Journal of Behavior Therapy and Experimental Psychiatry
Body dissatisfaction and weight-related teasing: A model of cognitive vulnerability to depression among women
Introduction
A growing body of research has suggested that body dissatisfaction may contribute risk for depression (e.g., Allgood-Merten et al., 1990, Fabian and Thompson, 1989, Laessle et al., 1988, Rierdan et al., 1989, Stice et al., 1998, Thompson et al., 1995). Beginning in adolescence, rates of depression are approximately twice as high for women than for men (Hankin et al., 1998), and research suggests that body dissatisfaction contributes to elevated depression levels above and beyond other risk factors, such as body mass (Stice & Bearman, 2001). The 30-day prevalence of depression among 15–24 year old women is 8% and the lifetime prevalence is 20.8% (Blazer, Kessler, McGonagle, & Swartz, 1994). Given this, young-adult women may be an especially important group upon which to focus when examining risk for depression.
Starting as early as adolescence, girls have significantly higher levels of body dissatisfaction than do boys (Barker and Galambos, 2003, McCabe and Ricciardelli, 2001). Further, girls who are depressed also have significantly higher levels of body dissatisfaction than boys who are depressed (Bennett, Ambrosini, Kudes, Metz, & Rabinovich, 2005). It has been suggested that the gender differences in depression that first emerge during adolescence are in part a function of the developmental transition that occurs mid-puberty (Angold, Costello, & Worthman, 1998), as well as increased developmental challenges for girls, such as dissatisfaction with weight (Wichstrøm, 1999). The discrepancy between real and ideal physical appearance is more marked for females than males, and this increased discrepancy may contribute to depressed mood (Higgins, 1987, Strauman et al., 1991, Wichstrøm, 1999). Further, gender differences in depressed mood are substantially reduced when the difference in body dissatisfaction is accounted for (for a review, see Wichstrøm, 1999).
Among college students, women have higher levels of body dissatisfaction, disordered eating habits, and dieting behaviors than men, despite having similar body mass indices (Edman, Yates, Aruguete, & DeBord, 2005). One study found that undergraduate women had higher levels of body dissatisfaction than undergraduate men even when matched on levels of body focus, or the tendency to focus on aspects of the body that are most often associated with reasons for dieting or social acceptance (Lokken, Ferraro, Kirchner, & Bowling, 2003). As such, this may be evidence for why women are at significantly increased risk for depression and eating disorders (Hankin et al., 1998, Hudson et al., 2007, Nolen-Hoeksema and Girgus, 1994).
Despite the established link between body dissatisfaction and depression (e.g., Johnson and Wardle, 2005, Paxton et al., 2006, Paxton et al., 2006), the potential risk conveyed by body dissatisfaction is rarely considered within the context of environmental stressors that the individual may also be experiencing. Indeed, most cognitive theories of depression present vulnerability–stress models of risk in which certain cognitions are hypothesized to increase risk for depression in the presence, but not absence, of negative life events (e.g., Abramson et al., 1989, Clark et al., 1999). Further, according to Beck’s event congruency hypothesis (Beck, 1983, Beck, 1987, Clark et al., 1999), depressive reactions should be more likely when there is a match between the specific type of event experienced and the vulnerability exhibited. Building upon Beck’s theory, cognitive-interpersonal models of depression (e.g., Hammen, 1992) have emphasized the interaction between specific types of negative cognitive styles and individuals’ interpersonal relations in contributing vulnerability to depression. Specifically, negative interpersonal events are hypothesized to activate pre-existing negative schema, which then contribute to depression. Further, it has been suggested that the gender differences seen in depression are, in part, a function of the increasing influence of negative interpersonal life events on emotional maladjustment throughout adolescence (Hankin, Mermelstein, & Roesch, 2007). Not only are females more likely to experience negative interpersonal events than males, but females are also more likely than males to become depressed following these events (Hankin et al., 2007). This said, however, relatively little is known about which specific types of negative interpersonal events may increase risk for depression.
One type of negative interpersonal event that may be particularly salient to individuals with high levels of body dissatisfaction is teasing about one’s weight. Research has suggested that perceptions of body dissatisfaction are heavily influenced by social events such as peer, parent, and media influences (van den Berg et al., 2002, Keery et al., 2004, Schutz and Paxton, 2007) and that peer influences among college women affect dysfunctional eating behaviors (van den Berg et al., 2002). Consistent with Beck, 1983, Beck, 1987, Clark et al., 1999) cognitive vulnerability-event congruency hypothesis, one would predict that weight-related teasing, which includes messages directly targeted toward a person’s body weight and shape, may be more likely than other types of events to “activate” pre-existing thoughts of body dissatisfaction.
The primary goal of the current study was to prospectively examine a specific vulnerability–stress model of depression in women. Building from Beck’s cognitive vulnerability-event congruency hypothesis, we hypothesized that women’s levels of body dissatisfaction would moderate the link between weight-related teasing and depressive symptoms. Specifically, we predicted that experiences of weight-related teasing would be more likely to predict depressive symptom increases among women with high, compared to low, levels of body dissatisfaction, and that this relation would persist irrespective of actual weight status. Further, we predicted that this moderation would not exist when examining the link between other types of teasing (e.g., general appearance teasing) and depressive symptoms, thus providing a stronger test of Beck’s cognitive vulnerability-event congruency hypothesis.
Section snippets
Participants
Participants in this study were 116 undergraduate women recruited from their introductory psychology classes who participated in exchange for receiving course credit. The mean age was 18.64 years (SD = .97). The racial/ethnic background of the participants was as follows: 53% Caucasian, 15% African American, 15% Asian, 9% Hispanic, and 8% other. Of the Time 1 participants, 73.3% (n = 85) completed the follow-up assessment. There were no significant differences between completers and attritors on
Results
Preliminary analyses were conducted to determine if there was significant skew among any of the variables. Variables that exhibited skew were transformed (e.g., square root, log 10, inverse) to satisfy assumptions of normality prior to any further analysis. Due to the low levels of reported experiences of current weight-related teasing (i.e., 68% denied any experiences of weight-related teasing during the follow-up), scores on the PARTS W/ST were dichotomized to indicate presence versus absence
Discussion
The primary goal of this study was to provide a prospective test of a cognitive vulnerability–stress model of depression in young women. Specifically, we tested the hypothesis that higher levels of body dissatisfaction would contribute to prospective depressive symptom changes in the presence, but not absence, of a vulnerability-congruent stressor – weight-related teasing. As hypothesized, we found that levels of body dissatisfaction moderated the link between weight-related teasing and
Acknowledgements
This project was supported in part by National Institute of Child Health and Human Development grant HD048664 awarded to the third author.
References (45)
- et al.
Gender differences in adolescent depression: do symptoms differ for boys and girls?
Journal of Affective Disorders
(2005) - et al.
The tripartite influence model of body image and eating disturbance: a covariance structure modeling investigation testing the mediational role of appearance comparison
Journal of Psychosomatic Research
(2002) - et al.
Negative emotion and disordered eating among obese college students
Eating Behaviors
(2005) - et al.
The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication
Biological Psychiatry
(2007) - et al.
Protective and vulnerability factors predicting new-onset depressive episode in a representative of U.S. adolescents
Journal of Adolescent Health
(2008) - et al.
Hopelessness depression: a theory-based subtype of depression
Psychological Review
(1989) - et al.
Multiple regression: Testing and interpreting interactions
(1991) - et al.
Sex differences and adolescent depression
Journal of Abnormal Psychology
(1990) - et al.
Puberty and depression: the roles of age, pubertal status and pubertal timing
Psychological Medicine: A Journal of Research in Psychiatry and the Allied Sciences
(1998) - et al.
Body dissatisfaction of adolescent girls and boys: risk and resource factors
Journal of Early Adolescence
(2003)
The skinny on body dissatisfaction: a longitudinal study of adolescent girls and boys
Journal of Youth and Adolescence
Cognitive therapy of depression: new perspectives
Cognitive models of depression
Journal of Cognitive Psychotherapy
Beck depression inventory manual
The prevalence and distribution of major depression in a national community sample: the national comorbidity survey
American Journal of Psychiatry
Change in diet, physical activity, and body weight in female college freshman
American Journal of Health Behavior
Scientific foundations of cognitive theory and therapy of depression
The development and validation of the body shape questionnaire
International Journal of Eating Disorders
Body image and eating disturbance in young females
International Journal of Eating Disorders
The hopelessness theory of depression: a prospective multi-wave test of the vulnerability–stress hypothesis
Cognitive Therapy and Research
Cognitive, life stress, and interpersonal approaches to a developmental psychopathology model of depression
Development and Psychopathology
Development of depression from preadolescence to young adulthood: emerging gender differences in a 10-year longitudinal study
Journal of Abnormal Psychology
Cited by (22)
Social media photo activity, internalization, appearance comparison, and body satisfaction: The moderating role of photo-editing behavior
2021, Computers in Human BehaviorCitation Excerpt :Body satisfaction refers to the extent to which individuals are content with and have positive feelings about their own physical appearance (Grogan, 2016). Body satisfaction is one of the principal concepts in the body image literature because of its significant power to explain the risks to physical and mental health, including low levels of self-esteem, depression, and disordered eating (Benas et al., 2010; Brechan & Kvalem, 2015). Other studies have indicated that sociocultural factors influence women's perceived levels of body satisfaction through the psychological process of body image development, such as internalization and appearance comparison (Franchina & Coco, 2018; Hendrickse et al., 2017; Myers & Crowther, 2009).
Exploring weight-related teasing and depression among overweight and obese adolescents
2017, Revue Europeenne de Psychologie AppliqueeGerman version of the multidimensional body-self relations questionnaire - appearance scales (MBSRQ-AS): Confirmatory factor analysis and validation
2014, Body ImageCitation Excerpt :The correlations of these two subscales and the BDI were also relatively high, which differed slightly from our expectation for a measure that we had used to estimate discriminatory validity. However, a number of studies have shown that body dissatisfaction is linked to depression (e.g., Benas, Uhrlass, & Gibb, 2010; Gavin, Simon, & Ludman, 2010; Green et al., 2009; Juarascio, Perone, & Timko, 2011). In these studies, a moderate to high association between body dissatisfaction and depression was found.
Direct and indirect effects of sociocultural influences on disordered eating among Malaysian male and female university students. A mediation analysis of psychological distress
2011, AppetiteCitation Excerpt :The associations between psychological distress and disordered eating are likely to be bi-directional (Bradford & Petrie, 2008). Other studies found that these two variables share some similar risk factors, such as low self-esteem, body dissatisfaction (Berg, Frazier, & Sherr, 2009; Cooley et al., 2007; Green, Scott, Cross, et al., 2009; Thomas, Khan, & Abdulrahman, 2010), pressure to be thin, and weight-related teasing (Benas & Gibb, 2008; Benas, Uhrlass, & Gibb, 2010; Gilbert, Crump, Madhere, & Schutz, 2009). Yet, most of these studies focus on women but not men (Santos, Richards, & Bleckley, 2007).