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Bidirectional associations between body dissatisfaction and depressive symptoms from adolescence through early adulthood

  • Helen Sharpe (a1), Praveetha Patalay (a2), Tse-Hwei Choo (a3), Melanie Wall (a3), Susan M. Mason (a4), Andrea B. Goldschmidt (a5) and Dianne Neumark-Sztainer (a4)...

Body dissatisfaction and depressive symptoms are commonly experienced during adolescence and increase the risk of adverse health outcomes, especially eating disorders. However, the dominant temporal associations between these two experiences (i.e., whether one is a risk factor for the other or the two are mutually reinforcing) has yet to be fully explored. We examined the associations between body dissatisfaction and depressive symptoms assessed at baseline and 5- and 10-year follow-up in younger (M age = 12.9 years at baseline, 56% female, n = 577) and older (M age = 15.9 years at baseline, 57% female, n = 1,325) adolescent cohorts assessed as part of Project Eating Among Teens and Young Adults. Associations between body dissatisfaction and depressive symptoms were examined using cross-lagged models. For females, the dominant directionality was for body dissatisfaction predicting later depressive symptoms. For males, the picture was more complex, with developmentally sensitive associations in which depressive symptoms predicted later body dissatisfaction in early adolescence and early adulthood, but the reverse association was dominant during middle adolescence. These findings suggest that interventions should be tailored to dynamic risk profiles that shift over adolescence and early adulthood, and that targeting body dissatisfaction at key periods during development may have downstream impacts on depressive symptoms.

Corresponding author
Address correspondence and reprint requests to: Helen Sharpe, Department of Clinical Psychology, University of Edinburgh, Teviot Place, Edinburgh EH8 9AG, Scotland; E-mail:
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This study was supported by Grant R01HL084064 from the National Heart, Lung, and Blood Institute (Principal Investigator, D.N.-S.). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health. Andrea B. Goldschmidt was supported by Grant K23-105234 from the National Institute of Diabetes and Digestive and Kidney Diseases.

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