Electronic Theses and Dissertations Archive

Date

2026

Document Type

Dissertation

Degree Name

Doctor of Philosophy

Department

Psychology

Committee Chair

Kristoffer Berlin

Committee Member

Diana Rancourt

Committee Member

Emily Srisarajivakul

Committee Member

Robert Cohen

Abstract

Individuals with type 1 diabetes (T1D) are uniquely vulnerable to body image dissatisfaction due to a complex interplay of pre-existing psychosocial risk factors and health demands necessitated by T1D care. These individual-level risk factors lend to high degrees of heterogeneity in body image (dis)satisfaction. Given that body image dissatisfaction heightens the risk of disordered eating behaviors and subsequent adverse diabetes-related outcomes, it is important to understand antecedents of body image dissatisfaction in individuals with T1D to inform care. The present study included a sample of adolescents and young adults (AYA) ages 13-35 with T1D (N=891, Mage=21.14 years (SDage=6.03 years), 57.8% assigned female at birth, 85% White/non-Hispanic, MHbA1c=8.36%, 69% insulin pump users) who completed the Body Image subscale of the Screen for Early Eating Disorder Signs (SEEDS; Powers et al., 2016) as well as other questions regarding eating thoughts/behaviors (including insulin omission) and sought to 1) derive patterns of body image concerns among AYA with T1D, 2) determine demographic and illness-related predictors of body image (dis)satisfaction class membership, and 3) understand whether these patterns relate to glycemic health, insulin omission behaviors, and other diabetes-related outcomes. Four distinct profiles of body image (dis)satisfaction were evident in this sample (“Satisfied”, “Dissatisfied”, “Size Dissatisfaction”, and “Shape Dissatisfaction”). Compared to the reference group (“Satisfied”), higher prior body mass index, lower income, and longer illness duration increased likelihood of membership in dissatisfaction classes, whereas assigned male at birth individuals had lower odds of body image dissatisfaction class membership. Body image dissatisfaction groups reported elevated concerns across all distal outcomes. Implications for future research and clinical care were discussed.

Comments

Data is provided by the student.

Library Comment

Dissertation or thesis originally submitted to ProQuest/Clarivate.

Notes

Open Access

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