor structure. Dutch FAS scores demonstrated acceptable internal consistency and construct validity via their positive associations with the additional variables of interest. Dutch FAS scores also demonstrated gender invariance, and women reported higher functionality appreciation than men. Dutch FAS scores evidenced incremental validity for gratitude (but not self-esteem), and were inversely correlated with age and body mass index. Last, 2-week test-retest reliability of the Dutch FAS scores was supported. Overall, these findings provide support that the Dutch FAS is a psychometrically sound instrument to assess functionality appreciation among Dutch speaking adults in the Netherlands. • Scores on the Dutch Functionality Appreciation Scale (FAS) are one-dimensional. • Dutch FAS scores have acceptable internal consistency and test-retest reliability. • Dutch FAS scores demonstrate acceptable construct and incremental validity. • Dutch FAS scores are invariant across gender, and women scored higher than men. • Dutch FAS scores are inversely correlated with age and body mass index. [ABSTRACT FROM AUTHOR]

Highlights • Fitness-related pride was associated with engagement in physical activity (PA). • Pride that stems from attributions to both effort and superiority were associated with PA. • Appearance-related pride was not associated with PA. • Results support importance of pride based on functionality rather than appearance. Abstract Body-related pride has been associated with health behaviors such as physical activity; however, researchers have overlooked distinctions between different domains of pride (appearance/fitness) and the two facets of pride (authentic/hubristic). The objective of the present research was to examine relationships between fitness- and appearance-related authentic and hubristic pride and physical activity. In Study 1, participants (N = 115) completed measures of fitness-related pride and participation in moderate-to-vigorous physical activity (MVPA). Both authentic and hubristic pride were positively associated with MVPA. In Study 2, participants (N = 173) completed measures of appearance-related pride and MVPA. Neither facet of pride predicted engagement in MVPA. In Study 3, participants (N = 401) completed measures of both fitness-related pride and appearance-related pride as well as MVPA. Authentic and hubristic fitness-related pride were associated with MVPA, while appearance-related hubristic pride was negatively associated with MVPA. Results support the adaptive nature of pride in motivating engagement in health behaviors when it is experienced around the body's functionality rather than appearance. [ABSTRACT FROM AUTHOR]

In three studies, we tested the effect of self-compassionate, body-compassionate, and body-functionality-focused writing exercises on college women’s body satisfaction. In Study 1, two hundred fifty-one undergraduate women completed one of the four letter-writing conditions: a general self-compassionate letter, a body-compassionate letter, a letter about body functionality, or a neutral writing task. In Study 2, two hundred forty undergraduate women completed one of the two compassion-focused conditions from Study 1, or one of the two new writing tasks that instructed participants to write either about their bodies or general selves, without any specific compassion cues. In both studies, participants in the compassion conditions reported significantly greater body satisfaction and positive affect relative to the neutral writing conditions. In Study 1, participants in the body-functionality condition also reported increased body satisfaction and positive affect relative to those in the neutral writing condition. Results for negative affect were inconclusive. In Study 3, the writing exercises were modified; we used an online format with 1,158 sorority women in the United States. Again, results indicated that both self-compassion-focused and body-functionality-focused writing led to higher body satisfaction and higher positive affect (relative to a control condition focused on writing about a recent, positive event); however, no effect on negative affect emerged. Clinicians, educators, and activists may consider using these types of compassionate or body-functionality-focused writing exercises as brief interventions for increasing body satisfaction in young women. Additional online materials for this article are available at https://osf.io/fvgcp [ABSTRACT FROM AUTHOR]

Objective: Negative body image is prevalent in women with rheumatoid arthritis and can affect other areas of well-being. Patients have expressed desire for body image to be addressed in treatment. Yet, it is not routinely addressed and no experimental intervention research has been conducted, until now. This randomized trial evaluated a brief online body image intervention for women with rheumatoid arthritis, with a focus on body functionality (everything the body is capable of doing) as the primary technique. Method: Women with rheumatoid arthritis and who wanted to feel better about their body (N = 84; M = 44.82) were randomized to the Expand Your Horizon intervention (comprising 3 writing exercises focusing on body functionality) or a waitlist control group. Primary outcomes concerned body image and secondary outcomes related to rheumatoid arthritis; these outcomes were assessed at pretest, posttest, and at 1-week and 1-month follow-up. Results: Multilevel modeling analyses showed that, relative to control, participants in the intervention experienced improvements in various aspects of body image (functionality appreciation, body appreciation, body satisfaction, body-self alienation) and decreases in depression, with effects persisting at 1-week and 1-month follow-up. No intervention effects were found for body-self harmony, rheumatoid arthritis-specific disability, pain-related disability, and anxiety. Conclusions: Focusing on body functionality can improve body image and reduce depression in women with rheumatoid arthritis. The intervention technique is easy and affordable to deliver and could be a fruitful addition to extant treatments for rheumatoid arthritis. [ABSTRACT FROM AUTHOR]

The present study experimentally examined the impact of different forms of inspirational fitness images (“fitspiration”) on women’s body image. Australian female participants (n = 152, 17-30 years-old; Mage = 21.55, SD = 3.94) were randomly assigned to view fitspiration media which depicted the body in a functional (performing exercise) or non-functional (posed) way, with or without accompanying appearance-focused text. There were no main effects of image type or text presence for body satisfaction, mood, or state self-objectification. However, state body satisfaction decreased and negative mood increased over time following exposure to the fitspiration images. Trait self-objectification moderated the impact of image type and text on state body satisfaction, such that viewing functional images presented with appearance-focused text resulted in poorer body satisfaction for women with higher trait self-objectification, but not for those with lower self-objectification. The findings demonstrate that irrespective of focus or presence of text, exposure to fitspiration images decreases body satisfaction and increases negative mood, highlighting the potential negative consequences of engaging with fitspiration media. [ABSTRACT FROM AUTHOR]

Focusing on body functionality is a promising technique for improving women’s body image. This study replicates prior research in a large novel sample, tests longer-term follow-up effects, and investigates underlying mechanisms of these effects ( body complexity and body-self integration ). British women ( N  = 261) aged 18–30 who wanted to improve their body image were randomised to Expand Your Horizon (three online body functionality writing exercises) or an active control. Trait body image was assessed at Pretest, Posttest, 1-week, and 1-month Follow-Up. To explore whether changes in body complexity and body-self integration ‘buffer’ the impact of negative body-related experiences, participants also completed beauty-ideal media exposure. Relative to the control, intervention participants experienced improved appearance satisfaction, functionality satisfaction, body appreciation, and body complexity at Posttest, and at both Follow-Ups. Neither body complexity nor body-self integration mediated intervention effects. Media exposure decreased state body satisfaction among intervention and control participants, but neither body complexity nor body-self integration moderated these effects. The findings underscore the value of focusing on body functionality for improving body image and show that effects persist one month post-intervention. [ABSTRACT FROM AUTHOR]

We tested the effectiveness of exposure to two functionality-focused media campaigns, This Girl Can and #jointhemovement , in improving state appearance and physical functionality satisfaction, exercise intent, and protecting against exposure to idealised imagery. Across two studies, 339 ( M age = 24.94, SD = 4.98) and 256 ( M age = 26.46, SD = 5.50) women viewed the campaign or control video, followed by images of models who were posed or physically active, or images of landscapes. State satisfaction and exercise intent was measured at pre-test, post-video, post-images, and 1-week follow-up. Social comparison was measured at post-images. Viewing either campaign produced higher appearance satisfaction and exercise intentions than the control video. Effects weren’t maintained after viewing idealised imagery or 1 week later. Further, the campaigns did not decrease social comparisons when viewing idealised imagery. Results can inform agencies about campaign effectiveness and suggest that women benefit from campaigns that feature non-idealised depictions of women exercising. [ABSTRACT FROM AUTHOR]

Research demonstrates that exposure to appearance-focused images of models depicting societal standards of beauty negatively affect women’s state-oriented body dissatisfaction. The purpose of this research was to extend this experimental research to women’s state-oriented body appreciation. The 374 women participants were randomly assigned to view images that were either depicting a model who was representative or not representative of the thin ideal (body size), while this model was in either an appearance-focused pose or a function-oriented pose (pose type). State body appreciation increased significantly after viewing images depicting models who did not conform to societal standards of thinness ( p < 0.001). Exposure to the control condition images, which were images of natural environments, also produced increases in state body appreciation ( p = 0.049). These findings provide insight into the construct of state body appreciation and offer implications for future positive body image research. [ABSTRACT FROM AUTHOR]

We examined whether shifting young women’s (N =322) attention toward functionality components of media-portrayed idealized images would protect against body dissatisfaction. Image type was manipulated via images of models in either an objectified body-as-object form or active body-as-process form; viewing focus was manipulated via questions about the appearance or functionality of the models. Social comparison was examined as a moderator. Negative outcomes were most pronounced within the process-related conditions (body-as-process images or functionality viewing focus) and for women who reported greater functionality comparison. Results suggest that functionality-based depictions, reflections, and comparisons may actually produce worse outcomes than those based on appearance. [ABSTRACT FROM AUTHOR]

We tested the effectiveness of a positive appearance or functionality reflective writing task on women’s body satisfaction and whether these writing task reflections offered any protective advantage when exposed to idealised imagery. Young adult women ( N = 230; M age = 23 years) wrote about positive elements of either their appearance or their body’s functionality, and then were exposed to images of scenery, or thin and attractive models presented in posed or active form. Direction and amount of social comparison were also examined. Women reported immediate gains in both appearance and physical functionality satisfaction regardless of reflection type. However, neither reflection was protective against decreased satisfaction after exposure to idealised images. Greater upward comparison on either appearance or physical functionality domains was related to poorer outcomes. Our reflection task has potential to shift body focus but future research could examine multiple sessions and reflections on a broader range of self-relevant domains. [ABSTRACT FROM AUTHOR]

Body functionality has been identified as an important dimension of body image that has the potential to be useful in the prevention and treatment of negative body image and in the enhancement of positive body image. Specifically, cultivating appreciation of body functionality may offset appearance concerns. However, a scale assessing this construct has yet to be developed. Therefore, we developed the Functionality Appreciation Scale (FAS) and examined its psychometric properties among three online community samples totalling 1042 women and men ( n s = 490 and 552, respectively). Exploratory factor analyses revealed a unidimensional structure with seven items. Confirmatory factor analysis upheld its unidimensionality and invariance across gender. The internal consistency, test-retest reliability, criterion-related, and construct (convergent, discriminant, incremental) validity of its scores were upheld. The FAS is a psychometrically sound measure that is unique from existing positive body image measures. Scholars will find the FAS applicable within research and clinical settings. [ABSTRACT FROM AUTHOR]