An observational study in Blindness and Implicit Bias, sponsored by University of Haifa. Completed at 1 site in Israel. Open to female participants aged 18 Years to 45 Years, including healthy volunteers. Per ClinicalTrials.gov, last updated 2022-07-06.
Sponsored by University of Haifa · Observational
High levels of body image concerns and disordered eating in western women have been associated with the promotion of an unrealistically thin body ideal. The pressure to conform with the thin-ideal forms both explicit and implicit attitudes favoring thinness. Visual-based media depicting thin-idealized bodies plays a major role in forming such attitudes. However, attitudes favoring thinness can also be transmitted through non-visual communication such as peer pressure and significant others. The current study will examine if implicit attitudes favoring thinness and disliking overweight bodies can be formed without ever being exposed to visual-based media or being visually exposed to body shapes. To achieve this goal, the study will assess implicit attitudes towards thin and overweight bodies in congenitally blind women and those who were blinded early in life. The assessment will be carried out using a novel auditory weight-bias implicit association test.
Previous studies have demonstrated strong implicit associations between images portraying thin bodies and positive words and images portraying overweight bodies and negative words among healthy individuals in Western society. This so-called "implicit weight bias" is thought to represent individuals' unconscious or automatic stereotypical attitudes against being overweight. The goal of the current study is to examine implicit weight biases among congenitally blind as well as sighted women using a novel auditory version of the weight bias implicit association task. In this task, participants hear a series of words and are requested to classify each word using a motor response to the matching category. The categories used will be negative and positive words as well as words describing thin and overweight bodies. Implicit anti-fat bias is reflected by longer response times and higher error rates, when positive words and those describing overweight bodies require the same motor response and when negative words are coupled with words describing thin bodies compared to when positive and negative words are coupled with words describing thin and overweight bodies, respectively.
The investigators have collected preliminary results in a sample of blind women (N = 18) in Israel. The investigators plan to a) expand the data collection in Israel to reach a sample of 30 blind women and to b) carry out a full replication of the study in an independent sample of blind and sighted women in the US. Data have not been collected yet for the US replication study. Based on the effect size of the the implicit bias effect (represented by the IAT D score) obtained in preliminary results in the Israeli sample (Cohen's D = 0.74), a power analysis using G*power was carried out and showed that a sample of 22 participants is sufficient to detect the IAT implicit bias effect with a power > 95% and an a-priori alpha set at 0.05.
Based on preliminary results in the Israeli sample, it is hypothesized that:
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The blind women group will only include women who were blinded earlier than the age of 7 and cannot see themselves in the mirror not recognize other people's faces or bodies or use visual-based media. The sighted women group will include women with normal or corrected-to-normal vision.
Blind Women
Inclusion Criteria:
Exclusion Criteria:
Sighted women
Inclusion Criteria:
Exclusion Criteria:
The blind women group will include women who are congenitally blind or that were blinded early in life (up to the age of 7).
Women with normal or corrected-to-normal eye sight.
Implicit Association Test
IAT D-Score calculated for assessing an implicit weight bias. The IAT D score will be computed using the improved algorithm suggested by Greenwald et al. (2003). According to this algorithm, RTs longer than 10,000 ms will be deleted. Participants with more than 10% of the trials that are shorted than 300 ms will be excluded from the analysis. Mean RTs for correct trials will be computed for each block separately. Error trials will be replaced by the mean score of each block + 600 ms. Then, the difference in RTs between the practice stereotype incongruent and practice congruent conditions will be divided by their pooled SD. Then, the different in RTs between the test stereotype congruent and incongruent blocks will be divided by their pooled RTs. Lastly, the two scores form the practice and test blocks will be averaged to compute the IAT D score.
Time frame: One assessment at baseline after study information and informed consent was given
Sociocultural Attitudes Toward Appearance Questionnaire-4 (SATAQ-4R)
The SATAQ-4R is a gender-specific self-report tool composed of 31 items in the female version. It includes four scales to evaluate the perceived pressure from family, peers, significant others, and the media to attain a thin body and three sub-scales that evaluate the desire to attain a lean body, to attain a muscular physique and overall concern with personal appearance. Participants rate their agreement with various statements on a 5-point scale.
Time frame: up to 72 hours after completion of the baseline assessment
Ideal Body Stereotype Scale-Revised (IBSS-R)
The IBSS-R measures the pursuit of the thin beauty ideal. Participants are asked to indicate to what extent they agree with six statements about what attractive women look like on a 5-point scale from strongly disagree to strongly agree. The total sum ranges from 0 to 30 with higher scores indicating a stronger internalization of the thin ideal.
Time frame: up to 72 hours after completion of the baseline assessment
Body Parts Dissatisfaction Scale (BPDS)
The BPDS assesses body dissatisfaction by asking the respondents to rate their satisfaction with 9 body parts on a scale from 1 (extremely dissatisfied) to 5 (extremely satisfied). Lower scores represent greater body dissatisfaction.
Time frame: up to 72 hours after completion of the baseline assessment
Body mass index (BMI)
Weight and height data will be collected via self-report in order to calculate BMI (kg/cm2).
Time frame: up to 72 hours after completion of the baseline assessment
Plan to share: Yes — The study will provide open access for de-identified data as well as for the analytical plan and protocol.
Supporting information: Study protocol, Sap
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University of Haifa