The influence of puberty and ethnicity on awareness and internalization of the thin ideal

Racial identity differences in pathways from sociocultural and objectification constructs to body satisfaction: The U.S. Body Project I

Racial minority men and women face a wide variety of appearance-related pressures, including ones connected to their cultural backgrounds and phenotypic features associated with their identity. These body image concerns exist within a larger context, wherein racial minorities face pressures from multiple cultures or subcultures simultaneously to achieve unrealistic appearance ideals. However, limited research has investigated racial differences in the relationships between theorized sociocultural risk factors and body image in large samples. This study tests pathways from an integrated sociocultural model drawing on objectification theory and the tripartite influence model to three key body image outcomes: appearance evaluation, body image quality of life, and face image satisfaction. These pathways were tested using multigroup structural equation modeling in a national sample of White, Black, Hispanic, and Asian men and women (ns = 205-4797 per group). Although many hypothesized associations were similar in strength across groups, race moderated some of the pathways between sociocultural pressures (media, peer, family), internalization of appearance ideals (thin-ideal, muscular/athletic), appearance surveillance, and body image outcomes. Findings support the likely role of both shared and specific risk factors for body image outcomes, suggesting avenues for tailoring adapted interventions in order to target culturally-salient risk factors.

Demographic predictors of objectification theory and tripartite influence model constructs: The U.S. Body Project I

We examined how demographic factors (gender, sexual orientation, racial group, age, body mass) were linked to measures of sociocultural appearance concerns derived from objectification theory and the tripartite influence model (McKinley & Hyde, 1996; Schaefer et al., 2015) among 11,620 adults. Men were less likely than women to report high body surveillance, thin-ideal internalization, appearance-related media pressures, and family pressures; did not differ in peer pressures; and reported greater muscle/athletic internalization. Both men and women expressed greater desire for their bodies to look "very lean" than to look "very thin". Compared to gay men, heterosexual men reported lower body surveillance, thin-ideal internalization, peer pressures, and media pressures. Black women reported lower thin-ideal internalization than White, Hispanic, and Asian women, whereas Asian women reported greater family pressures. Being younger and having higher BMIs were associated with greater sociocultural appearance concerns across most measures. The variation in prevalence of sociocultural appearance concerns across these demographic groups highlights the need for interventions.

The Mediating Role of Temperamental Traits on the Relationship between Age of Puberty and Eating Disorders: A Mediating Analysis through Structural Equation Modelling of Australian Eating Disorder Outpatients

The current study had the aim to assess whether temperamental traits mediate the relationship between time of puberty and eating disorder (ED) severity using a sample of 292 outpatients with EDs [68 with Anorexia Nervosa Restrictive Type (AN-R), 101 with Anorexia Nervosa Binge Purging Type (AN-BP), 72 with Bulimia Nervosa (BN) and 51 with Other Specified Feeding and Eating Disorder (OSFED)]. Age of puberty, the severity of EDs, and temperamental traits were assessed through Demographic and Medical History Form, Eating Disorder Examination 17.0d (EDE-17.0d) and Temperament and Character Inventory-Revised (TCI-R), with a focus on the temperament scales: novelty seeking (TCI-NS), harm avoidance (TCI-HA), reward dependence (TCI-RD) and persistence (TCI-P). One-way ANOVA, correlation, and mediating analyses through structural equation modeling were performed to test the relationship between variables under investigation and assess if the four temperamental traits act as mediators in the relationship between time of puberty and ED severity. The results show a full mediating effect of the temperamental sub-scales on the relationship between puberty and EDE-17. In particular, TCI-R HA showed a complementary mediation on the relationship between age of puberty and EDE-17.0d, meaning that age of puberty increases the level of TCI-R HA, which in turn increases the severity of ED, confirming that this temperamental trait plays an important role in the development of ED after puberty. To conclude, temperamental traits seem to play a full mediating role in the relationship between puberty and ED severity, but more research is needed.

A virtual issue highlighting eating disorders in people of black/African and Indigenous heritage

While eating disorders affect people from all racial/ethnic backgrounds, research has traditionally focused on eating disorders in white populations. In this virtual issue, we present a collection of 14 articles previously published in the International Journal of Eating Disorders highlighting eating disorders in people of black/African and Indigenous heritage. Featured articles examine the prevalence and presentation of disordered eating in black and Indigenous populations; access to care and treatment experiences for black and Indigenous people; and environmental stressors, such as acculturative stress and discrimination, that may contribute to disordered eating in these populations. Future directions for inclusive research with people of black/African and Indigenous heritage are discussed, including reporting participant demographics, examining differences in risk factors and treatment outcomes across race/ethnicity, and partnering with black and Indigenous communities to produce culturally sensitive research attuned to the needs and priorities of these populations.

Associations between Race and Eating Disorder Symptom Trajectories in Black and White Girls

Epidemiological research suggests racial differences in the presentation of eating disorder symptoms. However, no studies have examined associations between race and eating disorder symptom trajectories across youth and adolescence, which is necessary to inform culturally sensitive prevention programs. The purpose of the current study was to examine the trajectories of eating disorder symptoms from childhood to young adulthood and to examine whether race was associated with trajectory group membership. Data were drawn from 2,305 Black and White girls who participated in a community-based longitudinal cohort study (Pittsburgh Girls Study) examining the development of psychopathology. The child and adult versions of the Eating Attitudes Test assessed self-reported eating disorder symptoms at six time points between ages 9 and 21 years. Growth mixture modeling was used to examine developmental trajectories of dieting, bulimia/food preoccupation, and total eating disorder symptom scores. Given potential confounds with race and disordered eating, financial strain (i.e., receiving public assistance) and weight were included as covariates. Four to six distinct developmental patterns were found across eating disorder symptoms, including none, increasing, decreasing, or increasing-decreasing trajectories. Black girls had a greater likelihood of being in the decreasing trajectories for dieting, bulimia/food preoccupation, and total eating disorder symptom scores. White girls were more likely to follow increasing trajectories of dieting and total eating disorder symptom scores compared to Black girls. These results highlight the importance of examining the influence of racial background on eating disorder symptoms and the potential need for differences in the timing and focus of prevention interventions in these groups.

Recollections of puberty and disordered eating in young women

Puberty begins a period of vulnerability for disordered eating that is maintained and amplified through adolescence and early adulthood. In the present study, we test the association between young women's recollections of physical maturation and disordered eating outcomes in early adulthood. Participants comprised N = 421 female undergraduate students at a large, northeastern university in the United States (M_age = 19.7 years). Three models assessed the relative contributions of recollected puberty (perceptions of changes and preparedness, and timing of puberty), current contextual (social support, romantic bond, sorority or sport participation), and demographic (race, socioeconomic status, family structure) variables to three eating-disorder outcomes. Recollections of feeling unprepared and disliking the physical changes of puberty predicted eating disorder symptoms more than any other demographic or current contextual factor. Results indicate that how young women experience the pubertal transition is related to eating disorder symptoms many years later.

Socialization and selection effects in the association between weight conscious peer groups and thin-ideal internalization: A co-twin control study

Affiliation with weight conscious peer groups is theorized to increase thin-ideal internalization through socialization processes. However, selection effects could contribute if genetic and/or environmental predispositions lead to affiliation with weight conscious peers. Co-twin control methodology was used to examine socialization and selection effects in 614 female twins (ages 8-15) from the Michigan State University Twin Registry (MSUTR). Thin-ideal internalization and peer group characteristics were assessed via self-report questionnaires. Results suggested the presence of both socialization and selection effects. In terms of socialization, twins who reported increased exposure to weight conscious peers relative to their co-twins had elevated thin-ideal internalization scores, regardless of zygosity. However, associations between weight conscious peers and thin-ideal internationalization within twin pairs were attenuated, suggesting that genetic and shared environmental selection effects also contribute. Findings significantly extend previous work by confirming the presence of socialization processes and highlighting selection processes to be examined in future longitudinal research.

Research Review: What we have learned about the causes of eating disorders - a synthesis of sociocultural, psychological, and biological research

BACKGROUND

Eating disorders are severe psychiatric disorders with a complex etiology involving transactions among sociocultural, psychological, and biological influences. Most research and reviews, however, focus on only one level of analysis. To address this gap, we provide a qualitative review and summary using an integrative biopsychosocial approach.

METHODS

We selected variables for which there were available data using integrative methodologies (e.g., twin studies, gene-environment interactions) and/or data at the biological and behavioral level (e.g., neuroimaging). Factors that met these inclusion criteria were idealization of thinness, negative emotionality, perfectionism, negative urgency, inhibitory control, cognitive inflexibility, serotonin, dopamine, ovarian hormones. Literature searches were conducted using PubMed. Variables were classified as risk factors or correlates of eating disorder diagnoses and disordered eating symptoms using Kraemer et al.'s (1997) criteria.

FINDINGS

Sociocultural idealization of thinness variables (media exposure, pressures for thinness, thin-ideal internalization, thinness expectancies) and personality traits (negative emotionality, perfectionism, negative urgency) attained 'risk status' for eating disorders and/or disordered eating symptoms. Other factors were identified as correlates of eating pathology or were not classified given limited data. Effect sizes for risk factors and correlates were generally small-to-moderate in magnitude.

CONCLUSIONS

Multiple biopsychosocial influences are implicated in eating disorders and/or disordered eating symptoms and several can now be considered established risk factors. Data suggest that psychological and environmental factors interact with and influence the expression of genetic risk to cause eating pathology. Additional studies that examine risk variables across multiple levels of analysis and that consider specific transactional processes amongst variables are needed to further elucidate the intersection of sociocultural, psychological, and biological influences on eating disorders.

Genetic and environmental influences on thin-ideal internalization across puberty and preadolescent, adolescent, and young adult development

OBJECTIVE

Mean-levels of thin-ideal internalization increase during adolescence and pubertal development, but it is unknown whether these phenotypic changes correspond to developmental changes in etiological (i.e., genetic and environmental) risk. Given the limited knowledge on risk for thin-ideal internalization, research is needed to guide the identification of specific types of risk factors during critical developmental periods. The present twin study examined genetic and environmental influences on thin-ideal internalization across adolescent and pubertal development.

METHOD

Participants were 1,064 female twins (ages 8-25 years) from the Michigan State University Twin Registry. Thin-ideal internalization and pubertal development were assessed using self-report questionnaires. Twin moderation models were used to examine if age and/or pubertal development moderate genetic and environmental influences on thin-ideal internalization.

RESULTS

Phenotypic analyses indicated significant increases in thin-ideal internalization across age and pubertal development. Twin models suggested no significant differences in etiologic effects across development. Nonshared environmental influences were most important in the etiology of thin-ideal internalization, with genetic, shared environmental, and nonshared environmental accounting for approximately 8%, 15%, and 72%, respectively, of the total variance.

DISCUSSION

Despite mean-level increases in thin-ideal internalization across development, the relative influence of genetic versus environmental risk did not differ significantly across age or pubertal groups. The majority of variance in thin-ideal internalization was accounted for by environmental factors, suggesting that mean-level increases in thin-ideal internalization may reflect increases in the magnitude/strength of environmental risk across this period. Replication is needed, particularly with longitudinal designs that assess thin-ideal internalization across key developmental phases.

Puberty as a critical risk period for eating disorders: a review of human and animal studies

This article is part of a Special Issue "Puberty and Adolescence". Puberty is one of the most frequently discussed risk periods for the development of eating disorders. Prevailing theories propose environmentally mediated sources of risk arising from the psychosocial effects (e.g., increased body dissatisfaction, decreased self-esteem) of pubertal development in girls. However, recent research highlights the potential role of ovarian hormones in phenotypic and genetic risk for eating disorders during puberty. The goal of this paper is to review data from human and animal studies in support of puberty as a critical risk period for eating disorders and evaluate the evidence for hormonal contributions. Data are consistent in suggesting that both pubertal status and pubertal timing significantly impact risk for most eating disorders in girls, such that advanced pubertal development and early pubertal timing are associated with increased rates of eating disorders and their symptoms in both cross-sectional and longitudinal research. Findings in boys have been much less consistent and suggest a smaller role for puberty in risk for eating disorders in boys. Twin and animal studies indicate that at least part of the female-specific risk is due to genetic factors associated with estrogen activation at puberty. In conclusion, data thus far support a role for puberty in risk for eating disorders and highlight the need for additional human and animal studies of hormonal and genetic risk for eating disorders during puberty.

Pubertal development predicts eating behaviors in adolescence

OBJECTIVE

Early maturing girls are at increased risk for disordered eating. However, it is unclear if the association between puberty and disordered eating continues throughout pubertal development and if a similar association is exhibited in boys.

METHOD

Participants included 1340 same- and 624 opposite-sex twins from the Swedish Twin Study of Child and Adolescent Development. Pubertal development was assessed at age 13-14 with the pubertal development scale. General disordered eating, measured with the eating disorder inventory-2 (EDI) was assessed at age 16-17, and dieting and purging behaviors were assessed at both ages 16-17 and 19-20. We applied analysis of variance and logistic regression analyses to determine whether pubertal development in early-to-mid adolescence predicted eating disorder-related behaviors in late adolescence and young adulthood.

RESULTS

Pubertal development in early-to-mid adolescence was significantly associated with EDI scores and dieting in late adolescence. No significant association was observed between pubertal development and dieting and purging in young adulthood.

DISCUSSION

Complex combinations of cultural and biological influences likely converge during pubertal development increasing vulnerability to disordered eating. The impact of pubertal development on disordered eating appears to be limited to the adolescent period.

Spanish version of the Body Appreciation Scale (BAS) for adolescents

The need to study the positive aspects of body image led to the design of the Body Appreciation Scale (BAS). The aim of the present study was to develop a Spanish adaptation of the BAS for adolescents, testing its factor structure, construct validity and any differences between girls and boys. Participants were 312 adolescents aged between 12 and 20; there were 148 females and 164 males. The validation analysis of the BAS revealed a one-factor structure with adequate internal consistency (Cronbach's alpha = .908) and construct validity (correlations with body mass index, influence of the body shape model, perceived stress, coping strategies, self-esteem and variables from the Eating Disorders Inventory-2), as well as significant differences between boys and girls (p < .01). The BAS is suitable for administration in a Spanish adolescent population as a way of analysing the positive aspects of body image.

Puberty and the genetic diathesis of disordered eating attitudes and behaviors

Twin studies from the Minnesota Twin Family Study (MTFS) suggest negligible genetic effects on eating pathology before puberty but increased genetic effects during puberty. However, an independent study found no pubertal differences in genetic and environmental effects (R. Rowe, A. Pickles, E. Simonoff, C. M. Bulik, & J. L. Silberg, 2002). Discrepant results may be due to methodological differences. The MTFS studies divided twins at mid-puberty, whereas R. Rowe et al. (2002) divided twins based on menarche alone. In the present study, the authors aimed to reconcile discrepant findings by examining differences in etiologic effects for disordered eating attitudes and behaviors (i.e., levels of weight preoccupation, body dissatisfaction, binge eating, compensatory behaviors) using both classification methods in a new sample of 656 female twins. Using the MTFS method (i.e., K. L. Klump, M. McGue, & W. G. Iacono, 2003), the authors observed nominal genetic effects in prepubertal twins but significant genetic effects in pubertal and young adult twins. Conversely, genetic effects were moderate and equal in all groups using the R. Rowe et al. (2002) method. Findings highlight the potentially important role of puberty in the genetic diathesis of disordered eating attitudes and behaviors and the need to use early indicators of pubertal status in studies of developmental effects.

The influence of gender and puberty on the heritability of disordered eating symptoms

Eating disorders and disordered eating symptoms are clearly heritable, but recent research has suggested that genetic and environmental influences on disordered eating symptoms vary as a function of gender and development. Data are limited, but evidence suggests that gender may moderate the type of genetic risk, rather than the magnitude of genetic effects, on disordered eating symptoms. Only a moderate proportion of the genetic influences on disordered eating symptoms are shared between males and females. In females, at least some of the unique genetic risk may be related to puberty and ovarian hormone regulation. The heritability of disordered eating symptoms in females increases with both pubertal development and increasing levels of estradiol. Although much more research is needed to elucidate specific mechanisms, gonadal hormones may be promising candidates for understanding sex and developmental effects and the ways in which genes exert their influence on disordered eating.

Internalization of the thin ideal among low-income ethnic minority adolescent girls

Internalization of the thin ideal has been thought to occur disproportionately among Caucasian, upper-class girls and women. The current research challenges this view by assessing thin-ideal internalization among low-income ethnic minority girls (N=48). This research identifies differences between low-income ethnic minority adolescent girls who highly internalize the thin ideal (HI) and those who have lower internalization of thinness (LI). Results indicate that HI and LI groups do not differ based on ethnicity or weight categorization. Body satisfaction, competence, and perceived sociocultural pressure were analyzed as individual differences between HI versus LI participants. Those in the LI group have higher athletic competence and body satisfaction ratings for weight compared to the HI group. By identifying differences in thin-ideal internalization in this understudied population, factors that may protect someone from endorsing the thin ideal may be discovered.

Construção e fidedignidade teste-reteste de escalas de silhuetas brasileiras para adultos e crianças

O objetivo deste trabalho foi desenvolver escalas de silhuetas para crianças e adultos brasileiros de ambos os sexos e iniciar a avaliação de suas qualidades psicométricas. Foram fotografados adultos e crianças com Índice de Massa Corporal (IMC) previamente conhecidos, desenhadas as silhuetas e construídas as escalas por computação gráfica. Para avaliação da fidedignidade, procedeu-se ao teste-reteste com intervalo de um mês. As escalas foram aplicadas e reaplicadas a 90 adultos (18 a 60 anos) e 69 crianças (7 a 12 anos). As escalas apresentaram coeficientes de correlação entre teste e reteste positivos e significativos para o IMC real e IMC percebido como atual por adultos (r=0,84; p<0,01) e crianças (r=0,61, p<0,01). Concluiu-se que as escalas desenvolvidas constituem instrumentos apropriados à aplicação clínica e epidemiológica para avaliar a percepção da imagem corporal de crianças e adultos brasileiros.

Protective self-presentation style: association with disordered eating and anorexia nervosa mediated by sociocultural attitudes towards appearance

OBJECTIVE

We tested the hypothesis that a protective self-presentation style (Lennox and Wolfe, 1984) is associated with eating pathology and anorexia nervosa (AN) and that this association is mediated by sociocultural attitudes towards appearance emphasizing the thin ideal.

METHOD

We compared the protective-presentation style of women with AN (N=17), partially recovered women (N=110), fully recovered women (N=73), and female controls (N=374).

RESULTS

Ill women had a more protective self-presentation style than partially or fully recovered women, who in turn had a more protective self-presentation style than controls. Sociocultural attitudes towards appearance fully mediated the association between protective self-presentation and disordered eating.

CONCLUSIONS

Protective self-presentation may therefore be a risk factor for AN and/or a prognostic factor. Implications for therapy and prevention are discussed.

Disordered eating attitudes and symptomatology among adolescent girls in the United Arab Emirates

OBJECTIVE

To ascertain the prevalence and correlates of disordered eating attitudes and symptomatology in a school-based Arab population.

METHODS

A representative stratified random sample of 495 adolescent girls completed the Eating Attitudes Test (EAT-40) in the United Arab Emirates (UAE). A randomly selected subgroup from the those who scored above the recommended cut-off of 30 on the EAT-40 and an equal number of those who scored below 30 were interviewed in stage 2 by a psychiatrist, blind to the EAT scores, using the Schedule for Affective Disorders and Schizophrenia (KSADS) and DSM-IV criteria for the presence of eating disorders.

RESULTS

116 girls (23.4%) scored above the recommended cut-off on EAT. High EAT score was associated with age, BMI, internalization of thin ideal and drive for thinness, knowing someone on a weight loss strategy, having a family member with weight-related or mental health problem and watching western TV programs. Using clinical interview of 100 girls in stage 2, half of those who scored above the cut-off on EAT were found to have a propensity for anorexic behavior, while 2% met the criteria for the full clinical syndrome.

CONCLUSIONS

Thin body preoccupation as well as family and social factors are important in the development of abnormal eating attitudes among adolescents in this Arabian Gulf country.