Eating disorders affect individuals from most ethnic backgrounds. Research suggests that White females experience the greatest levels of disordered eating and body dissatisfaction. Studies examining Chinese females found they experienced similar levels of disordered eating but less body dissatisfaction to White females. This study was conducted to examine the prevalence of eating disorder symptomatology in Chinese and Other ethnicities in New Zealand. A sample of female university students at the University of Waikato completed questionnaires (N=116) to assess disordered eating and body dissatisfaction. In contrast to previous findings Chinese females actually exhibited more disordered eating behaviours and body dissatisfaction attitudes than did other females living in New Zealand. Also, fear of weight gain was more likely to be exhibited by Chinese females than other females. Pressure to be thin came from similar sources for both Chinese and other female students. While, length of time living in New Zealand did not appear to alter Chinese females' levels of disordered eating and body dissatisfaction. However in keeping with previous research, the present findings did suggest that the data from this study support the suggestion that the EAT-26 may not be an appropriate measure for Chinese females when assessing eating disorders. These findings have important implications for future research on ethnicities and eating disorders, and for clinicians working with Chinese female clients.

[Truncated abstract] Socio-cultural processes are often cited as one of the main causes of body dissatisfaction amongst women. Numerous studies have found that exposure to thin, idealized images in the media increases women's body dissatisfaction. The central aims of this thesis are to investigate how exposure to thin and fat bodies alters womens perceptions of body normality and body ideals, whether body dissatisfaction is related to these changes, and whether body dissatisfaction is associated with an attentional bias toward thin bodies. In Chapter 1 I review the main theories dominating body dissatisfaction research. In Chapter 2 I present two studies which investigate how exposure to thin and fat bodies influences perceptions of body normality and ideal body size. Women who varied on a measure of body dissatisfaction (Experiment 1 & 2) and awareness and acceptance of societal standards of beauty (Experiment 2) rated a range of computer generated bodies, varying in simulated BMI, for how normal (Experiment 1 & 2) and ideal they looked (Experiment 2). They were then exposed to either thin or fat bodies, and they re-rated the bodies. Increased levels of body dissatisfaction and internalisation of societal standards of beauty were related to a thinner most normal and ideal rated body, before any exposure, as well as a greater discrepancy between the most normal and ideal rated bodies. Both Experiments 1 & 2 revealed that brief exposure to thin or fat bodies altered women's perceptions of body normality and body ideal, where exposure to fat bodies made womens perceptions of a normal and ideal body fatter, and exposure to thin bodies, made perceptions of the most normal and ideal rated body thinner. ... In Chapter 5 I present normative data for the Body Shape Questionnaire-34 (a measure of dissatisfaction with body weight and shape) (Cooper et al, 1987) from an Australian university sample. Many researchers use university samples iv when investigating body dissatisfaction, so it is useful to have normative data for such a sample. One thousand and fifty two women aged between 16 and 30 completed the BSQ-34. A mean score of 94.4 (SD = 34.5) was found, with a range of 34-203. My scores are comparable with those found in an American undergraduate sample, and are significantly higher than those found in community, undergraduate and clinical samples in the UK and Italy. Results indicate that levels of body dissatisfaction may be higher in Australia than in the UK and Italy. Together, these studies provide some important new findings. 1) Body dissatisfaction and internalisation of societal standards of beauty are related to thinner body norms and ideals. 2) Women's perceptions of normal and ideal female body sizes can be readily altered by exposure to thin and fat bodies, and 3) women selectively attend to thin bodies, but the more dissatisfied she is with her own body, the less she attends to thin bodies. Potential implications of these results for the treatment of body dissatisfaction may include the incorporation of treatment programs which target not only unnaturally slim body ideals, but perceptions of what constitutes a normal body, as well as trying to alter selective attention toward thin bodies in the environment. The results may also highlight to the media that consistently showing ultra slim models will very likely affect women's perceptions of normal and ideal female body sizes.

The sociocultural model of eating disorders suggests that awareness of a thin physical ideal directly affects internalization of that ideal, which in turn, directly affects body dissatisfaction. The current study evaluated the general accuracy of the sociocultural model and examined the potential for ethnicity to protect against eating disorder symptomatology by moderating the relationships between awareness and internalization and between internalization and body dissatisfaction. Spanish (n = 100), Mexican American (n = 100), and Euro-American (n = 100) female participants completed various questionnaires measuring sociocultural attitudes towards appearance and body dissatisfaction. Analysis of covariance with tests of homogeneity of slope and path analysis using maximum likelihood with robust standard errors tested the two relationships by ethnic group. Results supported the sociocultural model: there was strong evidence for the mediational effect of internalization on the relationship between awareness and body dissatisfaction. Furthermore, ethnicity moderated the relationships such that both relationships were significantly stronger for Euro-American women than for Mexican American or Spanish women. Within the Mexican American group level of acculturation also moderated these relationships. Taken together, the results of this study highlight how ethnicity can protect against the development of eating disorder symptoms. Denouncing the thin ideal, minimizing appearance as an indicator of female value, and emphasizing personal traits other than appearance as determinants of worth are important in protecting against the development of body dissatisfaction and more severe eating pathology.

Tidigare forskning kring pojkars självkänsla och kroppsmissnöje i relation till massmedieanvändning, extraversion och BMI har utfallit något olika och är inte lika omfattande som forskningen kring flickor. Syftet med denna undersökning var att ta reda på om massmedia, extraversion och BMI har betydelse för tonåriga pojkars självkänsla och kroppsuppfattning. Kvantitativ metod i form av en enkätundersökning användes. Sjuttiotvå gymnasiestuderande pojkar besvarade enkäten som innehöll instrument för att mäta BMI, extraversion, kroppsmissnöje, massmedieanvändning och självkänsla. Resultatet visade att massmedieanvändning inte korrelerar med vare sig självkänsla eller kroppsmissnöje. Extraversion hade däremot betydelse för självkänsla; ju högre grad av extraversion desto högre självkänsla hade deltagarna. BMI hade betydelse för kroppsmissnöje enligt EDE-Q (Eating Disorder Examination Questionnaire); ju högre BMI desto högre kroppsmissnöje.

This thesis investigates a contextual behavioral approach for obesity surgery patients. In a contextual approach a behavior is interpreted as inseparable from its current and historical context. Candidates for bariatric surgery often have a history of self-stigma, body dissatisfaction and eating for emotional relief. Despite losing a large amount of weight post surgery, psychological problems may still be present for some patients. One possible common underlying process observed in body concerns and eating patterns is experiential avoidance. Experiential avoidance is defined as; any attempt to avoid, change, or control unwanted thoughts and feelings when so doing causes harm. Though a multidisciplinary team is recommended for post-surgical care, there are few studies evaluating the psychological treatment of patients undergoing bariatric surgery. In this thesis a protocol based on Acceptance and Commitment Therapy (ACT), was developed and implemented, partly via the Internet, in a clinical setting. In an acceptance-based approach to obesity, psychological well-being is the main outcome. ACT was significantly more effective than ‘treatment as usual’ in terms of body dissatisfaction and quality of life after surgery. Both groups improved in eating disordered attitudes and behaviors. Predictions based on the underlying treatment model were also investigated. Positive treatment outcomes were found to be associated with increased psychological flexibility.  Despite some methodological limitations, the results are promising and future studies should further evaluate ACT in the context of bariatric surgery. This thesis also acknowledges the need for clinical assessment tools appropriate for the bariatric surgery context. The Acceptance and Action Questionnaire for Weight (AAQ-W) is a measure of experiential avoidance, and was evaluated in the present thesis. The AAQ-W was found to be a reliable and valid measure for people undergoing bariatric surgery. Another measure, Disordered Eating in Bariatric Surgery (DEBS) was developed and evaluated. The DEBS was found to posses satisfactory psychometric properties in terms of reliability and validity.  The AAQ-W and the DEBS may facilitate both systematic clinical evaluation and future research within the area of bariatric surgery.

Abstract – “Aggregate complaints in banks MIS” Date:                       June 8th 2012 Level:                      Master thesis in Business Administration, 15 ECTS Institution:                School of Sustainable development of society and technology, Mälardalen University Authors:                  Abdulla Ahmed Ibrahim         Alexis Andersson Title:                       Aggregate complaints in MIS – A case study of Nordea Bank Tutor:                      Carl G Thunman Keywords:               Aggregate, complaint, dissatisfaction, content analysis, Nordea, MIS. Purpose:                  The paper aims to develop a model of how Nordea Bank can monitor customer dissatisfaction through aggregated dissatisfaction analysis. Furthermore, the study aims to identify improvement proposals in Nordea based on the developed model and conducted interviews. Method:                  This thesis consists of qualitative interviews. Personnel at the local office in Västerås has been interviewed as well as Nordea’s customer ombudsmen, former office employee at Nordea, data analyst, head of customer inquiries, Professor of database technology and also a researcher in language technology. A proprietary model was built based on the literature review constructed on variables that were expected to influence the monitoring process. The proprietary model was based on theory and formed the interview guide. The method that was used on the empirical data where “cut and paste”. The method was used to be able to place the interviews under each appropriate heading. The analysis then compared the empirical data with theories from the literature review, to be able to conduct a revised model and come up with a number of suggestions for improvement. Conclusion:            The model assumes wrongly that complaint and other grievances information can be integrated in the same process. There are several aggravating factors in Nordea's case; discontent information is in the current situation anonymous, it may be too small in scope for it to be profitable integrated or delivered in pre-packaged aggregate form. In this thesis, it became also clear that overall understanding should be based on a results-oriented attitude in which the results of the analysis provide employees with new insights to shape the monitoring process. Even at the central level, Nordea more often tends to follow up individual cases instead of analyzing them systematically in aggregate form, which the model does not take into account. / Sammanfattning – ”Aggregerade kundmissnöjen i informationssystem” Datum:                    8 juni, 2012 Nivå:                        Magisteruppsats i företagsekonomi, 15 ECTS Institution:             Akademin för hållbar samhälls- och teknikutveckling, HST,                                  Mälardalens Högskola Författare:              Abdulla Ahmed Ibrahim         Alexis Andersson Titel:                       Aggregerade kundmissnöjen i informationssystem – En fallstudie av      Nordea Bank. Handledare:           Carl G Thunman Nyckelord:              Aggregering, informationssystem, klagomål, missnöje, innehållsanalys, Nordea Bank, MIS. Syfte:                      Syftet med denna studie är att utveckla en modell för hur Nordea Bank kan arbeta med uppföljning av kunders missnöje genom aggregerad missnöjesanalys. Vidare ämnar studien att utifrån modellen samt intervjuer identifiera förbättringsmöjligheter i Nordeas uppföljning av kundmissnöje. Metod:                               I studien utfördes kvalitativa intervjuer. Personal vid lokalkontoret i Västerås har intervjuats, samt Nordeas kundombudsman, Nordeas regionkontorschef i Västmanland, en f.d. kontorsanställd på Nordea, dataanalytiker, Finansinspektionens enhetschef på kundfrågor, en professor i databasteknik och en forskare inom språkteknologi. Ur litteraturundersökningen utformades en modell som bygger på variabler som förväntades påverka uppföljningsprocessen. Modellen ligger till grund för teori och intervjufrågor. I empirin användes ”klippa och klistra”-metoden för att placera intervjuerna under lämplig rubrik. I analysen jämfördes sedan empiri och teori från litteraturstudien för att utveckla modellen och ett antal förbättringsförslag. Slutsats:                  Modellen antar felaktigt att klagomål och annan missnöjesinformation kan integreras i samma process. Det finns flera försvårande faktorer i Nordeas fall; annan missnöjesinformationen är i dagsläget anonym och i vissa fall liten i omfattning för att det ska vara lönsamt att göra en aggregerad analys. Under uppsatsens gång blev det också klart att övergripande insikter bör utgå från ett resultatinriktat förhållningsätt där resultatet av analysen ger medarbetarna nya insikter för att utforma framtida uppföljningsprocesser. Även på central nivå arbetar Nordea oftare med att följa upp enskilda ärenden än att analysera dem systematiskt i aggregerad form, något som modellen inte tar hänsyn till.

Körperliche Attraktivität und gutes Aussehen spielen in der heutigen Gesellschaft eine entscheidende Rolle, was bereits frühzeitig auch Kinder und Jugendliche in ihren Einstellungen und der Wahrnehmung ihres Körpers prägt. Sorgen um den eigenen Körper gelten als normatives Problem unter Jugendlichen und bergen nicht selten das Risiko für gesundheitsgefährdendes Verhalten und psychische Erkrankungen. In der Suche nach den Ursachen gerieten in den letzten Jahren insbesondere soziokulturelle Faktoren, insbesondere der Einfluss von medial vermittelten Schönheitsidealen, in den Fokus der Forschung. Es ist jedoch fraglich, warum nicht alle Jugendlichen in gleicher Weise auf den allgegenwärtigen Mediendruck reagieren. Naheliegend ist, dass die Jugendlichen besonders gefährdet sind, deren unmittelbares soziales Umfeld das geltende Schönheitsideal direkt oder indirekt vermittelt und verstärkt. Das Verständnis der Rolle sozialen Drucks ist jedoch bislang noch durch zahlreiche inhaltliche und methodische Aspekte beschränkt (z.B. Einschränkungen in der Operationalisierung, ungenügende Berücksichtigung geschlechtsspezifischer Mechanismen, fehlende längsschnittliche Belege). Daher widmet sich die vorliegende Arbeit der Bedeutung aussehensbezogenen sozialen Drucks in der Entstehung von Körperunzufriedenheit im Jugendalter in drei aufeinander aufbauenden Untersuchungsschritten. Ausgehend von der Entwicklung eines umfassenden und zuverlässigen Erhebungsinstruments zielt die Arbeit darauf ab, unterschiedliche Aspekte sozialen Drucks gegenüberzustellen und hinsichtlich ihrer Verbreitung und Risikowirkung zu vergleichen. Die Umsetzung des Forschungsvorhabens erfolgte in unterschiedlichen Schülerstichproben der Klassen 7 bis 9 unterschiedlicher Gymnasien und Gesamtschulen (Hauptstichprobe N = 1112, im Mittel = 13.4 ± 0.8 Jahre). Dabei wurden sowohl quer- als auch längsschnittliche Analysen durchgeführt. Zusätzlich wurden zur Erprobung des Fragebogenverfahrens klinische Stichproben mit Ess- und Gewichtsstörungen herangezogen. Zur detaillierten Erfassung unterschiedlicher Formen aussehensbezogenen sozialen Drucks erfolgte im ersten Schritt die Entwicklung des Fragebogen zum aussehensbezogen sozialen Druck (FASD), welcher acht unterschiedliche Formen aussehensbezogene sozialen Drucks ausgehend von Eltern und Gleichaltrigen reliabel und valide erfasst. Dabei erwies sich das Verfahren gleichermaßen für Jungen und Mädchen, wie für Jugendliche mit unterschiedlichem Gewichtsstatus geeignet. Die psychometrische Güte des Verfahrens konnte sowohl für populationsbasierte als auch für klinische Stichproben mit Ess- und Gewichtsstörung belegt werden, wodurch eine breite Einsatzmöglichkeit in Forschung und Praxis denkbar ist. Im zweiten Schritt erfolgte die Untersuchung der Verbreitung aussehensbezogenen sozialen Drucks unter besonderer Berücksichtigung von Geschlechts-, Alters- und Gewichtsgruppenunterschieden. Dabei erwiesen sich Mädchen als stärker von aussehensbezogenem Druck durch Gleichaltrige betroffen als Jungen. Darüberhinaus legen die Ergebnisse nahe, dass Übergewicht ungeachtet des Geschlechts mit verstärkten aussehensbezogenen Abwertungen und Ausgrenzungserfahrungen verbunden ist. Zudem deuten die Alterseffekte der Studie darauf hin, dass der Übergang von früher zu mittlerer Adoleszenz aber auch Schulwechsel besonderes kritische Zeitpunkte für die Etablierung aussehensbezogener Einflüsse darstellen. Abschließend widmete sich die Arbeit der längsschnittlichen Risikowirkung unterschiedlicher Aspekte aussehensbezogenen sozialen Drucks in der Entstehung von Körperunzufriedenheit. Aussehensbezogene Einflüsse von Freunden verstärkten längsschnittlich Körpersorgen sowohl bei Mädchen als auch bei Jungen. Zudem ergab sich das Erleben von Ausgrenzung durch Gleichaltrige als entscheidender Risikofaktor für gewichtsbezogene Körpersorgen unter Jungen. Als bedeutsamster elterlicher Einfluss erwiesen sich Aufforderungen auf die Figur zu achten. Diese Aufforderungen verstärkten gleichermaßen für Mädchen und Jungen gewichtsbezogene Körpersorgen. Die vorliegende Arbeit widmete sich dem Ziel, die Rolle aussehensbezogener sozialer Einflüsse weiter aufzuklären. Das dazu vorgelegte umfassende Instrument ermöglichte eine differenzierte Betrachtung der Verbreitung und Wirkung unterschiedlicher Formen sozialen Drucks. Hierdurch weisen die Ergebnisse nicht nur auf wichtige geschlechtsspezifische Mechanismen hin, sondern leisten ebenso einen Beitrag zum vertieften Verständnis der Risikowirkung sozialen Drucks. Diese Erkenntnisse liefern somit einerseits konkrete Ansatzpunkte für Prävention und Intervention und ermöglichen andererseits auch eine weitere Konkretisierung bereits etablierter soziokultureller Wirkmodelle. / Physical appearance and attractiveness play a major role in today’s society, which affects also children and adolescents in their attitudes and the perception of their bodys. Body concerns, which have become normative among adolescents, however, bear the risk of health-endangering behavior as well as severe mental diseases. While investigating the reasons for this development, sociocultural pressures especially media promoted beauty ideals got into the focus of research. But the findings provoke the question why the media ideal does not affect all adolescents to the same extent. However, it seems likely that those adolescents who grow up in an appearance-focused social environment are particularly at risk of developing body concerns. The knowledge on the mechanisms of social pressure is still limited by several constraints, e.g. limitations in the assessment, insufficient consideration of gender-specific mechanisms as well as a lack of longitudinal findings. Hence, the dissertation examines the role of appearance-related pressure in the development of body dissatisfaction during adolescence by conducting three consecutive steps of investigation. By the development of a comprehensive and reliable instrument (1) this work aims at comparing the occurrence while considering interpersonal variations in the perception of different kinds of social pressure (2) as well as investigating the potential risk of these factors in the development of body dissatisfaction (3). The investigation was conducted in different samples of high school students from grade 7 to 9 (main sample: N = 1112, mean: 13.4 ± 0.8 years of age) using cross-sectional as well as longitudinal design. Additionally the psychometric quality of the questionnaire has been determined in clinical samples with eating and weight disorders. First, the Appearance-Related Social Pressure Questionnaire (FASD, Fragebogen zum aussehensbezogenen sozialen Druck) was developed which measures social pressure from peers and parents simultaneously while distinguishing eight types of pressure. The instrument has proved to be suitable for both, girls and boys, as well as for adolescents with different weight statuses. Evidence for its psychometric quality has been determined among population-based and clinical samples, which opens different fields of application. In a second step, the occurrence of the different aspects of pressure as well as variations according to individual characteristics (gender, age and weight status) have been investigated, revealing that girls as well as overweight students are particularly faced with social pressure. Moreover, the transition from early to middle adolescence as well as school transitions appear to be a crucial periods for the establishment of appearance related social pressure. Finally, the study delivers longitudinal evidence of the crucial impact of three types of social pressure on changes in body dissatisfaction over a one-year period. First of all, the results point to the crucial impact of friends in the development of body concerns among girls and boys alike. Second, the feeling of exclusion emerged as an important predictor of weight concerns in boys. Third, parental encouragement to control weight and shape play a crucial part in the development of body concerns. Summing up, the dissertation aimed at clarifying the role of appearance-related social pressure as a risk factor of body concerns during adolescence. The provided instrument allowed a reliable and differentiated analysis of different aspects of pressure. By this means, the results do not only point to interesting gender-specific mechanisms but also contribute to a better understanding of the impact of social pressure. These findings provide concrete targets for prevention and intervention and can also contribute to concretize already established sociocultural models.

Human immune deficiency virus (HIV) and Acquire immune deficiency syndrome (AIDS) is a worldwide epidemic that impacts individuals physically, socially, and psychologically, and the rates of HIV/AIDS in youth are rising. Antiretroviral treatments have drastically prolonged life in individuals with HIV/AIDS; however, this type of treatment requires strict medication adherence. Many psychosocial factors impacting antiretroviral adherence have been explored, yet very little has been investigated regarding body image. This study investigated the potential impact of body dissatisfaction on antiretroviral medication adherence in adolescents with HIV. Seventy five male and female youth were administered questionnaires on the constructs of body dissatisfaction and medication adherence. Results support the hypothesis that body dissatisfaction negatively impacts medication adherence; yet, its effect in this sample was small (R2 = .06; F(1,61) =3.87, p =.05). Additionally, it was predicted that gender would moderate the nature of the relation between body dissatisfaction and medication adherence, given the disparate societal presentations of ideal body types among genders. However, within the current sample, gender did not have an effect on this relation. Furthermore, this study was interested in exploring if body dissatisfaction within a population of HIV-infected youth was best explained by specific body dissatisfaction with areas of the body associated with lipodystrophy or lipoatrophy syndromes. Due to a very small presentation of these syndromes in the final sample (n = 4), it was not surprising that body dissatisfaction was not best explained through specific dissatisfaction with these body parts. However, dissatisfaction with muscularity in general, was predictive of general body dissatisfaction regardless of gender. A discussion of these findings is included. This study is one of the first of its kind to explore the potential detrimental effects of body dissatisfaction in HIV infected youth.

Self-reported mental health problems have increased dramatically among young female high school (Swedish: gymnasium) and university students in Sweden since the 1990’s. The reasons for this increase are mostly unknown but self-esteem and body image might be important factors behind this problem. The aim of this study was to test whether self-esteem and body dissatisfaction predict health. All correlation directions were in accordance with previous studies on the subject. There was no age group difference in levels of self-esteem, body dissatisfaction or health among the women. Multiple regression analysis revealed that global self-esteem was the strongest single predictor of health. These results give support for the importance of global self-esteem for subjective health. This should be considered in future studies and in the battle against the development of depression, anxiety and eating disorders among women.

I kollektivtrafiken är socialt oacceptabla beteenden vanligt förekommande och många anställda blir utsatta för kränkningar såsom utskällningar, förolämpningar och/eller svordomar (Strandberg et al. 2008). Branschstatistik visar att ungefär hälften av samtliga arbetsskadeanmälningar till Arbetsmiljöverket mellan åren 2005-2007 kunnat kopplas till våld, hot eller rån (Strandberg 2008). Både polis och socialsekreterare har en lägre anmälningar andel än kollektivtrafiken, medan endast yrkesgrupperna kriminalvårdare och väktare har en högre andel.För att ha en möjlighet till att reducera dessa oacceptabla beteenden är det viktigt att studera kundbeteenden och hitta orsaken till att kunder blir missnöjda. Företag och organisationers kunskap om kundbeteenden är en viktig framgångsfaktor. Kunder som är missnöjda leder till förlorade intäkter och spridning av negativ word of mouth leder till dåligt rykte på marknaden (Gopala et al. 2010).Studien genomfördes för att få kunskap om vilka faktorer som leder till missnöje i kollektivtrafiken och på vilket sätt resenärerna uttrycker sitt missnöje. Studien inriktades mot kollektivtrafiken i Karlstad och bland studenter vid Karlstads Universitet. Studien baseras dels på fokusgrupper, dels en enkätundersökning samt viss sekundärdata från Karlstadsbuss.Karlstadsbuss egna undersökningar visar att endast 2 % av Karlstads resenärer är missnöjda med bussbolaget (se bilaga 4). Däremot visar resultatet från denna studie att det finns ett betydligt större missnöje bland studenter. Missnöjet förmedlas dock sällan till Karlstadsbuss. Det absolut vanligaste sättet för studenter att uttrycka sitt missnöje genom negativ word of mouth.