Skip to main content
Log in

Depression, Self-Esteem, and Disordered Eating among Pakistani Adolescent Girls: The Mediating Role of Appearance Comparison and Internalization of Appearance Ideals

  • Published:
Child and Adolescent Social Work Journal Aims and scope Submit manuscript

Abstract

Although the link of depression and self-esteem with disordered eating is well reported in literature, there is insufficient insight into the underlying processes that inform the relationship. The present study examined the mediating effects of comparison of appearance and internalization of appearance ideals in the relationship of depression and self-esteem with disordered eating. The study sample comprised of 381 school-going adolescent girls, aged 13 to 18, from Islamabad, Pakistan. As part of the study, participants were required to complete several measures, including the Eating Disorder Examination Questionnaire—Short Form, Depression Anxiety Stress Scale 21, Rosenberg Self-Esteem Scale, Physical Appearance Comparison Scale—Revised, and Sociocultural Attitudes Toward Appearance Questionnaire—4. Findings revealed significant relationships between depression, self-esteem, comparison of appearance, internalization of appearance ideals, and disordered eating. Path analyses indicated that comparison of appearance and internalization of appearance ideals partially serially mediated the relationship between depression and disordered eating. Additionally, these two mediators were found to fully serially mediate the relationship between self-esteem and disordered eating. This study implicates the importance of considering depression and self-esteem in predicting disordered eating. Furthermore, findings posited that comparison of appearance and internalization of appearance ideals posed as potential risk factors in aggravating disordered eating. This study extends an opportunity for clinicians and community workers to initiate projects of social welfare such as awareness programs to address eating-related pathologies in educational as well as community settings, specifically amongst the adolescent population.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

Data can be shared upon request.

References

  • Alfalahi, M., Mahadevan, S., Balushi, R. A., Chan, M. F., Saadon, M. A., Al-Adawi, S., & Qoronfleh, M. W. (2022). Prevalence of eating disorders and disordered eating in Western Asia: A systematic review and meta-analysis. Eating Disorders, 30(5), 556–585. https://doi.org/10.1080/10640266.2021.1969495

    Article  PubMed  Google Scholar 

  • Ali, S. (2018). Women objectification and advertising: An analysis of sexually objectified portrayal of women in television advertising in Pakistan. Global Media Journal, 16(31), 1–9.

    Google Scholar 

  • American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders. American Psychiatric Association Publishing.

    Book  Google Scholar 

  • Aparicio-Martínez, P., Perea-Moreno, A., Redel-Macías, M. D., Pagliari, C., & Vaquero-Abellán, M. (2019). Social media, thin-ideal, body dissatisfaction and disordered eating attitudes: An exploratory analysis. International Journal of Environmental Research and Public Health, 16(21), 4177. https://doi.org/10.3390/ijerph16214177

    Article  PubMed  PubMed Central  Google Scholar 

  • Appel, H., Gerlach, A. L., & Crusius, J. (2016). The interplay between facebook use, social comparison, envy, and depression. Current Opinion in Psychology, 9, 44–49.

    Article  Google Scholar 

  • Argyrides, M., & Sivitanides, M. (2017). Body image, self-esteem, media, disordered eating and actual ideal weight discrepancy: Findings in Cyprus. The European Journal of Counselling Psychology, 6(1), 63–74. https://doi.org/10.5964/ejcop.v6i1.109

    Article  Google Scholar 

  • Arigo, D., Schumacher, L., & Martin, L. M. (2014). Upward appearance comparison and the development of eating pathology in college women. International Journal of Eating Disorders, 47(5), 467–470. https://doi.org/10.1002/eat.22240

    Article  PubMed  Google Scholar 

  • Barnhart, W. R., Braden, A. L., & Price, E. (2021). Emotion regulation difficulties interact with negative, not positive, emotional eating to strengthen relationships with disordered eating: An exploratory study. Appetite, 158, 105038.

    Article  PubMed  Google Scholar 

  • Bashir, A. (2018). The state of mental health care in Pakistan. The Lancet Psychiatry, 5(6), 471.

    Article  PubMed  Google Scholar 

  • Bennett, J., Greene, G., & Schwartz-Barcott, D. (2013). Perceptions of emotional eating behavior. A qualitative study of college students. Appetite, 60, 187–192. https://doi.org/10.1016/j.appet.2012.09.023

    Article  PubMed  Google Scholar 

  • Bibi, A., Lin, M., Zhang, X. C., & Margraf, J. (2020). Psychometric properties and measurement in variance of depression, anxiety and stress scales (DASS-21) across cultures. International Journal of Psychology, 55(6), 916–925.

    Article  PubMed  Google Scholar 

  • Brausch, A. M., & Decker, K. M. (2014). Self-esteem and social support as moderators of depression, body image, and disordered eating for suicidal ideation in adolescents. Journal of Abnormal Child Psychology, 42(5), 779–789. https://doi.org/10.1007/s10802-013-9822-0

    Article  PubMed  Google Scholar 

  • Brechan, I., & Kvalem, I. L. (2015). Relationship between body dissatisfaction and disordered eating: Mediating role of self-esteem and depression. Eating Behaviors, 17, 49–58. https://doi.org/10.1016/j.eatbeh.2014.12.008

    Article  PubMed  Google Scholar 

  • Chan, C. Y., Lee, A. M., Koh, Y. W., Lam, S. K., Lee, C. P., Leung, K. Y., & Tang, C. S. K. (2019). Course, risk factors, and adverse outcomes of disordered eating in pregnancy. International Journal of Eating Disorders, 52(6), 652–658. https://doi.org/10.1002/eat.23065

    Article  PubMed  Google Scholar 

  • Chua, T. H. H., & Chang, L. (2016). Follow me and like my beautiful selfies: Singapore teenage girls’ engagement in self-presentation and peer comparison on social media. Computers in Human Behavior, 55, 190–197. https://doi.org/10.1016/j.chb.2015.09.011

    Article  Google Scholar 

  • Culbert, K. M., Sisk, C. L., & Klump, K. L. (2021). A narrative review of sex differences in eating disorders: Is there a biological basis? Clinical Therapeutics, 43(1), 95–111.

    Article  PubMed  Google Scholar 

  • Egbert, A. H., Hunt, R. A., Williams, K. L., Burke, N. L., & Mathis, K. J. (2022). Reporting racial and ethnic diversity in eating disorder research over the past 20 years. International Journal of Eating Disorders, 55(4), 455–462.

    Article  PubMed  Google Scholar 

  • Espinoza, P., Penelo, E., Mora, M., Francisco, R., González, M., & Raich, R. M. (2018). Bidirectional relations between disordered eating, internalization of beauty ideals, and Self-Esteem: A longitudinal study with adolescents. Journal of Early Adolescence, 39(9), 1244–1260. https://doi.org/10.1177/0272431618812734

    Article  Google Scholar 

  • Evans, E. H., Tovée, M. J., Boothroyd, L. G., & Drewett, R. F. (2013). Body dissatisfaction and disordered eating attitudes in 7-to 11-year-old girls: Testing a sociocultural model. Body Image, 10(1), 8–15. https://doi.org/10.1016/j.bodyim.2012.10.001

    Article  PubMed  Google Scholar 

  • Fardouly, J., Pinkus, R. T., & Vartanian, L. R. (2017). The impact of appearance comparisons made through social media, traditional media, and in person in women’s everyday lives. Body Image, 20, 31–39. https://doi.org/10.1016/j.bodyim.2016.11.002

    Article  PubMed  Google Scholar 

  • Ferreiro, F., Seoane, G., & Senra, C. (2012). Gender-related risk and protective factors for depressive symptoms and disordered eating in adolescence: A 4-year longitudinal study. Journal of Youth and Adolescence, 41(5), 607–622. https://doi.org/10.1007/s10964-011-9718-7

    Article  PubMed  Google Scholar 

  • Fitzsimmons-Craft, E. E. (2011). Social psychological theories of disordered eating in college women: Review and integration. Clinical Psychology Review, 31(7), 1224–1237. https://doi.org/10.1016/j.cpr.2011.07.011

    Article  PubMed  Google Scholar 

  • Fitzsimmons-Craft, E. E., Harney, M. B., Brownstone, L. M., Higgins, M. K., & Bardone-Cone, A. M. (2012). Examining social physique anxiety and disordered eating in college women. The roles of social comparison and body surveillance. Appetite, 59(3), 796–805. https://doi.org/10.1016/j.appet.2012.08.019

    Article  PubMed  Google Scholar 

  • Froreich, F. V., Vartanian, L. R., Grisham, J. R., & Touyz, S. W. (2016). Dimensions of control and their relation to disordered eating behaviours and obsessive-compulsive symptoms. Journal of Eating Disorders, 4(1), 1–9.

    Article  Google Scholar 

  • Gideon, N. (2014). The development and validation of a shortened version of the Eating Disorder Examination Questionnaire (EDE-Q) (Doctoral dissertation, UCL (University College London)).

  • Gitimu, P. N., Jameson, M. M., Turel, T., Pohle-Krauza, R., Mincher, J., Rowlands, Z., & Elias, J. (2016). Appearance issues, depression, and disordered eating among college females. Cogent Psychology, 3(1), 1196512. https://doi.org/10.1080/23311908.2016.1196512

    Article  Google Scholar 

  • Hamid, S., Stephenson, R., & Rubenson, B. (2011). Marriage decision making, spousal communication, and reproductive health among married youth in Pakistan. Global Health Action, 4(1), 5079. https://doi.org/10.3402/gha.v4i0.5079

    Article  PubMed  Google Scholar 

  • Harriger, J. A., Evans, J. A., Thompson, J. K., & Tylka, T. L. (2022). The dangers of the rabbit hole: Reflections on social media as a portal into a distorted world of edited bodies and eating disorder risk and the role of algorithms. Body Image, 41, 292–297.

    Article  PubMed  Google Scholar 

  • Hassan, S. M. U., Hamid, T. A., Haron, S. A., & Ibrahim, R. (2020). Emotional regulation as a mediator between the filial behaviour of the oldest son and subjective well-being of older parents in Pakistan. Psychogeriatrics, 20(1), 59–69. https://doi.org/10.1111/psyg.12458

    Article  PubMed  Google Scholar 

  • Hassan, S. M. U., Jilani, S., & Zubair, M. (2023). Adult attachment and depressive symptoms among community-dwelling older parents: A moderated mediation model of cognitive reappraisal and social connectedness. Current Psychology, 43(10), 1–14. https://doi.org/10.1007/s12144-023-05011-3

    Article  Google Scholar 

  • Hawes, T., Zimmer-Gembeck, M. J., & Campbell, S. M. (2020). Unique associations of social media use and online appearance preoccupation with depression, anxiety, and appearance rejection sensitivity. Body Image, 33, 66–76. https://doi.org/10.1016/j.bodyim.2020.02.010

    Article  PubMed  Google Scholar 

  • Hazzard, V. M., Telke, S. E., Simone, M., Anderson, L. M., Larson, N. I., & Neumark-Sztainer, D. (2021). Intuitive eating longitudinally predicts better psychological health and lower use of disordered eating behaviors: Findings from EAT 2010–2018. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 26(1), 287–294. https://doi.org/10.1007/s40519-020-00852-4

    Article  Google Scholar 

  • Henrich, J., Heine, S. J., & Norenzayan, A. (2010). Most people are not WEIRD. Nature, 466(7302), 29–29.

    Article  PubMed  Google Scholar 

  • Herbozo, S., Schaefer, L. M., & Thompson, J. K. (2015). A comparison of eating disorder psychopathology, appearance satisfaction, and self-esteem in overweight and obese women with and without binge eating. Eating Behaviors, 17, 86–89.

    Article  PubMed  Google Scholar 

  • Higgins, E. T. (1987). Self-discrepancy: A theory relating self and affect. Psychological Review, 94(3), 319–340. https://doi.org/10.1037/0033-295x.94.3.319

    Article  PubMed  Google Scholar 

  • Holland, G., & Tiggemann, M. (2016). A systematic review of the impact of the use of social networking sites on body image and disordered eating outcomes. Body Image, 17, 100–110.

    Article  PubMed  Google Scholar 

  • Huddson, J. L., Hiripi, E., Pope, H. G., & Kessler, R. C. (2007). The prevalence and correlates of eating disorders in the national co-morbidity survey replication. Biological Psychiatry, 6, 348–358. https://doi.org/10.1016/j.biopsych.2006.03.040

    Article  Google Scholar 

  • Huhmann, K. (2020). Menses requires energy: A review of how disordered eating, excessive exercise, and high stress lead to menstrual irregularities. Clinical Therapeutics, 42(3), 401–407. https://doi.org/10.1016/j.clinthera.2020.01.016

    Article  PubMed  Google Scholar 

  • Husain, W. (2020). Barriers in seeking psychological help: Public perception in Pakistan. Community Mental Health Journal, 56(1), 75–78.

    Article  PubMed  Google Scholar 

  • Jung, J., Barron, D., Lee, Y. A., & Swami, V. (2022). Social media usage and body image: Examining the mediating roles of internalization of appearance ideals and social comparisons in young women. Computers in Human Behavior, 135, 107357.

    Article  Google Scholar 

  • Jung, J., & Lee, S. H. (2006). Cross-cultural comparisons of appearance self-schema, body image, self-esteem, and dieting behavior between Korean and US women. Family and Consumer Sciences Research Journal, 34(4), 350–365. https://doi.org/10.1177/1077727X06286419

    Article  Google Scholar 

  • Kärkkäinen, U., Mustelin, L., Raevuori, A., Kaprio, J., & Keski-Rahkonen, A. (2017). Do disordered eating behaviours have long-term health-related consequences? European Eating Disorders Review, 26(1), 22–28. https://doi.org/10.1002/erv.2568

    Article  PubMed  PubMed Central  Google Scholar 

  • Kenny, B., Fuller-Tyszkiewicz, M., Moodie, M., Brown, V., & Williams, J. (2022). Bi-directional associations between depressive symptoms and eating disorder symptoms in early adolescence. Body Image, 42, 246–256.

    Article  PubMed  Google Scholar 

  • Kontele, I., & Vassilakou, T. (2021). Nutritional risks among adolescent athletes with disordered eating. Children, 8(8), 715. https://doi.org/10.3390/children8080715

    Article  PubMed  PubMed Central  Google Scholar 

  • Konttinen, H., Van Strien, T., Männistö, S., Jousilahti, P., & Haukkala, A. (2019). Depression, emotional eating and long-term weight changes: A population-based prospective study. International Journal of Behavioral Nutrition and Physical Activity, 16(1), 1–11.

    Article  Google Scholar 

  • Lantz, E. L., Gaspar, M. E., DiTore, R., Piers, A. D., & Schaumberg, K. (2018). Conceptualizing body dissatisfaction in eating disorders within a self-discrepancy framework: A review of evidence. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 23(3), 275–291.

    Google Scholar 

  • Latif, A., & Khan, B. (2020). Gender difference in sociocultural attitude towards appearance. Pakistan Journal of Gender Studies, 20(2), 1–24.

    Article  Google Scholar 

  • Latif, A., Khan, S., & Farooq, W. (2011). Impact of media on development of eating disorders in young females of Pakistan. International Journal of Psychological Studies, 3(1), 122.

    Google Scholar 

  • Ledoux, T., Winterowd, C., Richardson, T., & Clark, J. D. (2010). Relationship of negative self-schemas and attachment styles with appearance schemas. Body Image, 7(3), 213–217.

    Article  PubMed  Google Scholar 

  • LeMoult, J., & Gotlib, I. H. (2019). Depression: A cognitive perspective. Clinical Psychology Review, 69, 51–66. https://doi.org/10.1016/j.cpr.2018.06.008

    Article  PubMed  Google Scholar 

  • Lennon, S. J., Lillethun, A., & Buckland, S. S. (1999). Attitudes toward social comparison as a function of self-esteem: Idealized appearance and body image. Family and Consumer Sciences Research Journal, 27(4), 379–405. https://doi.org/10.1177/1077727X99274001

    Article  Google Scholar 

  • Liechty, J. M., & Lee, M. J. (2013). Longitudinal predictors of dieting and disordered eating among young adults in the US. International Journal of Eating Disorders, 46(8), 790–800. https://doi.org/10.1002/eat.22174

    Article  PubMed  Google Scholar 

  • Linardon, J., Brennan, L., & De la Piedad Garcia, X. (2016). Rapid response to eating disorder treatment: A systematic review and meta-analysis. International Journal of Eating Disorders, 49(10), 905–919.

    Article  PubMed  Google Scholar 

  • Loth, K. A., MacLehose, R., Bucchianeri, M., Crow, S., & Neumark-Sztainer, D. (2014). Predictors of dieting and disordered eating behaviors from adolescence to young adulthood. Journal of Adolescent Health, 55(5), 705–712.

    Article  Google Scholar 

  • Luo, Y. J., Jackson, T., Niu, G. F., & Chen, H. (2020). Effects of gender and appearance comparisons on associations between media-based appearance pressure and disordered eating: Testing a moderated mediation model. Sex Roles, 82(5), 293–305. https://doi.org/10.1007/s11199-019-01058-4

    Article  Google Scholar 

  • McCabe, M., Alcaraz-Ibanez, M., Markey, C., Sicilia, A., Rodgers, R. F., Aimé, A., & Fuller-Tyszkiewicz, M. (2023). A longitudinal evaluation of a biopsychosocial model predicting BMI and disordered eating among young adults. Australian Psychologist, 58(2), 57–79.

    Article  Google Scholar 

  • Micali, N., De Stavola, B., Ploubidis, G., Simonoff, E., Treasure, J., & Field, A. E. (2015). Adolescent eating disorder behaviours and cognitions: Gender-specific effects of child, maternal and family risk factors. The British Journal of Psychiatry, 207(4), 320–327.

    Article  PubMed  PubMed Central  Google Scholar 

  • Midgley, C., Thai, S., Lockwood, P., Kovacheff, C., & Page-Gould, E. (2021). When every day is a high school reunion: Social media comparisons and self-esteem. Journal of Personality and Social Psychology, 121(2), 285. https://doi.org/10.1037/pspi0000336

    Article  PubMed  Google Scholar 

  • Mischner, I. H., van Schie, H. T., & Engels, R. C. (2013). Breaking the circle: Challenging Western sociocultural norms for appearance influences young women’s attention to appearance-related media. Body Image, 10, 316–325. https://doi.org/10.1016/j.bodyim.2013.02.005

    Article  PubMed  Google Scholar 

  • Munawar, K., Abdul Khaiyom, J. H., Bokharey, I. Z., Park, M. S. A., & Choudhry, F. R. (2020). A systematic review of mental health literacy in Pakistan. Asia-Pacific Psychiatry, 12(4), e12408.

    Article  PubMed  Google Scholar 

  • Myers, T. A., & Crowther, J. H. (2009). Social comparison as a predictor of body dissatisfaction: A meta-analytic review. Journal of Abnormal Psychology, 118(4), 683.

    Article  PubMed  Google Scholar 

  • Nagata, J. M., Ganson, K. T., & Murray, S. B. (2020). Eating disorders in adolescent boys and young men: An update. Current Opinion in Pediatrics, 32(4), 476.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nawaz, H., Rabia, M., Javed, H., Yousaf, M., Mahmood, S., & Riaz, M. (2023). Stimulating appearance comparison dynamics and their effects on psychological dysfunctions: The moderating role of self-compassion. PLoS ONE, 18(11), e0293798. https://doi.org/10.1371/journal.pone.0293798

    Article  PubMed  PubMed Central  Google Scholar 

  • Nightingale, B. A., & Cassin, S. E. (2019). Disordered eating among individuals with excess weight: A review of recent research. Current Obesity Reports, 8(2), 112–127. https://doi.org/10.1007/s13679-019-00333-5

    Article  PubMed  Google Scholar 

  • Nisar, M., Mohammad, R. M., Fatima, S., Shaikh, P. R., & Rehman, M. (2019). Perceptions pertaining to clinical depression in Karachi. Pakistan. Cureus, 11(7), e5094.

    PubMed  Google Scholar 

  • O’Garo, K. N., Morgan, K., Hill, L. K., Reid, P., Simpson, D., Lee, H., & Edwards, C. L. (2019). Internalization of Western ideals on appearance and self-esteem in Jamaican undergraduate students. Culture, Medicine and Psychiatry, 44(2), 249–262. https://doi.org/10.1007/s11013-019-09652-7

    Article  Google Scholar 

  • Pakistan Bureau of Statistics (2017). Household Integrated Economic Survey (HIES) 2015–16. Retrieved from https:// www.pbs.gov.pk/publication/household-integrated-economic-survey-hies-2015-16

  • Palmeroni, N., Claes, L., Verschueren, M., Raemen, L., & Luyckx, K. (2021). Internalization of appearance ideals and appearance comparison among adolescent boys and girls: The role of identity formation. Identity, 21(3), 219–237. https://doi.org/10.1080/15283488.2021.1930542

    Article  Google Scholar 

  • Patrick, H., Neighbors, C., & Knee, C. R. (2004). Appearance-related social comparisons: The role of contingent self-esteem and self-perceptions of attractiveness. Personality and Social Psychology Bulletin, 30(4), 501–514. https://doi.org/10.1177/0146167203261891

    Article  PubMed  Google Scholar 

  • Pelc, A. R., Winiarska, M., Polak-Szczybyło, E., Godula, J., & Stępień, A. E. (2023). Low self-esteem and life satisfaction as a significant risk factor for eating disorders among adolescents. Nutrients, 15(7), 1603. https://doi.org/10.3390/nu15071603

    Article  PubMed  PubMed Central  Google Scholar 

  • Phillipou, A., Tan, E. J., Toh, W. L., Van Rheenen, T. E., Meyer, D., Neill, E., & Rossell, S. L. (2021). Mental health of individuals with and without eating disorders across six months and two waves of COVID-19. Eating Behaviors, 43, 101564. https://doi.org/10.1016/j.eatbeh.2021.101564

    Article  PubMed  PubMed Central  Google Scholar 

  • Piccoli, V., Carnaghi, A., Grassi, M., & Bianchi, M. (2022). The relationship between Instagram activity and female body concerns: The serial mediating role of appearance-related comparisons and internalization of beauty norms. Journal of Community & Applied Social Psychology, 32(4), 728–743.

    Article  Google Scholar 

  • Prieler, M., Choi, J., & Lee, H. E. (2021). The relationships among self-worth contingency on others’ approval, appearance comparisons on Facebook, and adolescent girls’ body esteem: A cross-cultural study. International Journal of Environmental Research and Public Health, 18(3), 901. https://doi.org/10.3390/ijerph18030901

    Article  PubMed  PubMed Central  Google Scholar 

  • Qamar, A., Safdar, A., & Manzoor, S. (2020). Objectification of women through public discourse: Analysis of Pakistani female celebrities’ viral pictures on Facebook. Journal of Business and Social Review in Emerging Economies, 6(2), 651–659. https://doi.org/10.26710/jbsee.v6i2.1174

    Article  Google Scholar 

  • Raosoft, I. (2004). Sample size calculator. Available from: http://www.raosoft.com/samplesize

  • Rauh, M. J., Nichols, J. F., & Barrack, M. T. (2010). Relationships among injury and disordered eating, menstrual dysfunction, and low bone mineral density in high school athletes: A prospective study. Journal of Athletic Training, 45(3), 243–252. https://doi.org/10.4085/1062-6050-45.3.243

    Article  PubMed  PubMed Central  Google Scholar 

  • Rizwan, M., Aftab, S., Shah, I., et al. (2012). Psychometric properties of the Rosenberg self-esteem scale in Pakistani late adolescents. The International Journal of Educational and Psychological Assessment., 10(1), 125–138.

    Google Scholar 

  • Rodgers, R. F., Berry, R. A., & Laveway, K. (2022). Body image concerns and disordered eating among older women: Identifying variables of interest for integrated models. International Journal of Eating Disorders, 55(7), 886–891.

    Article  PubMed  Google Scholar 

  • Rodgers, R. F., Paxton, S. J., & McLean, S. A. (2014). A biopsychosocial model of body image concerns and disordered eating in early adolescent girls. Journal of Youth and Adolescence, 43(5), 814–823. https://doi.org/10.1007/s10964-013-0013-7

    Article  PubMed  Google Scholar 

  • Rosenberg, M. (1965). Rosenberg self-esteem scale (RSE). Acceptance and Commitment Therapy. Measures Package, 61(52), 18.

    Google Scholar 

  • Rounsefell, K., Gibson, S., McLean, S., Blair, M., Molenaar, A., Brennan, L., & McCaffrey, T. A. (2020). Social media, body image and food choices in healthy young adults: A mixed methods systematic review. Nutrition & Dietetics, 77(1), 19–40.

    Article  Google Scholar 

  • Sadia, A., Strodl, E., Khawaja, N. G., Kausar, R., & Cooper, M. J. (2021). Understanding eating and drinking behaviours in Pakistani university students: A conceptual model through qualitative enquiry. Appetite, 161, 105133. https://doi.org/10.1016/j.appet.2021.105133

    Article  PubMed  Google Scholar 

  • Sanlier, N., NavruzVarli, S., Macit, M. S., Mortas, H., & Tatar, T. (2017). Evaluation of disordered eating tendencies in young adults. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 22(4), 623–631. https://doi.org/10.1007/s40519-017-0430-9

    Article  Google Scholar 

  • Santarossa, S., & Woodruff, S. J. (2017). #SocialMedia: Exploring the relationship of social networking sites on body image, self-esteem, and eating disorders. Social Media Society, 3(2), 2056305117704407.

    Google Scholar 

  • Schaefer, L. M., Burke, N. L., Calogero, R. M., Menzel, J. E., Krawczyk, R., & Thompson, J. K. (2018). Self-objectification, body shame, and disordered eating: Testing a core mediational model of objectification theory among White, Black, and Hispanic women. Body Image, 24, 5–12. https://doi.org/10.1016/j.bodyim.2017.10.005

    Article  PubMed  Google Scholar 

  • Schaefer, L. M., Burke, N. L., Thompson, J. K., Dedrick, R. F., Heinberg, L. J., Calogero, R. M., & Swami, V. (2015). Development and validation of the sociocultural attitudes towards appearance questionnaire-4 (SATAQ-4). Psychological Assessment, 27(1), 54. https://doi.org/10.1037/a0037917

    Article  PubMed  Google Scholar 

  • Schaefer, L. M., & Thompson, J. K. (2014). The development and validation of the physical appearance comparison scale-revised (PACS-R). Eating Behaviors, 15(2), 209–217. https://doi.org/10.1016/j.eatbeh.2014.01.001

    Article  PubMed  Google Scholar 

  • Schlechter, P., & Morina, N. (2023). The role of aversive appearance-related comparisons and self-discrepancy in depression and well-being from a longitudinal general comparative-processing perspective. Behavior Therapy. https://doi.org/10.1016/j.beth.2023.09.003

    Article  PubMed  Google Scholar 

  • Sherlock, M., & Wagstaff, D. L. (2019). Exploring the relationship between frequency of Instagram use, exposure to idealized images, and psychological well-being in women. Psychology of Popular Media Culture, 8(4), 482.

    Article  Google Scholar 

  • Smolak, L., & Levine, M. P. (2019). Critical issues in the developmental psychopathology of eating disorders. Understanding eating disorders (pp. 37–60). Taylor & Francis eBooks.

    Chapter  Google Scholar 

  • Sparti, C., Santomauro, D., Cruwys, T., Burgess, P., & Harris, M. (2019). Disordered eating among Australian adolescents: Prevalence, functioning, and help received. International Journal of Eating Disorders, 52(3), 246–254. https://doi.org/10.1002/eat.23032

    Article  PubMed  Google Scholar 

  • Stice, E., Gau, J. M., Rohde, P., & Shaw, H. (2017). Risk factors that predict future onset of each DSM–5 eating disorder: Predictive specificity in high-risk adolescent females. Journal of Abnormal Psychology, 126(1), 38.

    Article  PubMed  Google Scholar 

  • Suhail, K. (2002). Prevalence of eating disorders in Pakistan: Relationship with depression and body shape. Eating and Weight Disorders-Studies on Anorexia, Bulimia and Obesity, 7, 131–138.

    Google Scholar 

  • Sultan, T., Ahmad, S., & Ayub, A. (2020). At risk of “leftover singles”: Dimensions and sociopsychological repercussions of delayed marriageability among educated females in Pakistan. The Family Journal, 28(4), 403–412. https://doi.org/10.1177/1066480720902454

    Article  Google Scholar 

  • Trekels, J., & Eggermont, S. (2017). Beauty is good: The appearance culture, the internalization of appearance ideals, and dysfunctional appearance beliefs among tweens. Human Communication Research, 43(2), 173–192. https://doi.org/10.1111/hcre.12100

    Article  Google Scholar 

  • Turel, T., Jameson, M., Gitimu, P., Rowlands, Z., Mincher, J., & Pohle-Krauza, R. (2018). Disordered eating: Influence of body image, sociocultural attitudes, appearance anxiety and depression-a focus on college males and a gender comparison. Cogent Psychology, 5(1), 1483062. https://doi.org/10.1080/23311908.2018.1483062

    Article  Google Scholar 

  • Tylka, T. L., & Sabik, N. J. (2010). Integrating social comparison theory and self-esteem within objectification theory to predict women’s disordered eating. Sex Roles, 63(1), 18–31.

    Article  Google Scholar 

  • Vartanian, L. R., Froreich, F. V., & Smyth, J. M. (2016). A serial mediation model testing early adversity, self-concept clarity, and thin-ideal internalization as predictors of body dissatisfaction. Body Image, 19, 98–103.

    Article  PubMed  Google Scholar 

  • Watt, A. D., & Konnert, C. A. (2020). Body satisfaction and self-esteem among middle-aged and older women: The mediating roles of social and temporal comparisons and self-objectification. Aging & Mental Health, 24(5), 797–804. https://doi.org/10.1080/13607863.2018.1544222

    Article  Google Scholar 

  • Yamamiya, Y., Shroff, H., & Thompson, J. K. (2008). The tripartite influence model of body image and eating disturbance: A replication with a Japanese sample. International Journal of Eating Disorders, 41(1), 88–91. https://doi.org/10.1002/eat.20444

    Article  PubMed  Google Scholar 

  • Zeigler-Hill, V., & Noser, A. (2015). Will I ever think I’m thin enough? A moderated mediation study of women’s contingent self-esteem, body image discrepancies, and disordered eating. Psychology of Women Quarterly, 39(1), 109–118. https://doi.org/10.1177/0361684313515841

    Article  Google Scholar 

  • Zubair, S. (2022). Is women’s beauty used as a means to achieve certain ends? Pakistani women’s perceptions of body objectification. Journal of International Women’s Studies, 23(1), 98–114.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Sumara Masood Ul Hassan.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to disclose.

Ethical Approval

This study was approved by the Ethical Committee at S3H, NUST, Islamabad (Ref: 0988/Ethic/01/S3H/062/DBS).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Malik, R.Z., Hassan, S.M.U. & Tariq, I. Depression, Self-Esteem, and Disordered Eating among Pakistani Adolescent Girls: The Mediating Role of Appearance Comparison and Internalization of Appearance Ideals. Child Adolesc Soc Work J (2024). https://doi.org/10.1007/s10560-024-00972-1

Download citation

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s10560-024-00972-1

Keywords

Navigation