Depression, anxiety and related disorders

Abstract

Within contemporary Western cultures, women are subject to ubiquitous sociocultural factors that are thought to play a central role in the development of body image and eating disorders. These sociocultural pressures comprise the thin body ideal promoted for women, the emphasis of appearance in the female gender-role and the importance of appearance for the societal success of women (Thompson et al., 1999). Not surprisingly, then, there are high rates of body dissatisfaction amongst women, particularly young women, so much so that weight has been described as a “normative discontent” for women (Rodin et al., 1985, p. 267). This chapter sets out to introduce the sociocultural perspective on body image and body image disturbance, and presents body dysmorphic disorder (BDD) and the eating disorders anorexia nervosa (AN), bulimia nervosa (BN) and binge eating disorder (BED) as exemplars of body image disorders in women. Body image Body image is a multidimensional construct that represents how an individual thinks, feels and behaves in relation to their physical appearance (Cash, 2002). The body image construct can be further divided into two core facets comprising evaluation and investment. Body image evaluation refers to the evaluative thoughts and beliefs a person may have about appearance, such as the degree of satisfaction or dissatisfaction with their body. In contrast, body image investment refers to the cognitive and behavioral importance that a person assigns to their physical appearance (Cash et al., 2004), including the extent to which they focus on their physical appearance and engage in behaviors associated with management or enhancement of their appearance, including dieting and exercise. When an individual maintains disturbances in the cognitive, behavioral and emotional aspects of their body image, however, this may lead to the development and subsequent maintenance of disorders such as BDD, AN, and BN (Hrabosky et al., 2009). The manner in which body image disturbances may arise will be examined within the context of the sociocultural model. Sociocultural model The sociocultural model posits that, within a particular culture, there exist societal ideals of beauty that are transmitted via a variety of sociocultural channels, most notably mass media, family and peers (Thompson et al., 1999). These ideals are internalized by individuals such that dissatisfaction with appearance becomes a function of the extent to which individuals do not meet the body image ideal.