Background: It is posited that attachment difficulties in infancy may result in reduced mentalisation capacity (understanding self and others’ subjective thoughts/mental processes), leading to potentially deleterious psychopathological outcomes such as eating disorders. The exact nature of the relationship between mentalisation and eating disorders/disordered eating is unclear however. Objectives: A systemic review examined whether those with Anorexia Nervosa (AN) experience mentalisation deficits compared to those without EDs. An empirical study, examining the link between mentalisation and disordered eating (DE) in an adolescent sample, was conducted to assess whether borderline trait features mediated the relationship between the two constructs. Method: A systematic search of 6 databases was conducted, and articles were assessed against predetermined inclusion/exclusion criteria. Included articles were assessed against 14 quality criteria and study findings were reported. For the empirical study, 162 participants aged 12-18 completed a questionnaire pack including mentalisation, borderline traits, impulsivity, emotion dysregulation and depression scales, and sociodemographic questions. Results: Results from 10 articles indicated those with AN may experience subtle mentalisation deficits, particularly in recognising negative emotions in others. Mentalisation ability may also vary according to interpersonal context. Mediation analyses found mentalisation ability exerted a significant effect on DE indirectly through borderline trait features, and partially through emotion dysregulation, but not impulsivity. Conclusion: More robust empirical studies are required in order to assess the relationship between mentalisation and AN. Findings regarding the link between mentalisation, borderline traits and DE may further aid psychological assessment/treatment. Therapies where the main focus is improving mentalisation capacity may be useful.

Exercise rooted in changing one’s appearance is associated with increased disordered eating and body image pathology. There are a limited number of scales assessing appearance-based exercise, and those that do are methodologically flawed. The aim of the current work was to develop a psychometrically sound measure of appearance-based exercise (Exercise Appearance Motivations Scale (EAMS)). Female undergraduate students (N = 650) completed an online survey designed to assess the EAMS’ psychometric properties. Factor analysis and hierarchical regressions were used for measure development and validation. Five factors of the EAMS were identified through factor analysis: muscularity, appearance, societal pressures, shape/weight, and avoidance/shame. Pearson product moment correlations were used to examine the associations between the EAMS and scales assessing convergent validity (appearance comparison, disordered eating, appearance evaluation, internalization of body ideals) and discriminant validity (belief in a just world). Results indicated that Cronbach’s alpha (α = .94) and test-retest reliability coefficients (r = .77) were adequate. The EAMS demonstrated adequate construct and incremental validity. These results provide preliminary evidence that the EAMS scale is a reliable and valid measure of appearance-based motives of exercise behavior when used with undergraduate women. Implications, limitations, and future research ideas are discussed.

The primary purpose of this study was to investigate the knowledge and experiences of school counsellors, teachers, and school-based personnel in the area of girls body image. Participants perspectives were described and implications identified for ways in which teachers can encourage positive body image for girls in their classrooms. The idea for this research evolved from my interest in positive self-esteem, and academic and social success. As a teacher, I find that girls (more so than boys) base their success on body image. Girls often turn to harmful health behaviours such as disordered eating or excessive exercise because of dissatisfaction with their bodies (Tiggemann, 2005; ODea, 2000). I hoped to find ways for teachers to foster positive body image, and I believed school counsellors, teachers, and school-based personnel would be a useful source of information on this topic. I brought to this research a desire to hear, understand, and make meaning from these professionals experiences of working with girls.<p>There are a variety of things a teacher can do to create a positive environment in the school setting relating to body image. Focus group participants felt teachers and other school personnel could: <br>(a) openly allow body image discussion in the classrooms either through Talking Circles or Body Talk; <br>(b) promote active lifestyles; <br>(c) promote healthy eating habits; and <br>(d) act as role models by modelling the right examples. <p>Listening and encouraging students can also create a positive environment. The normal development of bodies should be discussed openly in the classrooms. In order to help create positive body images in young girls, participants believed it was important for teachers and school personnel to: participate in empathy training (learning to talk to each other and to listen to each other), educate parents; train physical education teachers; encourage students to write daily journals and critically analyze media literacy.

The primary purpose of this study was to investigate the knowledge and experiences of school counsellors, teachers, and school-based personnel in the area of girls body image. Participants perspectives were described and implications identified for ways in which teachers can encourage positive body image for girls in their classrooms. The idea for this research evolved from my interest in positive self-esteem, and academic and social success. As a teacher, I find that girls (more so than boys) base their success on body image. Girls often turn to harmful health behaviours such as disordered eating or excessive exercise because of dissatisfaction with their bodies (Tiggemann, 2005; ODea, 2000). I hoped to find ways for teachers to foster positive body image, and I believed school counsellors, teachers, and school-based personnel would be a useful source of information on this topic. I brought to this research a desire to hear, understand, and make meaning from these professionals experiences of working with girls.<p>There are a variety of things a teacher can do to create a positive environment in the school setting relating to body image. Focus group participants felt teachers and other school personnel could: <br>(a) openly allow body image discussion in the classrooms either through Talking Circles or Body Talk; <br>(b) promote active lifestyles; <br>(c) promote healthy eating habits; and <br>(d) act as role models by modelling the right examples. <p>Listening and encouraging students can also create a positive environment. The normal development of bodies should be discussed openly in the classrooms. In order to help create positive body images in young girls, participants believed it was important for teachers and school personnel to: participate in empathy training (learning to talk to each other and to listen to each other), educate parents; train physical education teachers; encourage students to write daily journals and critically analyze media literacy.

The present study assessed participants’ motivations for misusing insulin using phenomenological analysis and risk theory. Eleven women with type 1 diabetes were interviewed and asked to discuss body image, their experiences with adjusting to type 1 diabetes, and their particular insulin misuse behaviour. Nine women misused insulin for body image and weight concerns, as a result of diabetes burnout, or a combination of these factors. The majority of participants had poor body image at the time of insulin misuse, and reported feeling more confident following weight loss related to misusing insulin. The opinions of family, friends, and health care providers were, generally, not influential on the women’s self-care behaviour. The perceived benefits of insulin misuse (i.e. weight loss and improved body image) were deemed more important than both short-term and long-term health. Participants in this study did not consider themselves to be at risk of developing diabetes-related complications in the short-term, and this belief appeared to foster their continued insulin misuse. There is a need for health care providers to recognize the signs of insulin misuse behaviour and offer resources where available. / Ministry of Health and Long-Term Care as supporter of the Ontario Women's Health Scholar Award

Eating disorders and disordered eating attitudes and behaviors are characterized by an over-evaluation of weight and shape, under or over-controlled eating, as well as engagement in compensatory behaviors. The disorders are associated with psychological suffering, acute and long-term health impairments, a high rate of suicide attempts as well as an increased risk of mortality. Knowledge regarding the etiology of eating disorders is limited and based on current models it is not possible to adequately predict either who will get an eating disorder or who will recover. This lack of understanding has hindered the development of effective prevention and treatment interventions. The aim of the present thesis was to contribute towards an increased understanding of eating disorders and disordered eating attitudes and behavior through the collection of norms and psychometric data, investigation of risk factors and their roles, and focusing on the understudied group of males with eating disorders. Five studies were included. Specifically, Study I focused on collecting general population and clinical norms on the well-established Eating Disorder Examination Questionnaire (EDE-Q) and the Clinical Impairment Assessment Questionnaire (CIA). Study II both collected general population norms on, and investigated psychometric properties of, the Body Shape Questionnaire (BSQ-8C), an instrument intended to assess body dissatisfaction. Study III focused on the role of perfectionism (an established risk factor for eating disorders) as a possible mediator or moderator between body dissatisfaction and disordered eating behavior and attitudes. Finally, in Study IV and V attention was placed on males. In Study IV the specific aim was to compare the clinical characteristics between young males and females with eating disorders while in study V the specific aim was to explore variables associated with disordered eating among young males based on a compilation of factors known to play a role among females as well as factors thought to be uniquely associated with males, such as sexual orientation and drive for muscularity. A greater understanding of eating disorders will help reduce the stigma that is associated with eating disorders, easing the way for affected individuals to seek help and ultimately improve the development of effective prevention and intervention.

[Truncated abstract] Eating disorders affect a significant proportion of adolescent and young adult women and a smaller proportion of children, men, and older individuals. They are associated with a range of physical, psychological, and social consequences that can have a profound and lasting impact on affected individuals. Eating disorder symptoms (e.g., marked weight and shape concern, strict dieting, binge eating, purging) are also associated with physiological and psychosocial morbidity, and are reported by up to half of adolescent girls and one-third of adolescent boys. If eating disorders are to be effectively prevented or treated, it is imperative that risk and maintaining factors for the conditions are identified. ... This thesis aimed to identify the variables and models that may best account for the development and maintenance of eating disorder symptoms, through two broad studies and six sub-studies. Study 1 focused on identifying predictors of cognitive (i.e., elevated weight and shape concern) and behavioural (i.e., binge eating) eating disorder symptoms in pre- to early-adolescent children followed over time. Prospective tests of the dual-pathway (Stice, 2001) and cognitive-behavioural (Fairburn, 2002; Fairburn, Cooper, & Shafran, 2003) models of eating pathology were also conducted, and a distinction was made between weight and shape concern and weight and shape over-evaluation. Low selfesteem, perceived media pressure to be thin, weight and shape over-evaluation, and maternal concern about child weight prospectively predicted increases in child weight and shape concern over time (Studies 1b and 1c), and weight and shape concern was the most robust predictor of increases in dietary restraint (Studies 1b and 1d). Dietary restraint and affect-related eating prospectively predicted binge eating onset (Studies 1a and 1d), and the dual-pathway and cognitive-behavioural models were both able to account for the development of binge eating over a two year period (Study 1d). Evidence was also provided for the relative superiority of the most recent, enhanced cognitivebehavioural model (Fairburn et al., 2003) over other available theoretical accounts. Study 2 focused more specifically on the role of mood intolerance in predicting and maintaining eating pathology in adults. In Study 2a, a new measure of mood intolerance was developed, revised, and evaluated. In Study 2b, the role of mood intolerance in cross-sectionally predicting binge eating and purging was examined within the framework of the enhanced cognitive-behavioural model. The importance of mood intolerance in accounting for eating disorder symptoms was confirmed, and additional support for the cognitive-behavioural model was provided. Collectively, the six empirical studies have provided new data regarding the relative importance of different variables in the development and maintenance of different eating disorder symptoms. They also provide initial insight into the relative validity of alternate theoretical models in this area. The results suggest that the most recent, enhanced cognitive-behavioural model may provide the best account of how eating disorder symptoms develop and are maintained, providing that the mood intolerance component of the model is specified.

Both theory and research implicate appearance comparison processes in the development of body image disturbance and disordered eating. Although several measures of appearance comparison exist, each has significant limitations. The Physical Appearance Comparison Scale-Revised (PACS-R) and its earlier versions are measures designed to assess the frequency of appearance comparisons among men and women. In the current study, the PACS-R was revised to (a) examine comparisons of weight/shape, muscularity, and overall physical appearance, (b) include items to assess comparisons with distal targets, (c) provide an assessment of upward versus downward comparisons, and (d) provide an assessment of the acute emotional impact of comparisons. The psychometric properties of the newly revised measure, labeled the PACS-3, were then examined in a college sample. The PACS-3 was administered to 1,533 college men and women, along with existing measures of appearance comparison, body satisfaction, eating pathology, and self-esteem. In Study 1, exploratory factor analysis was conducted to examine the factor structure of the PACS-3. In Study 2, confirmatory factor analysis was conducted to verify the resulting factor structure. In addition, the internal consistency, convergent validity, incremental validity, and two-week test-retest reliability of PACS-3 scores were examined. The final PACS-3 is comprised of 27 items and nine subscales: Frequency: Proximal, Frequency: Distal, Frequency: Muscular, Direction: Proximal, Direction: Distal, Direction: Muscular, Effect: Proximal, Effect: Distal, Effect: Muscular. PACS-3 subscale scores demonstrated good reliability and convergent validity. Moreover, PACS-3 subscales improved the prediction of body satisfaction and disordered eating relative to existing measures of appearance comparison, supporting the incremental validity of the scale. Future research may seek to examine the psychometric properties of the scale in more diverse samples, as well as associations between the PACS-3 and additional theoretically related constructs (e.g., drive for muscularity).

This study explores the potential relationship between disordered eating and appearance-related possible selves. The sample consisted of 293 female college students (mean age=22). Participants were administered interviews consisting of demographic information, the Possible Selves Interview, the Eating Attitudes Test-26, The Physical Self Description Questionnaire, and the Rosenberg Self-Esteem Scale. More than half of the participants reported an appearance-related possible self (n=154). As expected, disordered eating scores were found to be higher for participants who reported an appearance-related possible self: t(288)=-3.04, p

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