Aim 1: changes in body image distress over time across the life span.
Of those young Australians (aged 16-25 years) who completed the 2009 ( headspace web-based Community Youth Survey), 2012 (Young and Well First National Survey on the web), or 2015 (Global Health and Wellbeing Survey) surveys, self-reported body image distress rose by 33% from 2009 to 2015 (419/949, 44.2% reported distress in 2009; 1158/1731, 66.89% in 2012; and 300/388, 77.32% in 2015). The mean difference was significant across both the 2009 and 2012 time points (2009 vs 2015: t 387 =15.56, P <.001; 2012 vs 2015: t 387 =4.90, P <.001).
Table 2 displays frequency statistics for measures of body image items, BMI, and current dieting status by age band and sex from the Global Health and Wellbeing Survey 2015. Significance tests comparing items across sex and age are presented in Multimedia Appendix 1 . Approximately half of all respondents (2806/5513, 50.89%) reported feeling very distressed or preoccupied with their body image. Women reported higher levels of distress related to body image than men (1953/3338, 58.51% vs 853/2175, 39.22%). Respondents aged 16-25 years showed higher levels of body image distress than all other age groups, at 75.19% (961/1278), with distress decreasing as age increased.
Frequency statistics for measures of body image item by age and sex (maximum N=5517).
Body image item | Sex | Age bands (years) | Full sample | ||||||
| Men | Women | 16-25 | 26-49 | ≥50 | | |||
2175 (39.45) | 3338 (60.55) | 1278 (23.18) | 1502 (27.24) | 2733 (49.57) | 5513 (100) | ||||
| Yes | 853 (39.22) | 1953 (58.51) | 961 (75.19) | 837 (55.73) | 1008 (36.88) | 2806 (50.89) | ||
| No | 1322 (60.78) | 1385 (41.49) | 317 (24.8) | 665 (44.27) | 1725 (63.12) | 2707 (49.1) | ||
2169 (39.47) | 3327 (60.53) | 1275 (23.19) | 1497 (27.24) | 2724 (49.56) | 5496 (100) | ||||
| 1=not at all, n (%) | 510 (23.51) | 425 (12.77) | 130 (10.17) | 181 (12.09) | 624 (22.91) | 935 (17.01) | ||
| 6=a great deal, n (%) | 256 (11.8) | 771 (23.17) | 330 (25.88) | 321 (21.44) | 376 (13.8) | 1027 (18.69) | ||
| Score, median (IQR) | 3 (2-4) | 4 (2-5) | 4 (3-6) | 4 (2-5) | 3 (2-5) | 4 (2-5) | ||
2115 (39.32) | 3264 (60.68) | 1248 (23.2) | 1464 (27.22) | 2667 (49.58) | 5379 (100) | ||||
| Underweight | 30 (1.42) | 141 (4.32) | 97 (7.77) | 39 (2.67) | 35 (1.31) | 171 (3.18) | ||
| Healthy weight | 671 (31.73) | 1344 (41.19) | 721 (57.77) | 580 (39.64) | 714 (26.77) | 2015 (37.47) | ||
| Overweight | 791 (37.39) | 836 (25.62) | 232 (18.59) | 438 (29.94) | 957 (35.88) | 1627 (30.25) | ||
| Obese | 623 (29.46) | 842 (28.87) | 198 (15.87) | 406 (27.75) | 961 (36.03) | 1565 (29.09) | ||
2176 (39.46) | 3339 (60.54) | 1279 (23.19) | 1503 (27.25) | 2733 (49.56) | 5515 (100) | ||||
| Very underweight | 25 (1.15) | 19 (0.56) | 16 (1.25) | 9 (0.59) | 19 (0.69) | 44 (0.79) | ||
| Slightly underweight | 154 (7.08) | 143 (4.28) | 129 (10.09) | 74 (4.92) | 94 (3.44) | 297 (5.39) | ||
| About the right weight | 646 (29.69) | 1057 (31.66) | 574 (44.88) | 522 (34.73) | 607 (22.21) | 1703 (30.88) | ||
| Slightly overweight | 1000 (45.96) | 1348 (40.37) | 429 (33.54) | 624 (41.52) | 1295 (47.38) | 2348 (42.57) | ||
| Very overweight | 351 (16.13) | 772 (23.12) | 131 (10.24) | 274 (18.23) | 718 (26.27) | 1123 (20.36) | ||
2178 (39.48) | 3339 (60.52) | 1278 (23.16) | 1503 (27.24) | 2736 (49.59) | 5517 (100) | ||||
| Yes, to lose weight | 427 (19.61) | 868 (25.99) | 268 (20.97) | 374 (24.88) | 653 (23.87) | 1295 (23.47) | ||
| Yes, to gain weight | 49 (2.25) | 27 (0.81) | 38 (2.97) | 17 (1.13) | 21 (0.77) | 76 (1.38) | ||
| No | 1702 (78.15) | 2444 (73.20) | 972 (76.06) | 1112 (73.99) | 2062 (75.37) | 4146 (75.15) |
Only 17.01% (935/5496) of respondents in the full sample indicated that their weight and shape did not influence how they thought of themselves as a person. Women (425/3327, 12.77%) and the younger age bands (16-25 years: 130/1275, 10.19%; 25-44 years: 181/1497, 12.09%) were significantly less likely to endorse that their weight or shape did not influence their self-perception ( P <.001).
Although 57.77% (721/1248) of young people (16-25 years) were in the healthy BMI range, fewer (574/1279, 44.88%) considered themselves about the right weight. This pattern was repeated in women, of whom 41.19% (1344/3264) were in the healthy BMI range, but fewer (1057/3339, 31.66%) endorsed that they were about the right weight. The percentage of men who were in a healthy BMI range was 31.73% (671/2115), which reflected the rates of men who felt they were about the right weight (646/2176, 29.69%). In the older age brackets, more participants were in the obese BMI category (26-49 years: 406/1464, 27.75%; ≥50 years: 961/2667, 36.03%) than those who felt that they were very overweight (26-49 years: 274/1503, 18.23%; ≥50 years: 718/2733, 26.27%). Across the full sample, 23.47% (1295/5517) of all participants were currently dieting to lose weight, and 1.38% (76/5517) were currently dieting to gain weight. Across ages, not engaging in any dieting was relatively consistent (between 1112/1503, 73.99% and 972/1278, 76.06%). Women reported they were dieting to lose weight significantly more frequently (868/3339, 25.99%) than men (427/2178, 19.61%; P <.001).
For addressing aim 3, a series of linear regressions were conducted to examine the relationship between body image distress or preoccupation and health and well-being items. Table 3 presents the full sample results ( Multimedia Appendix 2 for each age group). Individual Pearson product-moment r correlations for each health and well-being item by body image distress are presented in Multimedia Appendix 3 . The regression model using the full sample significantly accounted for 24% of the variance in body image distress or preoccupation ( F 15,4966 =105.8; P <.001; R 2 adj =0.24). After controlling for sex (β=.12; P <.001) and age (β=−0.24; P <.001), 5 variables significantly explained model variance. This included current dieting status (β=.13; P <.001), perception of weight (β=.09; P <.001), psychological distress (β=.21; P <.001), alcohol and/or other substance misuse (β=.04; P <.001), and well-being (β=−0.07; P <.001). Specifically, respondents who were currently dieting reported body image distress or preoccupation more frequently. Those who did not report that they were about the right weight reported higher psychological distress and had a higher likelihood of problematic alcohol or other substance use and higher body image distress or preoccupation. Participants with higher personal well-being scores reported lower levels of body image distress or preoccupation.
Linear regression of body image distress ( F 15,4966 =105.8; P <.001; R 2 adj =0.24).
Variable | ( ) | value | β (95% CI) | |
| Healthy weight (no vs yes based on BMI) | 0.04 | .97 | .00 (−0.03 to 0.03) |
| Current dieting (no vs yes) | 10.20 | <.001 | .13 (0.12 to 0.18) |
| Perception of weight (about the right weight vs not) | 6.06 | <.001 | .09 (0.07 to 0.13) |
| Physical activity (IPAQ ) | −0.03 | .97 | .00 (−0.02 to 0.02) |
| Psychological distress (K10 ) | 9.45 | <.001 | .21 (0.01 to 0.01) |
| Suicidal ideation (PSFS ) | 0.38 | .71 | .01 (−0.03 to 0.04) |
| Alcohol and/or other substance misuse | 2.82 | <.001 | .04 (0.01 to 0.04) |
| Days out of role | −1.42 | .16 | −0.02 (−0.01 to 0.00) |
| Well-being (PWI ) | −3.37 | <.001 | −0.07 (0.00 to 0.00) |
| Happiness (OHQ ) | −0.40 | .69 | −0.01 (−0.01 to 0.00) |
| Resilience (BRCS ) | 0.84 | .40 | .01 (0.00 to 0.01) |
| Social support (SSCS ) | −1.39 | .16 | −0.02 (−0.01 to 0.00) |
| Intimate bonds (IBM ) | −0.57 | .57 | −0.01 (0.00 to 0.00) |
| Sex | 9.46 | <.001 | .12 (0.10 to 0.15) |
| Age | −16.57 | <.001 | −0.24 (−0.01 to −0.01) |
a df =15,4966
b IPAQ: International Physical Activity Questionnaire short form.
c K10: 10-item Kessler Psychological Distress Scale.
d PSFS: Psychiatric Symptom Frequency Scale.
e PWI: Personal Well-being Index.
f OHQ: Oxford Happiness Questionnaire.
g BRCS: Brief Resilience Coping Scale.
h SSCS: Schuster Social Support and Conflict Scale.
i IBM: Intimate Bond Measure.
When analyzed separately by age group ( Multimedia Appendix 2 ), sex, current dieting status, perception of weight, and psychological distress consistently explained model variance across all age groups. Variation was found for happiness, alcohol or other substance misuse, and well-being items. Specifically, lower happiness also explained body image distress (β=−0.16; P =.003) in young people (aged 16-25 years). For those aged 26 to 49 years, alcohol and/or other substance misuse remained an item that explained body image distress (β=.07; P =.008). Conversely, for the ≥50 years age group, lower well-being continued to explain body image distress (β=−0.10; P =.001) variance.
To our knowledge, this is the largest international study to examine body image distress—and other related factors, including self-reported and perceived weight range and dieting status—across time, age, and sex. Our findings show that body image distress has become a highly prevalent issue by 2015. Of concern, considerable levels of body image distress were present in women and young people, and multiple psychosocial risk factors were associated with this distress.
One of our key findings comes from the cross-sectional longitudinal Australian data. Self-reported body image distress in young people aged 16 to 25 years increased from 44.2% (414/949) of those surveyed in 2009 to three-quarters (961/1278, 75.19%) in 2015. This finding is consistent with the increasing prevalence rates of body image distress in countries such as the United States [ 1 ]. Furthermore, although there are some suggestions in the literature that concern regarding body image has increased in Australia [ 84 - 86 ], this is the first known study to report changes across these 3 time points using web-based samples. Our data indicate that the issue is much more prevalent. This increasing prevalence of body image distress corresponds with the rise of social media. During the time frame of the survey, Instagram was launched in 2010, Snapchat was released in 2011, and TikTok was released in 2016. As photographs and videos are central to the use of these platforms, and previous research has shown an association between body image distress and social media use, perhaps this increased level of distress has occurred in parallel with the rise of social media [ 14 , 15 ].
This rise in prevalence is particularly concerning, given our findings that body image distress was associated with increased levels of current dieting, poorer self-perception of weight , higher psychological distress, increased alcohol or other substance misuse, and poorer personal well-being. This is consistent with previous research where higher body image dissatisfaction directly correlated with poor mental health–related quality of life and psychosocial functioning [ 17 ]. Furthermore, literature examining body appreciation has reported associations with greater subjective happiness [ 56 ] and fewer days of feeling mentally or physically unhealthy [ 87 ]. It is unclear whether these factors are precipitating factors or consequences of body image distress. As 24% of the variability in body image distress was accounted for by these factors, future research could endeavor to explore what other factors are potentially missing from this model that also contribute to distress, such as social media use or history of disordered eating. Overall, when considering the rise of body image distress and its link to poorer psychosocial outcomes, a sharper focus on this area is needed.
Another important finding was that in our 2015 international sample, more than half of the participants’ BMI in the overweight or obese range (59.34%), with men reporting higher levels of obesity than women. This in itself is concerning, as obesity is considered one of the greatest health epidemics worldwide [ 88 - 91 ]. Furthermore, our findings demonstrated a notable sex difference concerning how men and women perceive their weight compared with their self-reported weight as measured by BMI. Specifically, despite a higher percentage of men having an overweight or obese BMI, more women (772/3339, 23.12%) considered themselves to be very overweight than men (351/2176, 16.13%). Although more women in this sample were in a healthy weight range (women: 1344/3264, 41.19%; men: 671/2115, 31.73%), only one-third of women believed they were about the right weight . This is consistent with data from previous studies demonstrating that women are more likely to perceive themselves as overweight compared with men [ 35 , 92 - 95 ]. In the literature, possible factors that may contribute to this discrepancy include self-esteem [ 96 ], sociocultural influences, and expectations [ 97 - 99 ].
Interventions in this area are relatively unexplored, particularly those targeting both men and women. Evidence-based interventions include self-monitoring, cognitive restructuring, exposure exercises, fitness training, mirror work [ 100 ], media literacy, self-esteem enhancement, and psychoeducation. However, these interventions only achieve minor improvements in body image [ 101 , 102 ]. Interventions with a greater focus on stress management training, cognitions, and negative body image causes appear to be more effective [ 101 ]. There is some evidence that self-compassion training can be beneficial for weight loss, nutrition behaviors, eating behaviors, and body image [ 103 ]. This training focuses on promoting self-worth, creating a more positive body image, and decreasing body dissatisfaction, and may be the way forward to improve health outcomes in distressed individuals.
These discrepancies between actual and perceived weight were not only a function of sex but also of age. Our 2015 survey results indicated that 57.77% of young people were in the healthy BMI weight range—the highest endorsement across all age groups. Despite this, three-quarters of young people reported body image distress. Again, this was the highest endorsement across all age groups. As participants aged, their BMI increased—with far more in the overweight and obese categories. However, the rate of body image distress declined as participants aged, as did the influence of weight or shape on how they viewed themselves as a person. Previous literature supports this phenomenon [ 104 - 107 ]. This change could be attributed to a shift in body comparisons with age-appropriate peers [ 8 ], less cultural fat phobia [ 105 - 107 ], or a focus on body function rather than body appearance [ 108 ].
Furthermore, research has theorized that people’s preoccupation and desire to change their body weight via dieting behavior becomes less salient with age [ 26 ]. Interestingly, our survey results demonstrated that approximately three-quarters of people reported they were not dieting, and this proportion remained relatively stable across each age group. Thus, although body image distress decreases with age, in line with the Webster and Tiggemann study [ 26 ], our contradictory finding is that dieting behaviors remain relatively consistent. Further research is needed to examine whether this is explained by the changes in people’s reasons for dieting as they age. For example, older people might be dieting for health or medical reasons rather than because of their body image concerns.
This study supports the clear link between body image distress and poorer health and well-being [ 28 ]. Prevalence rates of body image dissatisfaction have increased worldwide in the past 30 years [ 109 ]. Our research shows that this prevalence is 3 in 4 young people when using a web-based survey methodology. These are compelling statistics. In 2019, the Australian government invested US $146 million into the prevention, detection, assessment, and treatment of eating disorders [ 110 ]. Although this is timely, our findings on the inverse relationship between individual distress and psychosocial outcomes make a strong case for the need for prevention and early intervention before eating disorders emerge. This may include more comprehensive assessment when accessing health services and the use of health information technologies to improve support services [ 111 ]. Given our findings, such interventions may benefit from targeting across sex and age.
Previously, body image distress was thought to result from the discrepancy between actual and perceived body image. However, our results suggest that the rates of body image distress within some age groups far exceed the proportion of the population who experience a discrepancy, indicative of other factors contributing to distress. For example, research is needed to determine whether these results are related to the considerable increases in the use and availability of social media in the past decade [ 14 ]. Exposure to social media, particularly in an individual’s formative years, could have a considerable impact on a young person’s sense of self, quality of life, and body image than is currently known. Some studies have demonstrated that the use of highly visual social media such as Instagram or Snapchat is linked to upward social comparison and internalization of symptoms of body dysmorphia, resulting in increased body image distress [ 112 - 115 ]. The more time spent on social media, the more significant the body image concerns [ 116 - 118 ]. Photograph-based activity (eg, posting photographs and viewing or making comments on others’ photographs) is particularly salient in contributing to body dissatisfaction and disordered eating [ 14 ]. As the data in this study were from a web-based sample recruited using social media channels, the results may reflect the experience of body image distress of a web-based population, who may be more likely to be using other platforms such as Instagram.
Body image distress and dieting behaviors are well understood to be risk factors for disordered eating and the development of an eating disorder. Our results indicate a relationship between dieting behavior, psychological distress, and the self-perception of weight, in addition to alcohol and/or other substance use and well-being impact on body image distress. The triangulation of items such as those used in this survey (BMI vs distress vs dieting status, or BMI vs distress vs perceptions of weight) may be beneficial as a brief screening tool. Given the burden of completing lengthy psychometrics, how these brief screeners compare with lengthier eating disorder questionnaires should be explored.
A key strength of this study is that it is one of the largest samples to date, providing data on weight, perceptions of weight, dieting status, body image distress, and health and well-being. As outlined in the main report’s executive summary [ 69 ], a key limitation of the research is the nonepidemiological nature of the web-based research; targeting efforts were made for age, sex, and by country to address this. Although most individuals in the participating countries have widespread internet access [ 119 ], this study will also yield some level of internet bias, in that those who do not frequently access the internet or social media recruitment websites may not have participated. However, a major advantage to using a web-based surveying methodology is that previous research has found that it is associated with increased disclosure of sensitive information [ 120 ], such as the items asked in this survey. There is also the possibility of avidity bias occurring, as those with a greater interest in the subject may be more likely to participate [ 121 ]. However, overall, this research remains highly relevant, as it is the interactions between variables, not merely the statistical frequencies, that generate meaningful information. Furthermore, as we move further into the 21st century, web-based questionnaires may become more the norm than the exception.
Where possible, measures that have been tested for reliability and validity across general populations worldwide were used. For example, the K10 is the standard tool used to measure distress in Australia’s National Survey of Mental Health and Wellbeing (Burgess et al [ 122 ]) and is used widely in international studies. The BMI [ 121 ] is the most recommended and widely used tool for classifying weight range in adults [ 123 ]. However, the use of BMI is limited and has several deficiencies as a measure of obesity [ 124 ]. BMI is not a reliable reflection of health status, does not accurately reflect changes that occur with age, cannot account for muscle mass, and is a poor indicator of body fat percentage [ 123 ].
Furthermore, the participants were asked to self-report their height and weight. Responses may have been subject to bias as BMI is often calculated with overestimated height and underestimated weight data [ 125 ]. Furthermore, owing to the breadth and sheer size of the Global Health and Wellbeing Survey 2015, validated measures for eating disorders such as Eating Disorder Inventory, third edition [ 126 ] and the Eating Attitudes Test [ 127 ] were not viable to use. Instead, we asked brief questions (all adapted from established literature) on areas such as dieting status, perceptions of weight, and body image distress. Overall, the results are still meaningful. Although they may not be fully representative of the populations with eating disorders, they demonstrate a clear link between body image distress and health and well-being concerns.
This research demonstrates the significant interplay between body image distress and psychosocial risk factors, including currently dieting, worse perceptions of weight, elevated psychological distress, increased alcohol or other substance misuse, and poorer personal well-being. Considering that an increasing number of young people are experiencing body image distress, body image should be closely monitored, given its association with poorer health outcomes. Further research into tailored intervention and prevention strategies for those experiencing any level of body image distress, obesity, eating disorders, and other health-related concerns is needed.
The Global Health and Wellbeing 2015 Survey was commissioned by the Movember Foundation and conducted by the University of Sydney’s Brain and Mind Centre and the Young and Well Cooperative Research Center (Young and Well Cooperative Research Centre: 2011-2016). The authors would like to acknowledge the respondents who consented to participate on the web in the Global Health and Wellbeing 2015 Survey; the international consortia for the Global Health and Wellbeing 2015 Survey, including Professor Sagar Parikh, Professor Richard Porter, Professor Jan Scott, and Dr Michael Rovito; the Movember Foundation (Australia) lead on the project Therese Fitzpatrick; and the Brain and Mind Centre team: Victoria Baldwin, Lisa Whittle, Django White, Laura Ospina Pinillos, Sarah Piper, Hannah Yee, and Frank Iorfino. The authors would also like to acknowledge the Young and Well CRC and headspace for the 2012 and 2009 data sets. The Movember Foundation commissioned this research. This project is also supported by philanthropic funding, for which donors are families affected by mental illness who wish to remain anonymous. This study was also funded by a National Health and Medical Research Council Australia Fellowship (No. 511921, awarded to IH).
K10 | 10-item Kessler Psychological Distress Scale |
Multimedia appendix 2, multimedia appendix 3.
Conflicts of Interest: IH was an inaugural Commissioner on Australia’s National Mental Health Commission (2012-18). He is the codirector of Health and Policy at the Brain and Mind Centre (University of Sydney, Australia). The Brain and Mind Centre operates early-intervention youth services at Camperdown under contract to headspace. IH has previously led community-based and pharmaceutical industry–supported (Wyeth, Eli Lilly, Servier, Pfizer, and AstraZeneca) projects focused on the identification and better management of anxiety and depression. He was a member of the Medical Advisory Panel for Medibank Private until October 2017, a board member of Psychosis Australia Trust, and a member of the Veterans Mental Health Clinical Reference group. He is the chief scientific advisor to and a 5% equity shareholder in InnoWell Pty Ltd. InnoWell was formed by the University of Sydney (45% equity) and PwC (Australia; 45% equity) to deliver the Aus $30 (US $22.2) million Australian government–funded Project Synergy (2017-20; a 3-year program for the transformation of mental health services) and lead transformation of mental health services internationally through the use of innovative technologies. JB is chair of the National Advisory Council for Open Arms, Veterans, and Families Counseling Service. She is a well-being and digital health consultant to Bupa, a member of the Veterans Mental Health Clinical Reference group, and a chief investigator and author of the Defense and Veterans Transition and Well-being Study. She is the founder of and an equity shareholder in InnoWell. She is a professor of Social Innovation and Chair of the Center for Mental Health at Swinburne University and an adjunct professor of Social Impact and Entrepreneurship at Royal Melbourne Institute of Technology. TD is now the director of Research & Insights at the Australian Digital Health Agency. The other authors have no conflicts of interest to disclose.
BUTLER, Pa. – Donald Trump and would-be assassin Thomas Crooks started on their violent collision course long before the former president's political rally ended in gunshots and death.
Crooks, 20, was a one-time registered Republican, a nursing home worker with no criminal record, shy in school, and living in a decent middle-class neighborhood in suburban Pennsylvania with his parents. Trump, 78, was eyeing Crooks' state as a key battleground – but not in the way that anyone envisioned on Saturday.
Riding high on polls showing that he's got a strong chance of toppling President Joe Biden, the former president had been campaigning for reelection in swing states, and Pennsylvania is a key prize. Trump won the state in 2016 but lost it four years later.
And on July 3, Trump's campaign announced he would hold a rally at the Butler Farm Show grounds, about 30 miles north of Pittsburgh.
"Pennsylvania has been ravaged by monumental surges in violent crime as a direct result of Biden’s and Democrats’ pro-criminal policies," Trump's campaign said in announcing the event, noting that when he's elected, he'll "re-establish law and order in Pennsylvania!"
The Saturday attack on Trump turned the heated rhetoric of the 2024 presidential campaign freshly violent. Authorities said bullets fired from Crooks' AR-15 style rifle about 150 yards away grazed Trump's ear, killed a rally attendee as he dove to protect his family, and critically wounded two others. Secret Service agents killed Crooks moments later.
Investigators are still seeking Crooks' motive – despite his Republican leanings, he had donated recently to a progressive voter-turnout campaign in 2021 – but indicated he'd planned the attack well in advance.
The shooting marks the first assassination attempt against a former or current U.S. president since President Ronald Reagan was injured in a March 1981 shooting at a Washington, D.C., hotel.
There are many questions about why Crooks turned into a would-be presidential assassin, firing indiscriminately into hordes of political supporters.
FBI special agent Kevin Rojek said on a call with media that law enforcement located "a suspicious device" when they searched Crooks' vehicle and that it's being analyzed at the FBI crime lab.
"As far as the actions of the shooter immediately prior to the event and any interaction that he may have had with law enforcement, we're still trying to flesh out those details now," Rojek said.
None of Crooks' shocked neighbors or high school classmates described him as violent or that he in any way signaled he was intent on harming Trump. Sunday morning, reporters and curious locals swarmed the leafy streets of the home where Crooks lived with his parents in Bethel Park, about 50 miles from the shooting scene.
Those who knew him described a quiet young man who often walked to work at a nearby nursing home. One classmate said he was bullied and often ate alone in high school.
Sunday morning, neighbor Cathy Caplan, 45, extended her morning walk about a quarter mile to glimpse what was happening outside Crooks’ home.“It came on the morning news and I was like ‘I know that street,’” said Caplan, who works for the local school district. "It feels like something out of a movie.”
Authorities say they are examining Crooks' phone, social media and online activity for motivation. They said he carried no identification and his body had to be identified via DNA and biometric confirmation.
Although no possible motive has yet been released, Crooks nevertheless embodies the achingly familiar profile of an American mass shooter: a young white man, isolated from peers and armed with a high-powered rifle. His attack was one of at least 59 shootings in the United States on Saturday, according to the Gun Violence Archive.
According to records and online posts of the ceremony, Crooks graduated from Bethel Park High School, about 42 miles from Butler County, on June 3, 2022. That same day, Trump met briefly with investigators at his Mar-a-Lago club in Florida as they examined whether he improperly took classified documents with him when he left the White House.
A classmate remembered Crooks as a frequent target of bullies. Kids picked on him for wearing camouflage to class and his quiet demeanor, Jason Kohler, 21, said. Crooks usually ate lunch alone, Kohler said.
Crooks worked as a dietary aide at the Bethel Park Skilled Nursing and Rehabilitation, less than a mile from his home. In a statement provided to USA TODAY on Sunday, Marcie Grimm, the facility's administrator, said she was "shocked and saddened to learn of his involvement."
Neighbor Dean Sierka, 52, has known Crooks and his parents for years. The families live a few doors apart on a winding suburban street, and Sierka’s daughter, who attended elementary, middle and high school with Crooks, remembers him as quiet and shy. Sierka said they saw Crooks at least once a week, often when he was walking to the nursing home from his parents' three-bedroom brick house.
"You wouldn’t have expected this," Sierka said. "The parents and the family are all really nice people."
"It's crazy," he added.
Founded in 1865, the Secret Service is supposed to stop this kind of attack, and dozens of agents were present Saturday. As the former president and presumptive Republican presidential nominee, Trump's public appearances are managed by the Secret Service, which works with local law enforcement to develop security plans and crowd-management protocols.
In the days before the event, the agency's experts would have scouted the location, identified security vulnerabilities, and designed a perimeter to keep Trump and rally attendees safe. Congress and the Secret Service are now investigating how Crooks was able to get so close to the former president, and several witnesses reported seeing him in the area with the gun before Trump took the stage.
As the event doors opened at 1 p.m., the temperature was already pushing close to 90, and ticketed attendees oozed through metal detectors run by members of the Secret Service's uniformed division. Similar to airport security screenings, rallygoers emptied their pockets to prove they weren't carrying guns or other weapons.
Media reports indicate the Secret Service had in place, as usual, a counter-sniper team scanning the surrounding area for threats.
In an exclusive interview, former Secret Service Director Julia Pierson told USA TODAY that maintaining such a sniper security perimeter is part of the agency's responsibility for safeguarding protectees like Trump from harm. She said agents typically consider 1,000 yards to be the minimum safe distance for sniper attacks.
The Secret Service has confirmed that it is investigating how Crooks got so close to Trump, who took the stage shortly after 6 p.m. Officials say Crooks' rifle was legally obtained but have not yet released specifics.
Outside the venue at that time, Greg Smith says he tried desperately to get the attention of police. He told the BBC that he and his friends saw a man crawling along a roof overlooking the rally. Other witnesses said they also saw a man atop the American Glass Research building outside the official event security perimeter, well within the range of a 5.56 rifle bullet.
"We noticed the guy bear-crawling up the roof of the building beside us, 50 feet away from us," Smith told the BBC. "He had a rifle, we could clearly see him with a rifle."
Smith told the BBC that the Secret Service eventually saw him and his friends pointing at the man on the roof.
"I'm thinking to myself, why is Trump still speaking, why have they not pulled him off the stage?" Smith said. "Next thing you know, five shots rang out."
From his nearby deck, Trump supporter Pat English watched as the former president took the stage to Lee Greenwood's "God Bless the U.S.A.," and attendees raised their cell phones to record.
English had taken his grandson to see the rally earlier but left when it got too hot. From his deck, they listened as Trump began speaking at 6:05 p.m., backed by a crown of red-hatted MAGA supporters waving "fire Joe Biden" signs.
And then gunfire began.
"I heard a 'boom, boom, boom' and then screams,” English said Sunday. "I could see people running and the police run in."
Trump was saying the word "happened" as the first pop rang out. He reached up to grab his ear as two more shots echoed, and the crowd behind him – and Trump himself – ducked. Plainclothes Secret Service agents piled atop the president as a fusillade of shots rang out, apparently the Secret Service killing Crooks.
The crowd screamed, and the venue's sound system picked up the agents atop Trump planning to move the former president to safety. One yelled, "shooter's down. Let's move, let's move."
The agents then helped Trump back to his feet as they shielded him on all sides.
The sound system then picked up Trump's voice: "Wait, wait," he said, before turning to the audience and triumphantly raising his fist to yell "fight, fight" as the crowd cheered, blood streaming down his face.
By 6:14 p.m. Trump's motorcade was racing from the scene, and in a later statement, Trump's campaign said he was checked out at a local medical facility.
"I was shot with a bullet that pierced the upper part of my right ear," Trump said in a statement. "I knew immediately that something was wrong in that I heard a whizzing sound, shots, and immediately felt the bullet ripping through the skin. Much bleeding took place, so I realized then what was happening."
Outside of the Butler Township Administration Office Sunday afternoon, Pennsylvania Gov. Josh Shapiro identified the rally attendee killed by Crooks as Corey Comperatore, a firefighter, father of two and longtime Trump supporter.
“Corey died a hero,” Shapiro said. “Corey dove on his family to protect them last night at this rally. Corey was the very best of us. May his memory be a blessing.”
Two other Pennsylvanians are still undergoing treatment for their injuries, Shapiro said.
Pennsylvania State Police identified two wounded attendees David Dutch, 57, of New Kensington, and James Copenhaver, 74, of Moon Township. Both are hospitalized and listed in stable condition. Shapiro said he spoke with the family of one victim and received a message from the other.
Biden spoke briefly with Trump on Saturday night, and the president condemned the assassination attempt as “sick.” He said there’s no place for political violence in the U.S. and called on Americans to unite together to condemn it.
But earlier in the week, Biden told campaign donors in a private phone call it was time to stop talking about his own disastrous presidential debate performance and start targeting Trump instead.
"I have one job and that's to beat Donald Trump," Biden said. "We're done talking about the (June 27) debate. It's time to put Trump in the bullseye."
Republicans across the country have used similar language to attack their opponents over the years, and political scientists say violent rhetoric used worldwide almost invariably leads to physical violence.
On Sunday, someone parked a truck-mounted electronic billboard at the gates to the Butler Farm Show grounds reading "Democrats attempted assassination," along with a picture of Trump clutching an American flag, his face overlaid with a bullseye crosshairs.
Authorities say they have not yet determined a motive for Crooks' attack. But in a statement, Trump declared the shooting an act of evil and thanked God for preventing the unthinkable.
"We will fear not, but instead remain resilient in our faith and defiant in the face of wickedness," Trump said.
And he said he'd be back on the campaign trail for the Republican National Convention in Milwaukee, which starts Monday.
"Based on yesterday’s terrible events, I was going to delay my trip to Wisconsin, and the Republican National Convention, by two days," Trump said on his Truth Social account Sunday, "but have just decided that I cannot allow a 'shooter,' or potential assassin, to force change to scheduling, or anything else."
Contributing: David Jackson, Aysha Bagchi, Christopher Cann, Bryce Buyakie, Emily Le Coz, Josh Meyer, USA TODAY Network
How the assassination attempt unfolded : Graphics, maps, audio analysis show what happened
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1. Introduction. Body image is defined as one's perception, thoughts, and emotions revolving around one's own body. It is the depiction of one's body representation, including their mirror reflection, and it reflects social constructs, which depend on a society's culture and norms.
1. Introduction. Body image (BI) is the internal representation of one′s external appearance [] and encompasses self-perceptions related to the body and personal attitudes, including thoughts, beliefs, feelings, and behaviors [].It is a multidimensional representation [] made up of four components: global subjective satisfaction (evaluation of the body); affection (feelings associated with ...
Body Image is an international, peer-reviewed journal that publishes high-quality, scientific articles on body image and human physical appearance. Body image represents a person's "inside view" of their body-that is, their feelings, perceptions, thoughts, and beliefs about their body that impact how they behave toward it (Cash, 2004).
I NTRODUCTION. Body image relates to how people think and feel about their own body. It relates to a person's perceptions, feelings, and thoughts about his or her body and is usually conceptualized as incorporating body size estimation, evaluation of body attractiveness, and emotions associated with body shape and size.[]Adolescents are particularly vulnerable to body dissatisfaction due to ...
Introduction. Many people are concerned about at least one part of their body ().A negative cognitive evaluation of one's body can be an expression of a negative body image ().Body image is conceptualized as a multidimensional construct, which encompasses a behavioral component involving body-related behaviors (e.g. checking behaviors), a perceptual component involving the perception of body ...
An extensive body of research has documented detrimental effects on women's body image from exposure to idealized images displayed in traditional media formats such as fashion magazines and television, especially for women with already high levels of body concern (for meta-analyses, see Ferguson, 2013; Grabe et al., 2008; Groesz et al., 2002; Want, 2009).
Among children and young people, body image concerns have been described as a 'normative discontent' (Cash and Henry, 1995), with 66% of young people under 18 reporting negative or very negative feelings about their body image most of the time (Women and Equalities Committee, 2021).Whilst some research reports that body image concerns are more prevalent in female adolescents, compared to ...
In the current paper, two different studies were designed to investigate body image dissatisfaction and perception of the attractive female body in Chinese and Croatian women and men using the ...
PDF | On Dec 5, 2016, Charlotte H. Markey and others published Body Image | Find, read and cite all the research you need on ResearchGate
This systematic review synthesizes and critically appraises measurement properties of influential body image measures. Eight measures that met the definition of an assessment of body image (i.e., an individual's cognitive or affective evaluation of their body or appearance with a positive or negative valence), and scored high on systematic expert priority ranking, were included.
Body image and self-esteem have long been known to be linked and are salient issues for young people, particularly during adolescence and puberty. These issues affect people throughout the life span, from childhood to old age. Past research has focused predominantly on body image and self-esteem in children and adolescents. More recently, research in this area has begun to focus on older people.
Body image concerns related to weight or other dimensions of appearance are now prevalent on a global scale. This paper reviews the theoretical frameworks that account for the global similarities and regional differences in rates and presentation of body image concerns, as well as reviewing the extant data.
Social Media and Body Image Concerns: Current Research and Future Directions Jasmine Fardouly and Lenny R Vartanian This paper provides an overview of research on social media
People have been influenced by social media, through both subtle and explicit means that appearance is crucial to a positive and successful experience as a person.
A correct perception of the body image, as defined by comparison with actual anthropometric analyses, is crucial to ensure the best possible nutritional status of each individual. Bioimpedance analysis (BIA) represents a leading technique to assess body composition parameters and, in particular, the fat mass. This study examined the self-perception of body image at various levels of adiposity ...
Culture affects individuals' perceptions and experiences of their bodies. In order to provide the most effective solutions to body image-related issues, it is necessary to understand cultures and their influences on body image in various populations. This paper focuses on the effects of culture on body image. Therefore, a systematic literature search following PRISMA guidelines was performed ...
This review presents recent trends in social media and body image research, with a particular focus on different social media platforms, features unique to social media, and potentially positive content for body image. First, it was found that visual platforms (e.g. Instagram) were more dysfunctiona …
The classic view of BI: negative BI and its dimensions. The BI construct seems to be composed of two dimensions: negative BI and positive BI. To date, research has focused primarily on the study of the negative dimension (Smolak & Cash, 2011; Tylka, 2011), characterized by BID.As noted above, BID is a key element in the expression of ED and one of the more common characteristics in anorexia ...
Learn about the major theories and methods in psychology of body image, and how it affects various aspects of human behavior and well-being.
1.Introduction. With the continued integration of social media into daily life, body dissatisfaction, defined as a negative subjective evaluation of one's body, is becoming an area of increasing concern (Choukas-Bradley et al., 2022, Jiotsa et al., 2021).The pervasive nature of idealized body images across social media and other digital platforms not only perpetuates unrealistic body standards ...
Body image issues among adolescents. The phrase "body image" encompasses how one perceives, acts toward, thinks, and feels about one's body and lies on a spectrum ranging from positive to negative perceptions ().Adolescents, especially females, have historically been subjected to pressures in favor of the thin body image ideal in traditional media outlets; this problem is suspected of ...
Shots rang out as former President Donald J. Trump spoke at a campaign event in Butler, Pa., on Saturday. Maps, photos and video show how the shooting unfolded.
Background: Body image dissatisfaction (BID) is the negative perception of the weight and shape of one's body. It is a prominent risk factor for conditions ranging from eating disorders, body ...
Background. There is a clear need to understand and address body image distress, particularly when considering the increasing prevalence rates of body image distress worldwide [1-3] and the noted relationship between body image distress and mental ill-health [].Furthermore, there is scant large-scale international research examining body image across the adult life span [] and from the ...
The Saturday attack on Trump turned the heated rhetoric of the 2024 presidential campaign freshly violent. Authorities said bullets fired from Crooks' AR-15 style rifle about 150 yards away grazed ...
The prevalence of social media use in modern society has led to increased imagery viewing, which can impact female body image satisfaction levels and subsequent eating disordered behavior.