Mother/Daughter Positive

Body Image Intervention

Jessica Hocking

WHAT IS POSITIVE BODY IMAGE?

➤ Not just a lack of body dissatisfaction
➤ Multiple domains (Wood-Barcalow, Tylka; Augustus-Horvath 2010):
➤ Unique beauty and functionality of one’s body
➤ Filtering information (e.g., appearance commentary, media
ideals) in a body-protective manner
➤ Defining beauty broadly
➤ Highlighting assets while minimizing body’s flaws
➤ Referred to by both “body appreciation” and “positive body image”
in the literature.
➤ Some questions about whether this is a complete
operationalization

WHAT IS POSITIVE BODY IMAGE?

➤ Not just a lack of body dissatisfaction, but they are on the
same spectrum

Neutral/Apathetic Body Image

Body Dissatisfaction Positive Body Image

“Just as happiness is more complex than the absence of depression,

positive body image is more complex than the absence of body dissatisfaction”
(Gillen, 2015, p. 67).

DEVELOPMENTAL PATHWAYS: RISK AND PROTECTIVE FACTORS

- Influenced by a myriad of factors, there is no single cause (in line with DP
➤ Body image development is influenced by a myriad of factors - there is no single
cause.
concept of equifinality)

- There are several individual differences that may set individuals up on

➤ Utilizing DP perspective is especially prudent.
➤ Individual differences
➤ Girls tend to have poorer body image than boys (e.g., Frisén and Holmqvist,
2010a).
➤ Elite female athletes different developmental pathways
➤ Higher Body Mass Index in adolescent girls led to greater levels of body
dissatisfaction (Barker & Galambos, 2003).
➤ Early puberty is a risk factor
➤ Personality characteristics (Swami, Hadji-Michael, & Furnham, 2008).
➤ higher levels of neuroticism are associated with higher levels of body
dissatisfaction
➤ higher levels of extraversion are associated with higher levels of positive
body image
DEVELOPMENTAL PATHWAYS: RISK AND PROTECTIVE FACTORS
risk and protective factors that influence body image exist at multiple
➤ Cultural factors ecological levels beyond within the individual, such as the macrosystem, the
➤ Living in a western country is a major risk factor (Grogan &

➤
Wainwright, 1996) due to the thin-ideal put forth by the media.
Many body image scholars think these sociocultural factors are the
microsystem.
primary root cause of body dissatisfaction

➤ Social factors
➤ Peer influences
➤ Perceived body acceptance by others (Andrew, Tiggeman, & Clark,
2016a)

➤ Mediated by self-objectification and social appearance

comparison (Andrew, Tiggeman, & Clark, 2015)
➤ Peer teasing

DEVELOPMENTAL PATHWAYS: RISK AND PROTECTIVE FACTORS

➤ Familial Factors
➤ Key risk factor is having a mother with body dissatisfaction.
Specific mechanisms include:
➤ Criticism from mother
➤ Poor role-modeling
➤ Maladaptive mother/daughter fat talk
➤ Direct instructions to lose weight
➤ Psychological control
➤ Positive findings
➤ Maternal acceptance linked with lower levels of body
dissatisfaction

DEVELOPMENTAL PATHWAYS: RISK AND PROTECTIVE FACTORS

Just qualitative data. No significance tests done.
➤ Maor & Cwikel (2016) interviewed 28 mother/daughter dyads on their
strategies to help guide their daughters to positive body image. Five
specific mechanisms emerged:
➤ “filtering – being cautious and sensitive in communicating about body
image issues,

➤ transmitting awareness of the dangers of eating disorders,

➤ positive reinforcement – providing affirmations in regard to daughters’
bodies;
➤ discussion – providing tools for criticism of the dominant body-related
social discourse; and

➤ positivity – shifting the focus from food, body-size and weight loss to
making healthy choices and taking pleasure in food” (Maor & Cwikel,
2016, p. 11).

DEVELOPMENTAL CASCADES OF BODY IMAGE

➤ Positive body image has been linked with:
➤ Mental Health Outcomes
➤ Lower levels of thin ideal internalization and other
negative media effects (Halliwell, 2013)
➤ Lower levels of depression
➤ Higher levels of self esteem (Gillen, 2015)
DEVELOPMENTAL CASCADES OF BODY IMAGE
Andrew, Tiggeman, and Clark 2015 was cross-sectional, but then their 2016
➤ Positive body image has been linked with: article was longitudinal. Two time points spaced one year apart to determine
Adaptive health outcomes
time ordering.
➤

➤ Higher levels of intuitive eating

➤ eating “in response to internal cues and not in response to difficult emotions or distress.
Those who eat intuitively are not preoccupied with dieting and food, do not categorize
food as “forbidden,” and food choices are a reflection of preferred taste and a desire to
assist the body’s functioning” (Andrew, Tiggeman, & Clark, 2015, p. 209).

➤ Increased physical activity

➤ Higher levels of sun protection and skin cancer screening
➤ Lower levels of weight-loss behaviors (Andrew, Tiggeman,
& Clark, 2016).
➤ Increased contraceptive use (Gillen & Markey, 2019)

DEVELOPMENTAL CASCADES OF BODY IMAGE

➤ Body dissatisfaction has been linked with:
➤ Mental Health
➤ Eating disorders (American Psychological Association, 2013;
Bruch, 1962; Cash & Deagle, 1997)
➤ Depression (Kaplan, Busner, & Pollack, 1988)
➤ Anxiety (Kostanski & Gullone, 1998)
➤ Health
➤ Risky sexual behavior (Larson, Clark, Robinson & Utter, 2012)
➤ Binge drinking
➤ Cigarette smoking (Jones, Winter, Pekarak, and Walters,2018)

POSITIVE BODY IMAGE INTERVENTIONS

➤ Sundgot-Borgen et al. (2019)
➤ Implemented Healthy Body Image curriculum in 30 Norwegian
high schools (N = 2446)
➤ Body Image
➤ Media Literacy
➤ Lifestyle
➤ Results: Girls in the treatment group reported…
➤ Improved feelings of positive embodiment
➤ Higher levels of self-reported health

INTERVENTIONS WITH MOTHERS

➤ Corning, Gondoli, Bucchianeri, and Salafia (2010)
➤ Examined the efficacy of the Healthy Girls Project
➤ Body Dissatisfaction
➤ Thin Ideal Internalization
➤ 31 mother-daughter dyads
➤ Daughters ages 12-14
➤ Results:
➤ Girls felt significantly less pressure from their moms to be thin
(F(1, 28) = 8.99, p = .006)
➤ No significant differences between groups on body dissatisfaction.
➤ Sample size too small? Lack of power?
INTERVENTIONS WITH MOTHERS
➤ Diedrichs et al. (2016)
➤ Dove Self-Esteem Project Website for Parents
➤ Self-esteem & Self-confidence
➤ Appearance-ideal media
➤ Appearance conversations
➤ Appearance-related teasing
➤ Modeling and interpersonal relationships
➤ Respecting and looking after yourself
➤ 235 Mother-Daughter Dyads
➤ Daughters mean age = 13 (SD = .86)
➤ Results:
➤ Improved self-esteem and lower rates of negative affect among mothers and
daughters
➤Body image did not significantly differ between treatment and control groups
➤ Online format not intensive enough?

INTERVENTIONS WITH MOTHERS

➤ Trost (2006), unpublished dissertation
➤ Healthy Image Partnership (HIP) Parents Program
➤ Parents only (80 mothers and 1 father)
➤ Daughters ages 10-15
➤ Targeted the thin-ideal, “fat talk,” and healthy versus unhealthy weight
attitudes
➤ Results
➤ Parents in the treatment group reported significantly reduced thin-ideal
internalization, bulimic symptoms, and dieting
➤ Daughters reported reductions in these areas as well, but they were not
quite significant
➤ Daughters also need to be involved?

STUDY PROPOSAL
➤ Why intervene with mothers and daughters?
➤ Interventions for many of the contributing factors of body image
development are not feasible
➤ Cultural factors
➤ Peer teasing
➤ Mothers can use their influence to steer daughters toward a positive body
image
➤ Role modeling, weight talk, etc.
➤ Can help daughters navigate the other contributing factors and process
them in an adaptive way
➤ Keeping them on a positive developmental pathway
➤ Mothers, as well as other siblings in the family, can benefit from the study
too

STUDY PROPOSAL
➤ Mother/daughter dyads
➤ Adapted Healthy Body Image project
➤ Body Image
➤ Media Literacy
➤ Lifestyle
➤ Mom/daughter relationship
➤ weight talk
➤ 5 mechanisms from Maor & Cwikel article (filtering, positivity,
discussion, positive reinforcement, and emphasizing dangers of eating
disorders)

STUDY PROPOSAL
➤ Participants

➤ Mother-daughter dyads from the community

➤ Goal will be to recruit 250 dyads (125 per
group)
➤ Plan to recruit through schools, local
community agencies, and religious
organizations through flyers and solicitation
letters


STUDY PROPOSAL Would expect to see more differences in the biological health measures at the
➤ Hypotheses: later time points. These types of things take time to change, and also most
➤ Mothers and daughters in dyads that completed the intervention will show:
➤ higher rates of positive body image at the immediate post-test as well as
the follow-up assessments as compared to the control group.
young teens have good blood pressure/cholesterol/blood sugar no matter
higher levels of health:
their health habits. So, also might expect to see more differences in moms.
➤

➤ higher levels of fruit and vegetable consumption and physical

exercise
➤ lower levels of cigarette and alcohol consumption
➤ exhibit lower blood pressure levels, cholesterol levels, and blood
sugar levels than their control group peers.
➤ lower levels of body dissatisfaction than their control group peers at all
post-tests and follow-ups.
➤ lower incidence of clinical eating disorders than the control group.


STUDY PROPOSAL
Mediators have been suggested in some of Andrew, Tiggeman, and Clark’s
➤Measures:
➤Self-report
cross-sectional work

Weight talk has been a mediator in some of Dawn and my preliminary work

➤Body Appreciation Scale (Avalos et al., 2005)

➤Eating Disorders Inventory (
➤Perceived Body Acceptance by Others (Avalos & Tylka, 2006)
➤Physical Activity
➤Fruit
➤Alcohol
and Vegetable Consumption
and Cigarette smoking
Weight talk (and more generally, negative body talk) is thought of as
➤Possible mediators
➤ Self-Compassion

➤ Rosenburg
➤ Mom/Daughter
Scale (Raes, Pommier, Neff, & Van Gucht, 2011)
Self-Esteem Scale (Rosenburg, 1965) normal and is expected for women to engage in. Think of that scene in Mean
Weight Talk
➤Objective
➤Blood
Health Measures
Pressure
➤Cholesterol
Girls.
➤Blood Sugar


STUDY PROPOSAL
➤ Longitudinal study
➤ Immediate post-test, 3 month follow-up, 6-
month follow-up, 1-year, 3-year, and 5-year
follow-ups (and more?).
➤ Planned analyses

➤ Repeated measures ANOVA (ANCOVA?)


DISCUSSION
Pros: controlling for BMI can give me more power

➤ Should I measure BMI at each time point?


Cons: seems counter to the study’s goals (Hello, let’s learn about positive
body image and loving our bodies. Please step on the scale)

- Can be inaccurate of actual health (athletes, muscle vs. fat mass. etc).