Disentangling body image: The relative associations of overvaluation, dissatisfaction, and preoccupation with psychological distress and eating disorder behaviors in male and female adolescents

Abstract

Objective: The distinctiveness and relative clinical significance of overvaluation, dissatisfaction, and preoccupation with body weight/shape remains inconclusive. This study sought to add to the evidence by testing associations between these three body image constructs and indicators of clinical significance.Method: Male and female secondary students (N 5 1,666) aged 12-18 years completed a survey that included measures of dissatisfaction with, overvaluation of, and preoccupation with weight/ shape, psychological distress, eating disorder behaviors, and basic demographic information. Conditional process analysis was employed to test the independent and mediating effects of overvaluation, dissatisfaction, and preoccupation on distress, dietary restraint, and objective binge eating.Results: Overvaluation, dissatisfaction, and preoccupation were highly correlated (r 5 0.47-0.84). In girls, preoccupation demonstrated the strongest independent and mediating effects on distress, dietary restraint, and binge eating; whereas neither the direct or indirect effects of dissatisfaction on distress and overvaluation on binge eating were significant. Among boys however, the direct and indirect effects of overvaluation, dissatisfaction, and preoccupation on distress and eating disorder behaviors were relatively equal.Discussion: Preoccupation with weight/ shape may be particularly clinically significant in girls, whereas all constructs of body image disturbance may be equally clinically significant in boys. The findings are consistent with the view that these constructs, while closely related, are distinct. V C 2016 Wiley Periodicals, Inc.

The relative importance of dissatisfaction, overvaluation and preoccupation with weight and shape for predicting onset of disordered eating behaviors and depressive symptoms over 15 years

“…The pattern of findings are also in support of the focus of the gender additive model of depression on body dissatisfaction (Bearman & Stice, 2008), as the current study shows that body dissatisfaction is the aspect of body image disturbance that is most consistently associated with depressive symptoms. However, these findings do stand in contrast to those of Mitchison, Hay, et al (2017), who found that dissatisfaction was not associated with psychological distress once the role of other aspects of body image (preoccupation, overvaluation) had been taken into account. One potential explanation is that while in the current study we measured general body dissatisfaction with a range of body parts (including height, face, shoulders, etc.…”

“…To some extent the specificity of the associations with preoccupation found in the current study mirrors the results of Mitchison, Hay, et al (2017). Although Mitchison, Hay, et al (2017) did not find an exclusivity of preoccupation’s association with disordered eating outcomes, they did find that preoccupation was the strongest independent predictor of dietary restraint and binge eating, particularly in girls.…”

“…Although Mitchison, Hay, et al (2017) did not find an exclusivity of preoccupation’s association with disordered eating outcomes, they did find that preoccupation was the strongest independent predictor of dietary restraint and binge eating, particularly in girls. Collectively, these results suggest that, whereas the majority of models of eating disorders do not include preoccupation with weight and shape, this aspect of body image may be important to incorporate.…”

“…This provides a substantial contribution to this body of literature, which to date has been largely cross sectional (Mitchison, Hay, et al, 2017). The large sample size also meant that the models had sufficient power to detect small effects, and the sample is weighted to be representative of the population from which it is drawn.…”

“…This two-item scale has good internal consistency (males: α = 0.84; females: α = 0.83) and test-retest reliability (males: r = 0.71, females r = 0.69). These items closely resemble items from the Eating Disorder Examination-Questionnaire (Fairburn & Beglin, 2008) that have been used to examine overvaluation and preoccupation in previous studies (e.g., Mitchison, Hay, et al, 2017; Mond & Hay, 2011). Dissatisfaction was rescaled to have a maximum value of 4 and a minimum value of 1, so as to be comparable to the other body image variables.…”