Abstract
Body image disturbance in anorexia nervosa (AN) has been widely studied with regard to the patient’s own body, but little is known about perception of or attitude towards other women’s bodies in AN. The aim of the present study was to investigate how 20 girls aged 12–18 years and 19 adult women suffering from AN compared to 37 healthy adolescent girls and women estimate weight and attractiveness of women’s bodies belonging to different BMI categories (BMI 13.8–61.3 kg/m²). Weight and attractiveness ratings of the participant’s own body and information on physical comparisons were obtained, and effects on others’ weight and attractiveness ratings investigated. Differential evaluation processes were found: AN patients estimated other women’s weight higher than control participants. Patients showed a bias towards assessing extremely underweight women as more attractive and normal weight and overweight women as less attractive than healthy girls and women. These effects were more pronounced in adult than in adolescent AN patients. The tendency to engage in physical comparison with others significantly correlated with weight as well as attractiveness ratings in patients. A logistic regression model encompassing own attractiveness ratings, attractiveness bias towards strongly underweight others’ bodies and the interaction of this bias with age as predictors differentiated best between AN patients and controls. Our results indicate that females suffering from AN and healthy girls and women perceive other women’s bodies differently. Assessment of others’ weight and attractiveness may contribute to the maintenance of dysfunctional physical comparison processes.
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References
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. American Psychiatric Publishing, Arlington
Gardner RM, Brown DL (2010) Body image assessment: a review of figural drawing scales. Personal Individ Differ 48:107–111
Gardner RM (1996) Methodological issues in assessment of the perceptual component of body image disturbance. Br J Psychol 87(Pt 2):327–337
Thompson KE (2001) Body image, eating disorders, and obesity in youth: assessment, prevention, and treatment. American Psychological Association
Gardner RM, Brown DL (2014) Body size estimation in anorexia nervosa: a brief review of findings from 2003 through 2013. Psychiatry Res 219(3):407–410. doi:10.1016/j.psychres.2014.06.029
Schneider N, Frieler K, Pfeiffer E, Lehmkuhl U, Salbach-Andrae H (2009) Comparison of body size estimation in adolescents with different types of eating disorders. Eur Eat Disord Rev 17(6):468–475. doi:10.1002/erv.956
Conley A, Boardman JD (2007) Weight overestimation as an indicator of disordered eating behaviors among young women in the United States. Int J Eat Disord 40(5):441–445. doi:10.1002/eat.20383
Legenbauer T, Thiemann P, Vocks S (2014) Body image disturbance in children and adolescents with eating disorders. Current evidence and future directions. Z Kinder Jugendpsychiatr Psychother 42(1):51–59. doi:10.1024/1422-4917/a000269
Tovee MJ, Emery JL, Cohen-Tovee EM (2000) The estimation of body mass index and physical attractiveness is dependent on the observer’s own body mass index. Proc Biol Sci 267(1456):1987–1997. doi:10.1098/rspb.2000.1240
Jv Wietersheim, Kunzl F, Hoffmann H, Glaub J, Rottler E, Traue HC (2012) Selective attention of patients with anorexia nervosa while looking at pictures of their own body and the bodies of others: an exploratory study. Psychosom Med 74(1):107–113
Alleva J, Jansen A, Martijn C, Schepers J, Nederkoorn C (2013) Get your own mirror. Investigating how strict eating disordered women are in judging the bodies of other eating disordered women. Appetite 68:98–104. doi:10.1016/j.appet.2013.04.015
Fairburn CG, Harrison PJ (2003) Eating disorders. Lancet 361(9355):407–416. doi:10.1016/S0140-6736(03)12378-1
Swanson SA, Crow SJ, Le Grange D, Swendsen J, Merikangas KR (2011) Prevalence and correlates of eating disorders in adolescents. Results from the national comorbidity survey replication adolescent supplement. Arch Gen Psychiatry 68(7):714–723. doi:10.1001/archgenpsychiatry.2011.22
Baluch B, Furnham A, Huszcza A (1997) Perception of body shapes by anorexics and mature and teenage females. J Clin Psychol 53(2):167–175
Festinger L (1954) A theory of social comparison processes. Hum Relat 7:117–140
Thompson JK, Coovert MD, Stormer SM (1999) Body image, social comparison, and eating disturbance: a covariance structure modeling investigation. The International journal of eating disorders 26(1):43–51. doi:10.1002/(SICI)1098-108X(199907)26:1<43:AID-EAT6>3.0.CO;2-R
Heinberg LJ, Thompson JK (1992) Social comparison: gender, target, importance ratings and relation to body image disturbance. J Soc Behav Personal 7:335–344
Corning AF, Krumm AJ, Smitham LA (2006) Differential social comparison processes in women with and without eating disorder symptoms. J Couns Psychol 53(3):338–349
World Health Organization (1993) The ICD-10 classification of mental and behavioural disorders: diagnostic criteria for research. World Health Organization
Döpfner M, Görtz-Dorten A, Lehmkuhl G (2008) DISYPS II Diagnostik-System für psychische Störungen nach ICD-10 und DSM-IV für Kinder und Jugendliche II. Huber, Bern
Schneider S, Margraf J (2006) Diagnostisches Interview bei psychischen Störungen, 3rd edn. Springer, Berlin
Thompson JK, Heinberg LJ, Tantleff S (1991) The Physical Appearance Comparison Scale (PACS). Behav Therap 14:174
Blechert J, Nickert T, Caffier D, Tuschen-Caffier B (2009) Social comparison and its relation to body dissatisfaction in bulimia nervosa: evidence from eye movements. Psychosom Med 71(8):907–912. doi:10.1097/PSY.0b013e3181b4434d
Legenbauer T, Kleinstäuber M, Müller T, Stangier U (2008) Are individuals with an eating disorder less sensitive to aesthetic flaws than healthy controls? J Psychosom Res 65:87–95
Garner DM (1991) Eating Disorder Inventory-2 manual. Psychological Assessment Resources, Odessa
Benninghoven D, Raykowski L, Solzbacher S, Kunzendorf S, Jantschek G (2007) Body images of patients with anorexia nervosa, bulimia nervosa and female control subjects: a comparison with male ideals of female attractiveness. Body Image 4(1):51–59. doi:10.1016/j.bodyim.2006.12.002
Sypeck MF, Gray JJ, Ahrens AH (2004) No longer just a pretty face: fashion magazines’ depictions of ideal female beauty from 1959 to 1999. Int J Eat Disord 36(3):342–347. doi:10.1002/eat.20039
Myers TA, Crowther JH (2009) Social comparison as a predictor of body dissatisfaction: a meta-analytic review. J Abnorm Psychol 118(4):683–698. doi:10.1037/a0016763
Hamel AE, Zaitsoff SL, Taylor A, Menna R, Le Grange D (2012) Body-related social comparison and disordered eating among adolescent females with an eating disorder, depressive disorder, and healthy controls. Nutrients 4(9):1260–1272. doi:10.3390/nu4091260
van den Berg P, Thompson JK, Obremski-Brandon K, Coovert M (2002) The Tripartite Influence Model of body image and eating disturbance: a covariance structure modeling investigation testing the mediational role of appearance comparison. J Psychosom Res 53(5):1007–1020
Keery H, van den Berg P, Thompson JK (2004) An evaluation of the Tripartite Influence Model of body dissatisfaction and eating disturbance with adolescent girls. Body Image 1(3):237–251. doi:10.1016/j.bodyim.2004.03.001
Trampe D, Stapel DA, Siero FW (2007) On models and vases: body dissatisfaction and proneness to social comparison effects. J Pers Soc Psychol 92(1):106–118. doi:10.1037/0022-3514.92.1.106
Martin MC, Gentry JW (1997) Stuck in the model trap: the effects of beautiful models in ads on female pre-adolescents and adolescents. J Advert 26(2):19–33. doi:10.1037/0022-3514.92.1.106
Engeln-Maddox R (2005) Cognitive responses to idealized media images of women: the relationship of social comparison and critical processing to body image disturbance in college women. J Soc Clin Psychol 24(8):1114–1138
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Horndasch, S., Heinrich, H., Kratz, O. et al. Perception and evaluation of women’s bodies in adolescents and adults with anorexia nervosa. Eur Arch Psychiatry Clin Neurosci 265, 677–687 (2015). https://doi.org/10.1007/s00406-015-0603-3
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DOI: https://doi.org/10.1007/s00406-015-0603-3