Compared to males, female adolescents show greater concerns about their appearance, concerns related to their self-esteem. We explored the associations between self-esteem, body image and BMI as proxies for appearance, and eating-disordered behavior among adolescent females.
Methods
A total of 263 females (mean age:15.78 years) took part in this study. They completed questionnaires covering anthropometric characteristics, self-esteem, eating-disordered behavior, subjective physical activity levels, and body image.
Results
Higher scores for self-esteem were associated with higher scores for eating-disordered behavior, indices of physical activity, and slimmer body image. Body image was not associated with eating-disordered behavior. Multiple regression analyses showed that self-esteem, but not physical activity, or body image predicted eating-disordered behavior.
Conclusions
Among a non-clinical sample of female adolescents, self-esteem and eating-disordered behavior were positively associated. Body image was associated in a complex and contradictory fashion. It is possible that cognitive-emotional mastering of the vital impulse to eat may enhance self-esteem.
AhmadiS.MoloodiR.ZarbakshM. R.GhaderiA. (2014).
Psychometric properties of the Eating Attitude Test-26 for female Iranian students.Eating and Weight Disorders,
19(2), 183–189. https://doi.org/10.1007/s40519-014-0106-7
2.
AlipourB.Abbasalizad FarhangiM.DehghanP.AlipourM. (2015).
Body image perception and its association with body mass index and nutrient intakes among female college students aged 18-35 years from Tabriz, Iran. Eating and Weight Disorders,
20(4), 465–471. https://doi.org/10.1007/s40519-015-0184-1
3.
Al-KhudairyL.LovemanE.ColquittJ. L.MeadE.JohnsonR. E.FraserH., Olajide, J., Murphy, M., Velho, R. M., O'Malley, C., Azevedo, L. B., Ells, L. J., Metzendorf, M. I., & ReesK. (2017).
Diet, physical activity and behavioural interventions for the treatment of overweight or obese adolescents aged 12 to 17 years.Cochrane Database of Systematic Review,
6, Cd012691. https://doi.org/10.1002/14651858.Cd012691
BoeT.HysingM.StormarkK. M.LundervoldA. J.SivertsenB. (2012).
Sleep problems as a mediator of the association between parental education levels, perceived family economy and poor mental health in children.Journal of Psychosomatic Research,
73(6), 430–436. https://doi.org/10.1016/j.jpsychores.2012.09.008
6.
BoeT.SerlachiusA. S.SivertsenB.PetrieK. J.HysingM. (2018).
Cumulative effects of negative life events and family stress on children’s mental health: The Bergen Child Study. Social Psychiatry and Psychiatric Epidemiology,
53, 1–9. https://doi.org/10.1007/s00127-017-1451-4
7.
BoeT.SivertsenB.HeiervangE.GoodmanR.LundervoldA. J.HysingM. (2014).
Socioeconomic status and child mental health: The role of parental emotional well-being and parenting practices.Journal of Abnormal Child Psychology,
42(5), 705–715. https://doi.org/10.1007/s10802-013-9818-9
8.
BorW.DeanA. J.NajmanJ.HayatbakhshR. (2014).
Are child and adolescent mental health problems increasing in the 21st century? A systematic review.Australian and New Zealand Journal of Psychiatry,
48(7), 606–616. https://doi.org/10.1177/0004867414533834
9.
BrüneM. (2015). Textbook of evolutionary psychiatry and psychosomatic medicine. The origins of psychopathology.
Oxford University Press.
10.
BussD. M. (2019). Evolutionary psychology. The new science of the mind (6th ed.).
Taylor & Francis.
11.
CardinalT. M.KacirotiN.LumengJ. C. (2006).
The figure rating scale as an index of weight status of women on videotape.Obesity (Silver Spring),
14(12), 2132–2135. https://doi.org/10.1038/oby.2006.249
12.
CollinP.KaratziasT.PowerK.HowardR.GriersonD.YellowleesA. (2016).
Multi-dimensional self-esteem and magnitude of change in the treatment of anorexia nervosa.Psychiatry Research,
237, 175–181. https://doi.org/10.1016/j.psychres.2016.01.046
13.
CooneyM.LiebermanM.GuimondT.KatzmanD. K. (2018).
Clinical and psychological features of children and adolescents diagnosed with avoidant/restrictive food intake disorder in a pediatric tertiary care eating disorder program: A descriptive study.Journal of Eat Disorders,
6, 7. https://doi.org/10.1186/s40337-018-0193-3
CrockerP. R.BaileyD. A.FaulknerR. A.KowalskiK. C.McGrathR. (1997).
Measuring general levels of physical activity: Preliminary evidence for the Physical Activity Questionnaire for Older Children. Medicine & Science in Sports & Exercise,
29(10), 1344–1349.
16.
DingC.ZhangJ.YangD. (2018).
A pathway to psychological difficulty: Perceived chronic social adversity and its symptomatic reactions.Frontiers in Psychology,
9, 615. https://doi.org/10.3389/fpsyg.2018.00615
17.
EspinozaP.PeneloE.MoraM.FranciscoR.GonzálezM. L.RaichR. M. (2019).
Bidirectional relations between disordered eating, internalization of beauty ideals, and self-esteem: A longitudinal study with adolescents. The Journal of Early Adolescence,
39(9), 1244–1260.
18.
FaghihimaniZ.NourianMNikkarA. H.FarajzadeganZ.KhavariyanN.GhatrehsamaniS.PoursafaP.KelishadiR. (2010).
Validation of the child and adolescent international physical activity questionnaire in Iranian children and adolescents. Arya Atherosclerosis,
5(4), 1–3.
19.
FournierM. E.LevyS. (2006).
Recent trends in adolescent substance use, primary care screening, and updates in treatment options.Current Opinion in Pediatrics,
18(4), 352–358. https://doi.org/10.1097/01.mop.0000236381.33907.9d
20.
GarfinkelP. E.NewmanA. (2001).
The eating attitudes test: Twenty-five years later. Eating and Weight Disorders,
6(1), 1–24.
21.
GarnerD. M.GarfinkelP. E. (1979).
The Eating Attitudes Test: An index of the symptoms of anorexia nervosa. Psychological Medicine,
9(2), 273–279.
22.
GossK.AllanS. (2009).
Shame, pride and eating disorders.Clinical Psychology & Psychotherapy,
16(4), 303–316. https://doi.org/10.1002/cpp.627
23.
GuyerA. E.CaouetteJ. D.LeeC. C.RuizS. K. (2014).
Will they like me? Adolescents’ emotional responses to peer evaluation.International Journal of Behavioral Development,
38(2), 155–163. https://doi.org/10.1177/0165025413515627
24.
HeJ.CaiZ.FanX. (2017).
Prevalence of binge and loss of control eating among children and adolescents with overweight and obesity: An exploratory meta-analysis.International Journal of Eating Disorders,
50(2), 91–103. https://doi.org/10.1002/eat.22661
25.
HoltzmanN. S.StrubeM. J. (2013).
Above and beyond short-term mating, long-term mating is uniquely tied to human personality. Evolutionary Psychology,
11(5), 1101–1129.
26.
HydeJ. S.MezulisA. H.AbramsonL. Y. (2008).
The ABCs of depression: Integrating affective, biological, and cognitive models to explain the emergence of the gender difference in depression.Psychological Review,
115(2), 291–313. https://doi.org/10.1037/0033-295X.115.2.291
27.
JohnstonJ.ShuC. Y.HoilesK. J.ClarkeP. J. F.WatsonH. J.DunlopP. D.EganS. J. (2018).
Perfectionism is associated with higher eating disorder symptoms and lower remission in children and adolescents diagnosed with eating disorders.Eating Behaviors,
30, 55–60. https://doi.org/10.1016/j.eatbeh.2018.05.008
28.
KostanskiM.GulloneE. (1998).
Adolescent body image dissatisfaction: Relationships with self-esteem, anxiety, and depression controlling for body mass. Journal of Child Psychology and Psychiatry,
39(2), 255–262.
29.
LangC.BrandS.FeldmethA. K.Holsboer-TrachslerE.PuhseU.GerberM. (2013).
Increased self-reported and objectively assessed physical activity predict sleep quality among adolescents.Physiology & Behavior,
120, 46–53. https://doi.org/10.1016/j.physbeh.2013.07.001
30.
LewerM.BauerA.HartmannA. S.VocksS. (2017).
Different facets of body image disturbance in binge eating disorder: A review. Nutrients,
9(12), 1294. https://doi.org/10.3390/nu9121294
31.
LinksonL.MacedoP.PerrinF. M. R.ElstonC. M. (2018).
Anorexia nervosa in cystic fibrosis.Paediatric Respiratory Reviews,
26, 24–26. https://doi.org/10.1016/j.prrv.2017.03.002
32.
LiuM.WuL.MingQ. (2015).
How does physical activity intervention improve self-esteem and self-concept in children and adolescents? Evidence from a meta-analysis.PLoS One,
10(8), e0134804.https://doi.org/10.1371/journal.pone.0134804
33.
MacleodS. (1981). The art of starvation.
Virago.
34.
MadsenK. A.McCullochC. E.CrawfordP. B. (2009).
Parent modeling: Perceptions of parents' physical activity predict girls’ activity throughout adolescence.Journal of Pediatrics,
154(2), 278–283. https://doi.org/10.1016/j.jpeds.2008.07.044
35.
MarucciS.RagioneL. D.De IacoG.MococciT.ViciniM.GuastamacchiaE.TriggianiV. (2018).
Anorexia nervosa and comorbid psychopathology.Endocrine, Metabolic, Immune Disorders— Drug Targets,
18(4), 316–324. https://doi.org/10.2174/1871530318666180213111637
36.
MilitelloL. K.KellyS.MelynkB. M.SmithL.PetosaR. (2018).
A review of systematic reviews targeting the prevention and treatment of overweight and obesity in adolescent populations. Journal of Adolescent Health,
63, 675–687. https://doi.org/10.1016/j.jadohealth.2018.07.013
37.
OzmenD.OzmenE.ErginD.CetinkayaA. C.SenN.DundarP. E.TaskinE. O. (2007).
The association of self-esteem, depression and body satisfaction with obesity among Turkish adolescents.BMC Public Health,
7, 80. https://doi.org/10.1186/1471-2458-7-80
38.
Pelletier BrochuJ.MeilleurD.DiMeglioG.TaddeoD.LavoieE.ErdsteinJ., Pause, R., Pesant, C., Thibault, I., & FrappierJ. Y. (2018).
Adolescents’ perceptions of the quality of interpersonal relationships and eating disorder symptom severity: The mediating role of low self-esteem and negative mood.Eat Disorders,
26(4), 388–406. https://doi.org/10.1080/10640266.2018.1454806
39.
RichardsonC. E.GradisarM.ShortM. A.LangC. (2017).
Can exercise regulate the circadian system of adolescents? Novel implications for the treatment of delayed sleep-wake phase disorder.Sleep Medicine Reviews,
34, 122–129. https://doi.org/10.1016/j.smrv.2016.06.010
40.
RosenbergM. (1965). Society and the adolescent self-image.
Princeton University Press.
41.
ShapurianR.HojatM.NayerahmadiH. (1987).
Psychometric characteristics and dimensionality of a Persian version of Rosenberg Self-esteem Scale.Perceptual and Motor Skills,
65(1), 27–34. https://doi.org/10.2466/pms.1987.65.1.27
42.
SheehanD. V.LecrubierY.SheehanK. H.AmorimP.JanavsJ.WeillerE., Hergueta, T., Baker, R., & DunbarG. C. (1998).
The Mini-International Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry,
59(Suppl 20), 22–33;quiz 34–57. http://www.ncbi.nlm.nih.gov/pubmed/9881538
43.
ShorakaH.AmirkafiA.GarrusiB. (2019).
Review of body image and some of contributing factors in Iranian population.International Journal of Preventive Medicine,
10, 19. https://doi.org/10.4103/ijpvm.IJPVM_293_18
44.
SinghD. (1993).
Adaptive significance of female physical attractiveness: Role of waist-to-hip ratio. Journal of Personality and Social Psychology,
65(2), 293–307.
45.
SinghD. (2002).
Female mate value at a glance: Relationship of waist-to-hip ratio to health, fecundity and attractiveness. Neuroendocrinology Letters,
23(Suppl 4), 81–91.
46.
SivertsenB.BoeT.SkogenJ. C.PetrieK. J.HysingM. (2017).
Moving into poverty during childhood is associated with later sleep problems. Sleep Medicine,
37, 54–59. https://doi.org/10.1016/j.sleep.2017.06.005
47.
SkarupkeC.SchlackR.LangeK.GoerkeM.DueckA.ThomeJ., Szagun, B., & CohrsS. (2017).
Insomnia complaints and substance use in German adolescents: Did we underestimate the role of coffee consumption? Results of the KiGGS study.Journal of Neural Transmission (Vienna),
124(Suppl 1), 69–78. https://doi.org/10.1007/s00702-015-1448-7
48.
SminkF. R. E.van HoekenD.DijkstraJ. K.DeenM.OldehinkelA. J.HoekH. W. (2018).
Self-esteem and peer-perceived social status in early adolescence and prediction of eating pathology in young adulthood.International Journal of Eating Disorders,
51(8), 852–862. https://doi.org/10.1002/eat.22875
49.
SticeE. (2016).
Interactive and mediational etiologic models of eating disorder onset: Evidence from prospective studies.Annual Review of Clinical Psychology,
12, 359–381. https://doi.org/10.1146/annurev-clinpsy-021815-093317
50.
StunkardA. J.SorensenT.SchulsingerF. (1983).
Use of the Danish Adoption Register for the study of obesity and thinness. Research Publication—Association for Research in Nervous and Mental Disease,
60, 115–120.
51.
ToniG.BerioliM. G.CerquigliniL.CeccariniG.GrohmannU.PrincipiN.EspositoS. (2017).
Eating disorders and disordered eating symptoms in adolescents with type 1 diabetes. Nutrients,
9(8), 906. https://doi.org/10.3390/nu9080906
52.
TruongA.MoukaddamN.ToledoA.Onigu-OtiteE. (2017).
Addictive disorders in adolescents.Psychiatrics Clinics of North America,
40(3), 475–486. https://doi.org/10.1016/j.psc.2017.05.012
53.
van der SchuurW. A.BaumgartnerS. E.SumterS. R. (2018).
Social media use, social media stress, and sleep: Examining cross-sectional and longitudinal relationships in adolescents. Health Communication,
34, 552–559. https://doi.org/10.1080/10410236.2017.1422101
54.
VitousekK. M. (1996). The current status of cognitive–behavioral models of anorexia nervosa and bulimia nervosa. In SalkovskisP. M.; (Ed.), Frontiers of cognitive therapy (pp. 383–418).
Guilford.
55.
WoodwardK.McIlwainD.MondJ. (2019).
Feelings about the self and body in eating disturbances: The role of internalized shame, self-esteem, externalized self-perceptions, and body shame. Self and Identity,
18(2), 159–182.
56.
World Medical Association. (2013).
World Medical Association Declaration of Helsinki: Ethical principles for medical research involving human subjects.Journal of American Medical Association,
310(20), 2191–2194. https://doi.org/10.1001/jama.2013.281053
57.
YangJ.ZhangS.LouY.LongQ.LiangY.XieS.YuanJ. (2017).
The increased sex differences in susceptibility to emotional stimuli during adolescence: An event-related potential study.Frontiers in Human Neuroscience,
11, 660. https://doi.org/10.3389/fnhum.2017.00660
58.
Zamani SaniS. H.FathirezaieZ.BrandS.PuhseU.Holsboer-TrachslerE.GerberM.TalepasandS. (2016).
Physical activity and self-esteem: Testing direct and indirect relationships associated with psychological and physical mechanisms.Neuropsychiatric Disease and Treatment,
12, 2617–2625. https://doi.org/10.2147/ndt.s116811
59.
ZhangL.QianH.FuH. (2018).
To be thin but not healthy—The body-image dilemma may affect health among female university students in China. PLoS One,
13(10), e0205282. https://doi.org/10.1371/journal.pone.0205282
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