Improving body image and sexual health behaviors among college women

ABSTRACT

Objective: To conduct a pilot test to determine if the Body Project, an eating disorder prevention program, was able to reduce risky sexual behaviors. Participants: Twenty college-age women ages 18–21 (in March, 2015) who endorsed both body image dissatisfaction and previous or current sexual activity. Methods: Participants were randomized to the Body Project or psychoeducational control group, and completed baseline, post-test, and 6-month follow-up measures assessing body image concerns, eating behaviors, and sexual behaviors and attitudes. Results: An intervention manipulation check demonstrated that body image variables were in expected directions, though were not significant by group. There was a significant interaction across group and time for “unanticipated sexual encounters,” which decreased in the Body Project group. Conclusions: This pilot study supports the feasibility of using an eating disorder prevention program to reduce other risky behaviors, specifically risky sexual behaviors.     

Examination of the relationships between dietary restraint,alcohol, and adverse problems among women

Objective: Women who report greater chronic dieting consume more alcohol, drink more frequently, and experience greater problems than women who report less chronic dieting. Alcohol may also temporarily disrupt a woman's dietary rules, leading to increased caloric intake and subsequent restriction. This study examined whether alcohol use mediated the relationship between dietary restraint and alcohol problems in a woman's daily life. Participants: Women (N = 59) completed the study by the fall of 2013. Methods: Participants completed up to six assessments for 10 days, including intended dietary restraint, alcohol use, and problems. Results: Drinking quantity partially mediated the relationship between dietary restraint and alcohol problems. For each drink consumed, there was a 1.4 times greater likelihood of eating after drinking, which was associated with greater intention to subsequently restrict calories. Conclusions: The types of drinks consumed and reasons for restricting one's caloric intake may inform the relationship between these behaviors.     

Attention-deficit hyperactivity disorder symptomatology,binge eating disorder symptomatology,and body mass index among college students

Abstract

Objective: To explore the relationship between symptoms of attention-deficit hyperactivity disorder (ADHD), symptoms of binge eating disorder, and body mass index (BMI) among students at a southern university. Participants: Two hundred seventy-seven college students. Methods: Between January 31, 2013 and March 27, 2013, participants completed the Adult ADHD Self-Report Scale (ASRS) Screener and the Binge Eating Scale (BES) in addition to permitting researchers to measure their height and weight. Results: Higher ASRS scores, higher BMIs, and lower BES scores were observed among men. Among both men and women, BES scores were positively correlated with BMI and ASRS scores; however, the correlation between ASRS and BMI was not significant. Conclusion: Binge eating disorder symptomatology was associated with increased ADHD symptomatology and a higher BMI among both men and women. Among students presenting with obesity or ADHD, screening for binge eating may assist with the identification of problematic eating behaviors.     

A Chinese beauty story: how college women in China negotiate beauty,body image,and mass media

This study examines how young Chinese women negotiate beauty and body image in context with mass media, paying particular attention to the relationship between ongoing sociocultural change in contemporary Chinese society and the attitudes and behaviors among young women towards beauty. Qualitative in nature, this study explores the “beauty stories” of 13 college women in mainland China through in-depth interviews. Several distinctive themes were found: (1) These women believed the ideal beautiful Chinese woman should have a tall and thin body, big eyes, a watermelon seed-shaped face, fair skin, and qi zhi (inner beauty); (2) Body image issues were centralized in these women's everyday experiences, and they were under significant cultural, societal, familial, and peer pressure to pursue physical beauty; (3) Cultural and media influences on their perceptions of beauty were complex and multi-layered; and (4) The women were hopeful of both potential positive social change and the liberation of Chinese women, and they were concerned about the superficiality and extreme beauty standards advocated in the media. The findings suggest that the contemporary Chinese beauty story is essentially different from the Western one, extending the existing literature on beauty and body image to include an Eastern and Chinese perspective.     

Expectations, alienation, and drinking motives among college men and women

Relationships among three motivational variables (negative-personal functions of drinking, alienation, and perceived discrepancies between valued goals and expected success toward valued goals) were evaluated in a group of 257 college drinkers. As predicted, a positive relationship between alienation scores and the extent of discrepancies between values and expectations for academic and social success was found. Negative-personal drinking functions were positively associated with both alienation and value-expectation discrepancies. Results are discussed in terms of heuristic consistency and potential applications.     

Body size,physical attractiveness,and body image among young adult women: Relationships to sexual experience and sexual esteem

Although links between women's sexuality and body size, attractiveness, and body image may seem apparent, little empirical work has been conducted on this topic. In the current study, young adult women (N = 192) completed questionnaires and were weighed and rated for facial attractiveness. In general, current body size, experimenter‐rated facial attractiveness, and self‐rated facial and bodily attractiveness were related in some ways to current relationship status and sexual experience. General body dissatisfaction, avoidance of social settings due to appearance concerns, and degree of investment in one's physical appearance were unrelated to relationship status and sexual experience. Higher sexual esteem was related to subjective views of attractiveness, but not to actual body size or experimenter ratings of facial attractiveness.     

Gender conformity,self-objectification,and body image for sorority and nonsorority women: A closer look

Sororities have been identified as placing young women at risk for body image concerns due to a focus on traditional gender role norms and objectification of women. Objective: This study assessed the relationship between conformity to feminine gender role norms, self-objectification, and body image surveillance among undergraduate women. Participants: In a random sample of undergraduates, the authors examined data from sorority and nonsorority women. Methods: In a random sample of undergraduate women, the authors assessed the impact of traditional feminine gender role norms on self-objectification, body image, and feedback regarding physical appearance for sorority and nonsorority undergraduate women. Results: Three linear regressions were conducted, and only conformity to feminine gender role norms contributed significantly in each regression model. Conclusions: Regardless of sorority membership, conformity to feminine gender role norms was found to significantly contribute to increased body consciousness, negative body image, and feedback on physical appearance.     

Pilot study of a personality-based approach to assessing eating disorder and Obsessive Compulsive Disorder symptom risk in college men and women

Abstract

Objective: To conduct a pilot test of the validity of using empirically derived personality types to characterize eating disorder (ED) risk in college students and resolve discrepancies regarding the role of perfectionism and obsessive-compulsive disorder (OCD) symptoms.

Participants: Man and woman undergraduate students (N?=?169) at a small, private university. Data were collected from February to May 2016 and 2018. Methods: Participants completed self-report measures of personality (perfectionism, impulsivity, and effortful control) and psychopathology (EDs, OCD). Results: Our analyses replicated three validated personality types: overcontrolled, undercontrolled, and resilient. Analysis of variances demonstrated perfectionism, ED, and OCD symptoms were significantly elevated in the overcontrolled subtype. There was no interaction by sex. Conclusions: These findings suggest that personality types may be useful for classifying ED risk and OCD symptoms in college students across sexes. Further study and relevance to prevention and intervention efforts to reduce the burden of EDs on college campuses will be discussed.     

Relationships between use of dietary supplements,caffeine and sensation seeking among college students

Abstract

Objective: Caffeine and dietary supplement (DS) use by college students is not well-documented. Given reported associations between energy drink consumption and sensation seeking, we used the Sensation Seeking Scale Form V (SSS-V) to assess relationships between sensation-seeking, caffeine, and DS use. Participants: Data from 1,248 college students from five US institutions were collected from 2009 to 2011. Methods: Linear regression was used to examine relationships between scores on the SSS-V and caffeine and DS use, demographic, and lifestyle characteristics. Results: Male sex, nonHispanic race-ethnicity, higher family income, tobacco use, consuming caffeinated beverages, more than 400?mg caffeine per day, and energy drinks with alcohol at least 50% of the time, were significantly associated with higher total SSS-V scores (P?<?0.001). Those using protein DSs had higher total, disinhibition, and boredom susceptibility SSS-V scores (Ps?<?0.001). Conclusions: Results demonstrate a positive correlation between sensation-seeking attitudes and habitual caffeine, energy drink, and DS consumption.     

Risk level, knowledge, and preventive behavior for human papillomaviruses among sexually active college women.

During the past decade, there has been mounting scientific evidence linking human papillomavirus (HPV) with cervical cancer and, at the same time, a great increase in physician consultations for HPV infections. HPV infection risk factors include multiple sex partners, early age at first intercourse, history of sexually transmitted diseases (STDs), and smoking. This study surveyed 263 sexually active college women and concluded that (1) they are at considerable risk for contracting HPV, (2) they lack awareness of HPV, and (3) they are not practicing preventive behaviors that could reduce their risk of HPV and its serious consequences.     

Tanning benefits,seasonal effects,and concerns about sunscreen: Measuring health beliefs about UV among college students

Abstract

Objective: To develop and validate a scale measuring health beliefs about UV in cloudy climates that may impact UV exposure behaviors. Participants: Students at a large university in Oregon completed pilot (N?=?115) and final (N?=?335) scales online March–July, 2016. Five participants underwent cognitive interviews. Methods: Expert feedback, cognitive interviews, and pilot data guided item development and refinement. We conducted factor analysis and invariance testing. Results: The final four-factor model fit well (χ²?=?37.97, df?=?37, RMSEA?=?0.000, CFI?=?1.000). HBAU subscales are Sunscreen Toxicity, Seasonal Effects, Health Benefits of Tanning, and Tanning Through the Winter. Invariance testing supported strong invariance across sex and tanning status. Conclusion: The HBAU measures beliefs that encourage UV exposure and discourage protection (eg, the belief that sunscreen ingredients are toxic). This scale will enable more comprehensive measurement of cognitive predictors of UV exposure for student health, clinical, and research purposes.     

A screening tool for detecting eating disorder risk and diagnostic symptoms among college-age women

Objective: As eating disorders (EDs) often emerge during college, managing EDs would ideally integrate prevention and treatment. To achieve this goal, an efficient tool is needed that detects clinical symptoms and level of risk. This study evaluated the performance of a screen designed to identify individuals at risk for or with an ED. Participants: Five hundred forty-nine college-age women. Methods: Participants completed a screen and diagnostic interview. Results: Using parsimonious thresholds for ED diagnoses, screen sensitivity ranged from 0.90 (anorexia nervosa) to 0.55 (purging disorder). Specificity ranged from 0.99 (anorexia nervosa) to 0.78 (subthreshold binge eating disorder) compared to diagnostic interview. Moderate to high area under the curve values were observed. The screen had high sensitivity for detecting high risk. Conclusions: The screen identifies students at risk and has acceptable sensitivity and specificity for identifying most ED diagnoses. This tool is critical for establishing stepped care models for ED intervention.     

Body image,self-esteem,and behavioral risk for chronic disease among college students: Additional evidence for integrated prevention

Abstract

Objective: To examine associations between two body image constructs (body appreciation and body satisfaction) and five health behaviors (diet, physical activity, weight management, tobacco exposure, and alcohol intake) associated with risk for chronic disease, controlling for self-esteem. Participants: Three hundred and forty-four college students enrolled at a large, public university in the southeastern US. Methods: Students completed an online survey composed of measures of body appreciation, body satisfaction, self-esteem, and frequency of engagement in preventive health behaviors. Hierarchical linear regression models were used to assess relationships between constructs. Results: Body appreciation, but not body satisfaction or self-esteem, significantly and positively predicted engagement in diet-, physical activity-, and weight-related health behaviors. No associations were found for substance use outcomes. Conclusions: Results illuminate health risks among college students and provide additional evidence to support the development of holistic preventive interventions that simultaneously address aspects of mental and physical health among college students.     

Problematic alcohol use and sexting as risk factors for sexual assault among college women

ABSTRACT

Sexual assault is a major public health concern and college women are four times more likely to experience sexual assault than any other group. We investigated whether sexting is a mechanism by which alcohol use increases risk for college women to be targeted for sexual assault. We hypothesized that sexting would mediate the relationship between problem drinking and sexual assault, such that drinking (T1 = beginning fall semester) would contribute to increased sexting (T2 = end fall semester), and in turn increase the risk of being targeted for sexual assault (T3 = end spring semester). Results: Among 332 undergraduate women (M(SD)age = 19.15(1.69), 76.9% Caucasian), sexting (T2) predicted sexual assault (T3; b = 3.98, p = .05), controlling for baseline sexual assault (b = 0.82, p < .01). Further, sexting (T2) mediated the relationship between problem drinking (T1) and sexual assault (T3) (b = 0.04, CI[.004,.12]). Conclusion: Findings suggest that sexting is one mechanism through which drinking increases the risk of college women being targeted for sexual assault.     

Body image, body satisfaction, and unsafe anal intercourse among men who have sex with men

Using survey results from the 1998 Twin Cities Lesbian, Gay, Bisexual, and Transgender (LGBT) Pride Festival (N = 535), we explored associations between body image and unsafe anal intercourse (UAI) among men who have sex with men (MSM), and evaluated whether body satisfaction mediated this association. MSM who reported underweight body image had lower odds than those who reported average weight of UAI (AOR = 0.33; 95% CI = 0.13, 0.85); body satisfaction was not found to mediate this association. 13.3% of men who reported overweight/obese body image had engaged in UAI compared with 21.6% of those who reported average weight and 8.2% of those who reported underweight (p < .05). Compared with MSM in exclusive relationships, MSM in non exclusive relationships had increased odds of UAI (AOR = 5.78; 95% CI = 2.96, 11.29) as did men who were not partnered (AOR = 3.20; 95% CI = 1.72, 5.93). These findings highlight the importance of including body image in sexual behavior models of MSM to better understand body image's role in influencing sexual risk and sexually transmitted infections (STI)/human immunodeficiency virus (HIV) transmission.     

Discrimination,mental health,and body image among transgender and gender-non-binary individuals: Constructing a multiple mediational path model

The purpose of the current study was to examine the relationships among discrimination, mental health, and body image in a national sample of transgender adults. Participants (N = 78) identified as transgender, genderqueer, or other gender-non-binary identities and were recruited via a national online survey. Harassment/rejection, work/school, and other discrimination explained 10.4% of the variance in body appreciation, while satisfaction with life, anxiety, self-esteem, and depression explained 60.7%. Within these models, harassment/rejection was inversely associated with body appreciation, while self-esteem and satisfaction with life were positively associated. A series of path models moving from a measurement model to a more parsimonious and excellent-fitting model found that the effect of harassment/rejection on body appreciation was fully mediated by self-esteem and satisfaction with life, resulting in a multiple mediation.     

Trends in long-acting reversible contraceptive (LARC) use,LARC use predictors,and dual-method use among a national sample of college women

Objective: Assess long-acting reversible contraceptive (LARC) and other contraceptive use trends, identify LARC use predictors, and examine dual method use. Participants: Women in the American College Health Association-National College Health Assessment (ACHA-NCHA) II, aged 18–24 years, who reported having vaginal sex (N = 37,899). Methods: Secondary analyses of Fall 2011–2014 ACHA-NCHA II data. Results: Statistically significant increases in LARC usage and, specifically, implant usage, were found. Characteristics associated with LARC use included age, race/ethnicity, relationship status, and school type. Students reporting LARC use had lower odds of condom usage compared with non-LARC hormonal method users. Conclusion: This analysis of LARC predictors and dual LARC/condom use has implications for research and health promotion efforts. Findings suggest that college health services are well positioned to meet the sexual and reproductive health needs of diverse populations of students. College health professionals should elicit students' individual and/or relationship priorities to tailor messaging/services offered for pregnancy/STI prevention.