Elsevier

Clinical Psychology Review

Volume 31, Issue 7, November 2011, Pages 1224-1237
Clinical Psychology Review

Social psychological theories of disordered eating in college women: Review and integration

https://doi.org/10.1016/j.cpr.2011.07.011Get rights and content

Abstract

Because peer interaction, weight/shape, and self-concept formation are particularly salient to college women, the implications of social psychological theories may be especially far-reaching during the college years. College women may be particularly vulnerable to the effects of social comparison, objectification, and uses and gratifications theories, which describe social-cognitive mechanisms that provide an individual with information regarding her own view of her body and how she perceives that others perceive her body. The current paper will review and integrate findings related to these three theories of disordered eating in college women in an effort to present a more comprehensive understanding of the social psychological mechanisms that play a role in the development and maintenance of such pathology for this group of young women. Limitations of and future directions for research on these theories will be discussed, as will their potential integration with other factors that contribute to disordered eating and implications for treatment and prevention.

Highlights

► Social psychological theories help to explain disordered eating in college women. ► Integrating these theories is useful and informative. ► These theories add to the sociocultural model of disordered eating. ► Future research should examine these theories concurrently. ► Future research should assess these theories' treatment/prevention implications.

Introduction

Research has indicated that a host of biological, psychological, and physical risk factors, such as body dissatisfaction, perfectionism, genetics, and early age of menarche, put individuals at risk for disordered eating (Bardone-Cone et al., 2007, Bryla, 2003, Graber et al., 1994, Leon et al., 1995). In addition to these vulnerabilities, certain environments may heighten the risk for disordered eating (Striegel-Moore, Silberstein, & Rodin, 1986). In particular, it may be that biological, psychological, and physical vulnerabilities, such as genes, “load the gun, but [that] environmental factors pull the trigger” (Cynthia Bulik, as quoted in Neumark-Sztainer, 2005, p. 29). College represents one environment that may spur the development or exacerbation of eating disorder symptoms, particularly among individuals who display known risk factors for disordered eating such as those mentioned above (Compas et al., 1986, Vohs et al., 2001). The current paper will review and integrate research findings related to three social psychological theories of disordered eating in college women in an effort to present a more comprehensive and complete understanding of the social psychological mechanisms that play a role in the development and maintenance of disordered eating for this group of young women. Implications for treatment and prevention will be discussed, as will these theories' potential integration with other perspectives on disordered eating.

For females, the lifetime prevalence of anorexia nervosa is between 1.4% and 2.0% (Favaro et al., 2003, Lewinsohn et al., 2000, Striegel-Moore et al., 2003, Wade et al., 2006), and the lifetime prevalence of bulimia nervosa ranges from 1.1% to 4.6% (Favaro et al., 2003, Garfinkel et al., 1995, Lewinsohn et al., 2000, Wade et al., 2004). In college settings, the prevalence is higher, with estimates of diagnosable eating disorders ranging from 4% to 9% (Hesse-Biber et al., 1999, Pyle et al., 1991). Furthermore, subthreshold levels of eating disordered behaviors have been reported at rates of up to 67% for college women (Franko and Omori, 1999, Hoerr et al., 2002, Mintz and Betz, 1988, Mintz et al., 1997), indicating that disordered eating is relatively “normative” for this group. Given that a majority of women indicate that they engage in some eating disordered behaviors and experience various levels of physical and psychological consequences as a result (e.g., nutritional deficiencies, poor self-esteem; Bryla, 2003, Dykens and Gerrard, 1986), researchers (e.g., Mintz and Betz, 1988, Scarano and Kalodner-Martin, 1994, Tylka and Subich, 1999) have suggested that disordered eating should be viewed on a continuum that ranges from lack of concern with weight/shape and normal eating patterns to “normative discontent” with weight/shape and moderately disordered/restrained eating to anorexia nervosa, bulimia nervosa, and other diagnosable eating disorders (Rodin et al., 1984, Striegel-Moore et al., 1989). Research has generally indicated that college women are concentrated toward the “problematic” end of this continuum (e.g., Hesse-Biber, 1989). Additionally, body dissatisfaction, one of the “most consistent and robust risk and maintenance factors for eating pathology” (Stice, 2002, pp. 832–833), has been reported at rates of up to 80% of college women (Heatherton et al., 1995, Silberstein et al., 1988, Spitzer et al., 1999, Vohs et al., 2001). Given elevated rates of disordered eating among college women, it is important to understand the specific factors or mechanisms that may contribute to such pathology for this group so that effective treatment and prevention programming may be implemented.

Section snippets

The sociocultural model of disordered eating

There is general agreement in the field that the etiology of eating disorders is multifactorial (Striegel-Moore & Cachelin, 2001). As such, researchers generally work within a “biopsychosocial” framework when attempting to integrate and understand the various factors that contribute to disordered eating (Polivy & Herman, 2002), and sociocultural factors have played a major role in these conceptualizations (e.g., Stice et al., 1994, Striegel-Moore et al., 1986, Thompson et al., 1999). According

Explaining the link between sociocultural factors and disordered eating

Research has found that pressure for thinness and exposure to the thin ideal do not invariably lead to negative outcomes (e.g., Joshi, Herman, & Polivy, 2004) and that individuals are not passive recipients of sociocultural pressures; rather, they tend to be active and deliberate in their engagement with idealized images (Dittmar, 2005, Herman and Polivy, 2004). Thus, it is likely that sociocultural factors exert their influence on disordered eating via social-cognitive mechanisms: complex

Social comparison theory

Social comparison theory, as put forth by Festinger (1954), holds that humans have a drive to assess their progress and standing in life. To achieve this end, they seek out standards against which to compare themselves. When objective standards are not available for such comparisons (and even at times when they are; Klein, 1997), individuals look to their social environments and make comparisons with available others (Corning et al., 2006). Indeed, comparison with others, both intentionally and

Objectification Theory

Objectification theory (Fredrickson & Roberts, 1997) is another social psychological theory that may help explain the development and maintenance of disordered eating patterns in college women. Within dominant American culture, theorists have posited that the feminine body has been constructed as an object to be looked at (Fredrickson and Roberts, 1997, McKinley and Hyde, 1996) and sexually gazed upon (Spitzack, 1990). It is not uncommon for a woman to feel sexually objectified, often by men,

Limitations of and future directions for social comparison and objectification research

Future research on social comparison and objectification theories should expand our knowledge on this theoretical framework in a number of ways. First, longitudinal research on these theories is sparse. As aforementioned, social comparison and body surveillance, the indicator of self-objectification, may fit into an elaborated sociocultural model of disordered eating and serve as explanations as to exactly how thin ideal internalization manifests itself in body dissatisfaction and disordered

Uses and Gratifications Theory

A final social psychological theory that is of interest in terms of understanding disordered eating among college women is uses and gratifications theory (Rubin, 1994). This theory is interested in how individuals choose to expose themselves to media images and messages and how they choose to respond (Hesse-Biber et al., 2006). One could argue that this also includes how individuals choose to expose themselves to and respond to media message sources other than the mass media, such as peers,

Integrating these perspectives

Although these social psychological theories have thus far been examined as separate theoretical perspectives on disordered eating, examining them concurrently as compatible theoretical perspectives may prove useful. Such integration would lead to a more complete understanding of the social psychological underpinnings of disordered eating in college women. Indeed, Hesse-Biber et al. (2006) conceptualized all three of these theories as ones that comprise a “nexus of influence” (p. 208) and help

Implications of the social psychological theories of disordered eating for treatment and prevention

Given that previous research suggests these theories play at least some role in the development and maintenance of disordered eating among college women, it is important to understand their potential treatment implications. For example, Tiggemann and McGill (2004) suggested that individuals should be taught to resist making comparisons with others and that this may be associated with reduced levels of body surveillance, body dissatisfaction, and disordered eating. For instance, clinicians may

Integrating the social psychological theories with other perspectives on disordered eating

Although sociocultural influences play a substantive role in the development and maintenance of disordered eating (Stice, 1994), other factors contribute to and potentially interact with sociocultural influences to produce such symptoms, as well. For instance, how do biology and genetics contribute to risk for disordered eating and potentially interact with the social psychological mechanisms discussed in this review? The complicated ways in which these factors interact are still not fully

Conclusion

Overall, future eating disorders research should work towards integrating these complementary social psychological perspectives in order to come to a more complete understanding of the role of social psychological factors in the etiology and maintenance of disordered eating among college women, a vulnerable population for whom identity formation and peer interaction are of the utmost importance (Arnett, 2000, Erikson, 1959). As laid out in this review, social comparison, objectification, and

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