The interaction of perfectionism, perceived weight status, and self-esteem to predict bulimic symptoms: the role of 'benign' perfectionism

The present study sought to replicate an interactive model of global perfectionism, perceived weight status, and self-esteem in predicting bulimic symptom development in a sample of young women [Bardone-Cone, et al. (2006). Predicting bulimic symptoms: An interactive model of self-efficacy, perfectionism, and perceived weight status. Behaviour Research and Therapy, 44, 27-42; Vohs, K. D., et al. (1999). Perfectionism, perceived weight status, and self-esteem interact to predict bulimic symptoms: A model of bulimic symptom development. Journal of Abnormal Psychology, 108, 695-700; Vohs, K. D., et al. (2001). Perfectionism, body dissatisfaction, and self-esteem: An interactive model of bulimic symptom development. Journal of Social and Clinical Psychology, 20, 476-497]. The aim was to investigate the role of 'problematic' and 'benign' perfectionism within this model, using data from 95 female university students over a 3-month period. Contrary to hypotheses, multivariate analyses revealed a significant three-way interaction only between 'benign' perfectionism, perceived weight status and self-esteem in predicting change in bulimic symptoms over a 3-month period. The predictive effect of the interaction between 'benign' perfectionism and perceived weight status on bulimic symptoms was strongest for women with high self-esteem, for whom feeling overweight and having perfectionistic attitudes preceded increased bulimic symptoms. These findings suggest that high self-esteem is insufficient to protect against the development of bulimic symptoms when both the perception of oneself as being overweight, and high levels of perfectionistic standards, are present. It would appear that the role of perfectionism within the context of disordered eating is complex.     

Body dissatisfaction, bulimic symptoms, and clothing practices among college women

Clothing use may be a behavioral avoidance strategy for individuals with body dissatisfaction and eating pathology. The authors administered the Body Image Avoidance Questionnaire (J. C. Rosen, D. Srebnik, E. Saltzberg, & S. Wendt, 1991), the Bulimia Test-Revised (M. Thelen, J. Farmer, S. Wonderlich, & M. Smith, 1991), and the Body dissatisfaction subscale of the Eating Disorder Inventory (D. M. Garner, M. P. Olmstead, & J. Polivy, 1983) to undergraduate college women from two universities (N = 540). Results indicated that women who were more dissatisfied with their bodies (beta = .396) and had greater disordered eating behaviors (beta = .378) were more likely to engage in clothing-related appearance-management behaviors (p < .001), including wearing apparel to camouflage their bodies; avoiding revealing, brightly colored, or tightly fitting clothing; and avoiding shopping for clothing. These findings suggest that the presence of certain clothing-related appearance-management behaviors may be a warning sign that an individual is at risk for developing an eating disorder or may currently have an eating disorder.     

Predicting bulimic symptoms: an interactive model of self-efficacy, perfectionism, and perceived weight status

An interactive model of perfectionism, perceived weight status, and self-efficacy was tested on 406 women to predict the bulimic symptoms of binge eating and inappropriate compensatory behaviors separately. This longitudinal study assessed hypothesized vulnerabilities of high perfectionism and low self-efficacy and the stressor of feeling overweight at Time 1 and then gathered weekly assessments of binge eating, vomiting, laxative use, fasting, and diet pill use for 11 weeks. As predicted, results showed that perfectionism, weight perception, and self-efficacy interacted to prospectively predict binge eating. In particular, women high in perfectionism who felt they were overweight and who had low self-efficacy reported the most number of weeks of binge eating. This interactive model did not predict inappropriate compensatory behaviors. Future directions and clinical implications are discussed.     

Perfectionism, perceived weight status, and self-esteem interact to predict bulimic symptoms: a model of bulimic symptom development

An interactive model of perfectionism, perceived weight status, and self-esteem was tested on 342 female undergraduates to predict bulimic symptoms. Using a longitudinal design, the authors tested the model on data collected at 2 points: the spring of participants' senior year of high school and during participants' first year of college. The authors hypothesized and found that self-esteem moderates the interaction between perfectionism and perceived weight status in predicting bulimic symptoms. Women who are high in perfectionism and who consider themselves overweight exhibit bulimic symptoms only if they have low self-esteem (i.e., if they doubt they can attain their high body standards). High self-esteem women with the same diathesis-stress conditions are less likely to exhibit bulimic symptoms. These findings clarify the role of perfectionism in bulimic symptomatology.     

Self-critical perfectionism and depressive symptoms: Low self-esteem and experiential avoidance as mediators

This study of community adults (N = 210) aimed to gain a better understanding of the links among self-critical (SC) perfectionism, self-esteem, experiential avoidance, and depressive symptoms. Participants completed self-report questionnaires assessing perfectionism dimensions, self-esteem, experiential avoidance, and depressive symptoms. Confirmatory factor analysis supported SC perfectionism, self-esteem, experiential avoidance, and depressive symptoms as distinct, but related, constructs. Structural equation modeling (SEM) demonstrated that the relation between SC perfectionism and depressive symptoms was mediated by lower self-esteem. SEM also showed that experiential avoidance independently mediated the relation between SC perfectionism and depressive symptoms, controlling for the effects of lower self-esteem. These results distinguish SC perfectionism from lower self-esteem by demonstrating that individuals with higher SC perfectionism have a unique propensity toward experiential avoidance, which, in turn, incrementally explains why they experience higher levels of depressive symptoms.     

The impact of adolescent girls' life concerns and leisure activities on body dissatisfaction, disordered eating, and self-esteem.

The aim of this study was to situate adolescent girls' body dissatisfaction, disordered eating, and self-esteem in the context of their life concerns and leisure activities. Questionnaires containing measures of life concerns, leisure activities, body dissatisfaction, disordered eating, and self-esteem were administered to 306 girls with a mean age of 16 years. It was found that although academic success and intelligence were rated as the most important life concerns, an emphasis on slimness was most strongly linked to body dissatisfaction, disordered eating, and global self-esteem. An emphasis on popularity with girls also was related to body dissatisfaction, and hours spent watching television were related to lower self-esteem. In contrast, emphasis on sport seemed to serve a protective function. It was concluded that adolescent girls who have a high concern for slimness should be assisted in decreasing this emphasis in order to improve their general well-being.     

No body is perfect: the significance of habitual negative thinking about appearance for body dissatisfaction, eating disorder propensity, self-esteem and snacking

Thinking negatively about one's appearance may be a major source of unhappiness. It was investigated whether the habitual quality of negative body image thinking constitutes an additional vulnerability factor, i.e. when such thinking is repetitive and automatic. The cognitive content of negative body image thinking ('what') was distinguished from the habitual occurrence of such thinking ('how'). The mental habit component uniquely predicted explicit as well as implicit body dissatisfaction (the latter measured by an implicit association test) over and above cognitive content. Mental habit also accounted for eating disturbance propensity, low self-esteem and restrained snacking behaviour over and above cognitive content, even when controlled for body dissatisfaction. The habitual component of negative thinking about appearance thus seems a significant body image construct, has discriminant validity against body dissatisfaction, and constitutes a vulnerability factor for feelings of low self-worth and eating disturbance propensity. Implications for intervention strategies, such as mindfulness-based approaches, are discussed.     

Bulimic symptomatology: the role of adaptive perfectionism, shape and weight concern, and self-esteem

An interactive model implicating high perfectionism, high weight and shape concern, and low self-esteem in the onset and maintenance of bulimic symptoms ( [Bardone et?al., 2000] and [Vohs et?al., 1999] ) has received mixed support. This study aimed to replicate the cross-sectional model in a clinical sample of women with eating disorders, and to investigate whether the model could predict changes in binge eating and purging at the end of treatment. Eating disorder outpatients (n = 353) completed measures of perfectionism, weight/shape concern, self-esteem, and bulimic symptoms at pre-treatment and discharge. Contrary to the hypotheses, the three-way interaction did not predict binge eating or purging cross-sectionally or prospectively as a moderator of psychotherapy outcome. It was concluded that the robustness of the interactive model seems questionable and may be impacted by an inadequate conceptualization of the perfectionism construct.     

Neurotic perfectionism, perceived stress, and self-esteem among Japanese men: a prospective study

The present study examined the relationship between self-report scores of neurotic perfectionism and of perceived stress and self-esteem 6 wk. later among 146 Japanese male college students. Hierarchical regression analysis indicated that scores for neurotic perfectionism accounted for statistically significant but functionally small variance (4% and 3%) in scores for perceived stress and self-esteem obtained at Time 2 (6 wk. later), after controlling for the scores for perceived stress and self-esteem at Time 1, respectively.     

An ecological momentary assessment of the effects of weight and shape social comparisons on women with eating pathology, high body dissatisfaction, and low body dissatisfaction

This research examined the effects of naturally occurring appearance comparisons on women's affect, body satisfaction, and compensatory cognitions and behaviors. Using ecological momentary assessment, women with high body dissatisfaction and eating pathology (EPHB), high body dissatisfaction (HB), or low body dissatisfaction (LB) recorded their reactions to appearance-focused social comparisons. EPHB and HB women made more upward appearance comparisons than LB women. All women experienced negative emotions and cognitions after upward comparisons, including increased guilt, body dissatisfaction, and thoughts of dieting. EPHB women were most negatively affected by comparisons; they experienced more intense negative emotions, more thoughts of dieting/exercising, and an increase in eating-disordered behavior after upward comparisons. HB women experienced more negative affective consequences and thoughts of dieting than LB women. Results are consistent with social comparison theory and provide important information that may be used to inform eating disorder treatment and prevention efforts.     

Dietary restraint and negative affect as mediators of body dissatisfaction and bulimic behavior in adolescent girls and boys.

Stice's dual pathway model of dietary restraint and negative affect was examined in both adolescent girls and boys. Self-report measures assessing body dissatisfaction, dietary restraint, negative affect and bulimic behavior were administered to 267 girls and 199 boys aged between 12 and 16 years. The findings for the girls were consistent with Stice's model, in that they indicated that both dietary restraint and negative affect mediated the relationship between body dissatisfaction and bulimic behavior. For the boys who desired a thinner body size, only negative affect was found to mediate the relationship between body dissatisfaction and bulimic behavior. On the other hand, for boys who desired a larger body size, both body dissatisfaction and dietary restraint were found to exert an independent effect on bulimic behavior. As boys can aspire to two contrasting and seemingly opposite body size ideals, the findings highlight that the relationship between body dissatisfaction, dietary restraint, negative affect and bulimic behavior are more complex in males than in females. Further research using longitudinal designs is needed in order to test the directional and bidirectional nature of the observed interrelationships.     

Gender differences in the interrelationships between weight dissatisfaction,restraint, and self-esteem

This study investigated the interrelationships between weight, weight dissatisfaction, restraint, and self-esteem in a group of young adult women and men. The subjects were students at the Flinders University of South Australia, whose student body consists of primarily local students from English-speaking backgrounds. A tentative causal model proposed actual overweight to lead to body dissatisfaction, which causes the person to diet, with the resulting failures leading to loss of self-esteem. This model was confirmed by path analysis for women, but not for men. In line with self-concept theory, subjective overweight was more strongly related to self-esteem for women than for men, with restraint mediating this relationship.This research was supported by an Australian Research Council Grant.     

Body image dissatisfaction: gender differences in eating attitudes,self-esteem,and reasons for exercise

Two hundred and thirty-five adolescents completed a questionnaire on the subject of eating attitudes, self-esteem, reasons for exercise, and their ideal versus current body size and shape. As predicted, boys were as likely to want to be heavier as lighter, whereas very few girls desired to be heavier. Only girls associated body dissatisfaction with the concept of self-esteem. Male self-esteem was not affected by body dissatisfaction. Specific reasons for exercise were found to correlate with low self-esteem and disordered eating, regardless of sex. The results are discussed in relation to burgeoning published research in this area.     

The role of mothers' use of control in children's perfectionism: implications for the development of children's depressive symptoms

The central aim of this research was to investigate the possibility that when parents use heightened control with children, children develop perfectionistic concerns, which may foster depressive symptoms. Mothers' use of control with their elementary school children (N=104) was observed in the laboratory along with their affective expression toward their children; children's behavior (e.g., task engagement) that might influence mothers' use of control was also observed. Self-oriented and socially prescribed perfectionism and depression were assessed in children through self-report. Mothers using heightened control had children with perfectionistic concerns, particularly socially prescribed ones. This was not due to mothers' affective expression or children's behavior. Children's socially prescribed perfectionism mediated the link between mothers' use of heightened control and children's heightened depressive symptoms.     

Gender differences in body size dissatisfaction among individuals with low,medium, or high levels of body focus

The authors designed the present study to test whether women reported higher levels of body dissatisfaction than did men even when the 2 genders were matched on a measure of degree of body focus. Sixty undergraduates (30 men, 30 women) were screened on attention-to-body-shape scores and divided into high, medium, and low body-shape-focus groups. The participants also completed questionnaires that provided information on age, education, vocabulary ability, levels of depression, and body-image assessment. The groups did not differ (ps > .05) on age, education, vocabulary ability, or levels of depression. However, women in all 3 body-shape-focus categories indicated a larger discrepancy between their real vs. ideal body images (p < .01) than did the men. In the high-body-focus group, there was an 11:1ratio between women's and men's reported real-ideal body-shape discrepancies. Women showed greater body dissatisfaction than did men, even when the genders were matched on a measure of body focus.     

Depression, low self-esteem and mindfulness

Negative biases in processing information about the self have long been recognised as a central feature in the development and maintenance of clinical depression. In practice, however, it may not be easy to distinguish between patients whose negative thinking about the self is primarily an aspect of current mood state, and those for whom it represents a reflection of more enduring issues (low self-esteem). The paper speculates that, in both cases, metacognitive awareness (acceptance of the idea that thoughts, assumptions and beliefs are mental events and processes rather than reflections of objective truth) may be an important precursor to active engagement in therapy on the part of the patient, and considers what aspects of cognitive therapy might be used to promote it in clinical practice.     

The experience of body dissatisfaction in men

Evidence suggests that the prevalence of body dissatisfaction (BD) is increasing amongst men. However, research has commonly examined the phenomenon in predominantly female groups. In view of this, the current study used a qualitative methodology to explore the experience of BD in men. Semi-structured interviews were conducted with 14 men. The data were analysed using Interpretative Phenomenological Analysis. Analysis yielded themes across four domains (societal, interpersonal, intrapersonal, and social presentation). Whilst participants exhibited a range of appearance concerns, there was commonality in the processes by which these were experienced and managed. These generic issues are the focus of the themes, and could usefully be incorporated into a new assessment tool. Findings are considered in relation to existing (cognitive behavioural, self-discrepancy, and sociocultural) theories, and implications for clinical practice and future research are discussed.     

Appearance-related teasing,body dissatisfaction,and disordered eating: A meta-analysis

A meta-analysis was conducted to determine the relationship between appearance and weight-based teasing and three outcome measures: body dissatisfaction, restrictive eating, and bulimic behaviors. Four meta-analyses were conducted. Fifty effect sizes (N = 10,618) resulted in a moderate effect size of .39 for the relationship between weight teasing and body dissatisfaction; 24 effect sizes (N = 7190) resulted in an effect size of .32 for the relationship between appearance teasing and body dissatisfaction; 20 effect sizes (N = 4792) resulted in an effect size of .35 for the relationship between weight teasing and dietary restraint; and 22 effect sizes (N = 5091) resulted in an effect size of .36 for the relationship between weight teasing and bulimic behaviors. Significant moderators that emerged were teasing measure type, publication type, study type, age group, and gender. The findings offer further support for the inclusion of strategies in body image and eating disorders’ prevention and intervention programs that focus on handling negative, appearance-related commentary.