Association between Body Image Focused Social Media Usage (BSMU), Resilience, Attachment and Eating-related Problems among High School Students in Bangkok

Objective: This study aimed to find the association among body image focused social media usage (BSMU), resilience, attachment, and eating-related problems among Thai adolescents. Materials and Methods: Cross-sectional descriptive research was conducted with a sample of 495 high school students from three schools in Bangkok. The participants answered an online questionnaire comprised of age, sex, height/weight, BSMU, Body-esteem Scale for Adolescents and Adults, Eating Attitudes Test, Inventory of Parent and Peer Attachment for Children, and the Thai Resilience Quotient. Descriptive statistics were used to analyze demographic information, body satisfaction, resilience, attachment, and eating-related problems. T-tests, chi-square, and multivariate logistic regression analysis were performed to explore the associations between these variables. Results: Mean (SD) age was 17.06 (0.805), with 307 female participants (62%). Time spent on social media was found to be associated with increased risk of binging (AOR (CI) = 1.71 (1.14-2.56)). BSMU was associated with increased risk of inappropriate eating attitudes, binging, purging and using laxative (AOR (CI) = 1.14 (1.03-1.27), 1.14 (1.06-1.22), 1.20 (1.04-1.40), and 1.21 (1.09-1.34) respectively). Higher resilience was found to associated with lower risk in binging (AOR (CI) = 0.45 (0.21-0.97)). However, attachment is not associated with any of eating-related problems. Conclusion: BSMU usage was associated with inappropriate eating attitudes and behavior. Findings also suggest that higher resilience and stronger attachment were  associated with lower risk of eating-related problems. The effectiveness of resilience and attachment improvement programs should be explored to help protect against eating problems

Validity and reliability of the Thai version of the Utrecht Gender Dysphoria Scale-Gender Spectrum (UGDS-GS) in Thai youths and young adults with gender dysphoria

Background Many people who are gender variant have undiagnosed gender dysphoria, resulting in delayed receipt of gender-affirming support and prolonged distress in living with their gender-non-conforming sex. The Utrecht Gender Dysphoria Scale-Gender Spectrum (UGDS-GS) is a newly developed tool that measures dissatisfaction with gender identity and expression. However, there is no translated version of this tool in Thai. Moreover, the sensitivity, specificity and cut-off point of the UGDS-GS to detect gender dysphoria in people who are transgender remain unknown.Aims This study translated the UGDS-GS into Thai and then examined the validity and reliability of the Thai UGDS-GS.Methods 185 participants with and without gender dysphoria were selected from the Gender Variation Clinic in Ramathibodi Hospital and from social media platforms. The UGDS-GS was translated into Thai according to the World Health Organization (WHO) guidelines on translation. The medical records of patients with gender dysphoria and semi-structured interviews were used to confirm the diagnosis of gender dysphoria. Subsequently, the validity and reliability of the instrument were analysed.Results The mean age of participants was 30.43 (7.98) years among the 51 assigned males (27.6%) and 134 assigned females (72.4%) at birth. The Thai UGDS-GS average score was 77.82 (9.71) for those with gender dysphoria (n=95) and 46.03 (10.71) for those without gender dysphoria (n=90). Cronbach’s alpha coefficient was 0.962, showing excellent internal consistency. In addition, exploratory factor analysis showed compatibility with the original version’s metrics. The value of the area under the curve was 0.976 (95% confidence interval: 0.954 to 0.998), indicating outstanding concordance. At the cut-off point of ‘60’, sensitivity and specificity were good (96.84% and 91.11%, respectively).Conclusions The Thai UGDS-GS is an excellent, psychometrically reliable and valid tool for screening gender dysphoria in clinical and community settings in Thailand. The cut-off point of ‘60’ scores suggests a positive indicator or a high chance of gender dysphoria