the role of appearance schematicity in the development of adolescent body dissatisfaction

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Cognitive Therapy and Research [cotr] pp675-cotr-455265 November 14, 2002 15:13 Style file version Jun 14th, 2002

Cognitive Therapy and Research, Vol. 26, No. 6, December 2002 ( C© 2002), pp. 691–700

The Role of Appearance Schematicityin the Development of AdolescentBody Dissatisfaction

Duane Hargreaves1,2 and Marika Tiggemann1

Although much is now known about the development of body image disturbance,relatively little is known about the role of cognitive processes. The aim of the presentstudy was to examine longitudinally the role of appearance schemas as a predictor ofbody dissatisfaction change over 2 years among adolescent girls and boys. Participantswere 54 Australian school students in Year 10 at Time 1 (M age = 15.1) who wereassessed 2 years later when they were in Year 12 (Time 2). It was found that girls’ bodydissatisfaction worsened from Time 1 to Time 2 compared to boys, and that this changein girls’ body dissatisfaction was related to initial appearance schematicity, but not toinitial self-esteem. The results support the importance of cognitive processing modelsfor understanding the development of body image disturbance.

KEY WORDS: appearance schemas; self-schemas; body dissatisfaction; body image; adolescence.

A small, but growing number of longitudinal studies have examined the impor-tance of various psychological, biological, and social risk factors for predicting the on-set of disordered eating (Attie & Brooks-Gunn, 1989; Button, Sonuga-Barke, Davies,& Thompson, 1996; Cattarin & Thompson, 1994; Killen et al., 1996; Phelps, Johnston,& Augustyniak, 1999; Stice, 1998, 2001; Stice, Agras, & Hammer, 1999; Stice, Killen,Hayward, & Taylor, 1998; Stice & Shaw, 1994; Striegel-Moore, Silberstein, Frensch,& Rodin, 1989; Twamley & Davis, 1999; Vogeltanz-Holm et al., 2000; Wertheim,Koerner, & Paxton, 2001). Based on this literature, some authors have suggestedthat body dissatisfaction may be the “most consistent” predictor of eating distur-bance (e.g., Thompson, Heinberg, Altabe, & Tantleff-Dunn, 1999, p. 36). Yet, despitethis apparent importance of body dissatisfaction in the development of disorderedeating (e.g., Stice, 1994), only relatively few studies have, in turn, examined bodydissatisfaction from a similar developmental perspective.

1School of Psychology, Flinders University, Adelaide, South Australia, Australia.2Correspondence should be directed to Duane Hargreaves, The Flinders University of South Australia,G.P.O. Box 2100, Adelaide 5001, South Australia, Australia; e-mail: [email protected].

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692 Hargreaves and Tiggemann

To summarize this research to date, the empirically-demonstrated significantpredictors of adolescent girls’ body dissatisfaction over time have included levelof obesity and teasing (Thompson, Coovert, Richards, Johnson, & Cattarin, 1995),previous body image and dieting behavior (Byely, Archibald, Graber, & Brooks-Gunn, 2000), physical attractiveness (Rosenblum & Lewis, 1999), perceived pressureto be thin/internalization of the thin-ideal (Stice, 2001), and self-esteem (Button,et al., 1996). However, as yet, no study has investigated longitudinally the role ofcognitive-processing factors thought to contribute significantly to the developmentand maintenance of body image disturbances (for a review, see Thompson et al.,1999).

In particular, appearance schemas, which refer to cognitive generalizationsabout the “importance, meaning, and effects of appearance in one’s life” (Cash& Labarge, 1996), may be especially crucial. Although conceptually similar to con-structs such as internalization (Thompson & Stice, 2001) and shape and weight basedself-evaluation (Cooper & Fairburn, 1993; Geller, Johnston, & Madsen, 1997), ap-pearance schemas may be uniquely important due to their hypothesized impact oncognitive processing. Broadly defined, schemata are “knowledge structures aboutthe self, world, and future that guide attention to and interpretation of stimuli”(Spangler & Stice, 2001, p. 814). Based on Markus’ (1977) self-schema theory, appear-ance schemas are hypothesized to have information-processing consequences in thatthey influence attention to, memory for, and interpretation of appearance-relatedmaterial (Altabe & Thompson, 1996; Cash & Labarge, 1996; Vitousek & Hollon,1990). Although everyone develops appearance schemas to some degree (Markus,Hamill, & Sentis, 1987), there are individual differences in the strength, elaboration,and accessibility of these schemas. In particular, the impact of appearance-relatedinformation on perceptions, thoughts, affect, and behavior may be especially strongfor individuals who develop highly elaborate schemata linking issues of appearancewith implications for the self.

Consistent with this view, experimental research has demonstrated the impactof appearance schemas on both cognitive and affective aspects of body image. Forexample, individuals high on appearance schematicity, who are said to invest morestrongly in their appearance, have shown increased recall for schema-relevant mate-rial (Altabe & Thomnpson, 1996; Geller et al. , 1997), greater Stroop interference forappearance-related words (Labarge, Cash, & Brown, 1998), as well as greater bodydissatisfaction after exposure to schema-relevant stimuli (Hargreaves & Tiggemann,2002; Lavin & Cash, 2001). Correlationally, women and girls high on appearanceschematicity also report higher levels of body dissatisfaction (Altabe & Thompson,1996; Cash & Labarge, 1996), although, at present, the causal link between appear-ance schemas and body image is uncertain.

According to cognitive theorizing about body image disturbance, the forma-tion of appearance schemas developmentally precedes body dissatisfaction, in thatpeople need to process information about appearance before experiencing negativeaffective consequences. Although Stice (2001) showed the related concepts of inter-nalization and perceived pressure to be thin to predict body dissatisfaction, as yet noresearch has examined this hypothesized developmental link between appearanceschematicity, the cognitive structures developed around the meaning of appearance,

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Appearance Schemas and Body Dissatisfaction 693

and body dissatisfaction, a subjective evaluation of one’s appearance. Thus the pur-pose of the present study was to trace both appearance schemas and body dissatis-faction over a 2-year time period to test the specific prediction that the developmentof appearance schemas would temporally precede the development of body dissatis-faction. Self-esteem was also included as a predictor. Although low self-esteem hasbeen linked correlationally to heightened body dissatisfaction, prospective studiesexamining the impact of self-esteem on the development of eating disturbances haveproduced mixed results (Field et al., 1999; Stice, Presnell, & Spangler, 2002; Vohs,Bardone, Joiner, & Abramson, 1999; Wertheim et al., 2001).

METHOD

Participants

The participants were 54 South Australian adolescents (29 girls and 25 boys)who had 2 years previously participated in a larger experimental study of exposure tomedia images of attractiveness (Hargreaves & Tiggemann, 2002). At Time 1 (August1999), 161 Year 10 students completed measures of body dissatisfaction.

A subset of 83 students (40 girls, 43 boys) had also participated in a session 3–4weeks earlier which assessed appearance schemas and self-esteem. Previous attritionanalyses of Time 1 data showed no differences between the students who completedboth sessions and those without the additional measures (Hargreaves & Tiggemann,2002). From this subsample of 83 students in Year 10 who had participated in bothsessions, 54 (29 girls and 25 boys) completed the follow-up questionnaire two yearslater when they were in Year 12 (September 2001). No student declined to com-plete the follow-up questionnaire, but rather the attrition rate over the 2 year periodwas primarily a function of students having left school. We conducted Time 2 attri-tion analyses which showed that participants in the follow-up had not initially dif-fered from the other students on any of age, BMI, body dissatisfaction, appearanceschematicity, or self-esteem.

The average age of the sample was 15.2 years (SD = 0.7) at Time 1 and 17.2 years(SD = 0.7) at Time 2. Their average Body Mass Index fell within the normal rangeat both times (Time 1 M = 20.6, SD = 3.7; Time 2 M = 21.9, SD = 3.4).

Materials

Body Dissatisfaction

Two visual analogue scales (VAS) were used to obtain a measure of body dissatis-faction. Participants were presented with 10 cm horizontal lines labelled from “none”to “very much,” and asked to indicate their current level of Weight Dissatisfactionand Overall Appearance Dissatisfaction. These were then measured to the nearestmillimeter and averaged to form a composite body dissatisfaction measure. Heinbergand Thompson (1995) have previously shown the two VAS (weight and appearancedissatisfaction) to correlate significantly with the Body Dissatisfaction Scale of theEating Disorders Inventory, r = .66, p < .01; r = .76, p < .01, respectively.

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Appearance Schematicity

The Appearance Schemas Inventory (ASI) measures core beliefs and assump-tions about the importance, meaning, and implications of appearance in one’s life(Cash, 2000; Cash & Labarge, 1996). Thus the ASI assesses the cognitive products(attitudes, beliefs, and evaluations about appearance) assumed to result from or un-derlie schematic processing (Ingram, Miranda, & Segal, 1998), rather than measuringschematic processing per se. Nevertheless, the ASI has been shown to correlate withcognitive processing as measured by performance on the Stroop color-naming task(Labarge et al., 1998). The ASI asks participants to use a 5 point Likert scale (from1 = strongly disagree, to 5 = strongly agree) to indicate their level of agreement with14 statements (e.g., “What I look like is an important part of who I am,” “Attractivepeople have it all”), such that high scores reflect higher appearance schematicity. TheASI has displayed a 1 month test-retest reliability of .71 (Cash & Labarge, 1996), andtests of internal consistency for the present sample of adolescents (α = .82) showedcomparable reliability to that observed with college-aged participants (α = .84).

Self-Esteem

The Rosenberg Self-Esteem Scale (RSES), measured at Time 1 only, is a 10-itemmeasure of global self-esteem (Rosenberg, 1965). The RSES has displayed good toexcellent reliability and validity across a wide range of settings (Brown, 1998). Testsof internal consistency indicated good reliability for the present sample (α = .85).

RESULTS

Change in Body Dissatisfaction Over Time

Time 2 data show that 62% of girls reported an increase in body dissatisfac-tion during the 2-year period. In contrast, 64% of boys reported a decrease or nochange. A 2-way (gender, time) repeated-measures ANOVA was conducted to ex-amine mean changes in body dissatisfaction over the 2 years. Although there was nosignificant main effect of time, F (1, 51) < 1, ns , there was a significant main effectof gender, F(1, 51) = 24.18, p < .001, as well as a significant gender × time inter-action, F(1, 51) = 4.40, p < .05. As can be seen in Fig. 1, on average, girls becameincreasingly more dissatisfied from Time 1 to Time 2, compared to boys who becameless dissatisfied over the same 2-year period. Correlations between Time 1 and Time2 body dissatisfaction show the greater stability of body dissatisfaction over time forboys, r = .55, n = 24, p = .005, compared to girls, r = .41, n = 29, p = .029.

Change in Appearance Schematicity Over Time

A second 2-way (gender, time) repeated-measures ANOVA was conducted toexamine changes in appearance schematicity for girls and boys. In contrast to the re-sults for body dissatisfaction, there were no significant main effects, gender F(1, 44) =2.10, p = .154; time F(1, 44) = 3.12, p = .084, or interaction, F(1, 44) < 1, ns.

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Fig. 1. Development of girls’ and boys’ body dissatisfaction and appearance schematicity from Time 1(age 15) to Time 2 (age 17).

Figure 1 shows that, at the group level, appearance schematicity remained stablefrom Time 1 (M = 2.52, SD = 0.58) to Time 2 (M = 2.41, SD = 0.59). Correlationsbetween Time 1 and 2 also reflect the relative individual stability of schematicity forboth girls, r = .73, n = 27, p < .001, and boys, r = .74, n = 19, p < .001, over the2-year period.

The Relationship Between Appearance Schematicity and Body Dissatisfaction

Appearance schematicity (ASI) was related to body dissatisfaction at Time 1for both girls, r = .64, n = 27, p < .001, and boys, r = .49, n = 20, p = .027, such thatthose higher on appearance schematicity were also more dissatisfied with their bodies.Schematicity and body dissatisfaction were also significantly positively related atTime 2, for girls, r = .60, n = 29, p = .001, but not for boys, r = .26, n = 22, p = .252.

Because of the significant gender × time interaction on body dissatisfaction,separate regression analyses for girls and boys to predict Time 2 change in bodydissatisfaction were conducted. Time 1 body dissatisfaction was entered on Step 1to account for the synchronous correlation between ASI and body dissatisfactionat Time 1. ASI (Time 1) and self-esteem (Time 1) were then entered on Steps 2and 3 respectively. The results of this analysis are summarized in Table I. As pre-dicted, appearance schematicity offered significant prediction of girls’ Time 2 body

Table I. The Results of Multiple Regression Analyses for the Prediction of Body Dissatisfaction atTime 2

Step Predictor (Time 1) Partial r p Overall F p R2change Fchange p

Girls 1 Body dissatisfaction 3.98 .058 .15 3.98 .0582 Appearance schemas .52 .009 6.67 .005 .23 8.31 .0093 Self-esteem −.29 .149 5.05 .009 .04 1.50 .234

Boys 1 Body dissatisfaction 8.16 .001 .34 8.16 .0112 Appearance schemas −.13 .608 4.03 .040 .01 <1 .6083 Self-esteem −.39 .088 3.79 .035 .10 2.50 .136

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dissatisfaction above and beyond that accounted for by Time 1 body dissatisfaction,R 2

change = .23, Fchange(2, 22) = 8.13, p = .01. Self-esteem did not predict any furthervariance, R 2

change = .04, Fchange(2, 21) = 1.50, ns . The standardized Beta’s at Step 3show that Time 1 appearance schematicity (β = .55, p < .05), but not self-esteem(β = −.21, ns ) or Time 1 body dissatisfaction (β = .01, ns ), predicted body dissat-isfaction at Time 2.

To test the alternative possibility that body dissatisfaction temporally precedesappearance schematicity, a second regression predicting Time 2 appearanceschematicity was conducted. Time 1 appearance schematicity was entered on thefirst step, followed by Time 1 body dissatisfaction on the second. In contrast to thefirst regression, body dissatisfaction (Time 1) did not add significantly to the predic-tion for Time 2 appearance schematicity beyond Time 1 appearance schematicity,R2

change = .00, Fchange(1, 24) < 1, ns. Overall, these results are consistent with the hy-pothesis that appearance schematicity temporally precedes body dissatisfaction forgirls.

The same set of regression analyses were conducted to examine the developmentof body dissatisfaction for boys. However, unlike the results for girls, as can be seen inTable I, Time 1 appearance schematicity and self-esteem did not contribute significantunique prediction of Time 2 body dissatisfaction, beyond that accounted for by Time1 body dissatisfaction. Similarly, Time 1 body dissatisfaction did not predict Time 2appearance schematicity, beyond Time 1 schematicity, R2

change = .01, Fchange(1, 16) <1, ns.

DISCUSSION

The purpose of the present study was to examine the development of bodydissatisfaction during adolescence. The results show that levels of body dissatisfactionchanged during the 2-year period, such that on average, girls’ body dissatisfactionworsened over time compared to boys. Consistent with previous research (e.g., Davies& Furnham, 1986; Rauste-von Wright, 1989; Richards, Boxer, Petersen, & Albrecht,1990; Rosenblum & Lewis, 1999; Wardle & Marsland, 1990), these data suggest ageneral trend toward increasing body image disturbance during adolescence for girls.However, for the present sample, 38% of girls either improved in body image orexperienced no change over the 2-years. Therefore, these data also implicate theoperation of physical, social, and psychological predisposing factors that facilitatethese negative changes for some girls but not others. In particular, the present studywas interested in the role of cognitive processing factors.

Importantly, the results showed that appearance schematicity, but not globalself-esteem, was antecedent to changes in body dissatisfaction for girls. As predicted,girls with a stronger personal investment in appearance (high schematicity) at age15 (Time 1) felt relatively more dissatisfied with their bodies at age 17. Multipleregression analyses confirmed that this relationship was not a function of the syn-chronous relationship between body dissatisfaction and schematicity, consistent withthe proposed causal role of appearance schematicity in the development of bodydissatisfaction.

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These findings extend previous cross-sectional and experimental research bydemonstrating that the influence of appearance schemas is not limited to immediateprocessing and responsiveness to appearance-related stimuli, but also to the cumula-tive development of body image concern. This approach provides a possible concep-tual link between “state like” body image which results from the interaction betweenperson and situation variables (e.g., Haimovitz, Lansky, & O’Reilly, 1993; Pruzinsky& Cash, 1990; Tiggemann, 2001), and more enduring aspects of body image distur-bance. More specifically, following a schema perspective, the heightened awarenessand responsiveness to the many daily situations that evoke schematic processing ofappearance information may cultivate the development of body dissatisfaction overtime.

In the present study, the impact of appearance schemas was limited to girls, al-though the result for boys should be interpreted cautiously due to their small samplesize. Nevertheless, the results for boys are more likely a function of their more stablebody dissatisfaction, and the fact there was little change over time to predict. How-ever, there are a number broader limitations which should also be acknowledged. Inparticular, the small sample size, moderate attrition rate for boys in particular, andhomogeneous nature of the sample may influence the stability and generality of theconclusions, and clearly future research needs to replicate these findings with largerand younger samples. Furthermore, a Time 2 measure of self-esteem would allow amore comprehensive investigation of self-esteem’s temporal relationship with bothappearance schematicity and body dissatisfaction. Self-esteem has previously beenshown to predict onset of eating disturbance in some studies (Field et al., 1999; Stice,et al., 2002), but not in others (Vohs et al., 1999; Wertheim et al., 2001), and furtherresearch investigating the relationship between self-esteem and body image seemswarranted. However, despite its limitations, the present study provides an importantstart in contributing to our understanding of the causal cognitive processes involvedin the development of body image disturbance.

Given the important role of appearance schemas in body image disturbance,future research should examine appearance schematicity from a similar develop-mental perspective. In particular, longitudinal research following prepubescent girlsand boys over time would identify key periods for the development of appearanceschemas prior to mid-adolescence, by which time appearance schematicity seems rel-atively stable. The inclusion of implicit measures of schematic processing, such as theStroop color-naming task or an Implicit Association Test (Greenwald, McGhee, &Schwartz, 1998), in addition to self-report measures of appearance schematicity suchas used here (ASI), would allow developmental changes in cognitive processes (e.g.,processing biases, reaction time) as well as their assumed product (e.g., beliefs, at-titudes, and evaluations) to be examined (Ingram et al., 1998). Such research mightalso usefully examine the factors which influence these developmental changes inschematicity. For example, Cash (1996) has suggested that body image attitudes andcognitions are shaped by the combined influence of a person’s personality attributes,physical attributes, and cultural and interpersonal socialization. Longitudinal re-search with younger populations would allow this model to be tested empirically.

Prospective research, such as that presented here, can also help identify impor-tant content and target ages for body image prevention programs. The present results

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suggest that body image interventions should target appearance schemas, perhapsaiming to challenge underlying attitudes and beliefs about appearance while also en-couraging the development of adaptive self-schemas in other non-appearance relateddomains. Based on a similar rationale, Cash’s cognitive–behavioural body image ther-apy (Cash, 1996, 1997; Cash & Grant, 1995) has produced significant improvementsin body image for non eating disordered body dissatisfied women. This body imageintervention, or other schema-focused therapies (e.g., McGinn & Young, 1996) maybe profitably adapted into a prevention program for younger adolescents. Certainlyfuture body image prevention efforts will benefit from ongoing longitudinal researchexamining body image and eating disturbance from a schema perspective.

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