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Body-image and eating disturbances prospectively predict increases in depressive symptoms in adolescent girls: A growth curve analysis.
Abstract
Using data from a longitudinal community study (N = 231), the authors tested whether body-image and eating disturbances might partially explain the increase in depression observed in adolescent girls. Initial pressure to be thin, thin-ideal internalization, body dissatisfaction, dieting, and bulimic symptoms, but not body mass, predicted subsequent increases in depressive symptoms, as did increases in these risk factors over the study. There was also prospective support for each of the hypothesized mediational relations linking these risk factors to increases in depressive symptoms. Effects remained significant when other established gender-nonspecific risk factors for depression (social support and emotionality) were statistically controlled. Results provide support for the assertion that body-image and eating disturbances, operating above and beyond gender-nonspecific risk factors, contribute to the elevated depression in adolescent girls.
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“Many studies suggested that dysfunctional eating habits, such as emotional eating, may emerge as a failure of emotion regulation strategies that allow individuals to regulate their own emotions by modulating their responses [16, 17].”
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“In addition, heightened internalization of the current thin ideal espoused for females and the belief that achieving thinness will result in a plethora of social benefits, such as acceptance and academic success, is also thought to promote body dissatisfaction (Stice & Bearman, 2001).”
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“These scales have high internal consistency (mean .88), test–retest reliability (mean r .69), and predictive validity (Furman, 1996; Stice & Bearman, 2001 ).”
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Grabe, S., & Hyde, J. S. (2006) · Psychological Bulletin · doi:10.1037/0033-2909.132.4.622 · Cited by 715
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Self-citationThe impact of obesity on psychological well-being
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“…about being or becoming fat is related to the development of eating problems, eating disorders, and depression (e.g.,Leon, Fulkerson, Perry, & Early-Zald, 1995; McKnight Investigators, 2003; Stice, 2002; Stice & Bearman, 2001; Stice, Hayward, Cameron, Killen, & Taylor, 2000; Wichstrom, 1999).”
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“For both genders, the desire to alter shape or weight is common (Ricciardelli and McCabe, 2001), and is associated with emotional distress (Johnson and Wardle, 2005), dramatic measures to alter appearance, such as cosmetic surgery or steroid use (Hoffman and Brownell, 1997; Thompson et al., 1999), as well as psychiatr…”
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“Body image dissatisfaction 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 ).”
BackgroundBody Image and Self‐Esteem Among Adolescent Girls: Testing the Influence of Sociocultural Factors
Clay, D., Vignoles, V. L., & Dittmar, H. (2005) · Journal of Research on Adolescence · doi:10.1111/j.1532-7795.2005.00107.x · Cited by 507
“Stice and Bearman (2001) report that perceived pressure to be thin, thin-ideal internalization, body dissatisfaction, dieting, and bulimic symptoms, prospectively predict increases in depressive symptoms among middle-class U.S. adolescent girls. participants in the control condition.”
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“Further, body dissatisfaction has been found to prospectively predict development of depressed mood (Holsen, Kraft, & Roysamb, 2001; Stice & Bearman, 2001 ).”
BackgroundAta, R. N., Ludden, A. B., & Lally, M. M. (2007) · Journal of Youth and Adolescence · doi:10.1007/s10964-006-9159-x · Cited by 382
“When adolescents perceive these pressures from the people who are closest to them— their family and friends—they may become more distressed, feel more negatively about themselves, diet, and engage in other negative eating behaviors such as bingeing and purging (Ricciardelli et al., 2006; Stice and Bearman, 2001).”
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“Various studies have found a correlation between body dissatisfaction and internalizing symptoms, such as anxiety and depression, in adolescents, among whom girls appear more at risk than boys (Bucchianeri et al., 2016; Rawana & Morgan, 2014; Stice & Bearman, 2001).”
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“Several longitudinal studies have also provided empirical evidence that internalization of the thin ideal predicts increases in body dissatisfaction among girls (Jones, 2004; Stice & Bearman, 2001; Stice & Whitenton, 2002).”
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“Body dissatisfaction has been found to consistently predict disordered and maladaptive eating behaviors as well as other psychological problems (e.g., clinical eating disorders, depression) among girls (Smolak 2004; Stice and Bearman 2001; Stice and Shaw 2002).”
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“Body dissatisfaction is also linked to low self-esteem and depression, ISSN 0954–0261 print/ISSN 1369–1627 online © 2012 Institute of Psychiatry DOI: 10.3109/09540261.2012.678817 especially in overweight or obese youth (Heinberg & Thompson, 2009; Smolak & Thompson, 2009; Stice & Bearman, 2001).”
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“10) is easier/simpler for the reader to understand: “Of the 98 studies that were retrieved for close reading, the following assessed the same longitudinal dataset: a) (34-36); b) (17, 37, 38); c) (39, 40); d) (41-43); e)(44-47); f) (48-50); g) (20, 51).”
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“Research has provided evidence that this measure possesses internal consistency (M .89), test–retest reliability ( M 1-month r .69), and predictive validity (Furman, 1996; Furman & Buhrmester, 1985; Stice & Bearman, 2001 ).”
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“Consistent with previous research (Stice and Bearman 2001), perceived pressure from media predicted body dissatisfaction and internalization of the media body ideal.”
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“…dissatisfaction and failure to meet one’s ideal (Cattarin & Thompson, 1994; Field et al., 1999, 2001; Pyle, Mitchell, & Eckert, 1981; Stice, 2001; Stice & Bearman, 2001; Stice, Mazotti, Krebs, & Martin, 1998; Stice, Presnell, & Spangler, 2002; Striegel-Moore, Silberstein, & Rodin, 1986;…”
BackgroundCorrelates of body image dissatisfaction among overweight women seeking weight loss.
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“Consistent with hypotheses, bulimic symptoms have been found to predict future increases in depressive symptoms ( Stice & Bearman, 2001 ) and onset of major depression (Stice et al., 2000).”
BackgroundResultSelf-citationFive-year change in body satisfaction among adolescents
Eisenberg, M. E., Neumark-Sztainer, D., & Paxton, S. J. (2006) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2006.05.007 · Cited by 183
“Importantly, studies have also distinguished between the role of body satisfaction and body mass index (BMI; expressed as weight in kilograms divided by squared height in meters) in the development of mental health concerns and have found that body satisfaction mediates the association between BMI and emotional well-b…”
BackgroundBody dissatisfaction: an overlooked public health concern
Bucchianeri, M. M., & Neumark‐Sztainer, D. (2014) · Journal of Public Mental Health · doi:10.1108/jpmh-11-2013-0071 · Cited by 182
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Social comparison and body image in adolescence: a grounded theory approach
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“Social comparison and prevention Research in the area of body image has mainly focused on evaluative comparisons as evaluation is a central dimension of body image [ 21 ].”
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Body dissatisfaction and psychological distress in adolescents: Is self-esteem a mediator?
Duchesne, A.-P., Dion, J., Lalande, D. R., Bégin, C., Émond, C., Lalande, G., & McDuff, P. (2016) · Journal of Health Psychology · doi:10.1177/1359105316631196 · Cited by 169
“…2015; Dooley et al., 2015; Ferguson et al., 2011; Kostanski and Gullone, 1998; Koronczai et al., 2013) and depression (Bélanger and Marcotte, 2013; Cruz-Sáez et al., 2015; Dooley et al., 2015; Johnson and Wardle, 2005; Murray et al., 2015; Stice and Bearman, 2001; Wichstrøm and Von Soest, 2016).”
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“…with a range of adverse outcomes, including the onset of eating disorders (e.g. Stice & Shaw, 2002), low self-esteem, increased negative affect (Stice & Bearman, 2001), and significant emotional distress (Johnson & Wardle, 2005), examining factors that contribute to lower levels of body…”
BackgroundA Biopsychosocial Model of Body Image Concerns and Disordered Eating in Early Adolescent Girls
Rodgers, R. F., Paxton, S. J., & McLean, S. A. (2014) · Journal of Youth and Adolescence · doi:10.1007/s10964-013-0013-7 · Cited by 154
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“For example, some research purporting to examine emotion regulation has examined participants’ experiences of depression, anxiety, and stress over the past few weeks (Ricciardelli and McCabe, 2001), whereas other studies assessed girls’ perceptions of their tendency to become emotionally distressed ( Stice and Bearman…”
BackgroundInfluentialSelf-Objectification, Risk Taking, and Self-Harm in College Women
Muehlenkamp, J. J., Swanson, J. D., & Brausch, A. M. (2005) · Psychology of Women Quarterly · doi:10.1111/j.1471-6402.2005.00164.x · Cited by 156
“Additionally, several studies have found that body dissatisfaction contributes to the development of depressive symptoms in females (Denniston, Roth, & Gilroy, 1992; Mori & Morey, 1991; Stice & Bearman, 2001; Stice, Hayward, Cameron, Killen, & Taylor, 2000).”
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A Prospective Study of Rumination and Depression in Early Adolescence
Broderick, P. C., & Korteland, C. (2004) · Clinical Child Psychology and Psychiatry · doi:10.1177/1359104504043920 · Cited by 151
Helfert, S., & Warschburger, P. (2013) · Child and Adolescent Psychiatry and Mental Health · doi:10.1186/1753-2000-7-16 · Cited by 175
Comorbidity between depression and disordered eating in adolescents
Santos, M., Richards, C. S., & Bleckley, M. K. (2007) · Eating Behaviors · doi:10.1016/j.eatbeh.2007.03.005 · Cited by 163
“In addition, the gender additive model of depression tested by Stice and Bearman (2001) did not find support for a significant relationship between body mass index and depressive symptoms.”
BackgroundMethodInfluentialIdentity and the body: Trajectories of body esteem from adolescence to emerging adulthood
Nelson, S. C., Kling, J., Wängqvist, M., Frisén, A., & Syed, M. (2018) · Developmental Psychology · doi:10.1037/dev0000435 · Cited by 151
The Origins and Development of Psychopathology in Females and Males
Zahn‐Waxler, C., Crick, N. R., Shirtcliff, E. A., & Woods, K. E. (2015) · Wiley eBooks · doi:10.1002/9780470939383.ch4 · Cited by 150
Holsen, I., Jones, D. C., & Birkeland, M. S. (2012) · Body Image · doi:10.1016/j.bodyim.2012.01.006 · Cited by 170
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“[7] Stice E, Bearman SK.”
BackgroundExploring the Tripartite Influence Model of body dissatisfaction in postpartum women
Lovering, M. E., Rodgers, R. F., George, J. E., & Franko, D. L. (2017) · Body Image · doi:10.1016/j.bodyim.2017.12.001 · Cited by 164
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Development and aetiology of body dissatisfaction in adolescent boys and girls
Dion, J., Blackburn, M.-E., Auclair, J., Laberge, L., Veillette, S., Gaudreault, M., Vachon, P., Perron, M., & Touchette, É. (2015) · International Journal of Adolescence and Youth · doi:10.1080/02673843.2014.985320 · Cited by 141
“…control behaviours as well as eating pathologies (Crow, Eisenberg, Story, & Neumark-Sztainer, 2008; Neumark-Sztainer, Paxton, Hannan, Haines, & Story, 2006b; Paxton, Neumark-Sztainer, Hannan, & Eisenberg, 2006b; Stice, 2002; Stice & Bearman, 2001; Stice, Marti, & Durant, 2011; Tiggemann, 2005).”
Body satisfaction, weight gain and binge eating among overweight adolescent girls
Sonneville, K. R., Calzo, J. P., Horton, N. J., Haines, J., Austin, S. B., & Field, A. E. (2012) · International Journal of Obesity · doi:10.1038/ijo.2012.68 · Cited by 140
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“This finding is encouraging given the evidence that body dissatisfaction in young adolescents can lead to poor self-esteem and future health problems when they are older (Neumark-Sztainer et al., 2006b; Stice & Bearman, 2001).”
BackgroundResultThe role of body dissatisfaction as a risk factor for depression in adolescent girls
Franko, D. L., & Striegel‐Moore, R. H. (2002) · Journal of Psychosomatic Research · doi:10.1016/s0022-3999(02)00490-7 · Cited by 141
“Recently, Stice and Bearman [72] replicated these findings in a sample of girls attending a private high school.”
BackgroundAdams, R. E., & Bukowski, W. M. (2008) · Journal of Child Psychology and Psychiatry · doi:10.1111/j.1469-7610.2008.01886.x · Cited by 133
Sachs‐Ericsson, N., Burns, A. B., Gordon, K. H., Eckel, L. A., Wonderlich, S. A., Crosby, R. D., & Blazer, D. G. (2007) · American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e3180a725d6 · Cited by 133
Heinicke, B. E., Paxton, S. J., McLean, S. A., & Wertheim, E. H. (2007) · Journal of Abnormal Child Psychology · doi:10.1007/s10802-006-9097-9 · Cited by 125
“In adolescent girls, body dissatisfaction prospectively predicts depressive symptoms ( Stice & Bearman, 2001; Paxton, Neumark-Sztainer, Hannan, & Eisenberg, 2006), low self-esteem (Paxton, Neumark-Sztainer et al., 2006), unhealthy weight loss behaviors (Neumark-Sztainer, Paxton, Hannan, Haines, & Story, 2006; Stice, 2…”
BackgroundWatson, B. N., Fuller‐Tyszkiewicz, M., Broadbent, J., & Skouteris, H. (2015) · Body Image · doi:10.1016/j.bodyim.2015.04.005 · Cited by 128
Exploring the Causes and Consequences of Engaging in Fat Talk
Arroyo, A., & Harwood, J. (2012) · Journal of Applied Communication Research · doi:10.1080/00909882.2012.654500 · Cited by 126
“Self-objectification increases body shame and body dissatisfaction, each of which undermines mental health (e.g., resulting in increased depression: Grabe, Hyde, & Lindberg, 2007; Stice & Bearman, 2001).”
BackgroundInfluential[Body image; literature review].
Vaquero‐Cristóbal, R., Alacid, F., Muyor, J. M., & López-Miñarro, P. Á. (2013) · PubMed · doi:10.3305/nh.2013.28.1.6016 · Cited by 178
Pearl, R., White, M., & Grilo, C. (2013) · Obesity · doi:10.1002/oby.20617 · Cited by 128
“To our knowledge, no longitudinal study has investigated this relationship, but prospective research has found that adolescent girls who internalize “thin ideal” body standards and experience body dissatisfaction exhibit increased depressive symptoms over time (17).”
BackgroundResultMorin, A. J. S., & Maïano, C. (2011) · Psychology of sport and exercise · doi:10.1016/j.psychsport.2011.04.003 · Cited by 128
“For instance, whereas the European/North American culture emphasizes lean “prepubertal” looks for girls, African-American/Black, Hispanic/Latin or Arabic/ Maghreb cultures put less emphasis on leanness and more on the fuller forms emerging with puberty (Siegel et al., 1999; Stice & Bearman, 2001).”
BackgroundSkinner, H. H., Haines, J., Austin, S. B., & Field, A. E. (2011) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2011.10.002 · Cited by 120
Accuracy of body size estimation: Role of biopsychosocial variables
McCabe, M. P., Ricciardelli, L. A., Sitaram, G., & Mikhail, K. (2006) · Body Image · doi:10.1016/j.bodyim.2006.01.004 · Cited by 125
Ginty, A. T., Phillips, A. C., Higgs, S., Heaney, J. L. J., & Carroll, D. (2011) · Psychoneuroendocrinology · doi:10.1016/j.psyneuen.2011.09.004 · Cited by 118
“The EDE-Q sub-scales have shown good internal consistency, Cronbach’s a = .84, and a test—retest reliability of .86 (Stice and Bearman, 2001).”
Goldschmidt, A. B., Doyle, A. C., & Wilfley, D. E. (2007) · International Journal of Eating Disorders · doi:10.1002/eat.20387 · Cited by 119
“Disordered eating behaviors and attitudes appear to be quite common in childhood and adolescence [5–9], and are associated with a host of negative health consequences [10–16] as”
Childhood obesity stigma: Association with television, videogame, and magazine exposure
Latner, J. D., Rosewall, J. K., & Simmonds, M. B. (2007) · Body Image · doi:10.1016/j.bodyim.2007.03.002 · Cited by 119
Relations between dietary restraint, depressive symptoms, and binge eating: A longitudinal study
Spoor, S. T. P., Stice, E. M., Bekker, M. H. J., van Strien, T., Croon, M. A., & Heck, G. L. V. (2006) · International Journal of Eating Disorders · doi:10.1002/eat.20283 · Cited by 118
Self-citationDiedrichs, P. C., Atkinson, M. J., Steer, R. J., Garbett, K. M., Rumsey, N., & Halliwell, E. (2015) · Behaviour Research and Therapy · doi:10.1016/j.brat.2015.09.004 · Cited by 118
Roomruangwong, C., Kanchanatawan, B., Sirivichayakul, S., & Maes, M. H. J. (2017) · Sexual & Reproductive Healthcare · doi:10.1016/j.srhc.2017.08.002 · Cited by 116
Measuring health‐related quality of life in adolescence
Frisén, A. (2007) · Acta Paediatrica · doi:10.1111/j.1651-2227.2007.00333.x · Cited by 112
“A negative body image is, for instance, related to psychosocial problems (8), eating disorders and dieting (9) and depression among adolescent girls (10).”
BackgroundPerceived weight, not obesity, increases risk for major depression among adolescents
ROBERTS, R. E., & Duong, H. T. (2013) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2013.03.019 · Cited by 112
“…eating and fewer health-promoting behaviors such as physical activity and consumption of fruits and vegetables (Holsen, et al., 2001; Stice, 2001; Stice and Bearman, 2001; Neumark-Sztainer et al., 2006). ter Bogt et al. (2006) report that body image is a better predictor of internalizing…”
BackgroundTesting a dissonance body image intervention among young girls.
Halliwell, E., & Diedrichs, P. (2014) · Health Psychology · doi:10.1037/a0032585 · Cited by 110
“…is an important health issue; it is reported by 50-70% of adolescent girls (Wertheim & Paxton, 2011) and has numerous negative consequences including increased negative affect (Stice & Bearman, 2001) and reduced levels of physical activity (NeumarkSztainer, Paxton, Hannan, Haines, & Story, 2006).”
Cruz-Sáez, S., Pascual, A., Włodarczyk, A., & Echeburúa, E. (2018) · Journal of Health Psychology · doi:10.1177/1359105317748734 · Cited by 111
“…et al., 2015; Dooley et al., 2015; Ferguson et al., 2011; Koronczai et al., 2013), depression (Cruz-Sáez et al., 2015; Dooley et al., 2015; Murray et al., 2015; Stice and Bearman, 2001), and low self-esteem (Delfabbro et al., 2011; Van den Berg et al., 2010; Wichstrøm and Von Soest, 2016).”
BackgroundStice, E. M., Presnell, K. E., Groesz, L. M., & Shaw, H. E. (2005) · Health Psychology · doi:10.1037/0278-6133.24.4.402 · Cited by 114
Self-citationBody Image Perceptions: Do Gender Differences Exist?
Brennan, M. A., Lalonde, C. E., & Bain, J. L. (2010) · Psi Chi Journal of Psychological Research · doi:10.24839/1089-4136.jn15.3.130 · Cited by 135
“Stice and Bearman (2001) found that self-reports of height and weight correlate strongly with measurements taken by research assistants, with correlations ranging from .94 to .99, therefore we used self-reports.”
MethodObesity as a prospective predictor of depression in adolescent females
Boutelle, K., Hannan, P., Fulkerson, J. A., Crow, S., & Stice, E. (2010) · Health Psychology · doi:10.1037/a0018645 · Cited by 125
“On the other hand, two previous epidemiological studies found that initial BMI was not related to risk for future onset of depression (Stice & Bearman, 2001; Stice, Hayward, Cameron, Killen, & Taylor, 2000).”
Self-citationSharpe, H., Patalay, P., Choo, T.-H. J., Wall, M. M., Mason, S. M., Goldschmidt, A. B., & Neumark‐Sztainer, D. (2017) · Development and Psychopathology · doi:10.1017/s0954579417001663 · Cited by 111
“…depressive symptoms, both directly, given that appearance is one facet of broader self-concept, and indirectly, when attempts to manipulate one’s appearance through self-control (e.g., dieting behaviors) fails to bring the body in line with unattainable appearance ideas (Stice & Bearman, 2001).”
BackgroundJansen, W., van de Looij‐Jansen, P. M., de Wilde, E. J., & Brug, J. (2007) · Journal of Adolescent Health · doi:10.1016/j.jadohealth.2007.07.015 · Cited by 110
Depression Prevention for Early Adolescent Girls
Chaplin, T. M., Gillham, J. E., Reivich, K. J., Elkon, A. G. L., Samuels, B., Freres, D. R., Winder, B., & Seligman, M. E. P. (2006) · The Journal of Early Adolescence · doi:10.1177/0272431605282655 · Cited by 111
“…(e.g., body changes, hormonal changes, changes in the ways others perceive them) are more strongly associated with depressive symptoms in girls than in boys (Allgood-Merten, Lewinsohn,&Hops, 1990; Brooks-Gunn, 1988; Petersen, Sarigiani,& Kennedy, 1991; Stice & Bearman, 2001; Wichstrom, 1999).”
Metadata
- Authors
- Stice, E., & Bearman, S. K.
- Affiliations
- The University of Texas at Austin (US)
- Venue
- Developmental Psychology
- Published
- 2001
- Volume
- 37
- Issue
- 5
- Pages
- 597-607
- ISSN
- 0012-1649 (ISSN-L)
- 1939-0599
- OpenAlex
- W2084237622
- Cited by
- 704
- References
- 68
- Citations by year
- 2026: 11 · 2025: 8 · 2024: 20 · 2023: 26 · 2022: 14 · 2021: 25 · 2020: 31 · 2019: 34 · 2018: 34 · 2017: 21 · 2016: 32 · 2015: 44 · 2014: 35 · 2013: 50 · 2012: 57
- FWCI
- 12.49
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Developmental Psychology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Mental Health (MH-19908, MH 01708, MH12834, F31MH012834, K01MH001708, T32MH019908)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Social Sciences › Psychology › Clinical Psychology › Child and Adolescent Psychosocial and Emotional Development
- Health Sciences › Nursing › Nutrition and Dietetics › Nutrition, Health and Food Behavior
- Keywords
- body image, disordered eating, depressive symptoms, adolescent girls, thin-ideal internalization, body dissatisfaction, dieting, bulimic symptoms, risk factors for depression, mediation, social support, emotionality
- MeSH terms
- Adolescent, Feeding and Eating Disorders, Body Image, Depression, Female, Humans, Predictive Value of Tests, Prospective Studies, Social Support, Somatoform Disorders, Temperament
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