Body dissatisfaction and weight-related teasing: A model of cognitive vulnerability to depression among women

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Abstract

Although a number of studies have linked body dissatisfaction to depressive symptoms, few have done so within the framework of a vulnerability–stress model. We hypothesized that women’s levels of body dissatisfaction would interact with recent experiences of vulnerability-congruent negative life events (i.e., weight-related teasing) to predict prospective changes in depressive symptoms. Consistent with these hypotheses, experiences of weight-related teasing were more strongly related to depressive symptom increases among women with high, compared to low, levels of body dissatisfaction. These results support the hypothesis that body dissatisfaction moderates the impact of weight-related teasing on depressive symptom changes.

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.

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