Depression and body image disorders in adolescence

Abstract

B oth depression and eating disorders have significant morbidity for adolescent girls and young women. These problems increase during adolescence,l-3 and there is some evidence that they increase above ultimate adult levels. 3 The gender differences that emerge in the adolescent period also persist into adulthood in both of these disorders. 4-6 Why are these disorders more prevalent among women than among men?7-9 The developmental issues involved may provide clues. The popular view of adolescence is that pubertal changes affect moods, and many have assumed that these biologic changes somehow create more mood problems for girls than for boys, leading to more serious psychopathology. Thus far, research has not adequately documented a direct link between pubertal change and moodiness, or the more serious problems of depression and eating disorders. 3 Although this lack of evidence may be in part due to the difficulty in studying these things in young people,lO we also need to examine the social factors associated with adolescent mood states and psychobiologic problems. The biologic changes of puberty are second only in rate and significance to what is seen in infancy, but the big difference is that adolescents can observe what is happening to them and their peers. Our research shows very clearly that biologic changes need to be examined along with changes in social contexts. Adolescence is also characterized by dramatic changes in every major social context, especially among family, peers, and school. 4, 11 Both biologic and social factors need to be considered for a complete picture.,10 Body image and depressive affect problems are linked to developmental change in each domain of individual development and each social context. 12 For example, pubertal development involves an increase in body fat as body shape changes. This increase in body fat is often misconstrued as a weight problem and is then associated with increases in dieting and other unhealthy behaviors related to weight gain. 13,14 This may lead to a distorted or poor body image and depressed affect for the cultural ideal of attractiveness (particularly for females) is one of a slender, long-limbed shape that is more typical of prepubertal development than of the mature woman's body after