A social identity analysis of disordered eating behaviour

Across the developed world, rates of disordered eating are increasing. Formal eating disorders, unhealthy dieting and obesity have all been escalating over the last forty years. Various theoretical models have been proposed to explain this increase. Sociocultural models have drawn attention to features of the social environment, such as the cultural value placed on thinness for women (causing body dissatisfaction, and subsequently, weight-loss attempts), or the hyperavailability of energy dense foods and energy-saving technologies (causing obesity). Individualistic models have identified a variety of genetic and personality factors, such as perfectionism, low self-esteem and thin-ideal intemalisation, that increase vulnerability to disordered eating. However, these two approaches to disordered eating are currently a) incompatible, and b) unable to account for the evidence of social influence in eating behaviour. In this thesis, I propose a social identity analysis of disordered eating behaviour. This conceptualisation is able to parsimoniously incorporate previous findings by attending to the mechanism through which sociocultural phenomena are represented psychologically (via self-categorisation). Across 10 studies and 5 empirical chapters, evidence is presented for this social identity analysis. Firstly, a Dieting Intentions Scale is developed and validated in four studies, such that future dieting behaviour may be adequately measured as a dependent variable in the research. Secondly, two experiments demonstrate that the perception of shared psychological group membership is a necessary condition for social influence in eating behaviour. Thirdly, three studies show that the predictors of dieting intentions are context-dependent, and are determined by an individual's salient self-categorisations. Fourthly and finally, one experiment tests the applicability of the social identity analysis of social influence in a clinical population. The thesis has implications for social-psychological theory, in extending and testing the social identity approach, particularly in the health domain. However, it has greater implications for clinical-psychological theory, in questioning the biomedical model of eating pathology and suggesting new strategies for modifying and preventing disordered eating behaviour. Overall, this thesis provides a strong case for the relevance of the social identity approach to health generally, and eating behaviour in particular

“I changed and hid my old ways”: how social rejection and social identities shape wellbeing among ex-prisoners

Being a member of a rejected group negatively affects well‐being but can also increase group identification, which can have positive effects on well‐being. However, this rejection‐identification model has never been investigated among the highly stigmatized group of ex‐prisoners. Furthermore, the potential buffering role of multiple group memberships has never been investigated within the rejection‐identification model. We conduct a novel investigation of a combined rejection‐identification and social cure model of group‐based rejection among ex‐prisoners. A survey of 199 ex‐prisoners found that experiencing group‐based rejection was associated with poorer well‐being and increased ex‐prisoner identification. However, identification as an ex‐prisoner magnified, rather than buffered, the relationship between rejection and reduced well‐being. Furthermore, the negative relationship between rejection and well‐being was particularly pronounced among ex‐prisoners with a higher number of group memberships. Ex‐prisoners with a greater number of group memberships experienced greater levels of rejection, suggesting group memberships increase their exposure to rejection. We therefore provide evidence of a boundary condition for the social cure properties of groups. Among members of strongly rejected social groups, multiple group memberships can be a social curse rather than social cure

"Depression is who I am": mental illness identity, stigma and wellbeing

Background Previous research has found that in the face of discrimination, people tend to identify more strongly with stigmatized groups. Social identification can, in turn, buffer wellbeing against the negative consequences of discrimination. However, this rejection identification model has never been tested in the context of mental illness identity. Methods A survey was conducted with 250 people with diagnosed depression or current symptoms of at least moderate clinical severity. Results Experiencing mental illness stigma was associated with poorer wellbeing. Furthermore, people who had experienced such stigma were more likely to identify as a depressed person. Social identification as depressed magnified, rather than buffered, the relationship between stigma and reduced wellbeing. This relationship was moderated by perceived social norms of the depressed group for engaging in depressive thoughts and behaviors. Conclusions These findings suggest that mental illness stigma is a double-edged sword: as well as the direct harms for wellbeing, by increasing identification with other mental illness sufferers, stigma might expose sufferers to harmful social influence processes

Stressful life transitions and wellbeing: a comparison of the stress buffering hypothesis and the social identity model of identity change

The relationship between stressful life transitions and wellbeing is well established, however, the protective role of social connectedness has received mixed support. We test two theoretical models, the Stress Buffering Hypothesis and the Social Identity Model of Identity Change, to determine which best explains the relationship between social connectedness, stress, and wellbeing. Study 1 (N=165) was an experiment in which participants considered the impact of moving cities versus receiving a serious health diagnosis. Study 2 (N=79) was a longitudinal study that examined the adjustment of international students to university over the course of their first semester. Both studies found limited evidence for the buffering role of social support as predicted by the Stress Buffering Hypothesis; instead people who experienced a loss of social identities as a result of a stressor had a subsequent decline in wellbeing, consistent with the Social Identity Model of Identity Change. We conclude that stressful life events are best conceptualised as identity transitions. Such events are more likely to be perceived as stressful and compromise wellbeing when they entail identity loss

“The we's have it”: Evidence for the distinctive benefits of group engagement in enhancing cognitive health in aging

Aligned with research in the social capital and general health literature, a large body of evidence shows that older people who are more socially active have better cognitive integrity and are less vulnerable to cognitive decline. The present research addresses the question of whether the type of social engagement (group-based vs. individual) has differential effects on these cognitive health outcomes. Drawing on population data (N = 3413) from three waves (i.e., Waves 3, 4 and 5) of the English Longitudinal Study of Ageing, we investigated the independent contribution of group and individual engagement in predicting cognitive functioning four years later. Hierarchical linear regression was used entering age, gender, socioeconomic status, ethnicity, and physical health as covariates. The final model, controlling for initial cognitive function and social engagement (both group and individual) showed that only group engagement made a significant, sustained, and unique contribution to subsequent cognitive function. Furthermore, the effects of group engagement were stronger with increasing age. These findings extend previous work on the social determinants of health by pinpointing the types of relationships that are particularly beneficial in protecting cognitive health. The fact that group engagement optimized health outcomes, and that this was especially the case with increasing age, has important implications for directing community resources to keep older adults mentally active and independent for longer

How conceptualising obesity as a disease affects beliefs about weight, and associated weight stigma and clinical decision-making in health care

Objectives: This study empirically investigated how conceptualizing obesity as a disease (i.e., pathologizing obesity) affects beliefs about weight, and weight stigma and discrimination among health professionals. Design: An experiment that manipulated the pathologization of obesity was completed by a multi-nation sample of health professionals from Australia, UK, and USA (N = 365). Methods: Participants were randomly assigned to one of two conditions where they were asked to conceptualize obesity as a disease or not a disease; then presented with a hypothetical medical profile of a patient with obesity who was seeking care for migraines. We measured biogenetic causal beliefs about obesity, endorsement of weight as a heuristic for health, negative obesity stereotypes, and treatment decisions. Results: Participants in the disease (vs. non-disease) condition endorsed biogenetic causal beliefs more strongly and made more migraine-related treatment recommendations. No effect of the manipulation was found for the remaining outcomes. Biogenetic causal beliefs about obesity were associated with less weight stigma. Endorsing weight as a heuristic for health was associated with greater weight stigma and differential treatment recommendations focused more on the patient's weight and less on their migraines. Conclusions: Pathologizing obesity may reinforce biogenetic explanations for obesity. Evidence demonstrates complex associations between weight-related beliefs and weight stigma and discrimination. Biogenetic causal beliefs were associated with less weight stigma, while endorsing weight as a heuristic for health was associated with greater weight stigma and differential treatment. Further research is needed to inform policies that can promote health without perpetuating weight-based rejection in health care

A community-led intervention to build neighbourhood identification predicts better wellbeing following prolonged COVID-19 lockdowns

IntroductionA growing body of research supports the importance of social cohesion for population wellbeing. However, the majority of this research has been correlational, and rarely have interventions been evaluated.MethodWe conducted a two-timepoint study investigating the role of Neighbour Day, a grass-roots, community-led intervention that seeks to build social cohesion across the population. Among a sample of 843, 125 were Neighbour Day participants while the remainder were not.ResultsWe found that, compared to non-participants, Neighbour Day participants had significantly higher neighbourhood identification, experienced greater social cohesion, and had larger neighbourhood social networks. Between timepoints, the majority of the sample experienced prolonged lockdowns to prevent COVID-19 transmission, and so unsurprisingly, wellbeing declined and psychological distress increased. However, Neighbour Day participants were protected against these negative mental health effects of lockdown. These benefits of Neighbour Day participation were mediated via neighbourhood identification.DiscussionOverall, the findings speak to the promise of large-scale interventions to build social identity, particularly due to their capacity to build resilience and protect people’s wellbeing during times of collective change or crisis

“That’s not what we do”: evidence that normative change is a mechanism of action in group interventions

Group interventions for mental health have proved very effective, but there is little consensus on their mechanism of action. In the present study, we posit that normative change is a plausible mechanism and provide a test of this in an eating disorder prevention group program. Participants were 112 women aged 15-25 years with body, shape or weight concerns who completed five questionnaires across the four session group-based intervention. Results indicated that participants experienced a significant reduction in thin-ideal internalization, body dissatisfaction and dieting intentions across the course of the program. These decrements were preceded by changes in group norms. Changes in both descriptive norms and injunctive norms in the first half of the program predicted improvement in thin-ideal internalization, body dissatisfaction and dieting intentions in the second half. Implications for theoretical models of attitude change are discussed, as well as implications for group interventions more generally

Suicide literacy predicts the provision of more appropriate support to people experiencing psychological distress

Mental health literacy has been hailed as a public health priority to reduce stigma and increase help seeking. We examined the effect of suicide literacy on the type of help provided to those experiencing suicidal ideation. A community sample of 363 Australians were randomly assigned to read one of three messages from a member of their social network (the target). The target reported symptoms consistent with either (1) subclinical distress, (2) clinical depression, or (3) suicidal ideation. Participants were most likely to recommend social support and least likely to recommend professional help. Suicide literacy interacted with the target's presentation, such that participants with higher suicide literacy who considered a suicidal target were less likely to recommend self-help or no action, and more likely to recommend professional help. Suicide literacy was also associated with lower suicide stigma, and unexpectedly, this indirectly predicted more reluctance to recommend professional help. Overall, results indicated that the relationship between mental health literacy, stigma, and provision of help is not straightforward. While suicide literacy was associated with greater sensitivity to a person's risk of suicide, it also predicted fewer recommendations for professional help overall, partly due to the stigma associated with seeking professional help

Risk-taking that signals trust increases social identification

ocial identification predicts many important phenomena; however, its determinants have received comparably little research attention. We argue that people are more likely to socially identify with others who engage in risky behavior that implies trust than with those who act cautiously, and test this in four experiments with over 900 participants. The experiments found support for the hypotheses across diverse risk contexts – specifically, risk of physical injury, disease risk, and financial risk. These findings indicate that others’ risk taking can strengthen shared psychological group membership