Weight, weight-related aspects of body image, and depression in early adolescent girls

This investigation assessed the hypothesis that early adolescent girls with more negative weight-related body images would report higher levels of depressive symptoms. The Beck Depression Inventory was administered, and measures of objective weight and four dimensions of weight-related body image were obtained: self-reported weight, subjective classification of weight from very underweight to very overweight, satisfaction with weight, and concerns about weight. The results indicated that the more subjective and personal measures of weight-related body image discontent--weight dissatisfaction and weight concerns--were associated with increased depressive symptoms, even controlling for objective weight status. These results are discussed in relation to the ontogenesis of body image and the place of body image in personality and the development of depression.     

Relationships between an index of body fat distribution (based on waist and hip circumferences) and stature, and biochemical complications in obese children

OBJECTIVE: To determine the clinical utility of a new age-adjusted measure of body fat distribution (based on waist and hip circumferences) and stature, in relation to biochemical complications in obese children. DESIGN: Cross-sectional, clinical study. The formula to calculate the common standard deviation score (SDS) of waist-to-hip ratio/height (WHR/Ht) was obtained from the data of control children. The relationship between WHR/Ht SDS, as the age-adjusted measure, in obese children and their clinical laboratory data was evaluated. SUBJECTS: Outpatient obese Japanese children (102 boys and 75 girls) and control children (508 boys and 549 girls), ranging in age from 6-15 y. MEASUREMENTS: Height, body weight, waist girth, hip girth, triceps and subscapular skinfold thicknesses, as anthropometric measures. Percent overweight, percent body fat, waist girth, WHR and WHR/Ht SDS as criteria for obesity. Clinical laboratory analyses for fasting blood samples of obese children. RESULTS: The WHR/Ht SDS closely correlated with age in obese children, thus reflecting the progress of abdominal obesity during growth. The obese boys were more hyperlipidaemic than the girls were, although the percent overweight was similar in both genders. The percent overweight, percent body fat, waist girth and WHR/Ht SDS all correlated well with triglyceride (TG), alanine aminotransferase (ALT) and insulin in boys, whereas only waist girth and WHR/Ht SDS showed a close correlation with TG and insulin in girls. The obese subjects were subdivided according to the number of abnormal values observed in TG, ALT and insulin. For obese boys, all five indices of obesity were higher in the groups with complications than in the group without. In the girls, only the WHR/Ht SDS constantly differed between subgroups. WHR/Ht SDS most obviously distinguished the groups with complications from the other group with a wide margin of difference (2-fold in boys and > 2-fold in girls) in the mean values. CONCLUSION: The WHR/Ht SDS can serve as an index predicting the occurrence of biochemical complications in obese children ranging from the age of 6-15 y.     

Body-image and eating disturbances prospectively predict increases in depressive symptoms in adolescent girls: A growth curve analysis.

Using data from a longitudinal community study (N?=?231), the authors tested whether body-image and eating disturbances might partially explain the increase in depression observed in adolescent girls. Initial pressure to be thin, thin-ideal internalization, body dissatisfaction, dieting, and bulimic symptoms, but not body mass, predicted subsequent increases in depressive symptoms, as did increases in these risk factors over the study. There was also prospective support for each of the hypothesized mediational relations linking these risk factors to increases in depressive symptoms. Effects remained significant when other established gender-nonspecific risk factors for depression (social support and emotionality) were statistically controlled. Results provide support for the assertion that body-image and eating disturbances, operating above and beyond gender-nonspecific risk factors, contribute to the elevated depression in adolescent girls. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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PURPOSE: Increased understanding of the early determinants of obesity is essential because of the increasing prevalence of obesity in many industrialized countries. METHOD: As part of the evaluation of a school-based heart health promotion intervention, we measured height, weight, and triceps skinfold thickness at baseline in 2108 students aged 9-12 years (80.5% of eligible students) in 24 inner-city elementary schools located in multiethnic, low income neighbourhoods in Montreal, Canada. Data on student's socio-demographic and lifestyle characteristics were collected in classroom-administered questionnaires, and parents completed an at-home self-administered questionnaire. RESULTS: Overall, 35.2% of boys and 33.0% of girls were overweight (> or = 85th age and gender-specific percentiles from NHANES 11, for body mass index and triceps skinfold thickness); 15.1% of boys and 13.3% of girls were obese (> or = 95th age and gender-specific percentiles for body mass index and triceps skinfold thickness). Younger age, having lived all one's life in Canada, and being of European or Central American/Caribbean family origin were independent correlates of obesity in boys. Younger age, ever smoked, mother obese and father obese were independent correlates of obesity in girls. Girls of Asian family origin were protected. CONCLUSIONS: The very high prevalence of overweight students in this low income, multiethnic population suggests an important need for preventive intervention.     

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PURPOSE: To examine differences between early adolescent girls' and their mothers' perceptions of girls' depressive symptoms. METHODS: 313 daughter-mother dyads completed the Children's Depression Inventory. RESULTS: Low to modest agreement was found for most symptoms, although higher agreement was found for symptoms relating to school performance. The hypothesis that girls would report more ideational symptoms and mothers more behavioral symptoms of depression was tested; girls generally reported more ideational and behavioral symptoms when differences occurred. However, several specific ideational symptoms (feeling like crying; feeling sad; guilt; worrying) tended to be more frequently endorsed by girls and had particularly poor daughter-mother agreement. Examining third variables associated with daughter-mother agreement, girls scoring high on social desirability tended to have smaller daughter-minus-mother difference scores for ideational, but not for behavioral items; therefore, social desirability may be associated with girls underreporting ideational symptoms. CONCLUSIONS: Mothers appear to be reliable raters of symptoms related to school functioning, but may be less aware of certain covert depressive symptoms in their early adolescent daughters.     

Prospective Relations Between Social Support and Depression: Differential Direction of Effects for Parent and Peer Support?

The authors tested whether deficits in perceived social support predicted subsequent increases in depression and whether depression predicted subsequent decreases in social support with longitudinal data from adolescent girls (N = 496). Deficits in parental support but not peer support predicted future increases in depressive symptoms and onset of major depression. In contrast, initial depressive symptoms and major depression predicted future decreases in peer support but not parental support. Results are consistent with the theory that support decreases the risk for depression but suggest that this effect may be specific to parental support during early adolescence. Results are also consonant with the claim that depression promotes support erosion but imply that this effect may only occur with peer support during this period. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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Despite increasing trends in the prevalence of overweight and obesity, fatness phobia is common during female adolescence. This study has demonstrated a high level of dissatisfaction with body weight in a sample of Dublin schoolgirls aged 15 y. Of 420 subjects, 59% reported that they wanted to be slimmer and 68% had previously tried to lose weight. Contrary to expectations, overweight girls were not found to hold the monopoly on such dissatisfactions. Normal weight and even underweight girls also expressed a desire to be thinner and reported using unhealthy weight control practices including random avoidance of staple foods, fasting, smoking and purging, in their pursuit of the 'perfect' female figure. Obesity prevention programmes which target adolescent girls 'at risk' of overweight and obesity, must take cognizance of their profound fear of fatness, otherwise the use of harmful slimming strategies may be further increased as teenage girls frantically try to lose weight and to avoid the stigma associated with female fatness.     

Is Depression Best Viewed as a Continuum or Discrete Category? A Taxometric Analysis of Childhood and Adolescent Depression in a Population-Based Sample.

The authors examined the latent structure of depression in a population-based sample of children and adolescents. Youth's self-reports and parents' reports of the youth's Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV; American Psychiatric Association, 1994) major depressive symptoms were assessed via a structured clinical interview. The authors used Meehl's (1995) taxometric procedures to discern whether youth depression is dimensional or categorical. Taxometric analyses that explicitly took into account the skewness of depressive symptoms suggested that depression is a dimensional, not categorical, construct. The dimensional structure of depression was obtained for all of the DSM-IV major depressive symptoms as well as for different domains of depression (emotional distress symptoms and vegetative, involuntary defeat symptoms), youth and parent reports, and different subsamples (i.e., boys vs. girls and younger vs. older youth). (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The unique effect of paternal depressive symptoms on adolescent functioning: Associations with gender and father–adolescent relationship closeness.

Prospective, longitudinal data from a community sample of 451 families were used to assess the unique contribution of paternal depressive symptoms to adolescent functioning. Results indicated that paternal depressive symptoms were significantly related to subsequent depressive symptoms in adolescent offspring; this association remained significant after controlling for previous adolescent depressive symptoms, maternal depressive symptoms, gender, and family demographic variables. Adolescent gender and perception of father–adolescent relationship closeness moderated this association such that paternal depressive symptoms were positively associated with adolescent depressive symptoms for girls whose relations with fathers lacked closeness. These findings add to a growing literature on the interpersonal mechanisms through which depression runs in families, highlighting the need for future investigation of paternal mental health, adolescent gender, and intrafamily relationship quality in relation to adolescent development. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Prospective reciprocal relations between physical activity and depression in female adolescents.

Objective: Although an inverse correlation between physical activity and depression among adolescents has been found in research, this relation has seldom been examined prospectively. Thus, we tested whether physical activity reduces risk for future escalations in depression and whether depression decreases likelihood of future change in physical activity. Method: Data from a longitudinal study involving annual assessments of 496 adolescent girls (mean age = 13 years, SD = 0.73) followed over a 6-year period were analyzed to address these questions. Results: Using analyses that controlled for several covariates, we found that physical activity significantly reduced risk for future increases in depressive symptoms and risk for onset of major–minor depression. Further, depressive symptoms and major–minor depression significantly reduced future physical activity. However, predictive effects were modest for both. Conclusions: Results support a bidirectional relation between exercise and depression and imply that interventions that increase physical activity may reduce risk for depression among this high-risk population. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Two decades of annual medical examinations in Japanese obese children: do obese children grow into obese adults?

OBJECTIVE: To investigate trends in frequency of obese children in Japan over two decades, the frequency of obese children who grow into obese adults and predictive factors for adult obesity. DESIGN: Annual cross-sectional studies for 22 y (1974-1995) with a follow-up study. SUBJECTS: Cross-sectional: Cumulatively 13,186 obese (% of standard body weight (SBW): > or = 120%) schoolchildren including 3158 extremely obese (> or = 140% of SBW) children out of 203,088 schoolchildren (age: 6-14 y) in Izumiohtsu City, Osaka, Japan. Follow-up: 151 initially obese children (initial age: 6-14 y and age at follow-up: 20-35 y) who lived in Izumiohtsu City. Control: 3552 Japanese men and 4631 Japanese women (age: 20-35 y). MEASUREMENTS: Cross-sectional: height, weight, trunk circumference, skin-fold thickness, blood pressure and blood biochemicals. Follow-up: height, weight, trunk circumference, skin-fold thickness during childhood, and body height and weight at follow-up. Adulthood obesity: > or = 120% of the average body mass indices (BMI) of the controls. RESULTS: Frequency of obese children increased from 5% to more than 10%, and that of extremely obese children increased from 1% to more than 2% during these 22 y. These increases were most prominent in the schoolboys aged 9-11 y. Prevalence of hyperglycemia and hyperlipidemia in the extremely obese children did not change, and that of hypertension and abnormal liver function gradually decreased during these two decades. After coming of age, 32.2% of the initially obese boys (relative risk: 5.3) and 41.0% of the initially obese girls (relative risk: 6.7) remained obese. BMI, percentage of the SBW and skin-fold thickness at the biceps during childhood were significantly larger in currently-obese girls. Positive correlations were demonstrated between these variables and percentage SBW at follow-up. CONCLUSIONS: Childhood obesity is increasing in Japan, especially in boys aged 9-11 y. Approximately 32% of the obese boys and 41% of the obese girls grow into obese adults, and the degree of obesity is a predictive factor for adult obesity.     

Body-image and eating disturbances predict onset of depression among female adolescents: A longitudinal study.

This study examined data from a 4-year school-based longitudinal study (n?=?1,124), to test whether the increase in major depression that occurs among girls during adolescence may be partially explained by the body-image and eating disturbances that emerge after puberty. Elevated body dissatisfaction, dietary restraint, and bulimic symptoms at study entry predicted onset of subsequent depression among initially nondepressed youth in bivariate analyses controlling for initial depressive symptoms. Although the unique effect for body dissatisfaction was not significant in the multivariate model, this set of risk factors was able to fairly accurately foretell which girls would go on to develop major depression. Results were consistent with the assertion that the body-image- and eating-related risk factors that emerge after puberty might contribute to the elevated rates of depression for adolescent girls. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Childhood depressive symptoms and adolescent cigarette use: A six-year longitudinal study controlling for peer relations correlates.

Objective: To examine potential pathways between childhood depressive symptoms and adolescent cigarette use, controlling for potential “third variable” causes. Design: Participants included 250 youth (60% girls) who were in Grades 4 to 6 at study outset and in Grades 10 to 12 (M age = 16.78) at a 6-year follow-up. At Time 1, children completed measures of depressive symptoms, as well as peer nominations of peer acceptance, rejection, and aggressive behavior. Main Outcome Measures: Time 2 measures included adolescents’ own and close friends’ cigarette use, depressive symptoms, and externalizing behaviors; parents also reported on adolescent behaviors. Results: Higher levels of childhood depressive symptoms and aggressive behavior were associated longitudinally with cigarette use in adolescence. After controlling for other associations, higher levels of childhood depressive symptoms also were associated with higher levels of friends’ cigarette use in adolescence and higher levels of adolescent depressive symptoms; each of these adolescent outcomes was concurrently associated with cigarette use. Conclusion: Depressive symptoms in childhood may lead to altered developmental trajectories that either directly or indirectly contribute to adolescent outcomes, including cigarette use. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological and Behavioral Risk Factors for Obesity Onset in Adolescent Girls: A Prospective Study.

Because little is known about risk factors for obesity, the authors tested whether certain psychological and behavioral variables predicted future onset of obesity. The authors used data from a prospective study of 496 adolescent girls who completed a baseline assessment at age 11-15 years and 4 annual follow-ups. Self-reported dietary restraint, radical weight-control behaviors, depressive symptoms, and perceived parental obesity--but not high-fat food consumption, binge eating, or exercise frequency-predicted obesity onset. Results provide support for certain etiologic theories of obesity, including the affect regulation model. The fact that self-reported, weight-control behaviors identified girls at risk for obesity implies that high-risk youths are not engaging in effective weight-control methods and suggests the need to promote more effective strategies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Depression and delinquency covariation in an accelerated longitudinal sample of adolescents.

Objectives: The current study tested opposing predictions stemming from the failure and acting out theories of depression–delinquency covariation. Method: Participants included a nationwide longitudinal sample of adolescents (N = 3,604) ages 12 to 17. Competing models were tested with cohort-sequential latent growth curve modeling to determine whether depressive symptoms at age 12 (baseline) predicted concurrent and age-related changes in delinquent behavior, whether the opposite pattern was apparent (delinquency predicting depression), and whether initial levels of depression predict changes in delinquency significantly better than vice versa. Results: Early depressive symptoms predicted age-related changes in delinquent behavior significantly better than early delinquency predicted changes in depressive symptoms. In addition, the impact of gender on age-related changes in delinquent symptoms was mediated by gender differences in depressive symptom changes, indicating that depressive symptoms are a particularly salient risk factor for delinquent behavior in girls. Conclusion: Early depressive symptoms represent a significant risk factor for later delinquent behavior—especially for girls—and appear to be a better predictor of later delinquency than early delinquency is of later depression. These findings provide support for the acting out theory and contradict failure theory predictions. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Pubertal transition, stressful life events, and the emergence of gender differences in adolescent depressive symptoms.

This study examined the role of both pubertal and social transitions in the emergence of gender differences in depressive symptoms during adolescence. This study generated the following findings: (a) Gender differences in depressive symptoms emerged during 8th grade and remained significant through 12th grade. (b) Pubertal status in 7th grade was related to adolescent depressive symptoms over time. (c) Early-maturing girls represented the group with the highest rate of depressive symptoms. (d) Depressive symptoms measured in 7th grade predicted subsequent symptom levels throughout the secondary school years. (e) Recent stressful life events were associated with increased depressive symptoms. (f) Early-maturing girls with higher levels of initial symptoms and more recent stressful life events were most likely to be depressed subsequently. The findings demonstrate the importance of the interaction between the pubertal transition and psychosocial factors in increasing adolescent vulnerability to depressive experiences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Maternal depressive symptoms and depressive symptoms in adolescents

The relationship between maternal depressive symptoms and rates of adolescent (15-16 years) depressive symptoms was studied in a birth cohort of 934 New Zealand children. There was a clear correlation between maternal depressive symptoms and subsequent depressive symptoms in adolescent females (r = .44) but no association (r = -.01) between maternal depressive symptoms and depressive symptoms in adolescent males. Subsequent analysis suggested that the correlation between maternal depression and depressive symptoms in adolescent females was largely explained by the associations of both measures with a series of social and contextual factors including social disadvantage, marital discord and family adversity. It is concluded that maternal depression is only associated with depression in adolescence insofar as maternal depression is associated with social disadvantage, marital discord or family adversity.     

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OBJECTIVE: This study examines three specific questions about obesity and overweight, using a nationally representative sample of Canadians. Are sociodemographic and lifestyle behaviors associated with body weight? Is body weight correlated with specific health outcomes? Has the prevalence of obesity in Canada changed since 1978? METHODS: Secondary data analysis of a cross-sectional survey. SAMPLE: This study uses the 1994 National Population Health Survey (NPHS) by Statistics Canada. It is a stratified random sample of 19600 Canadians across all provinces. RESULTS: The results show that age, gender, education, birth place and region, are significantly associated with obesity. When a lower criterion is used for overweight and obesity (body mass index, BMI > or = 25), dummy variables for marital status and occupation are also significant. Second, obesity is associated with poorer self-rated health, high blood pressure, heart disease, diabetes, arthritis, respiratory and stomach problems. For those respondents who have a BMI score of 25 or greater, there is also an association with stroke. Finally, it is unclear whether the prevalence of obesity has changed. However, there appears to be a systematic difference between studies using actual height and weight measurements (anthropometric) vs self-reported measurements. CONCLUSIONS: Weight can be considered a modifiable risk factor and reductions in the prevalence of obesity should reduce the risk of specific chronic conditions. Provincial variations in the prevalence of obesity (BMI > or = 27) and overweight and obesity (BMI > or = 25) suggest that collapsing provinces into regions may obscure important inter-provincial differences in body weight. More research is required to assess whether or not obesity is decreasing in Canada. Some of the limitations of self-reported data are discussed.     

Disability in geriatric depression

OBJECTIVE: The authors' purpose was to identify the relationship of disability to clinical measures that are part of a comprehensive psychiatric examination of depressed elderly patients. METHOD: The disability of 75 elderly inpatients and outpatients with major depression whose cognitive function ranged from normality to mild dementia was assessed with the Philadelphia Multilevel Assessment Instrument. Age at onset of depression, chronicity of depression, severity of depression, cognitive impairment, medical burden, social support and living environment were assessed with standardized instruments. RESULTS: Impairment in instrumental activities of daily living was significantly associated with advanced age, severity of depression, and medical burden. The relationship of depressive symptoms to impairment in instrumental activities of daily living was not influenced by age or medical burden. Anxiety and depressive ideation as well as retardation and weight loss were significantly associated with impairment in instrumental activities of daily living. Interviewer-rated global disability was associated with advanced age at onset of depression, medical burden, and overall cognitive impairment. Specifically, a disturbance in initiation and perseveration was significantly related to global disability. CONCLUSIONS: Impairment in instrumental activities of daily living appears to be a relatively independent dimension of health status that is related to depressive symptoms, particularly anxiety and depressive ideation as well as retardation and weight loss. Global disability may be associated with impairment in initiation and perseveration and with late onset of depression. These findings provide a basis for studies investigating whether psychotherapy aimed at depressive ideation and rehabilitation efforts focused on instrumental activities of daily living can improve the outcome of geriatric depression.     

Depression socialization within friendship groups at the transition to adolescence: The roles of gender and group centrality as moderators of peer influence.

Tests of interpersonal theories of depression have established that elevated depression levels among peers portend increases in individuals' own depressive symptoms, a phenomenon known as depression socialization. Susceptibility to this socialization effect may be enhanced during the transition to adolescence as the strength of peer influence rises dramatically. Socialization of depressive symptoms among members of child and adolescent friendship groups was examined over a 1-year period among 648 youth in grades six through eight. Sociometric methods were utilized to identify friendship groups and ascertain the prospective effect of group-level depressive symptoms on youths' own depressive symptoms. Hierarchical linear modeling results revealed a significant socialization effect and indicated that this effect was most potent for (a) girls and (b) individuals on the periphery of friendship groups. Future studies would benefit from incorporating child and adolescent peer groups as a developmentally salient context for interpersonal models of depression. (PsycINFO Database Record (c) 2011 APA, all rights reserved)