The Relationship Between Childhood Traumas with Social Appearance Anxiety and Symptoms of Body Dysmorphic Disorder: The Mediating Role of Sociocultural Attitudes Toward Appearance

Background: Body dysmorphic disorder (BDD) and social anxiety are two concepts related to body dissatisfaction. These concepts have been linked to sociocultural attitudes to appearances and painful experiences in interpersonal relationships. Objectives: The present study examines the relationship between childhood traumas with social appearance anxiety (SAA) and BDD through the mediating role of sociocultural attitudes toward appearance (SATA). Methods: This cross-sectional study was conducted on 415 university students in Tehran, Iran using the convenience sampling method in 2019 - 2020. Data were analyzed using SPSS version 24 and Amos version 21 software. Results: According to our results, while childhood traumas were not directly related to BDD (β = 0.059; SE = 0.31), SAA seemed to play a statistically significant mediating role (β = 0.17; SE = 0.005). Moreover, childhood trauma was related to SAA both directly (β = 0.24; SE = 0.001) and through the mediating role of SATA. In addition, SATA (β = 0.17; SE = 0.005) significantly predicted BDD (β = 0.27, P < 0.001). The assumed model was in good fit with the acquired data (CFI = 0.97, GFI = 0.95, NFI = 0.94, RMSEA = 0.046). Conclusions: Children who have had traumatic experiences may experience anxiety and self-doubt. Thus, childhood traumas are ostensibly related to signs of BDD and SAA through the mediation of sociocultural attitudes. Childhood traumas can also predict susceptibility to rejection in interpersonal relationships. However, no results have been found to mediate rejection sensitivity concerning trauma with BDD and SAA.

The Scleroderma Patient-centered Intervention Network Self-Management (SPIN-SELF) Program: protocol for a two-arm parallel partially nested randomized controlled feasibility trial with progression to full-scale trial

Background Systemic sclerosis (scleroderma; SSc) is a rare autoimmune connective tissue disease. We completed an initial feasibility trial of an online self-administered version of the Scleroderma Patient-centered Intervention Network Self-Management (SPIN-SELF) Program using the cohort multiple randomized controlled trial (RCT) design. Due to low intervention offer uptake, we will conduct a new feasibility trial with progression to full-scale trial, using a two-arm parallel, partially nested RCT design. The SPIN-SELF Program has also been revised to include facilitator-led videoconference group sessions in addition to online material. We will test the group-based intervention delivery format, then evaluate the effect of the SPIN-SELF Program on disease management self-efficacy (primary) and patient activation, social appearance anxiety, and functional health outcomes (secondary). Methods This study is a feasibility trial with progression to full-scale RCT, pending meeting pre-defined criteria, of the SPIN-SELF Program. Participants will be recruited from the ongoing SPIN Cohort (http://www.spinsclero.com/en/cohort) and via social media and partner patient organizations. Eligible participants must have SSc and low to moderate disease management self-efficacy (Self-Efficacy for Managing Chronic Disease (SEMCD) Scale score ≤ 7.0). Participants will be randomized (1:1 allocation) to the group-based SPIN-SELF Program or usual care for 3 months. The primary outcome in the full-scale trial will be disease management self-efficacy based on SEMCD Scale scores at 3 months post-randomization. Secondary outcomes include SEMCD scores 6 months post-randomization plus patient activation, social appearance anxiety, and functional health outcomes at 3 and 6 months post-randomization. We will include 40 participants to assess feasibility. At the end of the feasibility portion, stoppage criteria will be used to determine if the trial procedures or SPIN-SELF Program need important modifications, thereby requiring a re-set for the full-scale trial. Otherwise, the full-scale RCT will proceed, and outcome data from the feasibility portion will be utilized in the full-scale trial. In the full-scale RCT, 524 participants will be recruited. Discussion The SPIN-SELF Program may improve disease management self-efficacy, patient activation, social appearance anxiety, and functional health outcomes in people with SSc. SPIN works with partner patient organizations around the world to disseminate its programs free-of-charge. Trial registration ClinicalTrials.govNCT04246528. Registered on 27 January 2020

Investigation of Positive Thinking Skills and Social Appearence Anxiety of Faculty of Sport Sciences Students

Background: With the developing technology in the 21st century, societies are changing. With the change of societies, the spiritual and psychological needs of the people who make up the societies also change and the factors affecting these needs show differences. Aim: In this study; It was aimed to examine the positive thinking skill levels and social appearance anxiety of students studying at Trabzon University Faculty of Sport Sciences. Methods: The research is a survey model study. The sample group consists of a total of 165 students, 63' female and 102' male, studying at Trabzon University Faculty of Sports Sciences in the 2020-2021 period. Students participated in the study voluntarily. Detailed information about the scale was given to the participants. The data were both prepared electronically with Google Forms (online survey) and sent to the participants from faculty watsap groups, and were collected face-to-face from students who had the opportunity to reach them face-to-face. Positive Thinking Skills Scale (8 items) and Social Appearance Anxiety Scale (16 items) were used as data collection tools. The Positive Thinking Skills Scale is a 4-point Likert type, and the validity and reliability studies of the Turkish format of the scale were carried out by Akın, Uysal, and Akın (2015). The Social Appearance Anxiety Scale, on the other hand, is a 5-point Likert type, and the validity and reliability studies of the Turkish version of the scale were conducted by Doğan (2010). Conclusion: Within the scope of the study, the positive thinking skills of the students of the faculty of sports sciences and the social appearance anxiety correlation results show that there is a positive and significant difference. Keywords: Sports, Positive Thinking Skill, Social Appearance Anxiety

Persian Version of Social Appearance Anxiety Scale: A Psychometric Evaluation

Background: Social appearance anxiety refers to the fear of negative evaluation and judgment about appearance in social situations. Previous scales have focused more on body dysmorphic, and a tool that can measure this anxiety in social situations has not been previously introduced. Objectives: This study aimed to investigate the factor structure and psychometric properties of the Social Appearance Anxiety Scale (SAAS) in the student community. Methods: This psychometric study was conducted on a sample of 415 Iranian students in 2020 using the convenience sampling method. The participants completed the Social Physique Anxiety Scale, Body Dysmorphic Scale, and Body Shape Scale. Cronbach’s alpha, confirmatory factor analysis (CFA), exploratory factor analysis (EFA), and convergent validity were used to examine internal consistency. The data were analyzed using SPSS software (version 24) and AMOS software (version 21). Results: Cronbach’s alpha for total score was 0.95. The relationship between the SAAS and Body Dysmorphic Scale (r = 0.73; P < 0.01), Body Shape Scale (r = 0.46; P < 0.01), and Social Physique Anxiety Scale (r = 0.79; P < 0.01) showed good convergent validity. The EFA extracted one factor that explained 0.60 of the total variance. After testing the one-factor model in CFA, the analysis showed good fitness indexes (comparative fit index = 0.95; goodness of fit index = 0.91). The item-total correlation of the Iranian SAAS was within a range of 0.51 - 0.84. Conclusions: The present scale has a high internal consistency and reliability and can be used for research and evaluation objectives in clinical settings in Iranian society.

Cross-cultural adaptation of the Social Appearance Anxiety Scale to the Portuguese language

ABSTRACT Objectives To perform the cross-cultural adaptation of the Social Appearance Anxiety Scale (SAAS) to the Portuguese language and estimate its internal consistency in a sample of Brazilian young adults. Methods The cross-cultural adaptation process followed international references based on five stages (translation, synthesis, back-translation, expert assessment, and pretest) to assess idiomatic, semantic, conceptual, and cultural equivalence. The internal consistency was estimated by the ordinal alpha coefficient (α). Results The new Portuguese version is presented in this study with minor changes from the original that did not violate the meaning of the items. This version was tested in 30 adults (women = 56.7%, M age = 26.0 [SD = 6.2] years) who understood the content. The participants completed the scale in an average time of 4.6 (SD = .6) minutes. The internal consistency of the scale was good (α = .95) when applied in a sample of 80 adults (women = 51.2%, M age = 28.0 [SD = 5.7] years). Conclusions The new Portuguese version of the SAAS was equivalent to the original in the idiomatic, semantic, and conceptual area. As the Brazilian participants understood the Portuguese version, cultural equivalence was found. The instrument’s internal consistency was adequate to the sample. The findings of this study may help researchers and clinicians interested in using the SAAS in Brazilian context for tracking characteristic symptoms of social anxiety due to physical appearance. However, before using SAAS in any protocol, it is important to evaluate its psychometric properties, especially the construct validity.