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

Discrimination and social identity processes predict impairment and dysfunction among heavy drinkers

Background: Previous research has linked discrimination to poorer health. Yet health risk behaviours such as heavy alcohol consumption are often targeted with stigmatising public health campaigns. The current study sought to establish the link between experiencing discrimination and health outcomes among heavy drinkers, with a focus on exploring the multiple social identity processes that might underpin this relationship. Method: A survey was conducted with 282 people who self-reported consuming alcohol above recommended guidelines. We measured discrimination experienced as a drinker, components of social identification as a drinker (centrality, satisfaction, solidarity, homogeneity, and self-stereotyping), and two health outcomes: psychological distress and severity of alcohol use disorder symptomatology. Results: Discrimination was a moderate-large predictor of psychological distress and alcohol use disorder symptoms. Three social identity constructs were implicated in the link between discrimination and ill-health: identity centrality and homogeneity positively mediated this relationship, while identity satisfaction was a negative mediator. The model explained a large proportion of the variance (39-47%) in health outcomes. Discussion: Results are interpreted with an emphasis on the need to avoid stigmatising messaging and to prioritise social identity processes to prevent and treat substance use disorders. We further highlight the need for social identity researchers to consider the multidimensional nature of social identities, especially in the context of stigmatised groups

Greater number of group identifications is associated with healthier behaviour in adolescents

We investigated the relationship between group identification (with the family, school, and friendship groups) and adolescent health behaviour (smoking, binge drinking, and cannabis use). 1,111 students from 4 Scottish secondary (high) schools completed a questionnaire which included measures of group identification, group contact, health behaviours, and demographic variables. We found that identification with the family and school groups predicted reduced odds of substance use, whereas identification with the friend group predicted increased odds of substance use. Furthermore, the greater the number of social groups with which the participant strongly identified, the lower the odds that he/she participated in negative health behaviours. In contrast, merely having contact (rather than identifying strongly) with these groups increased the odds of participation in these behaviours. We suggest that group identification influences behaviour to the extent that it encourages adherence to group norms

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

“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

Identification with social groups is associated with mental health in adolescents: evidence from a Scottish community sample

The promotion and maintenance of mental health is an increasingly important societal issue. Previous research has shown that identification with social groups is positively associated with adult mental wellbeing, with multiple group identifications being particularly beneficial. The aim of the current study was to investigate whether the same is true for adolescents. 1111 Scottish secondary school students aged 13-17 completed a questionnaire investigating mental health symptoms and the extent of their identification with their family, school, and friendship groups. Higher identification with each group predicted better mental health. There was also an additive effect of group identification, with the odds of reporting psychiatric disturbance decreasing for every additional group with which participants identified strongly. These effects held even when age, gender, and group contact were controlled for. Our findings have implications for the prevention and treatment of mental problems, offering an alternative to traditional ways of viewing mental illness in adolescence and beyond

Multiple social identities enhance health post-retirement because they are a basis for giving social support

This is the final version of the article. Available from the publisher via the DOI in this record.We examine the extent to which multiple social identities are associated with enhanced health and well-being in retirement because they provide a basis for giving and receiving social support. Results from a cross-sectional study show that retirees (N = 171) who had multiple social identities following (but not prior to) retirement report being (a) more satisfied with retirement, (b) in better health, and (c) more satisfied with life in general. Furthermore, mediation analyses revealed an indirect path from multiple social identities to greater satisfaction with retirement and better health through greater provision, but not receipt, of social support to others. These findings are the first to point to the value of multiple group membership post-retirement as a basis for increased opportunities to give meaningful support to others. We discuss the theoretical and practical implications for the management of multiple identities in the process of significant life transitions such as retirement.This work was supported by three grants from the Australian Research Council awarded to JJ (FT110100238), CH (DP160102514), and AH (FL110100199

Greater number of group identifications is associated with healthier behaviour: evidence from a Scottish community sample

Objectives: This paper investigates the interplay between group identification (i.e., the extent to which one has a sense of belonging to a social group, coupled with a sense of commonality with in-group members) and four types of health behaviour, namely physical exercise, smoking, drinking, and diet. Specifically, we propose a positive relationship between one's number of group identifications and healthy behaviour. Design: This study is based on the Scottish portion of the data obtained for Wave 1 of the two-wave cross-national Health in Groups project. 1824 patients from 5 Scottish General Practitioner (GP) surgeries completed the Wave 1 questionnaire in their homes. Methods: Participants completed measures of group identification, group contact, health behaviours and demographic variables. Results: Results demonstrate that the greater the number of social groups with which one identifies, the healthier one’s behaviour on any of the four health dimensions considered. Conclusions: We believe our results are due to the fact that group identification will generally i) enhance one's sense of meaning in life, thereby leading one to take more care of oneself, ii) increase one's sense of responsibility toward other in-group members, thereby enhancing one’s motivation to be healthy in order to fulfil those responsibilities, and iii) increase compliance with healthy group behavioural norms. Taken together, these processes amply overcompensate for the fact that some groups with which people may identify can actually prescribe unhealthy behaviours

Social group memberships in retirement are associated with reduced risk of premature death: evidence from a longitudinal cohort study.

This is the final version of the article. Available from [publisher] via the DOI in this record.OBJECTIVES: Retirement constitutes a major life transition that poses significant challenges to health, with many retirees experiencing a precipitous decline in health status following retirement. We examine the extent to which membership in social groups following retirement determines quality of life and mortality. DESIGN: The longitudinal impact of the number of social group memberships before and after the transition to retirement was assessed on retirees' quality of life and risk of death 6 years later. SETTING: Nationally representative cohort study of older adults living in England. PARTICIPANTS: Adults who underwent the transition to retirement (N=424). A matched control group (N=424) of participants who had comparable demographic and health characteristics at baseline but did not undergo the transition to retirement were also examined. OUTCOME MEASURES: Analyses examined participants' quality of life and mortality during a period of 6 years. RESULTS: Retirees who had two group memberships prior to retirement had a 2% risk of death in the first 6 years of retirement if they maintained membership in two groups, a 5% risk if they lost one group and a 12% risk if they lost both groups. Furthermore, for every group membership that participants lost in the year following retirement, their experienced quality of life 6 years later was approximately 10% lower. These relationships are robust when controlling for key sociodemographic variables (age, gender, relationship status and socioeconomic status prior to retirement). A comparison with a matched control group confirmed that these effects were specific to those undergoing the transition to retirement. The effect of social group memberships on mortality was comparable to that of physical exercise. CONCLUSIONS: Theoretical implications for our understanding of the determinants of retiree quality of life and health, and practical implications for the support of people transitioning from a life of work to retirement are discussed.This research was supported by two grants from the Australian Research Council awarded to JJ (FT110100238) and SAH (FL110100199). The funding body did not play any role in the research design; in the collection, analysis, and interpretation of data; in the writing of the manuscript; or in the decision to submit the manuscript for publication

Social isolation predicts frequent attendance in primary care

Background. Frequent attenders in primary care have complex physical and mental healthcare needs as well as low satisfaction with their healthcare. Interventions targeting mental health or psychoeducation have not been effective in reducing attendance. Here, we test the proposition that both frequent attendance and poor health are partly explained by unmet social needs (i.e., limited social group support networks). Methods. Study 1 (N=1752) was a large cross-sectional community sample of primary care attenders in Scotland. Study 2 (N = 79) was a longitudinal study of a group of young people undergoing a life transition (moving countries and commencing university) that increased their risk of frequent attendance. Study 3 (N=46) was a pre-post intervention study examining whether disadvantaged adults who joined a social group subsequently had reduced frequency of primary care attendance. Results. All three studies found that low social group connectedness was associated with a higher frequency of primary care attendance. This was not attributable to poorer health among those who were socially isolated. In Study 3, joining a social group led to reduced primary care attendance to the extent that participants experienced a (subjective) increase in their social group connectedness. Conclusions. Unmet social needs among frequent attenders warrant closer consideration. Interventions that target social group connectedness show promise for reducing overutilization of primary care services