TRABAJO FIN DE GRADO
Examining the Relationship Between Instagram Use, Appearance Anxiety, and Psychological Flexibility
Author: Ariana Markowitz
Tutor: Lidia Budziszewska
Grado en psicología (modalidad 100% inglés) Facultad de Ciencias Biomédicas y Salud
Universidad Europea de Madrid
Number of words: 6,497
Examining the Relationship Between Instagram Use, Appearance Anxiety, and Psychological Flexibility
Ariana Markowitz
School of Biomedical and Health Sciences, Universidad Europea of Madrid Trabajo Fin de Grado
Lidia Budziszewska May 30th, 2022
Acknowledgements
I would like to express my immense gratitude to the following people as this thesis, among other important situations that led my life to this point, would not have been possible without them. To all the beautiful people who helped my mother and I when she was a single,
immigrant parent. To my parents, Eric and Alicia Markowitz, who gave me the privilege and opportunity to study this wonderful degree. To my brothers Reed and Harrison Markowitz for always having my back. To Carola Perez and family, and Bartosz Chmielewski and family for their unending support throughout my studies.
Your love brought light to my toughest days.
Abstract
In the last decade, social media use has grown exponentially, with Instagram becoming one of the most prominently used platforms. The effects Instagram has on its users have been widely researched, but there are still essential issues that are untouched. This study assesses the relationship between Instagram use, appearance anxiety, and psychological flexibility.
Instagram is especially chosen due to its focus on images, with trends on creating and consuming ideal body images that have been found to promote body dissatisfaction. In combination, testing participant psychological flexibility could give indication of possible treatments as it is one of the key elements in ACT. Participants were found through a convenience sample and were provided a link to a Google Form survey. The data analysis includes a descriptive and correlational analysis. The major findings of this study are as follows: a moderately positive correlation between passive Instagram use and use intensity, weak correlation between intensity and appearance anxiety, and moderate positive correlation between appearance anxiety and psychological flexibility. Although, there were several limitations that should be duly noted.
Keywords: Instagram use, appearance anxiety, psychological flexibility
Examining the Relationship Between Instagram Use, Appearance Anxiety, and Psychological Flexibility
Since over a decade ago, social media has quickly become a part of everyday life.
Already, this is enough reason to consider it imperative to analyze the effects it may be having on its users (Boyd, 2015). From a media space controlled by firms to one controlled by the very consumers, the social media space has become the fastest growing online media segment. Some of the largest platforms being Facebook, YouTube, Twitter, and Instagram (Goff, 2013). In this study, the purpose is to assess the relationship between Instagram use, appearance anxiety, and psychological flexibility. Appearance anxiety being the tendency to feel distress over one’s appearance (Harris & Carr, 2001) and psychological flexibility being the tendency to respond to different circumstances in a way that would make it easier to reach one’s goals (Doorley et al., 2020).
To begin, it is important to understand the grand scope of social media and Instagram use. The Pew Research Center (Auxier & Anderson, 2021) stated that around 70% of the US population used social media platforms in 2021. One of the most common is Instagram which is used by 40% of the population and 76% of Americans between the ages of 18 and 29.
Likewise, 84% of the Spanish population uses social media, 74% use Instagram, of which 93% are between the ages of 16 and 24 (Acebes & Montanera, 2021). Not only is there a large percentage of populations using this platform, but it is also very fast-growing. In February of 2022 there were nearly 300 million more users found on Instagram than in February of 2021 (Kemo, 2022).
Although social media has opened many doors to new career paths and worldwide connections, it has undeniably brought on hardships as well. Many of these hardships have been linked to the social comparison theory (Sherlock & Wagstaff, 2019; Hwang, 2019;
Trifiro & Prena, 2021), a phenomenon where people tend to evaluate themselves based off
how their characteristics compare to the information collected about others whom they consider have positive or desirable characteristics (Hwang, 2019). A decade ago, this may have happened in a more controlled manner with those in the individual’s direct
surroundings, TV shows, and magazines. But now, this social comparison can happen with hundreds to thousands of people a day on image-based platforms like Instagram.
Literature Review
Many research studies have been conducted on the possible effects social media has on its users. A peer-review article by Amedie (2015) states three main areas that show how users are negatively affected by social media. Firstly, the tendency for making them feel a misleading sense of social connectedness. This can promote issues psychologically and emotionally, as well as give a space for younger users to criticize and analyze themselves excessively. Secondly, it has a high probability of becoming addicting. This can diminish users’ interpersonal life as well as increase the likelihood of developing antisocial behaviors.
Third, the facility it has for becoming a criminal tool. In continuation, there have also been studies regarding the relationship between Instagram use and depression (Hwang, 2019), anxiety (Kohler, 2021), appearance anxiety (Shepherd et al., 2019; Shepherd et al., 2020;
Zimmer-Gembeck et al., 2021), body image (Tiggemann & Anderberg, 2019), self-esteem (Rahma & Setiasih, 2021; Romero-Rodriguez et al., 2020; Trifiro & Prena, 2021), and the overall well-being of the user (Sherlock & Wagstaff, 2019; Trifiro & Prena, 2021).
Before reviewing the different findings on the negative effects of Instagram, it is important to understand what this social platform consists of. Instagram is an application that can be downloaded for free onto any smartphone. It consists of a user interface where one can view, post, or share photos and videos that can be commented on, liked, and used to engage with others. What is specifically of interest in this application is that images are the center of
attention (de Vries et al., 2017) which has been found to affect user’s moods in a different way than text (Johnson & Knobloch, 2016). There is also a website where users can login and consume content, but not create it.
Instagram Use
The use of Instagram can be divided into two main ways: the intensity of its use and whether this use is passive or active. The intensity of use comes from a study conducted by Ellison and colleagues (2007) on the intensity in which people used Facebook. Here, intensity is introduced as the amount of social connectedness that the individual has to the platform, as well as how integrated it is in their life. The Facebook Intensity Scale used in that study was adapted by Trifiro and Prena (2021) into an Instagram Intensity Scale. According to another study conducted on physical education students, smartphone addiction had a significant positive correlation with the intensity of Instagram use (Romero-Rodríguez, 2020).
As mentioned, Instagram use can be passive or active. An active form of using the platform involves carrying out actions like posting pictures and communicating with others.
On the other hand, a passive style involves only content consumption by, for example, scrolling through the different images posted on the main feed or explore page (Gerson et al., 2017). In a study conducted by Gerson and colleagues (2017), Facebook users were tested using the Passive Active Use Measure (PAUM) to differentiate between the passive and active use styles. The scale has three sub-scales, active social, active non-social, and passive use. There was a positive association between several different factors. First, a positive association between reward reactivity and both active social and passive use. This means that those who used Facebook in an active social or passive way had more reactivity toward rewards. Second, a positive association between impulsivity and goal-drive persistence with active non-social use. This means that those who used Facebook in an active non-social way had more impulsivity and goal-drive persistence. Third, a positive association between fight-
flight-freeze system (FFFS) with passive use. This means that those who used Facebook in a passive way had more FFFS reactions. And fourth, a positive association between reward interest with active social, active non-social, and passive use. This means that all participants with any of the three forms of Facebook use had an interest in reward. The authors explained that these findings show that Facebook use, and possibly the use of other social media platforms, are impacted by individual differences.
Anxiety
In regard to anxiety, a study by Kohler (2021) experimented the effects that different images had on participants state and trait anxiety. It was suggested that the state-trait
dynamics are a key factor when assessing how image-conscious Instagram content affects people. This stems from the observation that those with lower trait anxiety were more vulnerable to state anxiety after viewing Instagram accounts that contained image-conscious photos (Kohler, 2021).
Furthermore, Shepherd and colleagues (2019) tested burn victims’ appearance anxiety and the possible effects that psychological flexibility could have on this. As predicted, it was found that a higher level of appearance anxiety was related to low psychological flexibility.
Although there is very little current research available, Acceptance and Commitment Therapy (ACT) could prove to be useful for treating appearance anxiety as it is known to be effective in treating distress related to other health conditions (Shepherd et al., 2020). For example, three case studies conducted by Shepherd and colleagues (2020) found that functional impairment was successfully reduced in all three patients with appearance anxiety with no negative effects.
Lastly, Zimmer-Gembeck and colleagues (2021) conducted a study that tested adolescent appearance anxiety in offline social environments and appearance preoccupation in online social environments including victimization in both contexts. In general, there was a
high correlation between appearance anxiety in both online and offline contexts.
Additionally, in-person appearance-related victimization by peers was a common risk factor.
Body Image
A study conducted by Tiggemann and Anderberg (2019) shows that the exposure to images of individuals, who are mostly feminine women and appear nearly flawless, has been related to body image concerns like self-objectification and body dissatisfaction. These falsified images have become so widely shared that a style of image labeled “Instagram versus reality” has become a way to expose it. This is done by posting a side-by-side picture of the same person, one in a position that is considered desirable and the other in a natural position. In this study, three groups of women were shown three different types of images:
ideal, natural, or “Instagram versus reality”. As predicted, those who viewed the ideal images had a greater body dissatisfaction than those who saw the natural and “Instagram versus reality” images.
Well-being & Self-esteem
As for the effects of Instagram use on overall well-being, Sherlock and Wagstaff (2019) found that social comparison mediates the correlation found between Instagram use and self-esteem, as well as symptoms of depression, body dissatisfaction, and appearance anxiety. Like other research, this shows that it could be a contributing factor in poor appearance-related self-perception and other negative psychological effects (Sherlock &
Wagstaff, 2019).
Regarding its effects on self-esteem, Rahma & Setiasih (2021) found that the intensity of the participants Instagram use was positively correlated to their self-esteem, meaning that the more intensely they used it, the higher their self-esteem. On the other contrary, Romero- Rodriguez and colleagues (2020) found that the intensity of the participants use was not correlated with their self-esteem level. The Rosenberg Self-Esteem Scale (RSES) used in
both studies mentioned is described to measure positive and negative feelings about oneself.
Related articles found on the official scale explain its connection to self-worth, belief of success and having good traits, to be resulting of good school or job performance, of having a strong relationship with happiness, and more. As seen in this description, the factor of self- esteem is quite focused on intrinsic qualities, like self-worth and performance, versus
extrinsic ones like appearance and aesthetics of the body. Nevertheless, it has been found that those with a higher self-esteem are more likely to say they are attractive and likeable
(Rosenberg, 1965).
In the study by Trifiro and Prena (2021), there was an assessment done on how the intensity of social media use could impact the relationship between an active form of use and two user outcomes, including self-esteem and well-being. The findings indicate that
participants that showed more active social media use were also those who used it more intensely. They also accurately hypothesized a positive correlation between the two user outcomes, self-esteem and well-being, and how actively the participants used Instagram, in which intensity was found to be the mediating factor. Although, it was not a direct
relationship. A significant indirect effect of active Instagram use on self-esteem was found through the intensity of the use. Essentially, those who used Instagram more actively, also used it more intensely, and showed higher self-esteem and well-being.
Depression
Hwang (2019) studied Instagram’s potential negative effects by assessing the relationship it has with depression. There were three main findings of which the most relevant is that depression was positively associated with the individual’s tendency toward upward social comparison and negatively associated with downward social comparison.
Upward social comparison is the tendency to compare oneself to another who is believed to be superior, and downward social comparison is the tendency to compare oneself to someone
who is believed to be inferior. Moreover, it seems that social comparison is a mediating factor in the effect Instagram use has on depression. And finally, it is suggested that although Instagram was not found to directly worsen depression, it could give rise to it if the social comparison occurring on the platform has been a trigger.
Psychological Flexibility
Finally, in the model of Acceptance and Commitment Therapy (ACT), psychological flexibility is considered the ability to be mindful of one’s feelings and thoughts, within a present moment, without the need to become defensive toward them. In continuation,
depending on the scenario, it involves being able to persist certain behaviors, or change them, to continue following one’s central goals and interests. There are many different abilities that fall into psychological flexibility, including the following: recognition and adaptation to varying demands, fluctuating behaviors and mindsets when social and personal functioning are vulnerable to damage, preservation of a balance between varying domains of life, and commitment to behaving in a way that is in line with central values. Some of the benefits of psychological flexibility include being able to self-regulate, have executive-control, ego- resiliency, and response modulation.
In psychopathologies like depression and anxiety, there is a loss of this psychological flexibility. For example, one of the key symptoms of anxiety is behaving with an avoidant response style with increasing evidence that experiential avoidance for a wide range of situations is a main characterizer of these disorders. In panic disorder, it is the experience of arousal in the body, in generalized anxiety disorder it is the fear of experiencing strong impulses emotionally, and more. Unfortunately, as these avoidant response styles become more prominent, the disorder continues to be maintained. ACT has different techniques that have been successful in treating this (Kashdan & Rottenberg, 2010).
Conclusion & Rationale
Throughout this literature review, it is clearly undeniable that Instagram is a platform that should be thoroughly investigated not only due to its incredibly fast-growing user base but also the number of implications it has been found to have in a person’s life. This platform is of special interest due to its large focus on images (de Vried et al., 2017), with trends on the creation and consumption of ideal body images that have been found to promote body dissatisfaction (Tiggeman & Anderberg, 2019). As per the social comparison theory, applications like this create a space where people can compare themselves with hundreds to thousands of people which is an exponential change compared to a decade ago. Although there is a lot of information regarding the different negative effects social media and
Instagram may be having on its users, as far as the extent of the research, there are no known studies that combine Instagram use, appearance anxiety, and psychological flexibility. The most similar articles found are that of Shepherd and colleagues (2019) and Trifiro and Prena (2021). According to Sherlock and Wagstaff (2019), social comparison is a mediating factor in the correlation between Instagram use and self-esteem, which could be a contributing factor in undesirable appearance related self-perception. In relation to this are the findings of a negative correlation between appearance anxiety and psychological flexibility (Shepherd et al., 2019) and the possible use of ACT as treatment for those with high appearance anxiety (Shepherd et al., 2020). For this study, the concept of appearance anxiety is highly intriguing in the context of Instagram as it is an image based and “superficial” online platform, in the sense that it is known to be very focused on the sharing and consumption of “ideal” bodies. In combination with this, testing participant psychological flexibility could help provide
information on a possible treatment style for appearance anxiety related to Instagram use as it is one of the key elements in ACT (Shepherd et al., 2019).
These concepts have been combined in hopes to continue the research being done on Instagram and all its implications, which leads to the final proposed research question: What relationship does Instagram use, appearance anxiety, and psychological flexibility have?
The main objective of this research study stems from the latter, to find more
information on whether the intensity of an adult’s Instagram use, and their passive or active use style tendencies, affects their appearance anxiety and if their psychological flexibility is correlated with this. In accordance with this, there are 7 specific objectives:
1. To assess the intensity of Instagram use among the adult population.
2. To assess whether adults tend to use Instagram more passively or actively.
3. To assess the level of appearance anxiety among the adult population.
4. To assess the level of psychological flexibility among the adult population.
5. To observe possible correlations between the adult population’s Instagram use, appearance anxiety, and psychological flexibility.
6. To associate the results with specific demographic variables including age, gender, and education.
7. To assess possible differences between those who do and do not use Instagram.
The following are the three hypotheses proposed to assess the relationship between Instagram use, appearance anxiety, and psychological flexibility:
Hypothesis 1: Adults who use Instagram more intensely and actively have a higher
appearance anxiety.
Hypothesis 2: Adults with a higher appearance anxiety have a lower psychological
flexibility.
Hypothesis 3: Adults who use Instagram more intensely and actively have a lower psychological flexibility.
Method Participants
The participants were recruited through a convenience sample, and each were
prompted to voluntarily share the survey link with those they are in contact with, as well. The inclusion criterion comprised of being 18 years old or above and literate in the English language. On the other hand, the participants were not required to be Instagram users. The goal number of participants for this study was between 100 and 150 people. After the data collection, a total of 157 participants completed the Google Form, 14 of which were excluded from the data analysis, meaning that 143 responses were valid and analyzed. The exclusions were mostly due to the lack of replies to the following open questions within the Instagram Intensity Scale: “7. Approximately how many TOTAL Instagram followers do you have?”
and “8. In the past week, on average, approximately how much time PER DAY have you spent actively using Instagram?”. There was also one exclusion due to being under 18-years- old.
There are a total of 104 women (73%), 38 men (27%), and 1 non-binary (<1%). The ages range from 18 to 80 (M = 42, SD = 13.94) with most participants in the 45 to 54 age group. The number of participants per age group are as follows: 25 between 18-24 years old, 24 between 25-34, 15 between 35-44, 64 between 45-54, 11 between 55-64, and 4 that were 65 or above. The number of participants with each level of education are as follows: 13 with a High School diploma or equivalent, 7 with trade/technical/vocational training, 7 with an associate degree, 63 with a bachelor's degree, 50 with a master's degree, and 3 with “other”.
There were 17 participants that did not have an Instagram.
Materials
The following are the tools that were used to measure each factor of this study, mentioned in the order they were presented within the Google Form:
Appearance Anxiety Measure. Appearance anxiety was tested using the Appearance Anxiety Inventory (AAI). This 10-item test is widely used to assess characteristics specific to Body Dysmorphic Disorder (BDD) like in the persons behavior and cognitive processes (Roberts et al., 2018). The structure of the test was first evaluated by Veale and colleagues (2013) where a convergent validity and good test-retest reliability was found. For those in the clinical group, there seemed to be two factors including avoidance and threat monitoring.
Although, it was found to have a one-factor structure in the community sample, like the sample found in this study. Roberts and colleagues (2018) conducted two studies to assess the AAI further. In the first study, it showed a good reliability with some indications that the item stating “I check my appearance (e.g., in mirrors, by touching with my fingers, or by taking photos of myself)” should be excluded. In the second study, the results for the 9-item and 10- item measure were compared. There was a great convergent validity found for the 9-item version when checking for BDD symptoms and rejection sensitivity based on the appearance.
Overall, it was explained that the decision to use either version comes down to the purpose of the research. For this study, the 10-item version was applied. Some other items included in this test are: “I am focused on how I feel I look, rather than on my surroundings” and “I try to camouflage or alter aspects of my appearance”.
Psychological Flexibility Measure. Psychological flexibility was tested through the Acceptance and Action Questionnaire (AAQ-II), a 7-item measure which has been found to have an evident external validity, internal consistency, and factor structure (Ruiz et al., 2013).
This self-report measure assesses experiential avoidance, a concept primarily used in Acceptance and Commitment Therapy (ACT) (Fledderus et al., 2012). This refers to the tendency to avoid or suppress aversive internal experiences, like thoughts, memories, and emotions (Gámez et al., 2011). Some examples of the phrases mentioned in the questionnaire
include “My painful experiences and memories make it difficult for me to live a life that I would value”, “I’m afraid of my feelings”, and “Worries get in the way of my success”.
Instagram Use Measures. Instagram use was tested through two separate tests including the Instagram Intensity Scale (IIS) and the Passive and Active Use Measure (PAUM). The intensity of Instagram use comes from an adaptation created by Trifiro and Prena (2021) of the Facebook Intensity scale by Ellison and colleagues (2007). This 8-item scale is used to review Instagram functions in the place of Facebooks’. In the adapted version, the participants behavior on Instagram is assessed through a Likert-scale self-report focused on their emotional connection to the platform (Trifiro & Prena, 2021). Some
examples of the items within the scale include “Instagram is part of my everyday activity”
and “I would be sorry if Instagram shut down”. Secondly, the PAUM was used to assess the participants style of Instagram use, being either active or passive. This 10-item scale has shown discriminant validity and an adequate amount of internal reliability (Gerson et al., 2017). Some examples of the items found in this measure include “Sending direct messages to others” and “Viewing photos”.
Procedure
This study was conducted with the use of the Google Form platform. The use of Google Form was chosen to create easy access to the survey on phones and computers, user friendly completion, and direct sharing among all participants. The latter was an important feature as the link to the survey was shared to the researchers WhatsApp contacts and
Instagram followers and the message sent included a request that prompted the participants to voluntarily share it with their contacts and/or followers, as well. This method of sharing allowed for higher participant rates as the convenience sample was extended through each participant found by the researcher. All the official measures were exactly transcribed onto one Google Form survey, separated into sections. Additionally, all participants were told that
the survey concerns the assessment of the relationship between Instagram use, appearance anxiety, and psychological flexibility and that it would take around 10 minutes to complete.
First and foremost, each participant was required to sign an informed consent form.
Only those who consented were allowed to enter the following sections of the survey. Those who consented were considered to be literate in the English language. After signing
anonymously, the participants were asked to share their age, gender, and education level for sociodemographic variable collection before entering the testing portion of the survey. In the testing portion, there were four sections, one for each of the tests the participants were required to complete. Every participant completed the AAI and the AAQ-II. After this, there was a short question included which allowed the participants to indicate whether they had an Instagram account or not. Those who answered “Yes” continued to complete the IIS and PAUM and were considered as participants that use Instagram. Furthermore, those who answered “No” ended the testing and were considered as participants that do not use Instagram. At the beginning and end of the Google Form, a short message containing the email of the researcher was included to ensure that any questions or doubts would be answered, if needed.
Data Analysis
The data collected was analyzed using JASP, an open-source statistical analysis program. Both a descriptive and correlational analysis were conducted. In order to test the three hypotheses, an alpha, or α, of 0.05 was used to ensure significance. If the p-value is equal to or less than α = 0.05, the correlation was considered statistically significant. The correlation coefficient Pearson’s r was also analyzed where at least a 0.2 is needed to show a weak correlation, 0.5 for a moderate correlation, and 0.8 for a strong correlation. All
participants scores were considered for the AAI and AAQ-II. Only Instagram users scores
were considered for the IIS and PAUM. Results pertaining to only one group or the other, meaning only Instagram users or only non-Instagram users, is specified.
Appearance Anxiety Inventory (AAI). The scores for the AAI are found by
summing the answer to each of the 10 items. The answers are labeled as follows: “Not at all”
as 0, “A little” as 1, “Often” as 2, “A lot” as 3, and “All the time” as 4 (Appendix B). The two subscales, including avoidance and threat monitoring, were not assessed as suggested for a community sample. The cutoff score, which is indicative of being at higher risk for clinical problems, is 20. The total scores ranged from 0 to 40 (M = 8.90, SD = 7.57). There were 14 participants that surpassed the cutoff score.
Acceptance and Action Questionnaire (AAQ-II). The scores for the AAQ-II are found by summing the responses for each of the 7 items. The higher the total score, the less psychological flexibility the participant has. The answers are labeled as follows: “Never true”
as 1, “Very seldom true” as 2, “Seldom true” as 3, “Sometimes true” as 4, “Frequently true”
as 5, “Almost always true” as 6, and “Always true” as 7 (Appendix C). It is important to note that, although this test does not normally use a cutoff, scores above 24 have been associated with other measures indicative of depression and anxiety (Bond et al., 2011; Hayes et al., 2004). The total scores ranged from 7 to 49 (M = 17.27, SD = 9.37). There were 38 participants that surpassed the cutoff score.
Instagram Intensity Scale (IIS). The scores for the IIS are found by calculating the average of all the 8 items. Although, before doing so, the log of the answers for 7 and 8 must be calculated. The answers are labeled as follows: “Strongly disagree” as 1, “Disagree” as 2,
“Neutral” as 3, “Agree” as 4, and “Strongly agree” as 5 (Appendix D). The total scores ranged from 0.75 to 4.27 (M = 2.48, SD = 0.81). In response to question 7 of the scale, the average number of followers indicated were 615 (SD = 844). In response to question 8, the average number of minutes the participants spent on Instagram per day were 51 (SD = 46).
Passive and Active Use Measure (PAUM). The scores for the PAUM are divided into two subscales: active and passive. To obtain the active score, items 1, 2, 3, 7, and 9 are summed. To obtain the passive score, items 4, 5, 6, 8, and 10 are summed. Each answer is labeled as follows: “Never” as 1, “Rarely” as 2, “Sometimes” as 3, “Somewhat frequently” as 4, and “Very frequently” as 5 (Appendix E). Those participants who scored higher on the active subscale than the passive subscale were considered to use Instagram more actively, and vice versa. Those who obtained the same score on both were considered to use Instagram equally in both ways. In the active subscale, the total scores ranged from 5 to 24 (M = 11.30, SD = 3.52). In the passive subscale, the total scores ranged from 5 to 24 (M = 15.50, SD = 4.20). Out of the 126 participants who indicated having an Instagram, there were 99 (~79%) in the passive subscale, 15 (~12%) who scored higher in the active subscale, and 12 (~9%) who scored equally in both.
Results
A total of 143 responses were analyzed. First, a descriptive analysis was conducted regarding possible differences between those who indicated they had an Instagram account and those who did not. There were 126 participants who had an Instagram account. The average age of this group is about 42 years old (SD = 14, Minimum = 18, Maximum = 80).
The number of participants per each gender are as follows: 98 women, 27 men, and 1 non- binary. The number of participants with each education level are as follows: 10 with a High School diploma or equivalent, 6 with trade/technical/vocational training, 7 with an associate degree, 57 with a bachelor's degree, 43 with a master's degree, and 3 with other. The average score was 9.34 on the AAI and 17.397 on the AAQ-II. Out of these participants, 13 people passed the cutoff score for the AAI and 35 people passed the cutoff score for the AAQ-II.
The mean score on the Instagram use tests are as follows: 2.48 on the IIS, 11.31 on the PAUM Active subscale, and 15.50 on the PAUM Passive subscale. Table 1 shows the
descriptive analysis for the education levels of the participants. Table 2 shows the descriptive analysis for the age and test scores.
Table 1
Instagram Users Frequencies for Education
Education Frequency Percent Valid Percent Cumulative Percent High School diploma or equivalent 10 7.937 7.937 7.937 Trade/technical/vocational training 6 4.762 4.762 12.698
Associate degree 7 5.556 5.556 18.254
Bachelor's degree 57 45.238 45.238 63.492
Master's degree 43 34.127 34.127 97.619
Other 3 2.381 2.381 100.000
Missing 0 0.000
Total 126 100.000
Note. This is a descriptive analysis for the education levels of those with an Instagram.
Table 2
Instagram Users Descriptive Statistics
Age AAI AAQ-II IIS PAUM Active PAUM Passive
Valid 126 126 126 126 126 126
Missing 0 0 0 0 0 0
Mean 41.198 9.349 17.397 2.484 11.310 15.508 Std. Deviation 14.085 7.727 9.498 0.816 3.522 4.210 Minimum 18.000 0.000 7.000 0.750 5.000 5.000 Maximum 80.000 40.000 49.000 4.270 24.000 24.000 Note. This is a descriptive analysis of the age and test scores of those with an Instagram.
There were 17 participants who indicated they did not have an Instagram account.
They had an average age of about 47 years old (SD = 11.86, Minimum = 26, Maximum = 63). The number of participants per each gender are as follows: 6 women and 11 men. The number of participants with each education level are as follows: 3 with a High School diploma or equivalent, 1 with trade/technical/vocational training, 6 with a bachelor's degree, and 7 with a master's degree. The average score on the AAI was 5.58 and 16.35 on the AAQ-
II. Only one person passed the cutoff score for the AAI and three passed the cutoff score on the AAQ-II. Table 3 shows the descriptive analysis for the education levels of the
participants. Table 4 shows the descriptive analysis for the age and test scores.
Table 3
Non-Instagram Users Frequencies for Education
Education Frequency Percent Valid Percent Cumulative Percent High School diploma or equivalent 3 17.647 17.647 17.647 Trade/techincal/vocational training 1 5.882 5.882 23.529
Bachelor's degree 6 35.294 35.294 58.824
Master's degree 7 41.176 41.176 100.000
Missing 0 0.000
Total 17 100.000
Note. This is a descriptive analysis for the education levels of those without an Instagram.
Table 4
Non-Instagram Users Descriptive Statistics
Age AAI AAQ-II
Valid 17 17 17
Missing 0 0 0
Mean 47.235 5.588 16.353
Std. Deviation 11.861 5.339 8.573
Minimum 26.000 0.000 7.000
Maximum 63.000 21.000 33.000
Note. This is a descriptive analysis of the age and test scores of those without an Instagram.
Next, a correlational analysis was conducted in order to test the hypotheses. As
mentioned, an α of 0.05 was used to ensure significance as well as at least a Pearson’s r of 0.2 to show a weak correlation. As seen on Table 5, there was a statistically significant,
moderately positive correlation between active Instagram use and intensity of use with a p- value of <.001 and Pearson’s r of 0.512. This is aligned with the findings by Trifiro and Prena (2021). Furthermore, it seems that there is an even stronger positive correlation
between passive Instagram use and intensity of use with a p-value of <.001 and Pearson’s r of 0.607.
Table 5
Instagram Use Pearson's Correlations
Variable IIS PAUM Active PAUM Passive
1. IIS Pearson's r —
p-value —
2. PAUM Active Pearson's r 0.512 *** —
p-value < .001 —
3. PAUM Passive Pearson's r 0.607 *** 0.480 *** —
p-value < .001 < .001 —
* p < .05, ** p < .01, *** p < .001
Note. Here are the correlations between the scores for the IIS and both subscales of the PAUM.
Regarding Hypothesis 1, adults who use Instagram more intensely and actively have a higher appearance anxiety: this was partially supported. A weakly positive correlation
between intensity of use and appearance anxiety was found with p-value of 0.001 and Pearson’s r of 0.266. Although, there was no correlation found between active use and appearance anxiety with Pearson’s r of 0.148 and p-value of 0.098, as seen on Table 6.
Table 6
Hypothesis 1 Correlation Table
Variable AAI IIS PAUM Active
1. AAI Pearson's r —
p-value —
2. IIS Pearson's r 0.266 ** —
p-value 0.003 —
3. PAUM Active Pearson's r 0.148 0.512 *** —
p-value 0.098 < .001 —
* p < .05, ** p < .01, *** p < .001
Note. Here are the correlations between the scores for the AAI, IIS, and the active subscale of the PAUM. All tests one-tailed, for positive correlation.
Regarding Hypothesis 2, adults with a higher appearance anxiety have a lower psychological flexibility: this was not supported. Interestingly, a moderately positive correlation was found with Pearson’s r of 0.645 and p-value of <.001, as seen on Table 7.
Table 7
Hypothesis 2 Correlation Table
Variable AAI AAQ-II
1. AAI Pearson's r —
p-value —
2. AAQ-II Pearson's r 0.654 *** —
p-value < .001 —
* p < .05, ** p < .01, *** p < .001
Note. Here are the correlations between the score for the AAI and AAQ-II for Instagram users.
Regarding Hypothesis 3, adults who use Instagram more intensely and actively have a lower psychological flexibility: this was not supported. Firstly, Instagram use intensity was not correlated with psychological flexibility with Pearson’s r of 0.193 and p-value of 0.03.
Secondly, active Instagram use and psychological flexibility were not correlated with Pearson’s r of 0.077 and p-value of 0.392, as seen on Table 8.
Table 8
Hypothesis 3 Correlation Table
Variable AAQ-II IIS PAUM Active
1. AAQ-II Pearson's r —
p-value —
2. IIS Pearson's r 0.193 * —
p-value 0.030 —
Hypothesis 3 Correlation Table
Variable AAQ-II IIS PAUM Active
3. PAUM Active Pearson's r 0.077 0.512 *** —
p-value 0.392 < .001 —
* p < .05, ** p < .01, *** p < .001
Note. Here are the correlations between the scores for the AAQ-II, IIS, and the active subscale for the PAUM.
Moreover, another correlational analysis was conducted between Instagram use, appearance anxiety, psychological flexibility, and each of the three demographic variables including age, gender, and education. Starting with the AAI scores and the demographic variables of all participants, on Table 9, there is represented a weak negative correlation between age and appearance anxiety with Pearson’s r of -0.367 and p-value of <.001, as well as with education with Pearson’s r of -0.256 and p-value of 0.002.
Table 9
AAI and Demographic variables Correlation Table
Variable Age Gender Education AAI
AAI Pearson's r -0.367 *** -0.158 -0.256 ** —
p-value < .001 0.059 0.002 —
* p < .05, ** p < .01, *** p < .001
Note. Correlational analysis between AAI scores and age, gender, and education of all participants.
On Table 10, there can be seen an almost moderate negative correlation between psychological flexibility and age with Pearson’s r of -0.496 and p-value of <.001. There is also a weak negative correlation with education with Pearson’s r of -0.277 and p-value of
<.001.
Table 10
AAQ-II and Demographic variables Correlation Table
Variable Age Gender Education
AAQ-II Pearson's r -0.496 *** 0.013 -0.277 ***
p-value < .001 0.877 < .001 Spearman's rho -0.418 *** 0.007 -0.219 **
p-value < .001 0.934 0.009
* p < .05, ** p < .01, *** p < .001
Note. Correlational analysis between AAQ-II scores and age, gender, and education of all participants.
On Table 11, there can be seen a weak negative correlation between passive Instagram use and age with Pearson’s r of -0.333 and p-value of <.001. There is no
correlation found between the active subscale and the three demographic variables. Finally, there were no correlations found between the IIS and the three demographic variables. This analysis was done only on the 126 participants who use Instagram.
Table 11
Note. Correlational analysis between Passive and Active Use Measure (PAUM) scores and age, gender, and education for those who use Instagram.
Discussion
In this study, the concepts of Instagram use, appearance anxiety, and psychological flexibility were combined in hopes of continuing the important search of the implications that PAUM and Demographic Variables Correlation Table
Variable Age Gender Education
4. PAUM Active Pearson's r 0.013 -0.144 0.023
p-value 0.884 0.108 0.799
5. PAUM Passive Pearson's r -0.333 *** 0.148 -0.125
p-value < .001 0.099 0.163
* p < .05, ** p < .01, *** p < .001
image-based applications like Instagram have on its users. As seen in the results, Hypothesis 1 was partially supported and Hypotheses 2 and 3 were not supported. Despite this, there were important findings regarding the relationship between the three main concepts.
In line with the previous literature (Trifiro & Prena, 2021), there was a moderate correlation between active Instagram use and intensity of use. Nevertheless, the correlation between intensity and passive use was stronger. In continuation, Hypothesis 1 was partially supported with a weak correlation found between Instagram intensity and appearance anxiety.
The explanation for this may be that the more integrated Instagram is in an individual’s life, if the content being consumed has a negative effect on the view of one’s appearance, then the anxiety and preoccupation regarding this is increased.
Next, Hypothesis 2 was not supported, but, instead, a moderately positive correlation between appearance anxiety and psychological flexibility was found. Contrary to the
investigation referenced in the literature (Shepherd et al., 2019), the correlation found between appearance anxiety and psychological flexibility in this study had a moderate positive correlation instead of a negative correlation. This result may have been affected by the sample, given it was a convenience sample. But, considering this as an accurate result, it would mean that those individuals with a high tendency to feel distress over their appearance would generally have the ability to respond to life scenarios in a way that helps them reach their goals. Seeing as this doesn’t sound quite right, and it does not connect with the previous literature, it would be good to find a larger and random sample group to test these concepts together.
Aside from the findings of this study, it is important to mention that there are three main limitations that should be considered. The first having to do with the sample of the study. The manner in which participants were found may have created bias in the results. As explained, they were contacted through WhatsApp and Instagram. This may have caused a
bias in the results as those who saw the Instagram post undoubtably use the platform and those on WhatsApp use social media. Not to mention that those who entered the Google Form through Instagram may have a bias toward using the platform actively. Furthermore, it would have been interesting to be in contact with participants who do not use social media to possibly see a larger difference in their results to the AAI and AAQ-II. Moreover, 73% of the participants were women. This may have tipped the results a certain direction as the social context of this gender can tend to be quite different than men and others. Along with this is also the fact that 64 (~45%) of the participants were between the ages of 45 and 54.
Secondly, there was a large discrepancy found between the scores calculated on the Instagram Intensity Scale and those in the previous literature by Trifiro and Prena (2021).
The directions indicated for this test were followed, including the necessity to take the log of the answers to items 7 and 8 before averaging all of the items together. The scores on the previous literature (Trifiro & Prena, 2021) were between 8 and 44 whereas on this study scores were between 0.75 and 4.27. When taking the information provided on the work of Trifiro and Prena (2021), an average of 400 followers and 60 minutes per day, the highest possible score would be 30 (strongly agree = 5 on all items), plus 2.6 (log of 400), and 1.7 (log of 60) at 34.3, divided by 8 is a score of 4.28. There were no indications about the reasoning for the scores in the study. Although the directions were followed correctly in this study, this discrepancy should be noted when comparing results across studies.
Thirdly, when reviewing the scores for the PAUM, it became apparent that Instagram users may interact with the platform actively, passively, or in both ways. After review, it is clear that it would have been more accurate to use a measure that allows for proper separation of participant use styles, or a proper assessment of the use in general. No measure like this was found or seemingly available at the time this study was conducted, but for future reference this should be duly noted.
In conclusion, there are four main future recommendations. The first is regarding the test used to measure appearance anxiety. The Appearance Anxiety Inventory (AAI) was not chosen due to being the best measure available for its purpose. Unfortunately, it was chosen due to lack of availability of the short version of the Derriford Appearance Scale (DAS24).
This is an adaptation of the full version of the Derriford Appearance Scale (DAS59) which was created to test psychosocial adjustment and psychological distress in those with issues in their appearance, whether due to deformities or aesthetics. It has also been successfully used in the general population on those who do not have specific appearance issues (Cogliandro, et al., 2016; Harris & Carr, 2001). The DAS24 assesses this appearance related distress in a reliable and valid manner in both clinical and general populations whether they have
concerns over their appearance or not (Moss, 2005). The DAS24 was unable to be used as it can only be purchased by professionals with specific criteria. For future research, this measure is recommended. Due to this scenario, it is possible that the more concentrated contents of the AAI were directed toward a more specific population whereas the DAS24 has a wider variety of contents. This may have biased the results and should be noted as a
limitation.
The second recommendation is to conduct a regression analysis. This could add useful information on the relationship between the three main variables of Instagram use,
appearance anxiety, and psychological flexibility. It would be interesting to see an estimate of the effects of the covariates on the dependent variable. For example, an analysis of the AAI scores as the dependent variable with covariates of AAQ-II, IIS, and PAUM scores. With the modification of the limitations and use of the other recommendations, a study like this one could show additional important results in this relationship and analysis.
The third recommendation is to add some data collection regarding the content being consumed or created by the participant during the Instagram use. This would be to test how
differing content may affect the individual’s appearance anxiety, not only in connection to the intensity or style of the use. And, lastly, it is recommended to find a larger and randomized sample to avoid further bias in the results.
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Appendix A Informed Consent Model
The following is the information that was included in the informed consent portion within the Google Form:
I declare that I have read and understood the information sheet that has been given to me; the characteristics and the objective of the study have been explained to me, as well as the possible benefits and risks of the same. I have had the time and opportunity to ask questions and raise any concerns that I had. All questions were answered to my satisfaction.
I understand that my participation is completely voluntary, that I can withdraw from the study at any time without having to give explanations and without this having an impact on future participations.
I freely give my consent to participate in the Research Project of the Final Year Degree Project entitled “Examining the Relationship Between Instagram Use, Appearance Anxiety, and Psychological Flexibility”, carried out by Ariana Markowitz, a student at the European University of Madrid.
I have also been informed that the confidentiality of my data will be maintained and that these will be protected and included in a file that must be subject to and with the
guarantees of the General Data Protection Regulation (RGPD), which came into force on the 25th May 2018, which supposes the repeal of Organic Law 15/1999, of December 13, referring to the protection of natural persons with regard to the processing of personal data.
Taking this into consideration, I GIVE my CONSENT to cover the objectives specified in the project.
Option 1: Yes, I give my consent.
Option 2: No, I do not give my consent.
Appendix B
Appearance Anxiety Inventory (AAI)
Instructions: Please check the box that best describes the way you have felt about your appearance or a specific feature OVER THE PAST WEEK, INCLUDING TODAY.
1. I compare aspects of my appearance to others.
2. I check my appearance (e.g., in mirrors, by touching with my fingers, or by taking photos of myself).
3. I avoid situations or people because of my appearance.
4. I brood about past events or reasons to explain why I look the way I do.
5. I THINK about how to camouflage or alter my appearance.
6. I am focused on how I feel I look, rather than on my surroundings.
7. I avoid reflective surfaces, photos, or videos of myself.
8. I discuss my appearance with others or question them about it.
9. I try to camouflage or alter aspects of my appearance.
10. I try to prevent people from seeing aspects of my appearance within particular situations (e.g., by changing my posture, avoiding bright lights).
Responses: 0 = Not at all, 1 = A little, 2 = Often, 3 = A lot, 4 = All the time
Appendix C
Acceptance and Action Questionnaire (AAQ-II)
Instructions: Below you will find a list of statements. Please rate how true each statement is for you by selecting a number next to it. Use the scale below to make your choice.
1. My painful experiences and memories make it difficult for me to live a life that I would value.
2. I’m afraid of my feelings.
3. I worry about not being able to control my worries and feelings.
4. My painful memories prevent me from having a fulfilling life.
5. Emotions cause problems in my life.
6. It seems like most people are handling their lives better than I am.
7. Worries get in the way of my success.
Responses: 1 = Never true, 2 = Very seldom true, 3 = Seldom true, 4 = Sometimes true, 5 = Frequently true, 6 = Almost always true, 7 = Always true
Appendix D Instagram Intensity Scale
Instructions: The Instagram Intensity scale is used to measure Instagram usage beyond simple measures of frequency and duration, incorporating emotional connectedness to the site and its integration into individuals’ daily activities.
1. Instagram is part of my everyday activity 2. I am proud to tell people I'm on Instagram 3. Instagram has become part of my daily routine
4. I feel out of touch when I haven't logged onto Instagram for a while 5. I feel I am part of the Instagram community
6. I would be sorry if Instagram shut down
7. Approximately how many TOTAL Instagram followers do you have?
8. In the past week, on average, approximately how much time PER DAY have you spent actively using Instagram?
Responses: range from 1 = strongly disagree to 5 = strongly agree
Appendix E
Passive and Active Use Measure (PAUM)
Instructions: How frequently do you perform the following activities when you are on Instagram? (Note: Choosing “Very Frequently” means that about 100% of the time that you log on to Instagram, you perform that activity).
1. Posting photos to your profile 2. Commenting on other users’ photos 3. Sending direct messages to other users 4. Checking to see what someone else is up to 5. Viewing photos
6. Viewing videos
7. Tagging other users in videos
8. Browsing the newsfeed passively (without liking or commenting on anything) 9. Browsing the newsfeed actively (liking and commenting on other users’ posts) 10. Looking through my friends’ posts
Responses: 1 = Never (0%), 2 = Rarely (25%), 3 = Sometimes (50%), 4 = Somewhat frequently (75%), 5 = Very frequently (100%)
