Depression, Self-Esteem, and Disordered Eating among Pakistani Adolescent Girls: The Mediating Role of Appearance Comparison and Internalization of Appearance Ideals

Although the link of depression and self-esteem with disordered eating is well reported in literature, there is insufficient insight into the underlying processes that inform the relationship. The present study examined the mediating effects of comparison of appearance and internalization of appearance ideals in the relationship of depression and self-esteem with disordered eating. The study sample comprised of 381 school-going adolescent girls, aged 13 to 18, from Islamabad, Pakistan. As part of the study, participants were required to complete several measures, including the Eating Disorder Examination Questionnaire-Short Form, Depression Anxiety Stress Scale 21, Rosenberg Self-Esteem Scale, Physical Appearance Comparison Scale-Revised, and Sociocultural Attitudes Toward Appearance Questionnaire-4. Findings revealed significant relationships between depression, self-esteem, comparison of appearance, internalization of appearance ideals, and disordered eating. Path analyses indicated that comparison of appearance and internalization of appearance ideals partially serially mediated the relationship between depression and disordered eating. Additionally, these two mediators were found to fully serially mediate the relationship between self-esteem and disordered eating. This study implicates the importance of considering depression and self-esteem in predicting disordered eating. Furthermore, findings posited that comparison of appearance and internalization of appearance ideals posed as potential risk factors in aggravating disordered eating. This study extends an opportunity for clinicians and community workers to initiate projects of social welfare such as awareness programs to address eating-related pathologies in educational as well as community settings, specifically amongst the adolescent population.