بررسی اضطراب اجتماعی و اختلال خوردن در زنان کالج. نقش مقایسه اجتماعی و نظارت بدن

Abstract Social physique anxiety has been found to be associated with disordered eating. However, what is not yet known is what behaviors college women may engage in that strengthen this relation. In the current study, we examined two possible moderating factors, social comparison and body surveillance. We examined whether these moderators might also generalize to trait anxiety, as well. Participants were 265 women attending a Southeastern university. Social comparison (both general and appearance-related) and body surveillance were tested as moderators of the relation between social physique anxiety and disordered eating. Results indicated that general social comparison, appearance-related social comparison, and body surveillance significantly moderated this relation. Individuals who were high in social physique anxiety and who reported high levels of general or appearance-related social comparison or body surveillance reported much higher levels of disordered eating than those with high social physique anxiety and low levels of these behaviors. Results indicated that only the trait anxiety × body surveillance interaction was significant in identifying elevated disordered eating. Results provide information regarding who may experience high levels of disordered eating in association with social physique anxiety, which has clinical implications including the conceptualization of social comparison and body surveillance as safety behaviors.

Introduction College women are a group at risk for disordered eating, as between 4% and 9% of college women have diagnosable eating disorders (Hesse-Biber et al., 1999, Keel et al., 2006 and Pyle et al., 1991) and 34% to 67% experience disordered eating at subthreshold levels (e.g., Berg et al., 2009, Franko and Omori, 1999, Hoerr et al., 2002, Krahn et al., 2005, Mintz and Betz, 1988 and Mintz et al., 1997). One construct associated with disordered eating is social physique anxiety, a type of anxiety that occurs as the result or prospect of others negatively evaluating one’s body (Hart, Leary, & Rejeski, 1989). For example, an individual may experience social physique anxiety when in a bathing suit at the beach, as she may perceive that this situation will possibly prompt others to evaluate her body in a negative way. Because of its focus on interpersonal evaluation and self-presentational concerns (Brunet et al., 2010 and Hart et al., 1989), social physique anxiety may be a particularly relevant construct for college women given that both social interactions and weight and shape become increasingly important and salient in the college setting (Bosari and Carey, 2001, Cash and Green, 1986, Cook-Cottone and Phelps, 2003, Fallon and Rozin, 1985, Fitzsimmons-Craft, 2011 and Martin and Hoffman, 1993). Indeed, research has indicated that social physique anxiety is associated with disordered eating among undergraduate women (Cox et al., 1997, Diehl et al., 1998 and Frederick and Morrison, 1998). Hayes and Ross (1987) purported that such anxiety and concerns about one’s social image may lead women to engage in disordered eating in an attempt to embody society’s ideal of beauty, the thin ideal. However, what is not yet known is what factors might exacerbate this relation. What behaviors might college women engage in that strengthen the relation between social physique anxiety and disordered eating, heightening risk for eating pathology? In this study, we examine how two potential moderators, social comparison and body surveillance, interact with social physique anxiety to identify elevated levels of disordered eating in a sample of college women. Individuals likely manage social physique anxiety in various ways (Hart et al., 1989). Indeed, Kowalski, Mack, Crocker, Niefer, and Fleming (2006) found that females reported using various coping strategies to manage social physique anxiety, including behavioral avoidance (e.g., physically keep away from a stressor), short-term appearance management strategies (e.g., selectively display or monitor one’s appearance), social support, cognitive avoidance (e.g., ignore the situation, try to forget about it), and acceptance. Similar results were obtained by Sabiston, Sedgwick, Crocker, Kowalski, and Mack (2007). As put forth by these researchers, it may be that most of these strategies are effective in the short-term but rather ineffective in the longer term (Kowalski et al., 2006). In fact, it may be that many of the strategies individuals use to cope with social physique anxiety can be conceptualized as safety behaviors, or actions that are intended to detect, avoid, escape, or endure a negative or feared outcome (Abramowitz et al., 2011 and Salkovskis et al., 1996). Such behaviors have been found to be quite common in response to anxiety among those with anxiety disorders (Powers et al., 2004 and Sloan and Telch, 2002). For example, many individuals with obsessive–compulsive disorder (OCD) experience unwanted intrusive thoughts (e.g., doubt whether important paperwork was completed properly), and in response, may engage in checking as a type of safety behavior (i.e., engage in checking as a means to detect whether their feared outcome has occurred; Abramowitz et al., 2011). Such safety behaviors may momentarily reduce anxiety, but in general, tend to enhance anxiety in the long run given that they prevent disconfirmation of maladaptive thoughts and beliefs (Salkovskis, 1991 and Thwaites and Freeston, 2005). By engaging in safety behaviors, individuals can diminish or eliminate their anxiety in the moment and seemingly prevent the occurrence of feared outcomes (e.g., completing important paperwork incorrectly); however, safety behaviors have the “paradoxical effect” of maintaining and/or strengthening the maladaptive thoughts that originally led to the anxiety (e.g., checking important paperwork many times is necessary; Abramowitz et al., 2011, p. 47). Thus, overall, safety behaviors help maintain anxiety since they prevent individuals from learning that a particular threat is non-existent or manageable. Similarly, individuals may engage in various safety-type behaviors in an effort to manage social physique anxiety. For instance, Haase, Mountford, and Waller (2007) found that one way that individuals cope with social physique anxiety may be via engagement in body checking behavior. This refers to the repeated checking of one’s body shape and/or weight and may involve behaviors such as repeatedly weighing oneself, touching one’s collar bone to determine the protrusion of the bone, pinching excess skin, and measuring the circumference of one’s thighs or forearms (Fairburn et al., 2003 and Shafran et al., 2004). Haase et al. (2007) purported that such behaviors could be construed as a safety behaviors in that they likely initially reduce anxiety but actually enhance it and are associated with negative outcomes more generally. Additional behaviors that individuals may use to cope with social physique anxiety and that may be construed as safety and checking behaviors include social comparison and body surveillance.

Results Descriptive statistics Means and standard deviations for the study variables and their correlations are presented in Table 1. Correlations were generally as expected based on the literature; that is, we observed significant, positive correlations among all of the study variables. Table 1. Correlations among and means and standard deviations of the measured variables (N = 265). 1 2 3 4 5 6 1. SPAS – M = 37.14, SD = 9.83 2. STAI, Trait Anxiety .53⁎⁎⁎ – M = 42.19, SD = 9.69 3. INCOM .32⁎⁎⁎ .32⁎⁎⁎ – M = 40.23, SD = 6.44 4. PACS .49⁎⁎⁎ .36⁎⁎⁎ .53⁎⁎⁎ – M = 15.40, SD = 3.85 5. OBCS, Surveillance .58⁎⁎⁎ .44⁎⁎⁎ .41⁎⁎⁎ .64⁎⁎⁎ – M = 4.73, SD = .99 6. EAT-26 .57⁎⁎⁎ .46⁎⁎⁎ .22⁎⁎⁎ .43⁎⁎⁎ .47⁎⁎⁎ – M = 7.94, SD = 8.61 Note. SPAS = Social Physique Anxiety Scale. STAI = State-Trait Anxiety Inventory. INCOM = Iowa-Netherlands Comparison Orientation Measure. PACS = Physical Appearance Comparison Scale. OBCS = Objectified Body Consciousness Scale. EAT-26 = Eating Attitudes Test-26. Possible ranges for the study variables are as follows: SPAS (12–60), STAI (20–80), INCOM (11–55), PACS (5–25), OBCS, Surveillance (1–7), EAT-26 (0–78). ⁎⁎⁎ p < .001. Table options Social physique anxiety × social comparison interactions Two hierarchical multiple regressions were performed involving the interaction of social physique anxiety and social comparison in relation to disordered eating. These results are displayed in Table 2. Both the social physique anxiety × general social comparison and social physique anxiety × physical appearance comparison interactions were significant (t(237) = 2.96, p = .003; t(243) = 3.93, p < .001, respectively). Women with high levels of social physique anxiety who engaged in high levels of general or physical appearance social comparison had higher levels of disordered eating than those with high social physique anxiety and low general or physical appearance social comparison orientation (see Fig. 1 and Fig. 2 where high and low levels of the independent variables were determined by one SD above and below the mean, respectively.) Further, simple slope analyses indicated that general and physical appearance social comparison behavior were significantly associated with disordered eating at high levels of social physique anxiety (1 SD above the mean) (β = .22, t(237) = 2.83, p = .005 for the model involving general comparison; β = .35, t(243) = 4.95, p < .001 for the model involving appearance comparison), but not at low levels of social physique anxiety (1 SD below the mean) (β = −.07, t(237) = −1.02, p = .308 for the model involving general comparison; β = −.03, t(243) = −.315, p = .753 for the model involving appearance comparison). Table 2. Hierarchical multiple regression analyses of the interaction of social physique anxiety (SPAS) and social comparison and body surveillance moderators in relation to disordered eating (EAT-26). Step and predictors B SE B β t (dfs) p ΔR2 Step 1 .33⁎⁎⁎ SPAS .47 .05 .55⁎⁎⁎ 9.78 (2,238) <.001 General social comparison .08 .07 .06 1.04 (2,238) .297 Step 2 .02⁎⁎ SPAS × general social comparison .02 .01 .16⁎⁎ 2.96 (1,237) .003 Step 1 .34⁎⁎⁎ SPAS .41 .05 .47⁎⁎⁎ 7.91 (2,244) <.001 Physical appearance social comparison .42 .13 .19⁎⁎ 3.17 (2,244) .002 Step 2 .04⁎⁎⁎ SPAS × physical appearance social comparison .04 .01 .20⁎⁎⁎ 3.93 (1,243) <.001 Step 1 .35⁎⁎⁎ SPAS .39 .06 .44⁎⁎⁎ 7.03 (2,246) <.001 Body surveillance 1.88 .55 .22⁎⁎ 3.44 (2,246) .001 Step 2 .08⁎⁎⁎ SPAS × Body surveillance .24 .04 .29⁎⁎⁎ 6.02 (1,245) <.001 ⁎⁎ p < .01. ⁎⁎⁎ p < .001. Table options The interaction of social physique anxiety and general social comparison with ... Fig. 1. The interaction of social physique anxiety and general social comparison with EAT-26 scores as the dependent variable. Figure options The interaction of social physique anxiety and physical appearance social ... Fig. 2. The interaction of social physique anxiety and physical appearance social comparison with EAT-26 scores as the dependent variable. Figure options Social physique anxiety × body surveillance interaction A hierarchical multiple regression was also performed involving the interaction of social physique anxiety and body surveillance in relation to disordered eating (see Table 2); this interaction was significant (t(245) = 6.02, p < .001). As seen in Fig. 3, like the results of the social physique anxiety × social comparison interactions, those with high levels of social physique anxiety who engaged in high levels of body surveillance had higher levels of disordered eating than those with high social physique anxiety and low levels of body surveillance. This suggests that high levels of body surveillance may strengthen the relation between social physique anxiety and disordered eating. Simple slope analyses confirmed that body surveillance was significantly associated with disordered eating at high levels of social physique anxiety (β = .51, t(245) = 6.67, p < .001), but not at low levels of social physique anxiety (β = −.04, t(245) = −.55, p = .585). The interaction of social physique anxiety and body surveillance with EAT-26 ... Fig. 3. The interaction of social physique anxiety and body surveillance with EAT-26 scores as the dependent variable. Figure options Trait anxiety × social comparison and trait anxiety × body surveillance interactions Altogether, three hierarchical multiple regressions were performed involving the interaction of trait anxiety and various moderators in relation to disordered eating. These results are displayed in Table 3. Neither the trait anxiety × general social comparison nor the trait anxiety × physical appearance comparison interaction was significant in identifying disordered eating (t(244) = .52, p = .601 for the model involving general comparison; t(250) = 1.60, p = .111 for the model involving appearance comparison). However, the trait anxiety × body surveillance interaction was significant (t(252) = 4.77, p < .001). As seen in Fig. 4, those with high levels of trait anxiety who engaged in high levels of body surveillance had higher levels of disordered eating than those with high trait anxiety and low levels of body surveillance. Simple slope analyses confirmed that body surveillance was significantly associated with disordered eating at high levels of trait anxiety (β = .58, t(252) = 7.67, p < .001), but not at low levels of trait anxiety (β = .12, t(252) = 1.72, p = .088). Table 3. Hierarchical multiple regression analyses of the interaction of trait anxiety (STAI) and social comparison and body surveillance moderators in relation to disordered eating (EAT-26). Step and predictors B SE B β t (dfs) p ΔR2 Step 1 .25⁎⁎⁎ STAI .40 .05 .47⁎⁎⁎ 8.05 (2,245) <.001 General social comparison .09 .08 .07 1.22 (2,245) .223 Step 2 .00 STAI × general social comparison .00 .01 .03 .52 (1,244) .601 Step 1 .30⁎⁎⁎ STAI .32 .05 .36⁎⁎⁎ 6.36 (2,251) <.001 Physical appearance social comparison .66 .13 .30⁎⁎⁎ 5.24 (2,251) <.001 Step 2 .01 STAI × physical appearance social comparison .02 .01 .09 1.60 (1,250) .111 Step 1 .30⁎⁎⁎ STAI .28 .05 .31⁎⁎⁎ 5.36 (2,253) <.001 Body surveillance 2.97 .51 .34⁎⁎⁎ 5.78 (2,253) <.001 Step 2 .06⁎⁎⁎ STAI × body surveillance .21 .04 .24⁎⁎⁎ 4.77 (1,252) <.001 ⁎⁎⁎ p < .001. Table options The interaction of trait anxiety and body surveillance with EAT-26 scores as the ... Fig. 4. The interaction of trait anxiety and body surveillance with EAT-26 scores as the dependent variable.