Greene, A.K. & Norling, H. (2023). “‘Follow to *actually* heal binge eating’: A mixed methods textual content analysis of #bedrecovery on TikTok.” Eating Behaviors. Advanced online publication. DOI: 10.1016/j.eatbeh.2023.101793

Binge eating disorder (BED) has been relatively overlooked in research on eating disorders and social media. Existing literature suggests that time spent on social media may be associated with increased binge eating. However, more granular details of social media experiences such as the consumption of pro-recovery content have not received sufficient scholarly attention. The present study begins to address this gap through analysis of 1074 captions from public posts on TikTok, a video-based social media platform, tagged with #BEDrecovery between July 2021-2022. We generated six themes by examining word frequencies in the data and engaging in reflexive categorization of commonly used words within the context of different posts. These themes were: (1) diets and eating approaches, (2) help and support, (3) mental health, (4) diet culture critique, (5) body monitoring, and (6) fitness. To understand which videos in the BED recovery community had the broadest reach, we also examined how themes were associated with user engagement - concretely, the number plays (times the post was watched) and shares (times users shared a link to the post with other TikTok users). Notably, we found that the number of shares was significantly lower in posts that included diet culture critique than in those that did not. By contrast plays and shares were higher in posts with body monitoring than in those without. Our findings suggest that highly engaged with #BEDrecovery TikTok content may include the promotion of diet culture and potentially create an unproductive environment for individuals seeking BED recovery support.

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Greene, A.K., Norling, H., Brownstone, L.M., Maloul, E., Moody, S., & Roe, C. (2023). “Visions of recovery: A cross-diagnostic examination of eating disorder pro-recovery communities on TikTok.” Journal of Eating Disorders. 11(109): 1-19. DOI: 10.1186/s40337-023-00827-7

Individuals seeking support or inspiration for eating disorder recovery may turn to pro-recovery content on social media sites such as TikTok. While research has thus far treated pro-recovery social media as a fairly homogeneous space, many pro-recovery hashtags single out particular eating disorder diagnoses. This exploratory study used codebook thematic analysis of 241 popular pro-recovery videos on TikTok to compare the presentation of eating disorders and eating disorder recovery across five different diagnosis-specific hashtags: #anarecovery, #arfidrecovery, #bedrecovery, #miarecovery, and #orthorexiarecovery. These hashtags refer to the following eating disorder diagnoses respectively: anorexia nervosa, avoidant restrictive food intake disorder, binge eating disorder, bulimia nervosa, and orthorexia nervosa. Our analysis generated the following qualitative themes across the entire dataset: (1) centrality of food to eating disorders and recovery, (2) what eating disorders look and feel like, (3) recovery as a process, (4) getting and giving help, and (5) negotiating diet culture in recovery. To supplement our qualitative findings and facilitate cross-diagnostic comparisons, we also conducted one-way ANOVAs and chi-square tests to probe for statistically significant differences in audience engagement and code prevalence across the different hashtags. Our results indicate that there are clear differences in how recovery is envisioned on TikTok based on which diagnostic hashtags are employed. Such variations in how different eating disorders are imagined on popular social media demand further investigation and clinical consideration.

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Greene, A.K., Maloul, E., Norling, H., Palazzolo, L.P., & Brownstone, L.M. (2023). “Systems and Selves: An exploratory examination of dissociative identity disorder on TikTok.” Qualitative Psychology. Advance online publication. DOI:10.1037/qup0000248

In 2020, in the midst of COVID-19 related social distancing, the relatively new social media platform, TikTok, burgeoned in popularity. One somewhat surprising topic area that rose to prominence on the platform during this time was dissociative identity disorder (DID). Some researchers and clinicians expressed concern that the proliferation of DID content on the platform may have contributed to a marked increase in individuals presenting with DID and related symptoms. However, given that the relationship between DID and the media has historically been fraught with skepticism, as well as recent work by Christensen (2022) highlighting the development of Plural cultures online, it is critical to better understand DID on TikTok before passing such judgements. This study presents the first examination of the DID TikTok community through a descriptive analysis of 325 user signatures. Using a combination of qualitative codebook thematic analysis and quantitative content analysis, this project maps the contours of the community and centers the creative identity work that individuals within this community appear to undertake. We identified the following three themes within this sample of signatures: (a) Describing DID (with System Architectures, Diagnostic Authenticity, and Being Plural as subthemes), (b) Establishing Boundaries, and (c) Labeling Intersecting Identities. In addition to providing insights into DID TikTok, this study offers a methodological contribution by modeling one way of scaling rigorous qualitative analysis for social media platforms by using quantitative content analysis to complement qualitative methods.

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Hunsicker, M., Maloul, E., Greene, A.K., Gilady, D., & Brownstone, L.M. (2023) “Filling a Gap: Virtual Clinician-Led Support Groups for Disordered Eating.” Counselling Psychology Quarterly. Advance online publication. DOI: 10.1080/09515070.2023.2192461

For people with disordered eating, support groups can play an important role in treatment and recovery journeys. Such resources became crucial during COVID-19, as people with disordered eating reported increased isolation, symptomology, and decreased treatment access. This study examines participants’ experiences of nine, rolling, clinician-led, free, virtual support groups for disordered eating. Participants (207 attenders and 70 nonattenders (individuals who signed up for groups and never attended)) completed an online survey. Codebook thematic analysis of open response items generated topics and themes including: reasons for signing up (“community connection and seeking support,” “filling a treatment gap,” “behavior and support changes due to COVID-19”), barriers to participation (“interpersonal dynamics,” “accessibility factors,” “group structure”), and benefits of attending group (“feeling less alone,” “identifying new treatment needs,” “coping skills and reduction of symptoms”). Participants discussed lack of accessible, identity-aware treatment options outside of these groups, particularly for those with minoritized identities. This paper highlights the role of groups in participants’ eating disorder recoveries and explores how virtual clinician-led support groups fit into the constellation of eating disorder care that increasingly includes virtual resources. Group psychotherapy specialists could consider bringing skills to facilitate spaces for community-based healing to complement conventional treatment approaches.

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Greene, A. K., Carr, S., & Jia, H. 2022. "Tech, Sex, and E-cigarettes: The gendered promotion of vaping on Instagram." Journal of Health Communication. DOI: 10.1080/10810730.2022.2150336

The promotion of vape products on social media has been implicated in increasing rates of e-cigarette usage, particularly among youth and young adults. While research has examined overall trends in vape-related content across a number of platforms, the role that social media “influencers” play in promoting vaping and potentially augmenting this public health crisis has been insufficiently explored. The present study examined 44,052 Instagram posts by 60 male presenting and 60 female presenting vape influencers to understand how influencer gender mediates the performance of vape culture online. Our textual and visual analysis of these influencers’ posts over one year revealed significant bifurcations based on gender. Independent sample t-tests showed statistically significant gender differences in word frequency. Male-presenting influencers tended to emphasize their expertise with vape devices as technologies, while female-presenting influencers tended to focus on their own appearance. Further, factor analysis indicated six major categories of textual features, and multiple linear regression tests showed varying levels of user engagement with the different categories across both genders. Chi-square tests indicated that female-presenting influencers highlighted their own bodies in the visual content of their posts, whereas male presenting influencers often posted images of vape devices or their component parts alone. These findings suggest that gender presentation plays an important role in shaping vape influencers’ promotional tactics and vape-related content on Instagram, and also provides insights into what kinds of content receive the most user engagement. This study can therefore help inform interventions to mitigate the impact of social media vape promotion.

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Greene, A. K. 2022. “Chronic Constellations: Instagrammatic Aesthetics of Crip Time.” The Routledge Handbook of Health and Media. 

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Greene, A. K., Brownstone, L.M., Kelly, D.A., Maloul, E., Norling, H.N., Rockholm, R.H., & Izaguirre, C.M. 2022. “Are people thinking I'm a vector…because I’m fat?”: Cisgender experiences of body, eating, and identity during COVID-19." Body Image.  https://doi.org/10.1016/j.bodyim.2022.01.002

While a range of studies have shown the negative impact of COVID-19 on disordered eating and body image, few have engaged with how identity and social context interact with these domains. The current study used inductive codebook thematic analysis to understand experiences of body and eating during the pandemic among a diverse (sub)clinical sample of individuals with self-reported disordered eating. We interviewed 31 cisgender participants (18/31 Black Indigenous People of Color (BIPOC), 24/31 women) with a history of disordered eating (diagnosed and undiagnosed). Five themes were identified: Body Surveillance and Dissatisfaction, Movement and Intake Fixation, Food Scarcity and Resource Concerns, Changes in Visibility of Body and Eating, and Bodies Are Vulnerable. We examined the extent to which themes pertained to certain identities over others. Notably, BIPOC, large-bodied, queer participants more commonly spoke to body vulnerability than White, small/medium-bodied, straight participants. BIPOC and large-bodied participants also particularly spoke to feeling relief from discrimination as social distancing and mask wearing reduced their public visibility. Participants related these themes to changed body and eating experiences that spanned distress and resilience. Our analysis offers insight into multifaceted and contextual impacts of COVID-19 on experiences of body, eating, and identity.

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Greene, A. K., Maloul, E., Kelly, D. A., Norling, H. N., & Brownstone, L. M. 2022. “'An Immaculate Keeper of My Social Media Feed': Social Media Usage in Body Justice Communities During the COVID-19 Pandemic." Social Media + Society.  https://doi.org/10.1177/20563051221077024

This article examines how individuals proximate to online body justice communities utilized and experienced social media during COVID-19.  The majority of research during the pandemic has been quantitative and survey-based; it has also tended to center (dis)information spread or mental health concerns.  Our qualitative interviews with 44 individuals offer nuanced insights into what social media meant to people during quarantine, how they used it, and how they reflected on their experience of it. Five major themes emerged through reflexive, thematic analysis of the interview data: changed temporal rhythms, influx of toxic content, resource building, additive and subtractive actions, and algorithmic awareness. Some participants described social media as an increasingly harmful influence in their lives during the pandemic due to compulsive usage and exposure to “toxic content” like misinformation, weight stigma, and homophobia. At the same time, participants noted how social media positively enabled social connection, education, and activation around social justice. Across both of these extremes, many elaborated on the intensive, self-reflective labor of cultivating their accounts so that they mirrored their identities and the kinds of experiences they wanted to have online, while preventing the infiltration of unwanted content.  In addition to offering new insights into social media usage in body justice communities during COVID-19, our data suggests alternative ways of understanding how individuals manage their experience of social media, curating their social media feeds through additive and subtractive actions and frequently reflecting on how their choices interact with platform algorithms.

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Greene, A. K. & Brownstone, L.M. 2021. “‘just a place to keep track of myself’: eating disorders, social media, and the quantified self” Feminist Media Studies. https://doi.org/10.1080/14680777.2021.1984272

In order to better understand the functional significance of pro-eating disorder (pro-ED) online spaces for users, the current study investigates identity performance as it plays out on pro-ED Tumblr and Instagram account bios. We used data scraping methodologies to illuminate key facets of pro-ED social media culture beyond thinspiration, and found that pro-ED Tumblr and Instagram bios commonly utilize self-tracking and self-quantification (e.g., selftracking data regarding exercise and food intake, lowest weight, current weight) to represent online personas. Drawing from this data, we suggest the importance of understanding pro-ED social media use as a mode of enacting eating disorder practices and articulating eating-disordered identities online. More specifically, we posit that self-quantification and self-tracking on social media can be seen as a way that individuals with eating disorders extend practices of self-containment and control online in a world that increasingly blends online and offline life. By understanding the multifaceted psychological functions of pro-ED social media use we can build more informed interventions aimed at minimizing individuals’ needs to engage in such spaces in the first place, which in turn might have a preventive impact.

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Brownstone, L. M., Kelly, D.A., Dinneen, J., Tiede, E., Maloul, E., & Greene, A.K. 2021. “‘It’s just not comfortable to exist in a body’: Transgender/Gender Non-Binary Individuals’ Experiences of Body and Eating Distress During the COVID-19 Pandemic.” Psychology of Sexual Orientation and Gender Diversity. https://doi.apa.org/fulltext/2021-82238-001.html

The collective trauma of COVID-19 has had a negative impact on people’s experiences of their bodies and eating, as demonstrated by studies showing increased disordered eating and body dissatisfaction during this time. The pandemic has also been shown to have had a unique and disproportionate impact on transgender and gender nonbinary (TGNB) individuals (e.g., lost gender affirming care access, elevated levels of job loss). Given that TGNB individuals already face increased risk of body distress and disordered eating compared to cisgender individuals in a nonpandemic context and have been disproportionately impacted by contextual changes with COVID-19, it is likely that the pandemic has had a distinct impact on TGNB individuals’ experiences of body and eating distress. The present study aims to understand these impacts through an inductive, reflexive thematic qualitative approach. Participants were 13 TGNB individuals (10/13 gender nonbinary/gender queer; 8/13 White). They completed semistructured audio interviews about their broad experiences of body and eating during COVID-19, as well as how they understood changes across domains of family, community, access to resources, and intersectional identities interacting with these experiences. Themes included (a) Losing Affirming Spaces and Security, (b) Gaining Affirming and Supportive Spaces Online, (c) Reflecting on Embodied Gender and Identities, (d) Realizing New Connections and Insights, and (e) Considering the Self in Social Context. Notably, each of these themes interacted with participants’ self-reported experiences of body and eating distress and, in some cases, healing. Our results illuminate risk and resilience factors and areas requiring innovation during and after COVID-19.

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Greene, A. K. 2021. “‘The Passing Hour’: 1930s Real-Time, Vile Bodies, and the Ethics of Reading.” Configurations 29.2.  https://doi.org/10.1353/con.2021.0009

Understanding real-time as an orientation toward the present and its documentation as opposed to a concrete (digitally determined) technological affordance, this article locates real-time in the burgeoning photographic tabloid culture of 1930s Britain. It traces how technical innovations in information transmission and circulation during the interwar years impacted the circuits between readers and their “real life” environment. Moreover, by engaging with Evelyn Waugh’s Vile Bodies (1930), a text strung between novel and tabloid supplement, it suggests how real-time’s newly habituated, melancholic modes of reading might push individuals to stand by in the face of individual pain and mass violence.

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Greene, A. K. and L.M. Brownstone. 2021. “Clinical Revulsion: Combatting weight stigma by confronting provider disgust.” Weight Bias in Health Education: Critical Perspectives for Pedagogy and Practice, Routledge Studies in the Sociology of Health and Illness.

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Greene, A. K. & Swann, J. 2021. “Codisciplinary Code-switching: bridging biology and the humanities during COVID-19.” Rhetoric of Health and Medicine. https://doi.org/10.5744/rhm.4006

This article describes an experimental, interdisciplinary course on the immune system that was co-taught by a humanist and a scientist, and that (inadvertently) coincided with the start of the COVID-19 crisis in the United States. We propose the term “codisciplinary code-switching” to capture the pedagogical strategy we developed in designing the course and adapting it over the semester to grapple with current events. We focus, in particular, on how this approach helped our students navigate the entanglement of science and society in the shifting, uncertain world of the pandemic. Although these were peculiar circumstances, codisciplinary code-switching has broader possibilities and points to alternative ways of integrating the humanities and sciences in medical education that respects both disciplines as rigorous tools for reading bodies, texts, and contexts.  

 

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Greene, A. K. 2020 “Biomarkers Can’t Bypass the ‘Mouth of a Wound.’” Perspectives in Biology and Medicine. 63.4: 602-615. https://muse.jhu.edu/article/775630

This article critiques the idealization of a biomarker-based “objective pain scale” in order to argue for increased investment in communication-centric approaches to chronic pain diagnosis and treatment. Although new technological advances and the rise of big data have revived old fantasies of objective pain measures, scholars have long affirmed the dangers of converting human experience into numbers, as well as the fundamental impossibility of reducing pain to physiology. Biomarkers can certainly be useful tools, but investments must also be made in fostering the “strong objectivity” that feminist scholars have advocated for and that the incorporation of narrative-driven initiatives can provide. Because expressing pain is notoriously difficult, doing this creative, communication-driven work well requires substantial effort, time, and training. Engaging with chronic pain from a feminist standpoint—one that affirms individuals’ situated experiences as valuable data and that attends to the rich multimodal vocabularies emerging on social media—can pave the way to a more equitable, ethical, and effective future of pain care.

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Greene, A. K. 2020. “Flaws in the Highlight Real: Fitstagram Diptychs and the Enactment of Cyborg Embodiment.” Feminist Theory. 10.1177/1464700120944794

This article inverts Donna Haraway’s proposition that “the ideologically charged question of what counts as daily activity, as experience, can be approached by exploiting the cyborg image”by instead exploiting everyday experience to approach the contemporary cyborg. It utilizes digital tools to compile a corpus of Instagram posts that foreground corporeal hybridity and examines this social media data through the lenses of feminist STS, affect theory, and digital studies. This strategy offers a new vantage on the cyborg by connecting it to concrete, ongoing user practices. To make these interventions, the article focuses specifically on a genre of post popularized by Instagram fitness (or fitstagram) influencers – diptych photographic montages that draw on the opposition between imperfectly real material bodies and unrealistically perfect media bodies. Although they formally rely on binary logics (real v. perfect, offline v. online), the posts simultaneously deconstruct them in a number of ways. These repeated boundary transgressions reflect users’ lived experiences of hybrid online/offline corporeality and help forward a theory of cyborg embodiment that relies on everyday practices as opposed to fixed products or identities. Moreover, close engagement with a final data set of 89 posts illuminates three particular modes of enacting the cyborg corpus on Instagram: occupation of multiple bodies, awareness of the analog body, and anxious boundary-work. This research extends the cyborg as a critical figure by situating it within a social media context, attending to its imbrication in ongoing everyday practices, and affirming female social media users as theorists of their cyborg selves.

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Greene, A. K. 2018 “Dismembering Remembering: Mourning with Disgust in Delbo’s Auschwitz and After.” Twentieth Century Literature 64.4: 483-503. 10.1215/0041462X-7298996

This essay argues that Charlotte Delbo’s deployment of disgust in her memoir Auschwitz and After challenges the ethics and possibilities of trauma representation.  As opposed to beautifying concentration camp victims through elegiac memorialization or by claiming the sublime unspeakability of the events, Delbo’s text dialogically oscillates between self-consciously aestheticized language and graphic physical representations of abject bodies. The irruptive visceral descriptions confront the reader with automatic, embodied repulsion in order to highlight the gaps in symbolization and the difficulties of witnessing. Yet as opposed to merely marking the limits of what can be witnessed, disgust offers an alternative, affective way of encountering the pain of others that still challenges the more soothing logic of mourning and meaning-making. It has a particular countermemorial capacity to preserve and communicate the embodied realities of the victims, if only through shudders of revulsion.

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Pearce, W., Ozkula, S., Greene, A.K., Teeling, L., Bansard, J., Joceli, J., & Rabello, E. 2018 “Visual cross-platform analysis: digital methods to research social media images.” Information, Communication, and Society. 10.1080/1369118X.2018.1486871

Analysis of social media using digital methods is a flourishing approach. However, the relatively easy availability of data collected via platform application programming interfaces has arguably led to the predominance of single-platform research of social media. Such research has also privileged the role of text in social media analysis, as a form of data that is more readily gathered and searchable than images. In this paper, we challenge both of these prevailing forms of social media research by outlining a methodology for visual cross-platform analysis (VCPA), defined as the study of still and moving images across two or more social media platforms. Our argument contains three steps. First, we argue that cross-platform analysis addresses a gap in research methods in that it acknowledges the interplay between a social phenomenon under investigation and the medium within which it is being researched, thus illuminating the different affordances and cultures of web platforms. Second, we build on the literature on multimodal communication and platform vernacular to provide a rationale for incorporating the visual into cross-platform analysis. Third, we reflect on an experimental cross-platform analysis of images within social media posts (n = 471,033) used to communicate climate change to advance different modes of macro- and meso-levels of analysis that are natively visual: image-text networks, image plots and composite images. We conclude by assessing the research pathways opened up by VCPA, delineating potential contributions to empirical research and theory and the potential impact on practitioners of social media communication.

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