Part 2: Neurological history and physical

• 1. COGNITIVE BEHAVIORAL THEORY OF BODY IMAGE Terri L. SchmittDoctoral Student UMKC School of Nursing

2.

• 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)

3. Historical Context

• Research of the term body image is relatively young.

• • Purely neurobiological until 1930s

• • Work by Seymour Fischer and Paul Schilder

• • 1990s 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 1928Coming of Age in Samoa

4. 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?

5. Cognitive Behavioral Theory

• Cognitive-behavioral theory assumes

• Cognitive processes Behaviors Emotions

• Names Like Skinner, Bandura, Beck, Ellis.

• What itlacked in relation to body image: Developmental and historical issues

• It is now an overriding theory in Psychology

6.

• 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 7. What do I mean by it overshadows all behavioral research? 8. 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

9. 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

10. Body Image Attitudes and Schemas

• Embodiment of body image

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

• Investment- the cognitive behavioral importance placed on ones own personal appearance (Cash, Melnyk, & Hrabosky, 2004)

• Evaluation positive and negative self-appraisals and beliefs about ones own personal appearance (Cash & Prunzinsky, 2005)

11. 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)

12. 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

13. 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.

14. 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

15. 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

16. Questions? 17. 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.