The association of temperament and character and body dissatisfaction in women with different levels of eating pathology

Type of content
Theses / Dissertations
Publisher's DOI/URI
Thesis discipline
Psychology
Degree name
Doctor of Philosophy
Publisher
Journal Title
Journal ISSN
Volume Title
Language
English
Date
2022
Authors
Jones, Hannah
Abstract

Recent research has investigated the association of personality with body dissatisfaction in women from the general population. Although general population samples provide a good overview, women vary in their level of eating pathology, ranging from having no problems to experiencing an eating disorder. Thus, important differences could exist between subgroups. The current thesis assessed the association of personality (measured by the Temperament and Character Inventory) with body dissatisfaction in four groups of women with different levels of eating pathology—women without an eating disorder, women at risk of an eating disorder and women with bulimia nervosa before treatment and one year after completing treatment. Whether indirect effects were observed through self-esteem and depression both independently and in serial for significant associations was also investigated.

Associations for women without an eating disorder and at risk of an eating disorder were examined in Studies One and Two. First-year psychology students without a diagnosed eating disorder completed an eating disorder screening questionnaire and measures of temperament and character, self-esteem, depression, and body dissatisfaction through an anonymous Qualtrics survey. Both the Eating Disorder Inventory-2 (EDI-2) body dissatisfaction subscale and Stunkard's Figure Rating Scale (FRS) were used as measures of body dissatisfaction to examine measurement of body dissatisfaction as a moderator of the association between temperament and character and body dissatisfaction. Participants were divided into two groups (women without an eating disorder and women at risk of an eating disorder) based on their responses to the eating disorder screening questionnaire. Self-directedness was significantly associated with EDI-2 body dissatisfaction and the FRS in both groups. Additionally, cooperativeness was significantly associated with EDI-2 body dissatisfaction in women without an eating disorder and self-transcendence was significantly associated with EDI-2 body dissatisfaction in women at risk of an eating disorder. Indirect effects were found for most of these significant associations, some through low self-esteem independently, some through depression and low self-esteem in serial and some through both pathways. The way body dissatisfaction was measured moderated the association between self-directedness and body dissatisfaction in women without an eating disorder but not in women at risk of an eating disorder.

Study Three assessed the association of temperament and character and body dissatisfaction in women with bulimia nervosa before treatment. Participants were from two randomized controlled trials (RCT) of interventions for eating disorders. Before attending treatment for their eating disorder, participants completed measures of temperament and character, self-esteem, depression, and body dissatisfaction. Results revealed that harm avoidance was significantly associated with body dissatisfaction and the association was explained by indirect pathways through both low self-esteem independently and depression and low self-esteem in serial.

Study Four analyzed data from those women with bulimia nervosa in Study Three who completed treatment and engaged in a one-year follow-up assessment. Whether temperament and character, low self-esteem, depression, and body dissatisfaction changed between pre- treatment and one-year follow-up was explored. As participants attended a varying number of therapy sessions it was then investigated whether the number of therapy sessions attended predicted change in these factors and temperament and character, low self-esteem, depression, and body dissatisfaction at one-year follow-up. Following this, whether change in temperament and character was significantly associated with change in body dissatisfaction was explored. Finally, the association of temperament and character with body dissatisfaction in women with bulimia nervosa one year after completing treatment was examined. Treatment for bulimia nervosa led to changes in body dissatisfaction, harm avoidance, reward dependence, self- directedness, cooperativeness, low self-esteem, and depression. The number of therapy sessions attended was negatively associated with cooperativeness at one-year follow-up. Change in self- directedness was found to account for variance in change in body dissatisfaction. The reverse was also found to be true whereby change in body dissatisfaction explained variance in change in self-directedness. Change in body dissatisfaction also accounted for variance in change in harm avoidance. The final result of the chapter showed that harm avoidance was significantly associated with body dissatisfaction in women with bulimia nervosa one year after completing treatment. This association was direct rather than mediated.

Overall, results revealed that different temperament and character dimensions were associated with body dissatisfaction depending on the eating pathology of the sample. Indirect effects through depression and low self-esteem were found for many of these associations. Further research is needed to establish the direction of the association between TCI dimensions and body dissatisfaction. Thesis results have practical implications. Of note, development of character dimensions was identified as important for eating disorder prevention programs. Change in self-directedness may be particularly important for change in body dissatisfaction in both prevention and intervention efforts. Finally, harm avoidance was found to be associated with body dissatisfaction after eating disorder treatments, thus, interventions should also target harm avoidance.

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