Body Dissatisfaction Among Adolescent Boys and Girls

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EMPIRICAL RESEARCH Body Dissatisfaction Among Adolescent Boys and Girls: The Effects of Body Mass, Peer Appearance Culture and Internalization of Appearance Ideals Margaret Lawler • Elizabeth Nixon Received: 14 September 2009 / Accepted: 17 December 2009 / Published online: 8 January 2010 Ó Springer Science+Business Media, LLC 2010 Abstract Body image dissatisfaction is a significant risk factor in the onset of eating pathology and depression. Therefore, understanding predictors of negative body image is an important focus of investigation. This research sought to examine the contributions of body mass, appearance conversations with friends, peer appearance criticism and internalization of appearance ideals to body dissatisfaction among adolescents. The sample was com- prised of 239 (54% female) adolescents, with a mean age of 16 years. Self-report questionnaires were completed on body dissatisfaction, peer appearance conversations and criticism, internalization of appearance ideals, height and weight. For girls and boys, body mass, appearance con- versations with friends, peer appearance criticism and internalized appearance ideals emerged as significant pre- dictors of body dissatisfaction. Gender moderated the effect of body mass on body dissatisfaction. Internalization mediated the relationship between peer appearance con- versations and criticism, and body dissatisfaction. These findings suggest that while body mass exerts a differential risk for body dissatisfaction among boys and girls, inter- nalisation may represent a key psychological process that underpins body dissatisfaction among both boys and girls. Keywords Body dissatisfaction Á Internalization Á Adolescence Á Peer influence Á Body mass Á Gender differences Introduction Adolescence may be characterised as a decisive period in the development of body image. The considerable social, cognitive and physical changes experienced at this time contribute to the heightened awareness of body and weight concerns among adolescent males and females (Ata et al. 2007 ). Contemporary research suggests that body image dissatisfaction, or subjective unhappiness with some aspect of one’s appearance, is indeed a prevalent concern with approximately 30% of boys and 60% of girls reporting a desire to alter their shape or size (Ricciardelli and McCabe 2001 ; Stice and Whitenton 2002 ). Body image dissatis- faction is of growing importance owing to its implication as a risk factor in the subsequent onset of eating disorders (Stice et al. 2002 ), depression (McCreary and Sasse 2000 ), emotional distress (Johnson and Wardle 2005 ) and low self-esteem (Stice and Bearman 2001 ). Given the negative consequences of body image dissatisfaction, it is impera- tive that factors associated with and contributing to nega- tive body image are explored. Socio-cultural models have been prominent in explain- ing the development of body image dissatisfaction among young people. These models propose that society promotes an appearance culture that highlights the desirability of physical attractiveness and beauty for both males and females (Thompson et al. 1999 ; Keery et al. 2004 ). Female beauty is inextricably linked to thinness, with low body weight defined as a central attribute and key evaluative dimension of physical attractiveness (Stice et al. 2000 ; Nichter and Nichter 1991 ). In contrast with the thin ideal espoused for females, evolving cultural ideals of male appearance endorse a muscular or mesomorphic physique (Frederick et al. 2007 ; Grogan 2008 ). While males and females may be aware of socio-cultural ideals, it has been M. Lawler ( & ) Á E. Nixon School of Psychology & Children’s Research Centre, Trinity College Dublin, Dublin 2, Ireland e-mail: lawlerma@tcd.ie E. Nixon e-mail: enixon@tcd.ie 123 J Youth Adolescence (2011) 40:59–71 DOI 10.1007/s10964-009-9500-2

argued that girls respond with greater intensity to these body ideals, and consequently experience greater body image dissatisfaction than boys (Knauss et al. 2007 ). These cultural ideals of beauty and body shape are modelled and reinforced through societal factors of which the mass media is arguably the most powerful communi- cator. Repeated exposure to media images of unrealisti- cally thin females and muscular males may significantly impact development and maintenance of body image through internalization of cultural ideals (Levine and Murnen 2009 ; Dittmar 2009 ). Greater exposure to media influence does not necessarily predict body dissatisfaction however, suggesting that the media only represents one element of the appearance culture and that body discontent may develop through reinforcement of cultural appearance ideals from more immediate socialisation agents, such as peers and parents (Ata et al. 2007 ; McCabe and Ricciard- elli 2005 ). Indeed, Keery et al. ( 2004a , b ) Tripartite Influence Model of body dissatisfaction identifies the media, peers and parents as the three formative socio-cul- tural influences on body image. Relative to the media and parents, peer influences on body image have received less attention in the research literature; thus, the current study sought to contribute to research in this area by focusing upon the influence of peer experiences on body image dissatisfaction. Peer experi- ences provide an important social context, in which appear- ance norms and ideals are communicated, modelled and reinforced, and, thus, may be of significant consequence for body image development (Jones and Crawford 2006 ; Thompson et al. 2007 ; Shroff and Thompson 2006 ). There are a number of peer experiences that are hypothesised to influence body image dissatisfaction, such as appearance conversations, criticism and teasing (Jones et al. 2004 ). The predictive role of these specific peer experiences (appear- ance conversations and peer criticism and teasing) in body image dissatisfaction was the first key focus of our investigation. Appearance Conversations with Friends Adolescents partake in ‘‘appearance training’’ with peers through everyday engagement in conversations regarding looks, image and attractiveness (Jones 2004 ). These appearance conversations provide an environment in which looks and image concerns are focused upon, interpreted and subsequently come to be valued. The time and attention given to body image issues reinforce the significance of appearance as a central attribute to peers and promotes the creation and adoption of appearance norms and ideals (Jones 2004 ). Peer appearance conversations may be par- ticularly influential in body image development due to the vast amount of time spent with same-gender peers, the high value attached to such friendships and the significance of friends in developing and determining the adolescent’s social perspective (Shroff and Thompson 2006 ; Berndt and Keefe 1995 ). Previous research has confirmed that children and ado- lescents reporting more frequent conversations with peers about appearance and possible ways of enhancing appear- ance demonstrated greater body dissatisfaction and inter- nalization of appearance ideals than those who engaged in appearance conversations less regularly (Clark and Tigge- mann 2006 ; Jones 2004 ). Gender differences have been evidenced regarding the frequency with which males and females engage in peer appearance conversations with adolescent females being more inclined than males to dis- cuss appearance and weight loss concerns with peers (Jones et al. 2004 ; Murray et al. 1995 ). More recently, Jones and Crawford ( 2006 ) argued that, while girls reported more frequent engagement in general appearance conversations, boys talked more frequently to peers about muscular enhancement than girls talked to friends about dieting. It appears that males actively partake in appearance related conversations when the focus is on muscularity, as muscle building talk fits with the masculine appearance ideal and, therefore, it may be considered socially desirable to adopt behaviours designed to approximate this ‘‘muscular’’ phy- sique ideal. Furthermore, male friendships are typically more activity focused; muscle building talk may provide a stereotypical interest that can be jointly pursued with friends (Jones and Crawford 2006 ). These findings suggest that prior research may have underestimated male engagement in appearance conversations by focusing on topics of gen- eral appearance and weight loss, which are typically of greater concern to females. Peer Appearance Criticism and Teasing Peers are inextricably implicated in the teasing experiences of adolescent boys and girls (Mooney et al. 2009 ; Eisen- berg et al. 2003 ). Empirical evidence from cross-sectional research has consistently identified a positive relationship between peer teasing about appearance and body dissatis- faction in boys and girls (Thompson et al. 2007 ; Barker and Galambos 2003 ). Jones et al. ( 2004 ) found positive asso- ciations between peer appearance criticism and body dis- satisfaction and in particular peer appearance criticism was the strongest direct predictor of body image dissatisfaction among boys but not among girls. Peer appearance criticism and teasing may be considered as a means through which norms and expectations of the peer appearance culture are identified, shared and acknowl- edged among adolescents. Negative peer appearance com- mentary is proposed to highlight appearance attributes that are deemed attractive, with criticism targeted towards boys 60 J Youth Adolescence (2011) 40:59–71 123

and girls who lack such attributes and thereby violate appearance norms (Jones et al. 2004 ). Actively experiencing criticism in regard to one’s body produces a direct experi- ence of negative evaluation of one’s personal appearance by another. Thus, peer teasing may also promote the internal- ization of cultural ideals by reinforcing the value of appearance to peers (Jones et al. 2004 ). In other words, internalization may be a key psychological process linking peer teasing with body dissatisfaction. Internalization of Appearance Ideals Internalization of appearance ideals refers to the extent to which an individual cognitively buys into socially defined ideals of attractiveness, incorporates these standards into one’s personal belief system and commits to behaviours intended to produce an approximation of these ideals (Thompson and Stice 2001 ). The commitment to societal appearance standards that are virtually unattainable theo- retically promotes body dissatisfaction due to inevitable discrepancies between one’s current shape and the physical ideal (Stice and Whitenton 2002 ). However, conflicting findings have emerged in the literature regarding the role of internalization in the development of body dissatisfaction for boys and girls. Some studies have supported a rela- tionship between internalization of appearance ideals and body dissatisfaction among girls (Chen et al. 2007 ; Knauss et al. 2008 ; Clark and Tiggemann 2008 ), and among boys (Halliwell and Harvey 2006 ; Knauss et al. 2007 ; Jones 2004 ). In contrast, other prospective research has found no support for internalization of appearance ideals as a pre- dictor of change in body dissatisfaction among adolescent boys and girls (Bearman et al. 2006 ; Presnell et al. 2004 ). Together, these findings suggest that gender moderates the role between internalization and body dissatisfaction, although further research is needed to characterise the nature of this gender moderation. Overall, the findings to date suggest that boys and girls may have varying experiences relating to peer appearance conversations and criticism, and internalization. Therefore, it is likely that the predictive influence of these experiences on body dissatisfaction may be distinct for boys and girls. In light of this, the current study sought to investigate how gender moderates the association between these peer experiences, internalization of appearance ideals and body dissatisfaction. Internalization as a Mediator of Socio-Cultural Influences Previous research has identified internalization as a critical mechanism underpinning the link between media exposure and body dissatisfaction (Thompson and Stice 2001 ), however internalization of media ideals appears to be moderated by gender. Knauss et al. ( 2008 ) reported that internalization of the media body ideal directly predicted body dissatisfaction among girls, but not among boys. This gender difference resonates with an earlier finding reported by these authors that girls internalized media body ideals to a greater extent than boys; thus, greater endorsement of media ideals and perceived pressure to live up to these ideals may well contribute to the greater body dissatisfac- tion observed among samples of girls (Knauss et al. 2007 ). In contrast to internalization of media-ideals, relatively little research has explored how specific peer experiences have been implicated in appearance-ideal internalization and body dissatisfaction of adolescents. The greater value placed on appearance by peers presumably reinforces commitment to idealised images and, in turn, these inter- nalized representations negatively impact body image sat- isfaction (Clark and Tiggemann 2006 ; Thompson and Stice 2001 ). To date, little research has examined the internalization of appearance ideals as a mediator of peer experiences and body image. Keery et al. (2004) reported that internalization partially mediated the relationship between peer influence and body dissatisfaction while Shroff and Thompson ( 2006 ) revealed that internalization did not mediate between peer influence and body dissatisfaction, although internalization did mediate between peer influence and drive for thinness, self-esteem and bulimic symptoms. An important limitation of these studies was that they only included samples of adolescent girls; thus, an important gap remains in our understanding of the meditational role of internalization among adolescent boys. Jones ( 2004 ) investigated inter- nalization as a mediator for boys, but not for girls, and found no mediating role for ideal body internalization, while in contrast Jones et al. ( 2004 ) provided evidence that inter- nalization of appearance ideals mediates the relationship between appearance conversations with friends and body dissatisfaction for both boys and girls. Thus, it appears that this psychological process of internalization warrants fur- ther investigation, both as a direct predictor of body dis- satisfaction and as a mediator that links peer experiences and body dissatisfaction. The current study seeks to address the gap in the existing literature by examining the medita- tional role of internalization among both boys and girls. Body Mass Models that take account of socio-cultural factors only go so far in understanding the development of body image dis- satisfaction. An individual’s body mass has also emerged as a central influence. Obesity and excess weight are stigma- tised in western cultures, with larger body shapes regarded as socially undesirable for both adolescent girls and boys (Grogan 2006 , 2008 ). Accordingly, cross-sectional and J Youth Adolescence (2011) 40:59–71 61 123

longitudinal research has empirically evidenced a positive correlation between elevated levels of body mass and body dissatisfaction in adolescent males and females (McCabe et al. 2009 ; Chen et al. 2007 ; Thompson et al. 2007 ). Greater deviation from the ultra-thin ideal has been proposed to account for the increased body dissatisfaction experienced by girls with elevated body mass, as girls with greater adiposity may experience more pressure to be thin from their social environment. Stice and Whitenton ( 2002 ) found that girls who perceived pressure to be thin from their social environment demonstrated a risk of body dis- satisfaction onset that was four times greater than girls who perceived low levels of pressure to be thin. However, it is not merely perceived pressure that accounts for the rela- tionship between increased body mass and body dissatis- faction. Prospective research has demonstrated that elevated adiposity can directly influence body dissatisfac- tion even in the absence of perceived pressure to be thin through negative evaluation of one’s body. Adolescent girls with increased body mass who perceived only mini- mal pressure to conform to the physical ideal evidenced a risk of developing body dissatisfaction that was still eight times that of average weight girls (Stice and Whitenton 2002 ). Thus, there appears to be both direct and indirect pathways through which elevated body mass influences body dissatisfaction among girls. The relation between body mass and body image satis- faction for adolescent males is more complex than for adolescent girls. Among boys, body dissatisfaction is reflected in a desire for some to lose weight, and a desire for others to gain weight and become more muscular (McCabe and Ricciardelli 2004 ). Jones and Crawford ( 2006 ) found that BMI was inversely related to muscularity concerns, with boys of lower body weight demonstrating the most concern for muscular enhancement. This is in contrast to the situation for girls, whose body dissatisfaction increased with higher body weight, suggesting that gender moderates the relation between body mass and body dissatisfaction. The experience of peer criticism and teasing also appears to be closely related to body mass and level of adiposity. Children and adolescents with greater adiposity typically receive greater appearance criticism and weight teasing (Eisenberg et al. 2006 ; Tyler et al. 2009 ; Thompson et al. 2007 ). Previous research has found, however, that when detailed measures of weight and shape are applied to peer teasing, boys reported significantly greater teasing and more negative appearance-related commentary than girls (Jones et al. 2004 ; Vincent and McCabe 2000 ). Moreover, it is underweight adolescent boys who most frequently encoun- ter criticism from peers in relation to their underdeveloped physique (Jones and Crawford 2006 ). Internalized images of ultra thin females and muscular males may lead to unreal- istic expectations of body shape among adolescents, which may account for some teasing of average weight girls and boys who deviate from cultural ideals (Eisenberg et al. 2003 ). It could be hypothesised that the impact of increased body mass on body dissatisfaction is both direct (experi- enced as a direct devaluation of one’s body image) and indirect (filtered through internalization of appearance ide- als). Thus, in addition to exploring internalization as a mediator between peer influences and body dissatisfaction, the present study sought to investigate internalization as a mediator between body mass and body dissatisfaction. The Present Study Prior studies have provided evidence that body mass, peer appearance conversations, peer criticism and internaliza- tion influence body dissatisfaction, although the nature of these associations appears to be different for boys and girls. One limitation with much of this research is that boys and girls have been studied separately and thus the opportunity to explore how gender moderates these associations has been largely lacking. The present study improves upon this research by testing whether and how gender moderates the predictive relation of body mass, peer variables and inter- nalization to body dissatisfaction among adolescent boys and girls. Only through carrying out an explicit test of the gender-by-risk factor interaction is it truly possible to determine whether such variables are associated with dif- ferent levels of risk for girls versus boys (Baron and Kenny 1986 ). An additional shortcoming in the existing literature concerns the contradictory findings evidenced with regard to the mediating role of internalization among biological and socio-cultural variables, and body dissatisfaction. Thus, the current study extends previous literature by testing internalized appearance ideals as a mediating psy- chological process in the development of body dissatis- faction for both boys and girls. In summary, the main purpose of the present study was to examine the contributions of body mass, peer appearance conversations, peer appearance criticism and internalization of appearance ideals to body image dissatisfaction of male and female adolescents, and to explore whether gender moderated these socio-cultural and biological risk factors. Internalization of appearance ideals was also evaluated as a mediating factor in the development of body dissatisfaction. Based on previous research, it was hypothesised that girls would demonstrate higher rates of body dissatisfaction than boys (Tremblay and Lariviere 2009 ; McCabe et al. 2009 ). Boys and girls were also hypothesised to differ on inter- nalization of appearance ideals, appearance conversations, and peer appearance criticisms (Hypothesis #1). However, given the inconsistency of findings in the previous litera- ture, the direction of these differences was unspecified. 62 J Youth Adolescence (2011) 40:59–71 123

Consistent with previous studies it was hypothesised that biological (BMI), peer-related variables (peer appearance conversations and criticism) and internalization would predict body dissatisfaction among boys and girls, and the predictive effects of these variables on body dissatisfaction would be moderated by gender (Hypothesis #2). In addition, internalization was hypothesised to mediate the relationship between BMI and body dissatisfaction, and between peer experiences and body dissatisfaction for both boys and girls (Hypothesis #3). Thus, the present study contributes to the existing research on adolescent body dissatisfaction by investigating gender specific risk factors associated with body image dissatisfaction and the role of internalization as a mediator between both peer experiences and BMI and body dissatisfaction. Method Participants Two hundred and thirty-nine students from secondary school Years One to Six participated in the study. One hundred and eleven boys aged between 12 and 18 years ( M = 15.76, SD = 1.17) and 129 girls aged between 12 and 19 years ( M = 16.23, SD = 1.46) were recruited from two coedu- cational secondary schools, one located in Dublin city ( N = 122), the other located in a large town in the centre of Ireland ( N = 117). The girls in the sample were significantly older than the boys ( t = - 2.75, p \ 0.01). The majority of the participants were aged between 15 and 17 years. Ten percent of the sample was aged between 12 and 14 years of age ( n = 25), 78% was between 15 and 17 years of age ( n = 186) and 12% was between 18 and 19 years of age ( n = 28). All participants were White. Measures Body Mass Index Participants’ self-reported height and weight were recor- ded. Body mass index was subsequently computed using the formula BMI = kg/m 2 . Previous research has con- firmed that self-reported weight and height are reliable and valid measures of actual weight and height (Field et al. 2001 ; Paradis et al. 2008 ) and similar studies have also relied upon this method of measuring BMI (Mellor et al. 2008 ; Bardone-Cone et al. 2008 ). Body Image Dissatisfaction The Contour Drawing Rating Scale (CDRS; Thompson and Gray 1995 ) was used to measure body image. The scale comprises nine male and nine female contour drawings numbered from one to nine, which increase incrementally in size from severely underweight to extremely obese. Par- ticipants select the figure that most closely approximates their current body (current figure) and the figure that they would most like to resemble (ideal figure). The discrepancy between these two responses (Current—Ideal) is concep- tualised as the degree of body dissatisfaction. For example, a participant who identified her current body as a 6 and ideal figure as a 4 is awarded a body dissatisfaction score of 2. Alternatively, an individual who indicates a current body score of 2 and an ideal figure of 5 attains a body dissatis- faction score of minus 3, reflecting a desire to gain weight. Thompson and Gray ( 1995 ) demonstrated good 1-week test–retest reliability in a sample of 32 female university students ( r = 0.78). In addition, they established concurrent validity by examining correlations between current fig- ure ratings and body mass index ( r = 0.59) and between self-reported weight and current figure ratings ( r = 0.71). Thompson ( 1993 ) also established concurrent validity by examining the degree of correspondence between BMI and current figure ratings for males ( r = 0.72) and females ( r = 0.76). The present sample also evidenced satisfactory concurrent validity for self-selected current figures and BMI (girls, r = 0.59; boys, r = 0.65) and between self-ratings and self-reported weight (girls, r = 0.66; boys, r = 0.57). Appearance Conversations with Friends A five-item scale developed by Jones et al. ( 2004 ) mea- sured how often adolescents reported talking about expectations for their bodies and appearance enhancements with friends. Items included, ‘‘My friends and I talk about what we would like our bodies to look like’’ and ‘‘My friends and I talk about what we can do to always look our best’’. Responses to each item range from never (1) to very often (5). Higher scores indicate more frequent conversa- tions with peers regarding appearance. The concurrent validity and internal reliability (girls, a = 0.85; boys, a = 0.83) of the scale was confirmed in previous research (Jones 2004 ; Clark and Tiggemann 2006 , 2008 ). Cron- bach’s alphas in the present study were satisfactory for both boys ( a = 0.84) and girls ( a = 0.89). Peer Appearance Criticism A seven-item scale, also developed by Jones et al. ( 2004 ) assessed the frequency with which adolescents experienced teasing from male and female peers about their body size and shape. Four items measured general criticism about the body e.g. ‘‘Boys laugh at me or make fun of me because of my body’’ and ‘‘Girls tease me or make fun of the size or shape of my body’’. These items tapped into criticism from J Youth Adolescence (2011) 40:59–71 63 123

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