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. Author manuscript; available in PMC: 2020 Dec 1.
Published in final edited form as: Body Image. 2019 Aug 22;31:48–58. doi: 10.1016/j.bodyim.2019.08.005

Validation of an Italian version of the Sociocultural Attitudes Towards Appearance Questionnaire-4-Revised (SATAQ-4R) on non-clinical Italian women and men

Cristina Stefanile a, Amanda Nerini b,*, Camilla Matera b, Lauren M Schaefer c, Joel Kevin Thompson d
PMCID: PMC6897498  NIHMSID: NIHMS1059964  PMID: 31446374

Abstract

Appearance-ideal internalization and appearance pressures are empirically-supported risk factors for body image disturbance and disordered eating in Western countries. Such a relationship has emerged also in the Italian context, where high rates of body dissatisfaction and disordered eating are present. The Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ) and its revisions are among the most commonly used instruments to assess the role of sociocultural influences on body image. Two studies were conducted to examine the psychometric properties of the female (Study 1, N =732) and male (Study 2, N=364) Italian versions of the SATAQ-4-Revised (SATAQ-4R-Female, SATAQ-4R-Male). Confirmatory factor analysis (CFA) indicated that the original seven-factor structure was replicated for women and men. The seven subscales (Internalization: Thin/Low Body Fat; Internalization: Muscular; Internalization: General Attractiveness; Pressures: Family; Pressures: Peers; Pressures: Significant Others; and Pressures: Media) showed good internal consistency and 4-week test-retest reliability. Associations between SATAQ-4R subscales and body dissatisfaction, eating disorder symptomatology, drive for muscularity, self-esteem, family influences, and peer influences, suggested good convergent validity among both women and men. The present study provides evidence for the validity and reliability of the male and female Italian versions of the SATAQ-4R.

Keywords: Sociocultural influence, Body image, Pressures, Internalization, SATAQ-4R

1. Introduction

Much research has shown that body dissatisfaction is associated with negative consequences not only among women, but also among men. Some of these deleterious outcomes are decreased self-esteem (Paxton, Neumark-Sztainer, Hannan, & Eisenberg, 2006; Tiggemann, 2005), as well as increased eating pathology (Amaral & Ferreira, 2017; Girard, Rodgers, & Chabrol, 2018; Thompson, Heinberg, Altabe, & Tantleff-Dunn, 1999), depressive symptoms (Olivardia, Pope, Borowiecki, & Cohane, 2004; Paxton et al., 2006), unhealthy behaviours aimed at increasing muscle size (Parent & Moradi, 2011; Tylka, 2011), and favourable attitudes towards unnecessary cosmetic surgery interventions (Matera, Nerini, & Stefanile, 2018; Stefanile, Nerini, & Matera, 2014).

Given the detrimental effects that body dissatisfaction can have on individuals’ physical and mental health, many studies have tried to identify its most potent predictors. Research findings consistently support the strong relationship between sociocultural influences and body dissatisfaction (Stice & Shaw, 2002). In particular, several studies have shown that thin-ideal internalization and perceived appearance pressures are uniquely associated with and predict body dissatisfaction (Girard et al., 2018; Knauss, Paxton, &Alsaker, 2007; Lovering, Rodgers, George, & Franko, 2018; Nerini, 2009; Shroff & Thompson, 2006; Stefanile, Matera, Pisani, & Zambrini, 2009). Appearance-ideal internalization refers to the acceptance of culturally-endorsed appearance ideals (e.g., thinness for females, muscularity for males) as one’s own personal appearance standard (Thompson & Stice, 2001), while perceived pressures can be defined as the feeling of being encouraged to modify one’s physical appearance in order to reach such ideals (Thompson, van den Berg, Roehrig, Guarda, & Heinberg, 2004).

The Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ) is one of the most commonly used instruments to assess the role of sociocultural influences on body image. Following publication of the initial version of this instrument (Heinberg, Thompson, & Stormer, 1995), the SATAQ has undergone multiple revisions in order to adapt to shifts in cultural appearance ideals, as well as to examine specific appearance ideals and pressures most relevant to males and females (Cusumano & Thompson, 1997; Schaefer et al., 2015; Thompson et al., 2004). In 2015, Schaefer and colleagues developed the SATAQ-4, which contains five subscales assessing three distinct sources of perceived weight and appearance pressures from family, peers, and media, as well as internalization of the thin and muscular/athletic ideals. This version proved to have good psychometric properties and convergent validity, demonstrating medium to strong associations with measures of body dissatisfaction and eating pathology in diverse samples, including women from Italy (Schaefer et al., 2015). Despite the scale’s strong psychometric properties and conceptual advantages over previous iterations of the measure, the authors suggested further revision of the scale in order to address several remaining limitations (Schaefer, Harriger, Heinberg, Soderberg, & Thompson, 2017).

Specifically, the authors developed the SATAQ-4-Revised to achieve five primary aims. The SATAQ-4 assesses desire for a muscular and athletic physique. However, the authors suggest that athleticism may connote a broad range of competence-based attributes such as agility and coordination that are independent of aesthetic standards. Therefore, the newly revised SATAQ-4R focuses exclusively on desire for muscularity, eliminating previous references to an “athletic” physique. Second, the SATAQ-4R eliminated behavioral internalization items, focusing exclusively on the cognitive aspects of internalization, consistent with definitions of the internalization construct. Third, items that assess internalization of a more general dimension of appearance (not specifically linked to thinness/low body fat or muscularity) were included in this new version of the scale. Fourth, the SATAQ-4R incorporated an additional pressures subscale to assess perceived appearance pressures from significant others including romantic partners, teachers, and coaches. Finally, the authors noted that previous versions of the SATAQ had been initially developed among primarily female respondents, which had important implications for the item retention and deletion process and resulted in a reduced emphasis on male appearance concerns such as muscularity pressures (Law & Labre, 2002). Therefore, with the SATAQ-4R, the authors sought to produce two separate versions of the measure (i.e., the SATAQ-4R-Male and SATAQ-4R-Female), which were each developed and validated within large samples of college men and women, respectively. As such, this revision significantly advanced the measurement of appearance-ideal internalization and appearance-related pressures among males.

Both the male and female versions of the SATAQ-4R are comprised of seven thematically-consistent subscales. The three internalization subscales are labelled Internalization: Thin/Low Body Fat (reflecting a desire to attain a thin figure); Internalization: Muscular (reflecting a desire to attain a muscular figure); and Internalization: General Attractiveness (reflecting an overall concern with appearance). The four pressures subscales are labeled Pressures: Family; Pressures: Peers; Pressures: Significant Others; and Pressures: Media. Each pressures subscale assesses perceived pressures from a specific sociocultural source to improve one’s appearance and attain a thin body (in the SATAQ-4R-Female) or a muscular physique (in the SATAQ-4R-Male).

The female version of the SATAQ-4R is composed of 31 items, and its scores have demonstrated good internal consistency (with Cronbach’s alpha values for each subscale at .82 or higher) and good test–retest reliability among college women from the United States (Schaefer et al., 2017). Regarding construct validity, positive relations between the SATAQ-4R-Female subscales and both eating disorder symptomatology and body dissatisfaction were observed in the same college female sample. Negative associations were observed with self-esteem, consistent with theory. Notably, factor analysis of the SATAQ-4R-Female among adolescent girls, resulted in a six-factor structure, where items assessing appearance related pressure from peers and significant others loaded onto a single factor (Schaefer et al., 2017). The male version of the SATAQ-4R is composed of 28 items. It has demonstrated good internal consistency (with Cronbach’s alpha values at .75 or higher) among college men from the United States (Schaefer et al., 2017). In the same sample, positive correlations were observed between the SATAQ-4R subscales and eating disorder symptomatology and body dissatisfaction, while negative associations were observed between the SATAQ-4R subscales and self-esteem.

Although, earlier versions of the SATAQ have been translated for use with Italian samples (Bagnara, Huon, & Donazzolo, 2004; Schaefer et al., 2015; Stefanile, Matera, Nerini, & Pisani, 2011;), to the best of our knowledge, only one published study to date has adapted the SATAQ-4R for use with other populations outside of the United States. Specifically, the factor structure of this scale was explored by Cihan, Bozo, Schaefer, and Thompson (2016) among Turkish college women. The exploratory factor analysis revealed a six-factor solution with items assessing perceived appearance pressure from peers and significant others contributing to a single factor, rather than two separate factors as was observed among women from the United States. The authors speculated that this difference might reflect Turkish culture and language, where significant others and peers may not represent highly distinct groups.

Given the advantages of the SATAQ-4R over earlier versions of the measure, validation of the scale in other sociocultural contexts where body image and disordered eating is a significant concern, represents an important line of research. A recent survey conducted with nearly 8000 Italian participants indicated that 26.5% of young adults were almost or completely unsatisfied with their current body (Pirani & Matera, 2018). Moreover, almost 3 million people are affected by eating disorders in Italy (Ministero della Salute, 2017), with an estimated lifetime prevalence of 1.7% (Carta et al., 2014). Although 95% of patients are women, the phenomenon is also increasing among the male population (Ministero della Salute, 2017). Importantly, sociocultural influences such as desire to be similar to TV characters, consumption of reality and entertainment TV, and the perceived discrepancy between one’s own body and those of TV characters, have been identified as significant factors contributing to Italian women’s eating-disordered behaviors (Barcaccia et al., 2018). Italian men also pay great attention to their own physical appearance (Ruspini, 2007). In Italy, men desire a more muscular body than the average male body shape (Gilli & Ruspini, 2014; Zelli, Lucidi, & Mallia, 2010) and are particularly concerned with the care of their appearance (Capellani, Codazzi, Del Greco, & Rossi, 2014). Moreover, sociocultural influences and internalization processes seem to be particularly relevant in explaining Italian men’s body dissatisfaction (Matera, Nerini, & Stefanile, 2019). Therefore, further examination of these influences among Italians represents an important area of research. To facilitate this work, the current project sought to translate and validate Italian versions of the SATAQ-4R among Italian women (Study 1) and men (Study 2).

2. Study 1

Given the high rates of body dissatisfaction among Italian women (Pirani & Matera, 2018) and the role played by sociocul tural influences (Barcaccia et al., 2018), the present study aimed to examine the psychometric properties of an Italian version of the SATAQ-4R-Female. Confirmatory Factor Analysis (CFA) was performed to examine the factor structure of the Italian version among women. As the SATAQ-4R-Female has demonstrated two different factor structures both among differently aged women in the United States (Schaefer et al., 2017) and among Turkish (Cihan, Bozo, Schaefer, & Thompson, 2016) college women, the fit of both the six- and the seven-factor models was tested. Internal consistency and test-retest reliability were examined for the model that presented the best fit to the data. Convergent validity for the best-fitting model was also assessed via Pearson correlation coefficients between the SATAQ-4R and measures of body dissatisfaction, eating disorder symptomatology, drive for muscularity, self-esteem, family, and peer influences. Based on findings from the validation of the English version of the SATAQ-4R-Female (Schaefer et al., 2017), we expected that the Pressures subscales, Internalization: Thin/Low Body Fat subscale, and Internalization: General Attractiveness subscale would demonstrate medium to large positive associations with eating disorder symptomatology, small to medium positive associations with body dissatisfaction, and small to medium negative associations with self-esteem. The Internalization: Muscular subscale was expected to exhibit a large positive association with drive for muscularity, but small positive associations with eating disorder symptomatology, and body dissatisfaction. The subscale was expected to demonstrate a small negative association with self-esteem. The SATAQ-4R-Female Pressures: Family subscale, Pressures: Peers subscale, and Pressures: Significant Others subscale were expected to exhibit medium to large positive associations with measures of family and peer influence.

2.1. Method

2.1.1. Participants

Participants for the CFA and reliability analyses were 732 Italian women aged between 18 and 65 years (89.6% of women aged from 18 to 30 years, consistent with the original United States validation sample). All participants had Italian nationality and were born in Italy (age M =25.13, SD = 8.34; body mass index, BMI, M =21.25, SD = 3.08). Given pragmatic limitations, only a subset of participants from the overall sample were administered additional self-report measures to assess the convergent validity and test-retest reliability of the SATAQ-4R-Female. Convergent validity was assessed using a subset of 335 participants from the larger sample (age M = 26.10, SD = 8.74; BMI M = 20.94, SD = 2.88), which conferred adequate power to detect small to moderate effects (Hulley, Cummings, Browner, Grady, & Newman, 2013). The four- week test-retest reliability of the SATAQ-4R was examined among a subset of 70 participants (age M =26.76, SD = 11.47; BMI M =21.21, SD = 3.38), which conferred adequate power to detect moderate- large effects (Hulley et al., 2013). Socio-demographic information for each sample is reported in Table 1.

Table 1.

Demographic Characteristics for all Samples.

Study 1
Women
N=732
CFA sample		 Study 1
Women
n = 335
Convergent validity
subsample		 Study 1
Women
n = 70
Test-retest
subsample		 Study 2
Men
N = 364
CFA sample		 Study 2
Men
n =110
Convergent validity
subsample		 Study 2
Men
n=28
Test-retest
subsample
Educational level
Lower secondary school 4.5% 3% 1.4% 4.7% 8.2% –
Secondary school 74.2% 75.8% 87.1% 67.3% 58.2% 75%
Undergraduate degree 10.8% 10.4% – 15.7% 16.4% 25%
Graduate degree 8.6% 8.1% 11.4% 11.0% 15.5% –
Other qualification 1.8% 2.7% – 1.4% 1.8% –
Marital status
Married 14.9% 13.1% 20.0% 14.4% 25.5% –
Not married 83.6% 85.1% 78.6% 82.0% 68.2% 100%
Separate/Divorced/Other 1.5% 1.8% 1.4% 3.6% 6.4% –
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2.1.2. Measures

2.1.2.1. Sociocultural attitudes towards appearance.

The Italian version of the Sociocultural Attitudes Towards Appearance Questionnaire-4-Revised-Female (SATAQ-4R-Female) was used to assess internalization of appearance ideals and appearance-related sociocultural pressures (see the Procedure section for the translation steps). The SATAQ-4R-Female is a 31-item scale composed of seven subscales: Thin/Low Body Fat (four items, e.g., “I want my body to look very thin”), Internalization: Muscular (five items, e.g., “It is important for me to look muscular”), Internalization: General Attractiveness (six items, e.g., “I think a lot about my appearance”), and Pressures: Family (four items, e.g., “I feel pressure from family members to look thinner”), Pressures: Peers (four items, e.g., “My peers encourage me to get thinner”), Pressures: Significant Others (four items, e.g., “I feel pressure from significant others to improve my appearance”), and Pressures: Media (four items, e.g., “I feel pressure from the media to look in better shape”). Items were rated on a 5-point Likert scale with response options from 1 (definitely disagree) to 5 (definitely agree).

2.1.2.2. Body dissatisfaction.

Body dissatisfaction was measured through the Italian version (Matera, Nerini, & Stefanile, 2013) of the Body Shape Questionnaire-14 (Dowson & Henderson, 2001), which is composed of 14 items (e.g., “Have you felt that it is not fair that other people are thinner than you?”) with a 6-point response format (1 = never; 6 = always). Higher scores indicate higher levels of body dissatisfaction. In previous work, exploratory and confirmatory factor analyses supported the structural validity of the Italian version of the BSQ-14, Cronbach’s alpha was high, and convergent validity was found to be good (Matera et al., 2013; Stefanile, Matera, & Pisani, 2009). Scores on this scale demonstrated high reliability in the current study (α = .95).

2.1.2.3. Disordered eating.

The Italian translation (Dalle Grave & Calugi, 2010) of the Eating Disorder Examination-Questionnaire (EDE-Q Fairburn and Beglin, 2008) was used to measure disordered eating symptomatology. The EDE-Q global score is composed of 22 Likert-type items (e.g., “Has your weight influence how you think about [judge] yourself as a person?”) assessing the frequency of eating-disordered thoughts and behaviors over the previous four weeks. Items are rated on a 7-point scale (0 = no days; 6 = every day). Higher scores on the EDE-Q indicate greater levels of eating pathology. Prior work using the Italian version of the EDE-Q supports the validity and reliability of its scores (Calugi et al., 2017). The EDE-Q global score demonstrated high internal consistency in the present study (α = .94).

2.1.2.4. Drive for muscularity.

The Italian version (Nerini, Matera, Baroni, & Stefanile, 2016) of the Drive for Muscularity Scale (DMS; McCreary & Sasse, 2000) was used to measure participants’ desire for muscularity and engagement in behaviors aimed at achieving a muscular physique. This version of the scale is composed of 14 items scored on a 6-point Likert-type response format (1 = never; 6 = always). Higher scores indicate higher levels of drive for muscularity. In prior work, scores on the Italian version of the DMS have demonstrated good validity and reliability within male and female samples (Nerini, Matera, & Stefanile, 2016; Nerini, Matera, Baroni et al., 2016; Stefanile, Nerini, Matera, & Antonelli, 2012). In the present study, Cronbach’s alpha was .80.

2.1.2.5. Self-esteem.

The Italian version (Prezza, Trombaccia, & Armento, 1997) of the Rosenberg Self-Esteem Scale (SES; Rosenberg, 1965) was used. The SES is a 10-item scale measuring global feelings of self-worth or self-acceptance. Items were rated on a four-point scale (1 = strongly disagree; 4 = strongly agree) with higher scores reflecting greater self-esteem. Previous work with the Italian version of the SES has demonstrated good construct validity, test-retest reliability, and internal consistency with men and women (Prezza et al., 1997). In the present study, Cronbach’s alpha was .83.

2.1.2.6. Feedback on physical appearance.

The Italian version (Nerini & Massai, 2010) of the Feedback On Physical Appearance Scale-Female (Tantleff-Dunn, Thompson, & Dunn, 1995) is an 8- item self-report instrument assessing comments or behaviors from family that could be interpreted as negative feedback on one’s weight or other aspects of physical appearance (e.g., “Some of your relatives watched closely what you ate”). Responses range from 1 (never) to 5 (always). Higher scores indicate higher perceived pressures from one’s family. Scores on the Italian version of the FOPAS-F have demonstrated good internal consistency among women and men (Matera, Nerini, Marconi, & Stefanile, 2015; Matera, Nerini, Di Gesto, Policardo, & Stefanile, 2019; Nerini & Massai, 2010). In the present study, Cronbach’s alpha was.78.

2.1.2.7. Peer appearance attribution.

The Italian version (Stefanile, Pisani, Matera, & Guiderdoni, 2010) of the Peer Attribution Scale (PAS), developed by Lieberman (see Shroff, 2004), was used to measure to what extent people feel that peers give importance to appearance for popularity. This is a 4-item scale ranging from 1 (false) to 6 (true) (e.g., “My friends would like me more if I lost weight”). Higher scores indicate higher peer appearance attribution. This scale has been found to be unidimensional, with evidence of good reliability among both women and men (Matera et al., 2018; Nerini, Matera, & Stefanile, 2017; Stefanile et al., 2010). In the present study, Cronbach’s α was .87.

2.1.2.8. Body mass index.

Participants reported their heights and weights, which were used to calculate BMI (kg/m2).

2.1.3. Procedure

The English version of the SATAQ-4R-Female was translated following widely accepted guidelines (Brislin, 1986). A native Italian speaker translated the SATAQ-4R-Female and Male items from English into Italian. It was then independently back translated into English to ensure accuracy by another native Italian speaker who was not affiliated with the study. The back-translated English version and the original version were carefully compared in order to arrive at a final Italian version (see Appendix A), which could be considered as clear, accurate and able to capture the meaning of the original scale.

Participants were asked to take part in a study on body image and completed a paper-pencil version of the scales in the presence of a researcher, and in the same place where they were recruited. Participants for the CFA and internal consistency analyses (n = 732) completed only the SATAQ-4R-Female, and were recruited from public places such as libraries, leisure centers, universities, and study rooms. Participants for the analysis of both convergent validity and test-retest reliability were recruited exclusively from university settings to facilitate greater recruitment and retention. Although all 732 women completed the SATAQ-4R-Female, a smaller subset sample (n = 335) was asked to complete a longer questionnaire containing six additional measures, which were utilized to assess the scale’s convergent validity. These participants were recruited from university classes and study rooms. Another subset sample (n = 70), drawn from the total sample, was used for the test-retest reliability analyses. Given that the analysis of test-retest reliability involved completing a single questionnaire at two different time-points four weeks apart, we decided to recruit students who attended small university courses, who were more likely to be present at retest, for this task. Consequently, a smaller number of participants was obtained for this kind of analysis. Participation was voluntary and no incentives were offered to respondents. Participants were informed that all data were held confidential and their responses were recorded anonymously. They provided informed consent prior to completing study questionnaires. Study procedures were approved by the Ethical Committee of the University of Florence.

2.1.4. Data analyses

Item distributions were first examined to identify items with excessive skew (> 2) and/or kurtosis (> 7; West, Finch, & Curran, 1995) values. CFA was implemented through LISREL 8.80 (Jöreskog & Sörbom, 2006). Starting from a matrix of polychoric correlations (Holgado-Tello, Chacón-Moscoso, Barbero-García, & Vila-Abad, 2010; Jöreskog, 1994), the Robust Diagonally Weighted Least Squares were estimated. Model fit was evaluated using the Satorra-Bentler Scaled Chi-Square (S–B χ2), and several absolute, comparative and parsimonious fit indices: the Root Mean Square Error of Approximation (RMSEA), the Standardized Root Mean Square Residual (SRMR), the Comparative Fit Index (CFI), and the Non-Normed Fit Index (NNFI). The Akaike Information Criterion (AIC) was used to compare nested models. According to the criteria suggested by Schermelleh-Engel, Moosbrugger, and Müller (2003)), CFI and NNFI values between .95 and .97 suggest an acceptable model fit, while values greaterthan .97 indicate a good model fit. An RMSEA value between .05 and .08 suggests an acceptable fit, while an RMSEA value lower than .05 suggests a good fit. With respect to SRMR, well-fitting models obtain values lower than .05; however, values below .10 are deemed acceptable. With respect to the AIC, the model that produces the lowest value is superior. Cronbach’s alpha was used to determine the internal consistency reliability of the SATAQ-4R-Female subscales. Given the large range of participants’ age, bivariate Pearson correlation coefficients among this variable and SATAQ-4R subscales were examined. Convergent validity was assessed via bivariate Pearson correlation coefficients between SATAQ-4R-Female subscales and measures of body dissatisfaction, eating disorder symptomatology, drive for muscularity, self-esteem, family, and peer influences. A correlation between .10 and .30 was considered small, between .30 and .50 was medium, and above .50 was considered large (Cohen, 1988). Pearson’s r was used to establish evidence of test-retest reliability. Correlations of .70 or higher indicate good test-retest reliability, while correlations between .60 and .70 indicate acceptable reliability (Crocker & Algina, 2008).

2.2. Results

2.2.1. Factor structure and reliability

Descriptive statistics were computed for all of the SATAQ-4R-Female items. For Item 23, skew was higher than 2, while kurtosis for all items was lower than 7 (West et al., 1995). Given that the assumption of multivariate normality was not met for one of the items, CFA was conducted using the Robust Maximum Likelihood method of estimation along with the Satorra-Bentler Scaled Chi-Square, which corrects for non-normality.

The six-factor model had a poor fit to the data. The S–B χ2 was significant (3217.65, p < .001), the CFI (.93) and the NNFI (.92) were not within the standard recommended range. The RMSEA (.10) and the SRMR(.13) suggested a poor fit. The A1C was 3371.65.The seven-factor model had a good fit to the data. The S–B χ2 was significant (1590.47, p < .001), but the CFI (.97) and the NNFI (.97) were within the standard recommended range, suggesting a good fit. The RMSEA (.06) and the SRMR (.05) indicated an acceptable fit. The AIC was 1191.28. The seven-factor model provided the best fit according to both absolute and comparative fit indices. Moreover, it had the lowest AIC value, which suggests it was more parsimonious than the six-factor model, and it was the model that most plausibly generated the data. Factor loadings for the seven subscales are presented in Table 2. Each item loaded strongly onto its intended subscale. All of the primary loadings were greater than .30, ranging from .58 to .96. The internal consistency of the seven subscales was good, ranging from .82 to .95 (see Table 2). Means and intercorrelations among the subscales are presented respectively in Tables 3 and 4. Generally, the intercorrelations between the SATAQ-4R-Female subscales were positive and significant. Age showed only small correlations with the scores that women obtained on the seven subscales of the SATAQ-4R (rs ranged from −.05 to −.20).

Table 2.

Italian SATAQ-4R Factor Loadings and Internal Consistency (Study 1, N = 732; Study 2, N = 364).

Internalization Pressures
Thin/Low Body
Fat		 Muscular General
attractiveness		 Family Peers Significant
Others		 Media
Women Men Women Men Women Men Women Men Women Men Women Men Women Men
Item 1 .88 .89
Item 2 .81 .68
Item 3 .87 .88
Item 4 .88 .86
Item 5 .91 .81
Item 6 .88 .93
Item 7 .70 .89
Item 8 .93 .77
Item 9 -.69 .75
Item 10 -.62 .78
Item 11 .76 .71
Item 12 .73 .93
Item 13 .58 .82
Item 14 −.66 .92
Item 15 79 .93
Item 16 .93 .96
Item 17 .88 .83
Item 18 .92 .86
Item 19 .66 .88
Item 20 .90 .79
Item 21 .91 .93
Item 22 .88 .89
Item 23 .87 .95
Item 24 .86 .90
Item 25 .91 .98
Item 26 .90 .91
Item 27 .85 .95
Item 28 .96 .92
Item 29 .96
Item 30 .84
Item 31 .82
Cronbach’s alpha .83 .80 .88 .90 .82 .88 .85 .84 .88 .92 .90 .91 .95 .97
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Note. Robust Maximum Likelihood method of estimation.

Table 3.

Means and Standard Deviations of the Italian SATAQ-4R Subscales (Study 1, N = 732; Study 2, N = 364).

Mean (SD)
Women		 Mean (SD)
Men
Internalization Thin/Low Body Fat 2.92 (0.01) 2.16 (1.02)
Muscular 2.22 (0.88) 2.66 (1.03)
General attractiveness 3.82 (0.73) 3.37 (1.14)
Pressures Family 1.91 (0.94) 1.68 (0.79)
Peers 1.64 (0.85) 1.91 (0.98)
Significant Others 1.84 (0.97) 1.87 (0.93)
Media 3.08 (1.33) 2.14 (1.24)
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Table 4.

Intercorrelations Among the Italian SATAQ-4R Subscales (Study 1, N = 732; Study 2, N=364).

Pressures Internalization
Thin/Low Body Fat Muscular General attractiveness Peers Family Significant Others Media
Internalization Thin/Low Body Fat – .43*** .27*** .36*** .45*** .43*** .35***
Muscular .17*** – .44*** .53*** .39*** .46*** .36***
General attractiveness .55*** .20*** – .24*** .20*** .25*** .26***
Pressures Family .12** .05 .06 .52*** – .64*** .37***
Peers .21*** .13*** .10** – .55*** .71*** .46***
Significant Others .19*** .13*** .12** .66*** .62*** – .41***
Media .38*** .05 .33*** .36*** .23*** .28*** –
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Note. Women are below the diagonal, men are above the diagonal.

*

p < .05.

**

p < .01.

***

p < .001.

2.2.2. Convergent validity

Table 5 summarizes the correlations between SATAQ-4R- Female subscales and convergent measures (i.e., EDE-Q BSQ-14, RSES, DMS, FOPAS-F, PAS). The Pressures subscales, as well as the Thin/Low Body Fat and General Attractiveness Internalization subscales, demonstrated small to large positive associations with eating disorder symptomatology and body dissatisfaction. As predicted, these SATAQ-4R-Female subscales exhibited small to medium negative associations with global self-esteem. The Internalization: Muscular subscale exhibited large positive associations with drive for muscularity, but was not significantly associated with eating disorder symptomatology, body dissatisfaction, or self-esteem. As predicted, the SATAQ-4R-Female Family, Peers, and Significant Others Pressures subscales presented medium to large positive associations with measures of family and peer influence.

Table 5.

Correlations Between the Italian SATAQ-4R Subscales and Convergent Measures (Study 1, n = 335; Study 2, n = 110).

Internalization Pressures
Thin/Low Body Fat Muscular General attractiveness Family Peers Significant Others Media
Women Men Women Men Women Men Women Men Women Men Women Men Women Men
EDE-Q .55*** .65*** .04 .50*** .39*** .44*** .23*** .55*** .30*** .36*** .31*** .52*** .38*** .65***
BSQ-14 .60*** – .08 – .41*** – .23*** – .32*** – .30*** – .40*** –
MBAS – .59*** – .44*** – .35*** – .51*** – .40*** – .51*** – .51***
RSES −.32*** −.37*** .02 −.28** −.19** −.14 −.11* −.32** −.24*** −.30** −.16** −.39*** −.19** −.27**
PAS .34*** .52*** .08 .42*** .23*** .32** .38*** .52*** .45*** .42*** .41*** .55*** .28*** .55***
FOPAS-F .25*** .57*** .11* .33*** .14* .27** .61*** .62*** .44*** .37*** .47*** .51*** .28*** .38***
DMS .12* .41*** .50*** .76*** .07 .45*** .04 .30** .04 .62*** .08 .54*** .03 .46***
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Note. EDE-Q= Eating Disorder Examination-Questionnaire; BSQ-14 = Body Shape Questionnaire-14; MBAS = Male Body Attitudes Scale; RSES = Rosenberg Self-Esteem Scale; PAS = Peer Attribution Scale; FOPAS-F = Feedback on Physical Appearance Scale-Family; DMS = Drive for Muscularity Scale.

*

p < .05.

**

p < .01.

***

p < .001.

2.2.3. Test-retest reliability

Test-retest reliability for each subscale was quite good, with r values ranging from .68 to .88 (Internalization: Thin/Low Body Fat = .84; Internalization: Muscular = .73; Internalization: General Attractiveness = .88; Pressures: Family = .86; Pressures: Peers = .70; Pressures: Significant Others = .74; and Pressures: Media = .68).

2.3. Discussion

The present study provides evidence for the validity and reliability of the Italian version of the SATAQ-4R-Female among Italian women. The original seven-factor structure identified among college women from the United States (Schaefer et al., 2017) was confirmed. Each of the original subscales cleanly replicated and showed good internal consistency and acceptable test-retest reliability. Results also support the convergent validity of the SATAQ-4R-Female among Italian women. Each Pressures subscale, the Thin/Low Body Fat, and the General Attractiveness Internalization subscales were significantly associated with body dissatisfaction, self-esteem, and disordered eating symptomatology. These findings are consistent with theory suggesting that thinness pressures and internalization of the thin ideal contribute to negative eating and body image outcomes (Thompson et al., 1999). In contrast, the Internalization: Muscular subscale was highly related to drive for muscularity but was not associated with disordered eating or body image. This finding is consistent with previous work indicating that the muscular ideal is more relevant to negative eating outcomes for boys and men than girls and women (Cafri et al., 2005). Family, Peers, and Significant Others Pressures subscales demonstrated moderate to large positive associations with measures of general family and peer influence, supporting the convergent validity of these scales.

3. Study 2

While body dissatisfaction appears to be more prevalent among women, Italian men pay great attention to the body (Ruspini, 2007), desire a more muscular body than the average male body shape (Gilli & Ruspini, 2014; Zelli et al., 2010), and are particularly concerned with the care of their appearance (Capellani et al., 2014). To help facilitate further research related to the influence of sociocultural factors on Italian men’s eating and body image, the aim of the present study was to translate and validate an Italian version of the SATAQ-4R-Male. A CFA was performed to evaluate the factor structure of the Italian version among men, and internal consistency and test-retest reliability of the scale were examined. Exploratory factor analysis on the English male version revealed a seven-factor structure. The structure of the English male version was examined with college men, while no studies analysed it with male adolescents. However, as the SATAQ-4R-Female demonstrated two different factor structures among differently aged women, we decided to examine the fit of both the six- and the seven-factor model also for men. Convergent validity was examined in relation to body dissatisfaction, eating disorder symptomatology, drive for muscularity, self-esteem, family, and peer influences. Consistent with previous work examining the SATAQ-4R-Male among a sample of college men in the United States (Schaefer et al., 2017), the Pressures subscales and the Internalization: Thin/Low Body Fat subscale were expected to demonstrated small to medium positive associations with eating disorder symptomatology and body dissatisfaction, and a medium negative association with self-esteem. The Internalization: General Attractiveness subscale was expected to exhibit a small positive association with eating disorder symptomatology. The Internalization: Muscular subscale was expected to exhibit a large positive association with drive for muscularity, but small positive association with eating disorder symptomatology, and a small negative association with self-esteem. The SATAQ-4R Family, Peers and Significant Others Pressures subscales were expected to exhibit medium to large positive associations with measures of family and peer influence.

3.1. Method

3.1.1. Participants

Participants were 364 Italian men aged between 18 and 72 (77.5% of men aged from 18 to 30 years, consistent with the original United States. validation sample). All participants had Italian nationality and were born in Italy (age M = 27.26, SD = 8.94; BMI M =24.45, SD = 4.06). All participants were utilized for the CFA. Convergent validity analyses were conducted using a subset of 110 participants (drawn from the larger sample) who completed the convergent measures (age M = 34.43, SD = 11.70; BMI M = 27.06, SD = 5.22). This sample size conferred adequate power to detect small to moderate effects (Hulley et al., 2013). The test-retest reliability of the SATAQ-4R-Male was examined among a subset of 28 participants (age M = 23.29, SD = 4.62; BMI M = 22.57, SD = 2.50), drawn from the larger sample, who completed the questionnaire on two occasions four weeks apart. This sample size conferred adequate power to detect a large effect (Hulley et al., 2013). Socio-demographic information for each of the samples is displayed in Table 1.

3.1.2. Measures

Participants completed the Italian version of the SATAQ-4R-Male (see Appendix B), which is composed of 28 items rated on a 5-point Likert scale with response options ranging from 1 (definitely disagree) to 5 (definitely agree). The translation steps were the same that we followed for the SATAQ-4R-Female; the translators for the male and female versions of the scale were the same individuals. Similar to Study 1, participants completed the SATAQ-4R-Male as well as the Italian versions of the EDE-Q(α = .94), DMS (α = .91), RSES (α = .82), FOPAS-F (α = .84), and PAS (α = .92). Studies examining the reliability and validity for the Italian versions of these scales are discussed in Study 1.

Additionally, participants completed the Male Body Attitudes Scale (MBAS). Male body dissatisfaction was assessed through the Italian version (Stefanile, Nerini, & Matera, 2016) of the MBAS (Tylka, Bergeron, & Schwartz, 2005). The MBAS is composed of 24 items (e.g., “I think my arms should be more muscular”) rated along a 6-point scale (1 = never, 6 = always). Higher scores reflect more negative body attitudes. Previous work using the Italian version of the MBAS (Stefanile et al., 2016) confirmed the same 3-factor structure of the English version and good reliability for the scale’s scores. Cronbach’s alpha in the current study was good (α = .86).

3.1.3. Procedure and data analyses

The procedure for data-collection and analysis in Study 2 was identical to the procedures described in Study 1.

3.2. Results

3.2.1. Factor structure and reliability

Three of the SATAQ-4R-Male items (Items 9,12, and 13) exhibited skew was higher than 2, while kurtosis values for all items were lower than 7 (West et al., 1995). Given that the assumption of multivariate normality was not met for some items, CFA was conducted using the Robust Maximum Likelihood method of estimation along with the Satorra-Bentler Scaled Chi-Square, which corrects for non-normality. The six-factor model had a good fit to the data. Although the S–B χ2 was significant (1205.65, p < .001), the CFI (.97) and the NNFI (.97) were within the standard recommended range, showing a good fit. The RMSEA (.09) and the SRMR (.06) suggested an acceptable fit. The AIC was 1347.65. The seven-factor model had a good fit to the data. The S–B χ2 was significant also for this model (1016.16, p < .001), but the CFI (.98) and the NNFI (.97) were within the standard recommended range, suggesting a good fit; the RMSEA (.08) and the SRMR (.06) suggested an acceptable fit. The AIC was 1170.16. If we compare the fit indices of the two models, we can observe that the seven-factor model provided a slightly better fit according to both absolute and comparative fit indices. Moreover, it had the lowest AIC value, which suggests it was more parsimonious than the other, and it was the model that most plausibly generated the data. Factor loadings for the seven subscales are presented in Table 2. All items loaded strongly onto their intended subscale. All primary loadings were greater than .30, ranging from .71 to .98. The internal consistency of the seven subscales was good, with Cronbach’s alpha ranging from .80 to .97 (see Table 2). Means and intercorrelations among the subscales are presented respectively in Tables 3 and 4. All associations were significant and positive. Age showed only small correlations with the scores men obtained on the seven subscales of the SATAQ-4R (r ranged from .01 to −.16).

3.2.2. Convergent validity

The correlations between the SATAQ-4R-Male subscales and body dissatisfaction (BSQ-14), drive for muscularity (DMS), eating disorder symptomatology (EDE-Q), self-esteem (RSES), family influence (FOPAS-F), and peer attributions (PAS) are presented in Table 5. The Pressures subscales and the Internalization: Thin/Low Body Fat subscale demonstrated medium to large positive associations with eating disorder symptomatology and body dissatisfaction, and small to medium negative associations with global self-esteem. The Internalization: General Attractiveness subscale exhibited medium positive associations with eating disorder symptomatology and body dissatisfaction. The Internalization: Muscular subscale exhibited large positive associations with drive for muscularity and with eating disorder symptomatology, and a small negative association with self-esteem. The SATAQ-4R-Male Family, Peers and Significant Others Pressures subscales exhibited medium to large positive associations with measures of family and peer influence.

3.2.3. Test-retest reliability

Test-retest reliability for the seven subscales was acceptable, with values ranging from .60 to .86 (Internalization: Thin/Low Body Fat = .76; Internalization: Muscular = .77; Internalization: General Attractiveness = .60; Pressures: Family = .76; Pressures: Peers = .67; Pressures: Significant Others = .60; and Pressures: Media = .86).

3.3. Discussion

The present study provides evidence for the validity and reliability of the Italian versions of the SATAQ-4R-Male among Italian men. The original seven-factor structure identified among college men from the United States (Schaefer et al., 2017) was confirmed. Each of the original subscales cleanly replicated and demonstrated good internal consistency and acceptable test-retest reliability. Results also support the convergent validity of the SATAQ-4R-Male among Italian men. Each Pressures subscale and the Internalization: Thin/Low Body Fat subscale was significantly associated with body dissatisfaction, self-esteem, disordered eating symptomatology, and drive for muscularity. In contrast to results obtained within the female sample, the Internalization: Muscular subscale was highly related to each of the unhealthy outcomes assessed. This finding suggests that Italian men who aspire to muscular aesthetic ideals are more likely to experience decreased self-esteem, higher levels body dissatisfaction and eating symptomatology, as well as and greater engagement in behaviors aimed at increasing muscularity. While the Internalization: General Attractiveness subscale was associated with body dissatisfaction and disordered eating among males, it did not correlate with self-esteem in the male sample. These results suggest that Italian men’s self-esteem might be more linked to specific features of appearance, such as thinness and muscularity, rather than to a general idea of attractiveness, which can be a more abstract and general concept.

4. General discussion

The current set of studies examined the psychometric properties of the Italian versions of the SATAQ-4R-Male and SATAQ-4R-Female. Results indicate that these measures provide a valid and reliable assessment of appearance-ideal internalization and appearance pressures among Italian men and women. The original seven-factor structure identified among college men and women from the United States (Schaefer et al., 2017) was confirmed in the current samples of Italian community men and women. Each of the original subscales cleanly replicated and showed good internal consistency and acceptable test-retest reliability. Notably, some scales presented lower test-retest reliability among men, which suggests that men’s sociocultural attitudes towards appearance might be more variable than the ones of women, for whom beauty ideals are more likely to be consolidated and socially shared. Overall, these results support the distinctiveness of thin, muscular, and general appearance-ideal internalization among Italian adults. Moreover, results support the presence of distinct sources of perceived appearance pressures in Italian culture. Notably, Italian men and women considered significant others to be distinct from peers and family members, in contrast to findings from Turkish women (Cihan et al., 2016). These findings are consistent with a growing body of research using Italian samples which suggests that significant others (such as one’s romantic partner) are relevant additional sources of appearance-related pressures for both women and men (i.e., Policardo, Matera, Nerini, & Stefanile, 2018). Results also support the convergent validity of the SATAQ-4R-Male and SATAQ-4R-Female among Italian men and women. Overall, these findings confirm the association between sociocultural influences and unhealthy outcomes, such as dissatisfaction with one’s body (Blond, 2008; Galioto, Karazsia, & Crowther, 2012; Grammas & Schwartz, 2009; Keery, van den Berg, & Thompson, 2004; Knauss et al., 2007; Shroff & Thompson, 2006; Stice & Shaw, 2002; Thompson & Stice, 2001; Thompson et al., 2004; Tylka, 2011), eating pathology (Thompson et al., 1999; Tylka, 2011), and decreased self-esteem (Paxton et al., 2006; Tiggemann, 2005) among Italian men and women.

Some limitations of this study should be acknowledged. First, in the current study, the psychometric properties of the scale were examined among adults, but not among adolescents. Given that the SATAQ-4R-Female demonstrated a slightly different factor- structure among adolescent girls compared to college women in the United States, additional psychometric testing of the Italian versions of the scales among younger Italians is recommended. Similarly, the scale may evidence a different structure or psychometric properties among older Italians. While age demonstrated only small, often nonsignificant associations with SATAQ-4R subscales in the current sample, further work may seek to evaluate the psychometric properties of the scale using larger samples of older adults. Second, the current study is unable to assess the degree to which other important demographic variables may influence the psychometric properties of the scale and its association with relevant constructs. For example, although the impact of appearance-ideal internalization and appearance pressures on body image and disordered eating may vary by sexual orientation (Cella, Iannaccone, & Cotrufo, 2013; Cohen & Tannenbaum, 2001 ; Hazzard et al., 2019; Nerini, Matera, & Stefanile, 2018; Yean et al., 2013), the current study is unable examine the impact of sexual orientation on the scale structure or associations with convergent measures. Third, the SATAQ-4R assesses the influence of significant others as a whole (i.e., romantic partners, teachers, coaches) and is unable to examine the specific impact that more narrowly defined groups may have on body image and disordered eating (Francisco, Narciso, &Alarcão, 2012; Markey &Markey, 2014; Nerini, Matera & Stefanile, 2016; Policardo et al., 2018; Schaefer & Blodgett Salafia, 2014). Finally, the decision to recruit participants from university classes led to obtain very small samples for the analysis of the test-retest reliability, especially for men; therefore, future studies should seek to evaluate the stability of scale scores within larger samples.

In sum, internalization of appearance ideals and appearance-related pressures are strongly implicated in the development of negative body image and disordered eating. Further, as evidence suggests high rates of body dissatisfaction and disordered eating among Italian men and women (Carta et al., 2014; Ministero della Salute, 2017; Pirani & Matera, 2018), continued examination of sociocultural influences among Italians is needed. The current set of studies supports the psychometric properties of commonly used measures of appearance-ideal internalization and appearance pressures, the SATAQ-4R-Male and SATAQ-4R-Female, in Italian men and women. Thus, this research contributes to a growing body of work examining risk and maintenance factors among Italians and provides an important tool for pursing further sociocultural risk factor work in this population.

Appendix A. SATAQ4R-Female version

Legga adesso attentamente ognuna delle seguenti affermazioni e indichi con una crocetta il Suo grado di accordo o disaccordo con ciascuna di esse. Nel rispondere pensi al Suo aspetto e a come si sente riguardo al modo in cui appare. Le affermazioni che seguono riguardano elementi diversi del Suo aspetto, inclusi peso, forma, muscoli, grasso corporeo e aspetto globale.

molto in disaccordo molto d’accordo
01. Per me è importante apparire muscolosa □1 □2 □3 □4 □5
02. Per me è importante avere un bell’aspetto con gli abiti che indosso □1 □2 □3 □4 □5
03. Voglio che il mio corpo sembri molto magro □1 □2 □3 □4 □5
04. Penso molto a sembrare muscolosa □1 □2 □3 □4 □5
05. Penso molto al mio aspetto □1 □2 □3 □4 □5
06. Penso molto a sembrare magra □1 □2 □3 □4 □5
07. Voglio essere bella □1 □2 □3 □4 □5
08. Voglio che il mio corpo sembri muscoloso □1 □2 □3 □4 □5
09. Non penso molto al mio aspetto □1 □2 □3 □4 □5
10. Non voglio che il mio corpo sembri muscoloso □1 □2 □3 □4 □5
11. Voglio che il mio corpo sembri molto snello □1 □2 □3 □4 □5
12. Per me è importante essere attraente □1 □2 □3 □4 □5
13. Penso molto ad avere poco grasso corporeo □1 □2 □3 □4 □5
14. Non penso molto a come appaio □1 □2 □3 □4 □5
15. Vorrei avere un corpo che sembri molto muscoloso □1 □2 □3 □4 □5
La preghiamo di rispondere alle seguenti domande attinenti alla Sua famiglia (inclusi genitori, fratelli, sorelle, parenti).
molto in disaccordo molto d’accordo
16. Sento le pressioni dei membri della mia famiglia a sembrare più magra □1 □2 □3 □4 □5
17. Sento le pressioni dei membri della mia famiglia a migliorare il mio aspetto □1 □2 □3 □4 □5
18. I membri della mia famiglia mi incoraggiano a diminuire la quantità di grasso del mio corpo □1 □2 □3 □4 □5
19. I membri della mia famiglia mi incoraggiano ad essere in gran forma □1 □2 □3 □4 □5
Risponda alle seguenti domande attinenti ai Suoi coetanei (inclusi amici, colleghi di corso o di lavoro, altre persone della Sua età).
molto in disaccordo molto d’accordo
20. I miei coetanei mi incoraggiano ad essere più magra □1 □2 □3 □4 □5
21. Sento le pressioni dei miei coetanei a migliorare il mio aspetto □1 □2 □3 □4 □5
22. Sento le pressioni dei miei coetanei a sembrare in gran forma □1 □2 □3 □4 □5
23. Ricevo pressioni da parte dei miei coetanei a diminuire la quantità di grasso del mio corpo □1 □2 □3 □4 □5
Risponda alle seguenti domande attinenti alle persone significative nella Sua vita (inclusi il partner, insegnanti, allenatore, altre persone particolarmente importanti per Lei).
molto in disaccordo molto d’accordo
24. Persone significative per me mi incoraggiano ad essere più magra □1 □2 □3 □4 □5
25. Sento le pressioni di persone significative a migliorare il mio aspetto □1 □2 □3 □4 □5
26. Sento le pressioni di persone significative a sembrare in gran forma □1 □2 □3 □4 □5
27. Ricevo pressioni da parte di persone significative a diminuire la quantità di grasso del mio corpo □1 □2 □3 □4 □5
Risponda alle seguenti domande attinenti ai media (inclusi TV, riviste, internet, film, tabelloni e avvisi pubblicitari).
molto in disaccordo molto d’accordo
28. Sento le pressioni dei media ad apparire in gran forma □1 □2 □3 □4 □5
29. Sento le pressioni dei media a sembrare più magra □1 □2 □3 □4 □5
30. Sento le pressioni dei media a migliorare il mio aspetto □1 □2 □3 □4 □5
31. Sento le pressioni dei media a diminuire la quantità di grasso del mio corpo □1 □2 □3 □4 □5
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Appendix B. SATAQ4-R Male version

Legga adesso attentamente ognuna delle seguenti affermazioni e indichi con una crocetta il Suo grado di accordo o disaccordo con ciascuna di esse. Nel rispondere pensi al Suo aspetto e a come si sente riguardo al modo in cui appare. Le affermazioni che seguono riguardano elementi diversi del Suo aspetto, inclusi peso, forma, muscoli, grasso corporeo e aspetto globale.

molto in disaccordo molto d’accordo
01. Per me è importante apparire muscoloso □1 □2 □3 □4 □5
02. Voglio che il mio corpo sembri molto magro □1 □2 □3 □4 □5
03. Penso molto a sembrare muscoloso □1 □2 □3 □4 □5
04. Penso molto a sembrare magro □1 □2 □3 □4 □5
05. Voglio che il mio corpo sembri muscoloso □1 □2 □3 □4 □5
06. Non penso davvero molto al mio aspetto □1 □2 □3 □4 □5
07. Non penso molto a come appaio □1 □2 □3 □4 □5
08. Vorrei avere un corpo che sembri molto muscoloso □1 □2 □3 □4 □5
La preghiamo di rispondere alle seguenti domande attinenti alla Sua famiglia (inclusi genitori, fratelli, sorelle, parenti).
molto in disaccordo molto d’accordo
09. Sento le pressioni dei membri della mia famiglia a sembrare più magro □1 □2 □3 □4 □5
10. Sento le pressioni dei membri della mia famiglia a migliorare il mio aspetto □1 □2 □3 □4 □5
11. I membri della mia famiglia mi incoraggiano ad essere in gran forma □1 □2 □3 □4 □5
12. Sento le pressioni dei membri della mia famiglia ad essere più muscoloso □1 □2 □3 □4 □5
13. I membri della mia famiglia mi incoraggiano ad aumentare la dimensione o la definizione dei miei muscoli □1 □2 □3 □4 □5
Risponda alle seguenti domande attinenti ai Suoi coetanei (inclusi amici, colleghi di corso o di lavoro, altre persone della Sua età).
molto in disaccordo molto d’accordo
14. Sento le pressioni dei miei coetanei a migliorare il mio aspetto □1 □2 □3 □4 □5
15. Sento le pressioni dei miei coetanei a sembrare in gran forma □1 □2 □3 □4 □5
16. Sento le pressioni da parte dei miei coetanei ad essere più muscoloso □1 □2 □3 □4 □5
17. I miei coetanei mi incoraggiano ad aumentare la dimensione o la definizione dei miei muscoli □1 □2 □3 □4 □5
Risponda alle seguenti domande attinenti alle persone significative nella Sua vita (inclusi il partner, insegnanti, allenatore, altre persone particolarmente importanti per Lei).
molto in disaccordo molto d’accordo
18. Sento le pressioni di persone significative a migliorare il mio aspetto □1 □2 □3 □4 □5
19. Sento le pressioni di persone significative a sembrare in gran forma □1 □2 □3 □4 □5
20. Ricevo pressioni da parte di persone significative a diminuire la quantità di grasso del mio corpo □1 □2 □3 □4 □5
21. Ricevo pressioni da parte di persone significative ad essere più muscoloso □1 □2 □3 □4 □5
22. Sento le pressioni di persone significative ad aumentare la dimensione o la definizione dei miei muscoli □1 □2 □3 □4 □5
Risponda alle seguenti domande attinenti ai media (inclusi TV, riviste, internet, film, tabelloni e avvisi pubblicitari).
molto in disaccordo molto d’accordo
23. Sento le pressioni dei media ad apparire in gran forma □1 □2 □3 □4 □5
24. Sento le pressioni dei media a sembrare più magro □1 □2 □3 □4 □5
25. Sento le pressioni dei media a migliorare il mio aspetto □1 □2 □3 □4 □5
26. Sento le pressioni dei media a diminuire la quantità di grasso del mio corpo □1 □2 □3 □4 □5
27. Sento le pressioni dei media ad essere più muscoloso □1 □2 □3 □4 □5
28. Sento le pressioni dei media ad aumentare la dimensione o la definizione dei miei muscoli □1 □2 □3 □4 □5
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Footnotes

Declaration of Competing Interest

The authors declare that they have no conflicts of interest concerning this article.

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