No-Body is Perfect: Risk and Protective Factors of Body Dissatisfaction and Eating Disorder Symptoms in Italian Adolescents

Body dissatisfaction in adolescence is associated with various negative outcomes, particularly Eating Disorders (EDs) and related symptoms. Therefore, it is crucial to investigate its risk and protective factors to develop timely preventive interventions. Among the primary theoretical perspectives explaining the development of body dissatisfaction and EDs is the Tripartite Influence Model (TIM). Regarding protective factors, instead, current research highlights the importance of considering positive body image, whose main components include body appreciation and functionality appreciation. However, numerous limitations and gaps remain in the literature on this topic. Based on these premises, the present doctoral dissertation aimed to expand evidence on the risk (i.e., appearance-related sociocultural pressures) and protective factors (i.e., positive body image) of body dissatisfaction and ED symptoms among Italian adolescents. To achieve this goal, three cross-sectional studies were conducted. Study 1 examined the factor structure and psychometric properties of the main self-report questionnaire to assess appearance-based sociocultural pressures, namely the Sociocultural Attitude Towards Appearance Questionnaire-4-Revised (SATAQ-4R), in a sample of 450 boys and 692 girls aged 13 to 17 years. The results revealed that the original seven-factor structure provided the best fit to the data for both sexes. Furthermore, the SATAQ-4R showed excellent psychometric properties in terms of both validity and reliability, suggesting that it can be considered a suitable tool for measuring the influence of sociocultural factors and beauty-ideal internalization in Italian adolescents. Study 2 aimed to verify the suitability of the original TIM in explaining body dissatisfaction and ED symptoms in a group of 788 adolescents (465 girls and 323 boys) aged 13 to 19 years. The results indicated that, for both sexes, family pressure was linked to body dissatisfaction directly and to ED symptoms via body dissatisfaction. Furthermore, peer pressure was associated with body dissatisfaction via appearance comparison. Media pressure was related to body dissatisfaction both directly and via appearance comparison, and indirectly linked to ED symptoms through body dissatisfaction. Additionally, significant direct relations emerged between family pressure and ED symptoms, as well as between media pressure and attractiveness-ideal internalization only for girls. Overall, these results suggest that some adjustments to the original TIM may be needed to better suit the characteristics of the contemporary Italian adolescent population. Study 3 adopted a person-centered approach to investigate profiles of negative body image (i.e., body dissatisfaction and body shame) and positive body image (i.e., body and functionality appreciation) in distinct groups of 625 girls and 398 boys aged 14 to 19 years. Additionally, associations between these profiles and ED symptoms, beauty-ideal internalization, and frequency of appearance comparisons were examined. For both sexes, three profiles were identified: (1) high negative body image and low positive body image levels, (2) low negative body image and high positive body image levels, (3) moderate levels of both negative and positive body image. Boys and girls in the profiles with low negative body image and high positive body image levels scored significantly lower in terms of ED symptoms, thin-ideal internalization, and frequency of appearance comparisons. Overall, these data support the coexistence of negative and positive body image, as well as the potential protective role of positive body image against maladaptive outcomes during adolescence. In conclusion, the findings from the three studies can be considered as an original empirical contribution that highlights the importance of considering both risk and protective factors for understanding and preventing body dissatisfaction and ED symptoms in Italian adolescents.