COGNITIVE BEHAVIORAL THEORY OF BODY IMAGE Terri L. Schmitt Doctoral Student UMKC School of Nursing

Seymour Fisher (1986) said, in a review of Body Image Research, that he included… “ In short, any study qualifies for inclusion if it even remotely deals with how individuals view and assign meaning to their own body.” (p. 1)

Seymour Fisher (1986) said, in a review of Body Image Research, that he included…

“ In short, any study qualifies for inclusion if it even remotely deals with how individuals view and assign meaning to their own body.” (p. 1)

Historical Context Research of the term “body image” is relatively young. Purely neurobiological until 1930’s Work by Seymour Fischer and Paul Schilder 1990’s work on body image and disturbance became common place in psychology Overshadowed first by psychoanalysis then by cognitive behavioral psychology Sociology also documenting adolescent body issues during this time. Margret Mead 1928 Coming of Age in Samoa

Research of the term “body image” is relatively young.

Purely neurobiological until 1930’s

Work by Seymour Fischer and Paul Schilder

1990’s work on body image and disturbance became common place in psychology

Overshadowed first by psychoanalysis then by cognitive behavioral psychology

Sociology also documenting adolescent body issues during this time.

Margret Mead 1928 Coming of Age in Samoa

Historical Understanding From this social and psychological scientists came to ask: What are the parts that make up body image and what is it as a concept?

From this social and psychological scientists came to ask: What are the parts that make up body image and what is it as a concept?

Cognitive Behavioral Theory Cognitive-behavioral theory assumes Cognitive processes – Behaviors – Emotions Names Like Skinner, Bandura, Beck, Ellis. What it lacked in relation to body image: Developmental and historical issues It is now an overriding theory in Psychology

Cognitive-behavioral theory assumes

Cognitive processes – Behaviors – Emotions

Names Like Skinner, Bandura, Beck, Ellis.

What it lacked in relation to body image: Developmental and historical issues

It is now an overriding theory in Psychology

Historical, Developmental Influences Proximal Events and Processes ( Cash & Prizomsky, 2004) Cultural Socialization Interpersonal Experiences Physical Characteristics Personality Attributes Body Image Schemas and Attitudes (Investment and Evaluation) Appearance-Schematic Processing Activating Events Internal Dialogues (Thoughts, interpretations, conclusions, etc.) Body Image Emotions Adjustive, Self-Regulatory Strategies and Behaviors

Historical, Developmental Influences

Proximal Events and

Processes

( Cash & Prizomsky, 2004)

What do I mean by it overshadows all behavioral research?

Historical and Developmental Constructs Socialization of the physical appearance Body-focused experiences during childhood/adolescence Person-Environment Interaction and includes: Cultural Socialization Interpersonal Experiences Physical Characteristics Personality Factors

Socialization of the physical appearance

Body-focused experiences during childhood/adolescence

Person-Environment Interaction and includes:

Cultural Socialization

Interpersonal Experiences

Physical Characteristics

Personality Factors

Proximal Events and Processes Processing of the Appearance (Activating Events)Situations and contexts that trigger cognitive processes…… TRIGGER…. Internal dialogues….TRIGGER… Adjustment to deal with distressing body image thoughts and emotions Avoidance Appearance fixing Positive rational acceptance

Processing of the Appearance

(Activating Events)Situations and contexts that trigger cognitive processes…… TRIGGER….

Internal dialogues….TRIGGER…

Adjustment to deal with distressing body image thoughts and emotions

Avoidance

Appearance fixing

Positive rational acceptance

Body Image Attitudes and Schemas Embodiment of body image It is the interplay between cognitive, emotional, and behavioral constructs (remember cog.-behav. theory or CBT) Investment- the cognitive behavioral importance placed on one’s own personal appearance (Cash, Melnyk, & Hrabosky, 2004) Evaluation – positive and negative self-appraisals and beliefs about one’s own personal appearance (Cash & Prunzinsky, 2005)

Embodiment of body image

It is the interplay between cognitive, emotional, and behavioral constructs (remember cog.-behav. theory or CBT)

Investment- the cognitive behavioral importance placed on one’s own personal appearance (Cash, Melnyk, & Hrabosky, 2004)

Evaluation – positive and negative self-appraisals and beliefs about one’s own personal appearance (Cash & Prunzinsky, 2005)

Empirical Referents and Current Research Appearance Schema Inventory (Cash, Melnyk & Hrabsoky 2004). “ Who Thinks I Need a Perfect Body?” Perceptions and Internal Dialogue among Adolescents about Their Bodies (McCabe, Ricciardelli & Ridge, 2006) Body-Image Ideals Questionnaire (Cash, and Szymansk, 1995) The swimsuit issue: Correlates of body image in a sample of 52,677 heterosexual adults (Frederick, Peplau & Lever, 2006) Assessment of Body-Image Cognitive Distortions scale. (Jakatdar, Cash, & Engle, 2006)

Appearance Schema Inventory (Cash, Melnyk & Hrabsoky 2004).

“ Who Thinks I Need a Perfect Body?” Perceptions and Internal Dialogue among Adolescents about Their Bodies (McCabe, Ricciardelli & Ridge, 2006)

Body-Image Ideals Questionnaire (Cash, and Szymansk, 1995)

The swimsuit issue: Correlates of body image in a sample of 52,677 heterosexual adults (Frederick, Peplau & Lever, 2006)

Assessment of Body-Image Cognitive Distortions scale. (Jakatdar, Cash, & Engle, 2006)

Nursing and Medicine Until recent decades nursing and medicine not concerned with body image. Cultural changes have occurred in the last century Health consequences of such cultural change Medicine did not try to define Nursing has begun to embrace psychology and feminist theory

Until recent decades nursing and medicine not concerned with body image.

Cultural changes have occurred in the last century

Health consequences of such cultural change

Medicine did not try to define

Nursing has begun to embrace psychology and feminist theory

Nursing Research Newell, R. (1991) Body-image disturbance: cognitive behavioural formulation and intervention. Journal of Advanced Nursing . 16(12): 1400-5. Sapountzi-Krepia, D., et. al (2001)Perceptions of body image, happiness and satisfaction in adolescents wearing a Boston brace for scoliosis treatment. Journal of Advanced Nursing . 35(5): 683-90. Stein, K. & Corte, C. (2003) Reconceptualizing causative factors and intervention strategies in the eating disorders: a shift from body image to self-concept impairments. Archives of Psychiatric Nursing . 17(2): 57-66.

Newell, R. (1991) Body-image disturbance: cognitive behavioural formulation and intervention. Journal of Advanced Nursing . 16(12): 1400-5.

Sapountzi-Krepia, D., et. al (2001)Perceptions of body image, happiness and satisfaction in adolescents wearing a Boston brace for scoliosis treatment. Journal of Advanced Nursing . 35(5): 683-90.

Stein, K. & Corte, C. (2003) Reconceptualizing causative factors and intervention strategies in the eating disorders: a shift from body image to self-concept impairments. Archives of Psychiatric Nursing . 17(2): 57-66.

Where we need to go Qualitative research to validate (i.e. proximal events and processes) Longitudinal research of body image development Introduction of Feminist philosophy Nursing validation of the model on adolescent and female populations

Qualitative research to validate (i.e. proximal events and processes)

Longitudinal research of body image development

Introduction of Feminist philosophy

Nursing validation of the model on adolescent and female populations

How this model could affect Nursing Science Places it could be used: Mastectomy care, Eating Disorders, Obesity, Skin disorders, Cancer treatment, Aging, School health, etc…. Can you think of more? Making this theory unique would involve a nursing perspective on patient, holism, and health. Body Image as a part of the whole patient that can affect self-care, motivation, behavior, change, and more. Body Image as a factor in health concerns Implementation studies focusing on one of the construct areas within nursing i.e. “supportive interpersonal experience intervention between teenagers and their mothers as a factor to improve body image”

Places it could be used: Mastectomy care, Eating Disorders, Obesity, Skin disorders, Cancer treatment, Aging, School health, etc…. Can you think of more?

Making this theory unique would involve a nursing perspective on patient, holism, and health.

Body Image as a part of the whole patient that can affect self-care, motivation, behavior, change, and more.

Body Image as a factor in health concerns

Implementation studies focusing on one of the construct areas within nursing

i.e. “supportive interpersonal experience intervention between teenagers and their mothers as a factor to improve body image”

Questions?

References Cash, T., Melnyk, S., & Hrabsoky, J. (2004). The Assessment of Body Image Investment: An extensive revision of the Appearance Schemas Inventory. International Journal of Eating Disorders , 35, 305-316. Cash, T. & Pruzinsky (Eds.) (2002). Body Image: A handbook of theory, research, and clinical practice . New York: Guilford Press. Cash, T. & Szymansk, M. (1995). The Development and validation of the Body-Image Ideals Questionnaire. Journal of Personality Assessment , 64(3), 466-477. Fisher, S. (1986). Development and Structure of Body Image, Volume 1 . Hillsdale, NY: Lawrence Erbaulm Associates. Frederick, D., Peplau, L., & Lever, J. (2006). The swimsuit issue: Correlates of body image in a sample of 52,677 heterosexual adults. Body Image , 3 (4), 413-419. Jakatdar, T., Cash, T., & Engle, E. (2006). Body-image thought processes: The development and initial validation of the Assessment of Body-Image Cognitive Distortions. Body Image , 3 (4), 325-333. McCabe, L., Ricciardelli, L., & Ridge, D. (2006). “Who Thinks I Need a Perfect Body?” Perceptions and Internal Dialogue among Adolescents about Their Bodies. Sex Roles , 55, 409-419 Newell, R. (1991). Body-image disturbance: Cognitive behavioural formulation and intervention. Journal of Advanced Nursing, 16(12), 1400-5. Sapountzi-Krepia, D., et. al (2001)Perceptions of body image, happiness and satisfaction in adolescents wearing a Boston brace for scoliosis treatment. Journal of Advanced Nursing . 35(5): 683-90. Stein, K. & Corte, C. (2003). Reconceptualizing causative factors and intervention strategies in the eating disorders: a shift from body image to self-concept impairments. Archives of Psychiatric Nursing, 17(2), 57-66.

Cash, T., Melnyk, S., & Hrabsoky, J. (2004). The Assessment of Body Image Investment: An extensive revision of the Appearance Schemas Inventory. International Journal of Eating Disorders , 35, 305-316.

Cash, T. & Pruzinsky (Eds.) (2002). Body Image: A handbook of theory, research, and clinical practice . New York: Guilford Press.

Cash, T. & Szymansk, M. (1995). The Development and validation of the Body-Image Ideals Questionnaire. Journal of Personality Assessment , 64(3), 466-477.

Fisher, S. (1986). Development and Structure of Body Image, Volume 1 . Hillsdale, NY: Lawrence Erbaulm Associates.

Frederick, D., Peplau, L., & Lever, J. (2006). The swimsuit issue: Correlates of body image in a sample of 52,677 heterosexual adults. Body Image , 3 (4), 413-419.

Jakatdar, T., Cash, T., & Engle, E. (2006). Body-image thought processes: The development and initial validation of the Assessment of Body-Image Cognitive Distortions. Body Image , 3 (4), 325-333.

McCabe, L., Ricciardelli, L., & Ridge, D. (2006). “Who Thinks I Need a Perfect Body?” Perceptions and Internal Dialogue among Adolescents about Their Bodies. Sex Roles , 55, 409-419

Newell, R. (1991). Body-image disturbance: Cognitive behavioural formulation and intervention. Journal of Advanced Nursing, 16(12), 1400-5.

Sapountzi-Krepia, D., et. al (2001)Perceptions of body image, happiness and satisfaction in adolescents wearing a Boston brace for scoliosis treatment. Journal of Advanced Nursing . 35(5): 683-90.

Stein, K. & Corte, C. (2003). Reconceptualizing causative factors and intervention strategies in the eating disorders: a shift from body image to self-concept impairments. Archives of Psychiatric Nursing, 17(2), 57-66.