Developmental Psychology 2015, Vol. 51, No. 5, 706 –713

© 2015 American Psychological Association 0012-1649/15/$12.00 http://dx.doi.org/10.1037/dev0000013

BRIEF REPORT

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Longitudinal Relationships Among Internalization of the Media Ideal, Peer Social Comparison, and Body Dissatisfaction: Implications for the Tripartite Influence Model Rachel F. Rodgers

Siân A. McLean and Susan J. Paxton

Northeastern University and Université Paul Sabatier

La Trobe University

Sociocultural theory of body dissatisfaction posits that internalization of the media ideal and appearance comparison are predictors of body dissatisfaction, a key risk factor for eating disorders. However, no data exist regarding the longitudinal relationships between these variables. The aim of this study was to explore longitudinal relationships among internalization of the media-ideal, social appearance comparison, and body dissatisfaction. A sample of 277 Grade 7 school girls (M age ⫽ 12.77 years, SD ⫽ 0.44) completed measures of internalization of the media ideal, social appearance comparison, and body dissatisfaction at baseline, 8 months, and 14 months. Path analyses indicated that baseline internalization of the media ideal predicted social appearance comparison and body dissatisfaction at 8 months, and social appearance comparison at 8 months predicted body dissatisfaction at 14 months. A reciprocal effect emerged with body dissatisfaction at 8 months predicting internalization of the media ideal at 14 months. The findings inform sociocultural theory of body dissatisfaction, suggesting that internalization of the media ideal precedes and predicts appearance comparison and that body image interventions that target internalization of the media ideal, and social appearance comparison as well as body dissatisfaction are likely to be effective. Keywords: longitudinal, media-internalization, social appearance comparison, thin-ideal internalization, tripartite

fruit and vegetable intake (Neumark-Sztainer et al., 2006; Ohring, Graber, & Brooks-Gunn, 2002; Paxton, Eisenberg, & NeumarkSztainer, 2006; Stice & Whitenton, 2002). In light of the role of body dissatisfaction in the development of eating disorders, understanding the predictors of the development of these concerns is crucial. Early adolescence is an important developmental period for girls in relation to body image concerns, as the physical changes associated with puberty tend to move them further away from the androgynous and extremely slender body ideal promoted by the media (McCabe, Ricciardelli. & Finemore, 2002). In contrast, among boys, puberty may not constitute a similar risk, as physical changes associated with puberty tends to increase muscularity, thus moving boys closer to the social ideal. Furthermore, adolescent girls seem to be more vulnerable to media influences compared to their male counterparts and engage in more social appearance comparison, both of which are important risk factors for body dissatisfaction (Knauss, Paxton, & Alsaker, 2008; Warren, Schoen, & Shafer, 2010). Increasing our understanding of the longitudinal risk factors for body dissatisfaction specifically among early adolescent girls is therefore critical to the development of successful etiological models of the development of body image concerns and eating pathology in this vulnerable age group. Although sociocultural models, in particular the tripartite influence model (Thompson, Heinberg, Altabe, & Tantleff-Dunn,

Among girls, rates of body image concerns and disordered eating increase rapidly in early adolescence (Abebe, Lien, & von Soest, 2012; Westerberg-Jacobson, Ghaderi, & Edlund, 2012), with over 45% of early adolescent girls reporting body dissatisfaction (Williams & Currie, 2000) The high prevalence of body dissatisfaction is very concerning as body dissatisfaction has been shown to prospectively predict increased psychopathology and unhealthy behaviors (Neumark-Sztainer, Paxton, Hannan, Haines, & Story, 2006). Most importantly, body dissatisfaction has been put forward as one of the two most important predictors of eating disorder onset (Stice, Marti, & Durant, 2011). However other negative outcomes include depressive symptoms, low self-esteem, disordered eating, weight gain, and reduced physical activity and

This article was published Online First March 9, 2015. Rachel F. Rodgers, Department of Counselling and Applied Educational Psychology, Northeastern University, and Laboratoire de Stress Traumatique, Université Paul Sabatier; Siân A. McLean and Susan J. Paxton, School of Psychological Science, La Trobe University. This work was conducted when Rachel F. Rodgers was a Visiting Scholar at LaTrobe University. Correspondence concerning this article should be addressed to Rachel F. Rodgers, Department of Counselling and Applied Educational Psychology, Northeastern University, Boston, MA 02115. E-mail: [email protected] 706

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INTERNALIZATION, COMPARISON AND BODY DISSATISFACTION

1999), dominate conceptualisations of the development of body dissatisfaction and disordered eating, there has been remarkably little longitudinal research into relationships between essential components of the models. The tripartite influence model posits that internalization of the thin media ideal (media-internalization) and social appearance comparison are two psychological predictors of body dissatisfaction (Thompson et al., 1999). The associations between these components have been confirmed with crosssectional studies (Keery, van den Berg, & Thompson, 2004; Rodgers, Chabrol, & Paxton, 2011; Shroff & Thompson, 2006). However, the absence of longitudinal data has resulted in a poor understanding of relationships between these variables, in particular, the direction and temporal relationships between mediainternalization and social appearance comparison, and the role of these variables in the development of body dissatisfaction. The aim of the present study was therefore to explore the longitudinal relationships among media-internalization, social appearance comparison, and body dissatisfaction to contribute to clarifying the temporal nature of these relationships, and prospective predictive ability of variables within the model. Clarifying these relationships among early adolescent girls would help inform the elaboration of more accurate models of the development of body dissatisfaction as well as successful interventions at this critical developmental period. Media-internalization, frequently referred to more generally as thin-ideal internalization, refers to the extent to which individuals subscribe to social standards for physical appearance and aspire to attain these standards (Thompson & Stice, 2001; Thompson, van den Berg, Roehrig, Guarda, & Heinberg, 2004). According to Thompson et al. (2004), internalization can be conceptualized as not only the endorsement of the media ideal but also modifications to one’s behavior to try to better approximate these standards, as reflected by comparison with ideal-images in the media. The first phase of the tripartite influence model posits that media influence leads to the development of media-internalization (Thompson et al., 1999; Thompson et al., 2004). Consistent with this, among preadolescent girls, TV exposure has been found to predict preferences for a thinner personal ideal 1 year later (Harrison & Hefner, 2006). Similarly, the introduction of mass-media into cultural settings in which Western media was not present has been associated with increases in media-internalization, lending further support to this etiological pathway (Becker, Burwell, Gilman, Hamburg, & Herzog, 2002; Bilukha & Utermohlen, 2002). In the second phase of the tripartite influence model, it is posited that internalization of media influences (i.e., media-ideal internalization) and appearance comparison lead to the development of body dissatisfaction (Thompson et al., 1999). Media-internalization is hypothesized to lead to increases in body dissatisfaction because a stronger endorsement of the media ideal as the standard of beauty highlights the gap between the largely unattainable media ideal and one’s own physical appearance, leading to feelings of dissatisfaction (Thompson et al., 1999). Both cross-sectional (Durkin, Paxton, & Sorbello, 2007; Keery et al., 2004; Rodgers et al., 2011) and longitudinal (Carlson Jones, 2004; Stice & Whitenton, 2002) studies have confirmed these relationships in adolescent girls. Social appearance comparison, or physical appearance comparison, refers to the tendency to compare one’s physical appearance with that of one’s peer group. Social comparison is hypothesized to lead to increases in body dissatisfaction as the tendency

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to compare one’s physical appearance with peers also highlights discrepancies between social and media appearance ideals and one’s own appearance. The relationship between social appearance comparison and body dissatisfaction is now well-established in cross-sectional studies (Myers & Crowther, 2009; Schutz, Paxton, & Wertheim, 2002; van den Berg, Thompson, Obremski-Brandon, & Coovert, 2002) and to a lesser extent support has been provided for social comparison as a prospective predictor of the development of body dissatisfaction in adolescent girls (Carlson Jones et al., 2004). Whereas the associations between both media-internalization and social comparison and body dissatisfaction are well established, the relationship between social appearance comparison and media-internalization has received little attention to date and are thus poorly understood. Festinger (1954) proposed that individuals are more likely to make social comparisons in areas of particular importance and relevance to them. As internalization of the media ideal reflects a high value placed on the thin ideal and adoption of this ideal as a personal standard, it has been suggested that mediainternalization may motivate appearance comparison as a means to determine success in approximating the ideal (Durkin et al., 2007; Schutz et al., 2002; Fitzsimmons-Craft, 2011). Following this proposition, social appearance comparison would mediate the relationship between media-internalization and body dissatisfaction. This pathway has been supported by cross-sectional research (Blowers, Loxton, Grady-Flesser, Occhipinti, & Dawe, 2003; Durkin et al., 2007; Fitzsimmons-Craft et al., 2012). Thus, this pathway was included in our hypothesized model (see Figure 1). The opposite pathway, in which appearance comparison would lead to media-internalization has also been proposed (Keery et al., 2004; Thompson et al., 1999). It has been hypothesized that individuals with a high tendency to engage in social comparison might seek out thin-ideal media and compare themselves more to surrounding media images, thus reinforcing the desirability of the media ideal and leading to greater internalization. A number of cross-sectional studies have also supported this relationship (Keery et al., 2004; Shroff & Thompson, 2006). Finally, it is also possible that both of the pathways described above exist, and that mediainternalization and appearance comparison influence one other (Schutz et al., 2002). This potential pathway from appearance comparison to media-internalization has also been included in our proposed model (see Figure 1). However, the lack of longitudinal data exploring these relationships means that conclusions as to the direction and temporal precedence of these relationships cannot be confirmed. It may also be that the relationships from media-internalization and social comparison to body dissatisfaction may not be as straightforward as have been proposed in sociocultural theory. Other authors have suggested that the temporal order of relationships between media-internalization and body dissatisfaction could be conceptualized in alternate ways, and that these relationships require empirical clarification (Tiggemann, 2006). In particular, uses-and-gratifications theory highlights how individuals are active consumers of media (Rubin, 1986). It could be that body dissatisfaction might spur young women to look for ways of changing their appearance such as those proposed by media (Cusumano & Thompson, 1997; Peixoto Labre & Walsh-Childers, 2003) and to compare themselves to media images with the aim of self-improvement. Thus, reciprocal relationships where body dis-

RODGERS, MCLEAN, AND PAXTON

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708 Time 1 Media Internalization

Time 2 Media Internalization

Time 3 Media Internalization

Time 1 Social Appearance Comparison

Time 2 Social Appearance Comparison

Time 3 Social Appearance Comparison

Time 1 Body Dissatisfaction

Time 2 Body Dissatisfaction

Time 3 Body Dissatisfaction

Figure 1. Hypothetical model.

satisfaction influences both media-internalization and social comparison on one hand and media-internalization and social appearance comparison influence body dissatisfaction on the other might exist. To first test the pathways that are consistent with the tripartite model, pathways from body dissatisfaction to media-ideal internalization and appearance comparison were not included in the initial hypothetical model; however, they were considered for inclusion in alternative models should the hypothetical model prove a poor fit. To our knowledge no data exist regarding the longitudinal and temporal relationships between media-internalization, social appearance comparison, and body dissatisfaction. Clarifying these relationships is critical in terms of understanding the mechanisms leading to increases in body dissatisfaction, one of the major risk factors for disordered eating (Stice et al., 2011). Furthermore, data of this kind would contribute to informing and refining sociocultural models of body dissatisfaction and disordered eating and contribute to bridging the gap in longitudinal evidence for the pathways proposed by the tripartite influence model of the development of body dissatisfaction (Thompson et al., 1999). The aim of the present study was, therefore, to explore the longitudinal associations between media-internalization, social appearance comparison, and body dissatisfaction among a sample of early adolescent girls, across three time-points. Consistent with past research, we hypothesized that both media-internalization and social appearance comparison would lead to increases in body dissatisfaction over time (see Figure 1). Furthermore, we hypothesized that media-internalization and social appearance comparison would both influence each other, as cross-sectional support has been found for both directions.

Methods Participants A sample of 277 Grade 7 school girls was recruited from three coeducational and one single-sex school in Melbourne, Australia to be involved in a body image intervention trial. In the present

research, data from baseline (Time 1), 8 month (Time 2), and 14 month (Time 3) assessments from the no intervention control group only have been used. In total, 230 (83%) girls provided complete data across the three time points and were thus included in the analyses. The mean age of participants was 12.77 years (SD ⫽ 0.44) at Time 1, 13.38 (SD ⫽ .43) at Time 2, and 13.80 (SD ⫽ .49) at Time 3. The majority of participants indicated they were born in Australia or New Zealand (85.2%). In addition, 4.8% reported being born in South East Asia, 1.7% in the Middle-East, and the remaining 8.3% in other countries.

Procedures Students from participating schools who provided parental consent were invited to participate in the study and complete a self-report questionnaire. Data collection was conducted in classroom settings and supervised by the researchers. Participants could choose to not provide information on height and weight. Participants who did choose to provide this information were invited to self-report their measurements. In rare cases when they were unsure of their measurements, scales were available to them in a private area and they could have their height and weight measured privately by the researcher. The study was approved by the La Trobe University Human Ethics Committee.

Measures Media-internalization of the thin ideal. The Internalization subscale of the Sociocultural Attitudes Toward Appearance Questionnaire was used to assess internalization of the thin media ideal (media-internalization) (Thompson et al., 2004). The scale includes nine items assessing the degree to which participants adopt the media-ideal as their own ideal and use it as a standard for comparison. Items are scored on a 4-point scale ranging from 1 (strongly disagree) to 5 (strongly agree), with higher scores indicating higher levels of internalization. An example item is “I would like my body to look like the models who appear in magazines.” This scale has demonstrated good reliability in pre-

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INTERNALIZATION, COMPARISON AND BODY DISSATISFACTION

vious studies among adolescent girls (Heinicke, Paxton, McLean, & Wertheim, 2007). In the present sample ␣ ⫽ .95 at Time 1, ␣ ⫽ .95 at Time 2, and ␣ ⫽ .96 at Time 3. Social appearance comparison. The Physical Appearance Comparison Scale (Thompson, Heinberg, & Tantleff, 1991) was used to assess social physical appearance comparison. The 5 items assess the degree to which participants tend to compare their physical appearance to that of other individuals in social situations. Items are rated on a 5-point scale ranging from 1 (never) to 5 (always), with higher scores indicating greater tendencies toward social comparison. An example item is “I compare my ‘looks’ to the ‘looks’ of others to determine if I am attractive or unattractive.” This scale has demonstrated good reliability in previous studies among adolescent girls (Schutz et al., 2002). In our sample, ␣ ⫽ .89 at Time 1, ␣ ⫽ .93 at Time 2, and ␣ ⫽ .92 at Time 3. Body dissatisfaction. The Body Dissatisfaction subscale of the Eating Disorders Inventory (Garner, Olmstead, & Polivy, 1983) was used to assess body dissatisfaction. The nine items assess dissatisfaction with various body parts, with higher scores indicating a greater degree of dissatisfaction. Items are rated on a 6-point scale ranging from 1 (never) to 6 (always). An example item is “I think that my stomach is too big.” The present study used the continuous scoring method, which has been shown to be appropriate in nonclinical populations (Celio et al., 2000). Previous studies have revealed that the scores from this scale demonstrates good reliability among adolescent girls (Richardson, Paxton, & Thomson, 2009). In our sample, ␣ ⫽ .90 at Time 1, ␣ ⫽ .92 at Time 2, and ␣ ⫽ .92 at Time 3. Body mass index. Body mass index (BMI) was calculated from self-reported height and weight.

Data Analyses Correlations between media-internalization, social appearance comparison, and body dissatisfaction at the three time points were computed. In addition, partial correlations controlling for baseline BMI were conducted among the subsample for which these data were available. Longitudinal path analyses were conducted to examine the prospective relationships, controlling for the predictor scores at the previous time point (Cole & Maxwell, 2003). Analyses were conducted using SPSS 22 and AMOS 22 (Arbuckle, 2013). Sample size recommendations for path analyses are of five

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cases per parameter (Bentler & Chou, 1987). Our hypothetical model included 32 parameters to be estimated, therefore our sample of n ⫽ 230 ⬎ 32 ⫻ 5 ⫽ 160. Model fit was evaluated using the values of chi-square, root mean square error of approximation (RMSEA), and Bentler’s comparative fit index (CFI). Cut-off values were used to judge model fit: RMSEA ⬍ .05 suggested good fit, .05–.08 suggested adequate fit, ⬎.10 suggested poor fit, and a CFI ⬎ .95 indicated good fit (Browne & Cudeck, 1993; Hu & Bentler, 1999). Nonsignificant chi-square tests are indicative of a better fit. However, this test is sensitive to sample size and correlations between variables (Kenny & McCoach, 2003) and therefore was interpreted with caution in the present analysis.

Results The hypothesized model (see Figure 1) displayed a poor fit to the data. Descriptive statistics and findings from the correlational analyses are presented in Table 1. These results indicated that the variables were correlated significantly with each other across the three time points. A subsample of n ⫽ 168 provided baseline measurements for calculating baseline BMI, with M (SD) BMI ⫽ 19.66 (3.46). Results from the partial correlations, conducted among this subsample, revealed relationships of similar magnitudes to those from analyses without BMI and all correlations remained significant at the p ⬍ .001 level, ␹2(13) ⫽ 44.53, p ⫽ .000, CFI ⫽ .98, RMSEA ⫽ .10. The modification indices indicated that an additional pathway between Time 2 body dissatisfaction and Time 3 media-internalization improve the model fit. As this modification was consistent with the idea of reciprocal relations, we added this pathway. After the addition of this pathway, the fit of the model was significantly improved, ␹2(1) ⫽ 11.92, p ⫽ .001, and the model revealed acceptable fit, ␹2(12) ⫽ 32.61, p ⫽ .001, CFI ⫽ .98, RMSEA ⫽ .09. Figure 2 illustrates the path coefficients for the final model in which the nonsignificant pathways have been removed, which did not significantly modify the fit. Contrary to our hypothesis, the pathways from social appearance comparison leading to media-internalization were nonsignificant. Furthermore, the pathway between Time 2 media-internalization and Time 3 body dissatisfaction was also nonsignificant and were removed. The final model with nonsignificant pathways removed was an acceptable fit to the data, ␹2(16) ⫽ 40.01, p ⫽ .001, CFI ⫽ .98,

Table 1 Correlations Among Variables at Time 1 (T1), Time 2 (T2), and Time 3 (T3) Media-internalization Variable Media internalization Appearance comparison Body dissatisfaction

ⴱⴱ

p ⬍ .001.

M (SD) Time Time Time Time Time Time Time Time Time

1 2 3 1 2 3 1 2 3

20.66 (9.43) 19.61 (9.04) 19.62 (9.33) 12.60 (4.88) 12.72 (5.18) 12.61 (5.28) 16.51 (9.76) 17.22 (10.52) 17.80 (10.25)

Range 9–45 9–45 9–45 5–25 5–25 5–25 0–43 0–43 0–43

T1

T2 ⴱⴱ

.68

T3 ⴱⴱ

.63 .73ⴱⴱ

Social appearance comparison T1 ⴱⴱ

.57 .45ⴱⴱ .43ⴱⴱ

T2 ⴱⴱ

.41 .60ⴱⴱ .51ⴱⴱ .59ⴱⴱ

Body dissatisfaction

T3 ⴱⴱ

.38 .49ⴱⴱ .62ⴱⴱ .53ⴱⴱ .70ⴱⴱ

T1 ⴱⴱ

.50 .33ⴱⴱ .39ⴱⴱ .52ⴱⴱ .31ⴱⴱ .30ⴱⴱ

T2 ⴱⴱ

.46 .51ⴱⴱ .51ⴱⴱ .48ⴱⴱ .43ⴱⴱ .34ⴱⴱ .72ⴱⴱ

T3 .40ⴱⴱ .40ⴱⴱ .57ⴱⴱ .48ⴱⴱ .43ⴱⴱ .50ⴱⴱ .65ⴱⴱ .78ⴱⴱ

RODGERS, MCLEAN, AND PAXTON

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46% Time 1 MediaInternalization

56%

Time 2 MediaInternalization

.68***

Time 3 MediaInternalization

.65*** .16**

.15*

.17***

.57

33% Time 1 Social Appearance Comparison

.49

Time 2 Social Appearance Comparison

.48***

47% .49

.58***

.45

Time 3 Social Appearance Comparison

.40 .40

.14*

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.52

.09* Time 1 Body Dissatisfaction

.65***

53% Time 2 Body Dissatisfaction

61%

.26

.74***

Time 3 Body Dissatisfaction

.41

Figure 2. Final model with standardized coefficients. Values for correlations between errors are indicated in italics. ⴱ p ⬍ .05. ⴱⴱ p ⬍ .01. ⴱⴱⴱ p ⬍ .001.

RMSEA ⫽ .08, and explained 46% of the variability in mediainternalization at Time 2, and 56% of the variability in mediainternalization at Time 3; 33% of the variability in social appearance comparison at Time 2, and 47% of the variability in social appearance comparison at Time 3; and 53% of the variability in body dissatisfaction at Time 2, and 61% of the variability in body dissatisfaction at Time 3. Time 1 media-internalization significantly predicted both Time 2 social appearance comparison (␤ ⫽ .15, p ⫽ .019) and Time 2 body dissatisfaction (␤ ⫽ .14, p ⫽ .006). At Time 2, media-internalization predicted Time 3 social appearance comparison (␤ ⫽ .16, p ⫽ .003). Time 2 social appearance comparison predicted Time 3 body dissatisfaction (␤ ⫽ .09, p ⫽ .032). In addition, Time 2 body dissatisfaction predicted Time 3 media-internalization (␤ ⫽ .17, p ⫽ .000). Thus, although media-internalization predicted later social appearance comparisons scores, the opposite was not true.

Discussion The aim of this study was to explore the longitudinal and temporal relationships between media-internalization, social appearance comparison, and body dissatisfaction among early adolescent girls. The findings suggest that media-internalization precedes and predicts social appearance comparison, which in turn predicts body dissatisfaction. Furthermore, our findings suggest the presence of a reciprocal relationship whereby media-internalization and body dissatisfaction influence each other. These findings are important given the critical role of body dissatisfaction in the development of eating disorders among older adolescents (Stice et al., 2011). To our knowledge, our study is the first to have explored the longitudinal associations between media-internalization, social appearance comparison, and body dissatisfaction. Consistent with certain theoretical predictions (Schutz et al., 2002; FitzsimmonsCraft, 2011), and cross-sectional findings (Durkin et al., 2007), our findings suggest that media-internalization temporally precedes social appearance comparison and is a prospective predictor of social appearance comparison, providing an important clarification

to the tripartite influence model. Media-internalization, as operationalized by the SATAQ-3 (Thompson et al., 2004), refers to the adoption of the social ideal as a personal standard of physical attractiveness, as well as comparisons with images presenting that ideal, and efforts to bring one’s appearance closer to the ideal. In line with our findings, this endorsement of the media-ideal might therefore lead to increased social comparison with peers, as increased importance is placed on physical appearance and further sources of comparison are sought to evaluate the results of efforts to attain the thin-ideal. Consistent with this, it has been proposed that social appearance comparison might be motivated by hopes of self-improvement (Buunk & Gibbons, 2007; Nabi & Keblusek, 2014). Consistent with previous research, our findings also suggest that both media-internalization and social appearance comparison predict body dissatisfaction (Jones et al., 2004). Thus, the effect of media-internalization on body dissatisfaction appears to be both direct and indirect via social appearance comparison, highlighting its critical role in the development of body dissatisfaction in girls (Cafri, Yamamiya, Brannick, & Thompson, 2005). Furthermore, past research has suggested that girls and young women mostly engage in upward appearance comparisons, that is comparisons with targets perceived as more attractive than them (Leahey, Crowther, & Mickelson, 2007; O’Brien et al., 2009). Thus, mediainternalization likely leads to an increasing number of unfavorable comparisons, resulting in body dissatisfaction. Interestingly, our findings also suggest a reciprocal relationship between media-internalization and body dissatisfaction. Thus, increased feelings of body dissatisfaction might lead to an increased desire to look like the media-ideal, longing for the “perfect” body, and willingness to engage in efforts to attain it. This is a novel finding, and if replicated, suggests that theoretical models of body image should include reciprocal effect loops, rather than depicting the process as a linear relationship. From a developmental perspective, recent literature has suggested age of puberty among girls in Westernized countries is 12.4 years (McDowell Brody & Hughes, 2007). The participants included in our study were just a

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INTERNALIZATION, COMPARISON AND BODY DISSATISFACTION

few months older at Time 1, therefore our findings should be interpreted in light of the potential physical changes occurring in our participants during the course of the study. It is possible that, as girls transition into puberty, feelings of body dissatisfaction might arise directly from physical changes and related variation in self-concept. These might then lead to outside sources such as the media being sought out as standards for evaluation. Thus the pathway from body dissatisfaction to media-internalization may result from girls at this age starting to look at media images as appropriate sources of information regarding appearance standards. This finding also suggests that programs seeking to decrease body dissatisfaction might consider simultaneously targeting media-internalization, appearance comparison, and body dissatisfaction, as the reciprocal pathways suggest that all three are required to decrease in order to produce positive outcomes. Thus, programs that combine exercises such as mirror exposure targeting body dissatisfaction (Luethcke, McDaniel, & Becker, 2011), media literacy (Espinoza, Penelo, & Raich, 2013) or cognitive dissonance targeting media-internalization (Stice, Shaw, Burton, & Wade, 2006; Yamamiya, Cash, Melnyk, Posavac, & Posavac, 2005), and exercises for decreasing social comparisons (Gollings & Paxton, 2006; Richardson et al., 2009) would have a high potential for success. In contrast, the hypothesized relationships between social appearance comparison and media-internalization were not significant for either time lag. It is possible that among early adolescent girls, social appearance comparison is not related to higher endorsement of media ideals because of the perception of the developmental gap between one’s peer group, still transitioning through puberty, and the young adult media models. Therefore, as peers rather than media ideals may seem to be appropriate targets for social comparison, engaging in comparison processes may not reinforce the salience of media ideals among this age group. It would be interesting to explore how these relationships might differ among older adolescents or young women whose physical appearance has the potential to more closely resemble that of media models. Our study includes a number of limitations. First, the measures used to operationalize the concepts of media-internalization and social appearance comparison present limitations in regard to overlap between the concepts measured, in that media-internalization represents internalization and comparison with media targets, whereas social appearance comparison represents comparisons with peers. Studies using recently developed versions of these measures that circumvent these limitations are warranted to replicate our findings. In addition, we used self-report measures from the participants at each time point, which may have produced measurement biases. Furthermore, we obtained assessments at baseline, 8 months, and 14 months. It may be that other timeframes better capture the relationships between these variables, and future work should aim to clarify the time-scale of these processes. Finally, our study included young adolescent females, and it is unclear how these findings might generalize to older adolescents or young adults, or whether similar pathways might be observed among male adolescents. Future studies should seek to replicate these findings and continue to investigate the temporal order and clarify the causal relationships between the variables leading to body dissatisfaction within sociocultural models. In particular, further work exploring

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the role, motivations, and development of social appearance comparisons is needed. Furthermore, studies exploring the individual contributions of endorsement of the media-ideal, media-comparisons, and social appearance comparisons would contribute to clarifying the mechanisms through which sociocultural influences affect body image. In conclusion, our study provides novel data on the longitudinal relationships between media-internalization, social appearance comparison, and body dissatisfaction, and adds to the body of evidence suggesting that media-internalization plays a crucial role in the development of body dissatisfaction both directly, and indirectly (Cafri et al., 2005). Furthermore, our findings suggest the existence of complex reciprocal relationships and highlight the importance of targeting all three of these concepts in programs aiming to decrease body image concerns. Early adolescence is a critical period for the development of body image concerns, prevention efforts in this age group, and among younger girls (e.g., Ross, Paxton, & Rodgers, 2013) may help to reduce these concerns and their repercussions in later adolescence.

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Received July 29, 2014 Revision received January 13, 2015 Accepted January 19, 2015 䡲