522676 research-article2014
HPQ0010.1177/1359105314522676Journal of Health Psychology X(X)Yamazaki and Omori
Article
The relationship between mothers’ thin-ideal and children’s drive for thinness: A survey of Japanese early adolescents and their mothers
Journal of Health Psychology 1–12 © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1359105314522676 hpq.sagepub.com
Yoko Yamazaki and Mika Omori
Abstract We examined the association of mothers’ thin-ideal internalization and children’s drive for thinness. Early adolescents (175 girls and 198 boys) completed a questionnaire to assess their drive for thinness and perceptions of mothers’ attitudes and behaviors related to body shape. The questionnaire for mothers (n = 206) measured mothers’ thin-ideal internalization. Mothers’ thin-ideal internalization was associated with girls’ drive for thinness through the perception of mothers’ attitudes directed to girls, and with boys’ drive for thinness through mothers’ weight-loss behavior. The findings suggest the possibility that mothers transmit social standards on body shape to their children.
Keywords drive for thinness, early adolescents, gender differences, maternal influences, thin-ideal internalization
Introduction Scholars have reported that many young children express the desire for thinness (Brown and Ogden, 2004; Hill et al., 1990; Marchi and Cohen, 1990; Smolak et al., 1999). Although the drive for thinness at an early age may not be immediately harmful, this attitude can result in various physical and psychological problems during adolescence and adulthood (Hill et al., 1990; Marchi and Cohen, 1990). Empirical findings on the development of the drive for thinness among young people would provide useful information for health-care providers developing preventive interventions for physical and psychological problems. This study was designed to investigate the association of mothers’ thin-ideal internalization with their children’s drive for thinness.
It has been argued that social influence, such as media, peers, and family, is very important to the development of body image during adolescence (Huon et al., 2000; Huon and Walton, 2000). Previous studies have found that parents, particularly mothers, play an important role in the development of the drive for thinness and weight-loss behaviors among children (Phares et al., 2004; Rodgers et al., 2009a; Smolak et al., 1999). Mothers’ attitudes and behaviors Ochanomizu University, Japan Corresponding author: Mika Omori, Department of Psychology, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 1128610, Japan. Email: [email protected]
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toward their own and their children’s body shape and weight—such as their comments and criticisms on body shape or weight, pressure on their children to be thin, and their own weightloss behaviors—can have a substantial influence on their children’s body image (Cordero and Israel, 2009; Hill et al., 1990; Mukai and McCloskey, 1996; Phares et al., 2004; Rodgers et al., 2009b). A logical question relates to how mothers’ attitudes and behaviors about body shape and weight are determined. Women’s attitudes and behaviors concerning body shape and weight— such as the drive for thinness, weight-loss behaviors, and body dissatisfaction—have often been explained by sociocultural theory, which asserts that Western culture has adopted the thin-ideal as an acceptable standard of physical beauty for women (Heinberg, 1996). The thin-ideal posits that thin women are idealized because thinness connotes not only attractiveness but also goodness. As a consequence, thinideal internalization reflects cultural values regarding women’s body shape, leading women to become dissatisfied with their own bodies and develop the desire for thinness (Cusmano and Thompson, 1997; Lavin and Cash, 2001). In other words, sociocultural theory posits that women’s thin-ideal internalization determines their attitudes and behaviors toward their own bodies (Sands and Wardle, 2003). We further assume that mothers display attitudes and behaviors toward their children concerning body shape and weight, which are based on their judgments of thinness as good. Several recent studies found that mothers’ attitudes and behaviors influenced thin-ideal internalization in adolescents (Keery et al., 2004; Rodgers et al., 2009b; Santoncini et al., 2012). For example, one study showed that the perceived messages from parents were consistent with the individual’s ideal image (Stanford and McCabe, 2002). In addition, it has been reported that children’s internalization of the thin-ideal was related to their drive for thinness and weight-loss behaviors (Ahern et al., 2011; Bojorquez-Chapela et al., 2013; Mask and Blanchard, 2010; Shroff and Thompson, 2006).
In line with sociocultural theory (Cusmano and Thompson, 1997; Lavin and Cash, 2001), these findings suggest that mothers appear to transmit their internalized thin-ideal to their children via their attitudes and behaviors. Therefore, we decided to examine the mechanisms in the development of children’s drive for thinness, focusing on the effect of mothers’ thin-ideal internalization on their attitudes and behaviors regarding body shape and weight. This study includes both boys and girls to investigate gender differences in the relationship between mothers’ thin-ideal internalization and children’s drive for thinness. Previous research has found evidence of gender differences in mothers’ influence on body image (Baker et al., 2000; Rodgers et al., 2009a; Smolak et al., 1999). However, much of the research on maternal influences on body image has neglected the mothers’ internalized beliefs about body shape and weight. Therefore, this study aims to explore gender differences in the association between mothers’ thin-ideal internalization and the drive for thinness in their children. Since the thin-ideal mainly applies to women, as mentioned above, mothers may transmit it more to their daughters than to their sons. Thus, we assume that mothers’ attitudes and behaviors toward their daughters would be based on the mothers’ thin-ideal internalization that being thinner is good for women, whereas the thin-ideal internalization would not serve as the basis for their attitudes and behaviors toward their sons. Furthermore, previous research among young adults suggested that females perceived strong messages from parents about the overall ideal body and rated messages from parents as more important than did males (Stanford and McCabe, 2002). Accordingly, we supposed that girls’ drive for thinness would be more influenced by mothers’ attitudes and behaviors. Surveys of body image among Japanese elementary-school students revealed that over half of girls and almost half of boys in the fifth and sixth grades (10- to 12-year-olds) expressed a desire to lose weight (Bennesse Education Research Inst., 2001: 9; Matsuda, 2012; Okuda, 2004). The drive for thinness and new cases of
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Yamazaki and Omori eating disorders have been increasingly reported in young children (Nakai, 2012). Empirical studies on the drive for thinness among Japanese children are needed to obtain a better understanding of their dieting behaviors. Similar to European or North American societies, Japanese society seems to value thinness of women’s body shape as a sociocultural ideal (Moriyasu et al., 2011; Moroi and Kokirima, 2008). It is worth exploring how the sociocultural thin-ideal impacts children’s drive for thinness. This study aimed to expand the understanding of maternal influences on their children’s body image among Japanese early adolescents. This study will extend this line of research to examine influences of mothers’ thin-ideal on their children’s drive for thinness; the majority of previous research was limited to mothers’ attitudes and behaviors toward their children. The hypotheses focus on the relationships between mothers’ thin-ideal internalization and their children’s drive for thinness. Furthermore, we explored the gender differences in these relationships. We hypothesized that mothers’ thin-ideal internalization would be related to their children’s drive for thinness, through mothers’ own weight-loss behavior or mothers’ attitudes and behaviors about their children’s body shape and weight. On the basis of the findings with adolescents and early adolescents (Phares et al., 2004; Rodgers et al., 2009a), the link between mothers’ thin-ideal internalization and their attitudes and behaviors toward their children’s body shapes and weight was expected to be stronger for daughters than for sons. Additionally, we expected girls’ drive for thinness to be more influenced by mothers’ attitudes and behaviors. Our model also involved the child’s actual body shape as a control variable because previous studies have shown that the magnitude of children’s drive for thinness (Stice, 2002) and mothers’ attitudes toward their children’s body shape and weight were influenced by the children’s actual body weight (Anschutz et al., 2009). We also examined the role of children’s
perception of their mothers’ attitudes and behaviors. A previous study with university students and their parents showed that children’s perceptions of their mothers’ attitudes and behaviors influenced children’s body image more than did mother-reported attitudes and behaviors (Baker et al., 2000).
Method Participants and procedures The participants of this study were children aged 10–12 years (fifth and sixth graders) and their mothers. The participants were recruited from two public elementary schools in a major city in the Tokyo area. In all, 373 students (198 boys, 175 girls) completed anonymous questionnaires under the supervision of their homeroom teachers during morning assemblies. Students brought home packets containing the mothers’ questionnaires and sheets with information on the study. Mothers sealed the completed questionnaires and returned them to their children, who put them into collection boxes placed around the school buildings. Of the 259 mothers contacted, 207 returned the questionnaires (103 mothers of boys, 104 mothers of girls; 79.9% response rate). One questionnaire was eliminated because the household had no mother; therefore, 206 mothers (102 mothers of boys, 104 mothers of girls; 79.5% valid response rate) became participants in our investigation.
Children’s measures Drive for thinness. We measured drive for thinness with 3 items on a 5-point scale that asked about the desire to lose weight, dislike of being overweight, and experiences of weight-loss behavior. These items were used to assess the desire to be thin in a relatively large-scale survey with 1097 Japanese elementary-school children (Bennesse Education Research Inst., 2001). Question 1 was “Do you want to lose weight?” and was scored from 1 (I don’t want to lose weight at all) to 5 (I want to lose weight very much). Question 2 was “Do you want to
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avoid gaining weight?” and was scored from 1 (I don’t want to avoid gaining weight at all) to 5 (I want to avoid gaining weight very much). Question 3 was “Have you ever done anything to lose weight?” and was scored from 1 (I have never done anything to lose weight) to 5 (I’m constantly doing something to lose weight). We chose these 3 items so that our young participants could easily understand our intended meaning. Higher scores indicated a stronger drive for thinness. The Cronbach’s alpha coefficient for the drive for thinness scale was .65 in this study. Although this coefficient is slightly low, it is an allowable level because of the small number of items in the scale (Haebara, 2011). Perceived weight-loss behaviors of mothers. We assessed perceived frequency of the mother’s weight-loss behaviors with a question asking with what frequency the respondent thought that his or her mother had engaged in weight-loss behavior. The respondent rated the mother’s weight-loss behavior on the following scale: 1 (I don’t think she has ever engaged in weight-loss behavior), 2 (I think she has engaged in weightloss behavior just once before), 3 (I think she has engaged in weight-loss behavior two or more times), 4 (I think she is constantly engaged in weight-loss behavior), and 5 (I don’t know). Since “I don’t know” might signify that the participant did not recognize any weight-loss behavior by his or her mother, we combined responses 1 and 5 for the analyses. The Maternal Influence Scale. The Maternal Influence Scale (MFS, Mukai, 1996) was translated into Japanese to measure how often children feel their mothers express attitudes and behaviors concerning body shape and weight. Experts in psychology and proficient in English reviewed the translation; we used the translation that was judged appropriate by these experts. The MFS consists of 15 items in two subscales that measure “mutual monitoring and modeling” (e.g. “How often does your mother bring up the topic of food in your conversation?”) and “perceived expectations and pressure” (e.g. “How
often have you been encouraged to diet by your mother?”). Respondents assessed the frequency with which they observed the display of maternal attitudes and behaviors on a 4-point scale ranging from 1 (not at all) to 4 (very often). Higher scores indicated higher frequency of perceived occurrence. In a study of 7th to 11th graders, a Cronbach’s alpha value of .83 was reported as evidence of the scale’s overall internal consistency (Mukai, 1996). Furthermore, it was reported that MFS was a significant predictor of eating problems characterized by the drive for thinness and weight-loss behaviors across grades. We examined the factor structure of the MFS due to the translation and the age difference of our participants (fifth and sixth graders) and the participants from the original study (seventh through eleventh graders; Mukai, 1996). A series of factor analyses on the MFS from this study extracted a two-factor structure. The first factor (eigenvalue = 3.57) accounted for 39.71 percent of the variance, and the second factor (eigenvalue = 1.41) accounted for 15.70 percent of the variance. The items that loaded onto each factor in our study were different from those in the original study (Mukai, 1996). We speculated that several of the words translated from English in the modified scale may have been difficult for fifth and sixth graders to understand despite the successful pilot test of this scale with several children. The Cronbach’s alpha coefficients were .80 and .64 for subscales loading on Factors 1 and 2, respectively; the internal consistency of the second factor is low (Jackson and Furnham, 2000). Therefore, we decided to use only the scale comprising items loading on Factor 1 as the variable “MFS Attitudes and Behaviors toward Children,” which measured perceived maternal attitudes and behaviors toward their children concerning body shape and weight. Table 1 shows the results of our factor analysis.
Measures for mothers Sociocultural Attitudes Towards Appearance Questionnaire. We employed the Japanese version
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Yamazaki and Omori Table 1. Summary of factor loadings of MFS “Attitude and Behaviors.” Factor loadings How often have you been encouraged to diet by your mother? How much overweight does your mother think you are at current weight? How many times have you been suggested by your mother to go on a diet together? How often does your mother think that you eat too much? How often does your mother bring up the topic of dieting in your conversations?
.86 .81 .66
.61 .41
MFS: Maternal Influence Scale.
(Saito, 2004) of the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ; Heinberg et al., 1995) to measure the magnitude of a mother’s internalization of the thin-ideal. The SATAQ was originally developed to measure levels of women’s recognition and internalization of thinness as a standard of beauty in society. It consists of 14 items in two subscales: “awareness/acknowledgment” of the importance that society places on beauty and “internalization/acceptance” of these beauty standards. Participants were asked to rate to what extent they agreed with each statement on a 5-point scale, from 1 (Does not apply at all) to 5 (Applies very much). Higher scores indicated higher magnitudes of thin-ideal internalization. In developing the scale, Cronbach’s alpha values of .71 for “awareness/acknowledgment” and .88 for “internalization/acceptance” were obtained as evidence of internal consistency (Heinberg et al., 1995). Evidence of good construct validity (a significant positive correlation between measures of body-image distortion and eating disorders) has also been reported (Heinberg et al., 1995).
In this study, the Cronbach’s alpha coefficient of the internalization/acceptance subscale of the SATAQ was .79, which indicates good internal consistency, but that of the awareness/ acknowledgment subscale was .39, which is not acceptable. Therefore, we decided to analyze only the internalization/acceptance subscale, labeled “SATAQ Internalization,” to represent the mother’s thin-ideal internalization. Demographic information. Mothers were asked to provide information about their children’s height and weight because we felt that children would prefer not to disclose their weight. Using this information, we computed the children’s Rohrer index to estimate their body shape (Rohrer index = weight (kg)/(height (cm))3 × 107). We adopted this index because it is widely used in Japanese school health programs (Hashimoto and Murata, 2011). Higher Rohrer indices indicate more rounded body shapes.
Data analyses We performed a simultaneous path analysis for boys and girls to test our hypothesized multigroup model. The model was analyzed using an observed variable model because it was necessary to take into account young participants’ physical and mental test burdens; therefore, we could not include a sufficient number of items to form a latent variable model (Tabachnick and Fidell, 1996). In addition, because Cronbach’s alpha coefficients of the MFS Attitudes and Behaviors factor and SATAQ Internalization demonstrated reasonable internal consistency (Table 2), we judged that these could be used as observed variables (Bollen, 1989). We analyzed the results using IBM SPSS Statistics version 19 and AMOS 19.
Results Descriptive statistics Descriptive statistics, including the means and standard deviations of the variables measured for mothers and children, are shown in Table 2.
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Table 2. Means, standard deviations (SD), and gender differences in children’s and mothers’ variables. Total (N = 373) Children Mothers
α Drive for thinness Perceived mother’s weight-loss behavior MFS Attitudes and Behavior Rohrer indexa SATAQ Internalization
M (SD)
Girls (n = 175)
Boys (n = 198)
M (SD)
M (SD)
t-value
.65 –
3.03 (.86) 1.96 (1.13)
3.20 (0.79) 2.10 (1.15)
2.87 (0.89) 1.83 (1.11)
3.83*** 2.32*
.80
1.55 (0.66)
1.61 (0.63)
1.50 (0.68)
0.62
– .79
120.29 (16.06) 2.66 (0.69)
117.86 (14.14) 2.57 (0.72)
122.63 (17.47) 2.75 (0.65)
−2.08* −1.84
MFS: Maternal Influence Scale; SATAQ: Sociocultural Attitudes Towards Appearance Questionnaire. aRohrer index = weight (kg)/(height (cm)3 × 107). *p < .05; ***p < .001.
Table 3. Correlations between child’s drive for thinness, child’s weight-loss behavior, perceived mother’s dieting behavior, MFS, SATAQ, and child’s Rohrer index.
1. Children’s drive for thinness 2. Perceived mothers’ weight-loss behaviors 3. MFS Attitudes and Behaviors 4. SATAQ Internalization 5. Children’s Rohrer index
1
2
3
4
5
– .31** .58** .10 .54**
.20* – .23** .28** .17
.48** .23* – .06 .67**
.07 .42** .18 – .09
.52** .10 .47** .01 –
MFS: Maternal Influence Scale; SATAQ: Sociocultural Attitudes Towards Appearance Questionnaire. The cells at the upper right: girls; the cells at the lower left: boys. *p < .05; **p < .01.
Gender differences were examined for each variable using t-tests. As seen in Table 2, among the children’s variables, the means of drive for thinness and perceived mother’s weight-loss behaviors were significantly higher for girls than for boys (t(370) = 3.83, p < .001 and t(368) = 2.32, p < .05, respectively) while Rohrer index scores were higher among boys than among girls (t(192) = −2.08, p < .05).
Influences of mothers’ thin-ideal internalization on children’s drive for thinness We conducted a simultaneous path analysis on the 206 mother–child pairs (mother–girl: 104; mother–boy: 102) extracted from our sample of 373 students. Table 3 presents the correlation
matrix that served as the basis for the path analyses. We hypothesized that children’s perceived maternal attitudes and behaviors (as measured by MFS Attitudes and Behaviors and perceived mother’s weight-loss behaviors) would mediate mothers’ thin-ideal internalization (as measured by SATAQ Internalization) and children’s drive for thinness. The exogenous variables of our model were the mothers’ SATAQ Internalization and the children’s Rohrer index. Endogenous variables included children’s perceived maternal attitudes and behaviors toward their children concerning body shapes and weight (as measured by the Attitudes and Behaviors subscale of the MFS), perceived weight-loss behavior of mothers, and children’s drive for thinness.
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Figure 1. Path diagram of the influence of mother’s thin-ideal internalization on child’s drive for thinness (girls). a“Mother”
refers to mother’s variables. refers to child’s variables. *p < .05; **p < .01; ***p < .001. Note: Values at the upper right of rectagles refer to multiple correlation coefficient. b“Child”
The indices of fit of our multigroup model were χ2(14) = 9.07 (not significant) goodnessof-fit index (GFI) = .983, comparative fit index (CFI) = .994, and root mean square error of approximation (RMSEA) = .026. The GFI is an absolute index that indicates the extent the model fits the data and is suitable for a simple model (Hu and Bentler, 1998). The CFI and RMSEA are non-centrality-based indices, which compare the model with a saturated model; these are preferable with small sample sizes (Hu and Bentler, 1998). For the GFI and CFI, values closer to 1 indicate a better fit of the model and the data, with index values above .90 indicating an acceptable fit (Hu and Bentler, 1998). For the RMSEA, values closer to 0 indicate a better fit between the model and the data; values below .05 and .05–.08 are considered to represent good and fair fits, respectively (Hu and Bentler, 1998). The observed values of these indices indicated that the hypothesized multigroup model fit the data well for both boys and girls. This implied that the structures of our model did not differ across gender (Byrne, 2010); however, gender differences in the parameters of our model were present in the path coefficients. Figures 1 and 2 illustrate the path coefficients for girls and boys, respectively. The path coefficient between mothers’ SATAQ Internalization and
maternal attitudes/behaviors (as measured by the Attitudes and Behaviors subscale of the MFS) was significant for girls, but not for boys. On the other hand, the path from perceived maternal weight-loss behaviors to children’s drive for thinness was significant for boys, but not girls. Furthermore, two paths from the children’s Rohrer index—those to MFS Attitudes and Behaviors and children’s drive for thinness—were significant for both boys and girls. In conclusion, compared with boys, girls reported a greater drive for thinness and higher levels of perception of mothers’ weight-loss behaviors; these observations were consistent with the results of previous studies (Phares et al., 2004). Mothers’ thin-ideal internalization was significantly associated with the drive for thinness through their children’s perception of maternal attitudes and behaviors concerning body shapes and weight in girls, but not in boys. Meanwhile, mothers’ thin-ideal internalization was significantly associated to boys’ drive for thinness through boys’ perception of their mothers’ weight-loss behaviors, but not girls’ perception. Children’s perceived maternal attitudes/behaviors concerning body shape and weight were more strongly related to children’s drive for thinness among boys than among girls.
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Figure 2. Path diagram of the influence of mother’s thin-ideal internalization on child’s drive for thinness (boys). a“Mother”
refers to mother’s variables. refers to child’s variables. *p < .05; **p < .01; ***p < .001. Note: Values at the upper right of rectagles refer to multiple correlation coefficient. b“Child”
Discussion An underlying premise of this study was that mothers’ thin-ideal internalization would explain the development of the drive for thinness in adolescents. We hypothesized that mothers’ thin-ideal internalization led to children’s drive for thinness through the mediating factor of mothers’ attitudes and behaviors concerning their own and their children’s body shapes and weight. Although our results confirmed that our hypothetical model applied to girls and boys, interesting gender differences were observed in the relationship between mothers’ thin-ideal internalization and children’s drive for thinness. We hypothesized that mothers’ thin-ideal internalization would be related to their daughters’ perception of mothers’ attitudes and behaviors more than their sons’ perceptions. Consistent with our hypotheses, we found that mothers’ thin-ideal internalization was significantly related to girls’ perceptions of their mothers’ attitudes and behaviors, but not to boys’ perceptions, after controlling for the effect of actual body shape. This gender difference in the effects of mothers’ thin-ideal internalization implies that mothers’ attitudes and behaviors are based on the idea that a thin body shape is ideal for women under any circumstance
because mothers’ thin-ideal internalization was related to their attitudes and behaviors only toward their girls. Mothers appear to share ideas about body shape and weight—which are based on the thin-ideal internalized by their mothers— more with their daughters than with their sons through their attitudes and behaviors toward their children. Physical attractiveness, including the thin-ideal, is considered an important part of women’s gender role and represents women’s success (Lavin and Cash, 2001; Stice, 1994). Thus, we speculate that mothers implicitly inculcate their daughters with the social value of appearance to secure their daughters’ happiness as females in society. Furthermore, previous studies focusing on adolescent girls illustrated that girls’ thin-ideal internalization mediated the relationship between their mothers’ influence and their own body dissatisfaction, drive for thinness, and weight-loss behaviors (Keery et al., 2004; Rodgers et al., 2009b; Santoncini et al., 2012). Although our study did not assess the magnitude of children’s internalization of the thin-ideal, our results seem to indicate that mothers transmit the thin-ideal to their daughters through their attitudes and behaviors. Future research that includes a measure of children’s thin-ideal internalization could confirm the influences of mothers’ thinideal internalization.
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Yamazaki and Omori In contrast, the perception of mothers’ attitudes and behaviors was more strongly correlated with actual body shape in boys than in girls. This result implies that mothers’ attitudes and behaviors concerning body shape and weight may be based on their boys’ actual body shapes rather than the thin-ideal. It also suggests that mothers may think that sons do not have to be thin in order to be attractive; alternatively, they may believe that an attractive appearance is not as important for male gender roles and success as it is for female ones. Mothers’ approach to their boys seems to be based on health. Furthermore, we expected that the perception of maternal attitudes and behaviors toward their children would affect the drive for thinness more among daughters than among sons. Surprisingly, inconsistent with the results of previous studies and our hypothesis, the perception of mothers’ attitudes and behaviors regarding ideal body shape were strongly associated with increased drive for thinness in boys. However, our result supports previous research (Dunkley et al., 2001; Fulkerson et al., 2002) that found a significant association between children’s weightloss behaviors and mothers’ encouragement to diet in boys, but not in girls. These previous studies suggested that the influences of mothers’ encouragement may not increase the already existing high level of weight concerns and dieting behaviors in girls. We supposed that mothers and boys worried about their boys being overweight and boys, too, wanted to remove excess fat because boys’ actual body shape was strongly related to perceived maternal attitudes/behaviors toward boys and boys’ drive for thinness. In addition, since our participants were younger than those in previous studies, their mothers may have a greater effect on their body image development (Anschutz et al., 2009). We also hypothesized that the impact of mothers’ perceived weight-loss behaviors on children’s drive for thinness would be stronger among girls than among boys. The striking finding of this study is the results on the relationship between mothers’ weight-loss behavior and children’s drive for thinness. Consistent
with our hypotheses, mothers’ thin-ideal internalization was positively associated with children’s (both boys and girls) perception that the mother engaged in weight-loss behavior. On the other hand, inconsistent with our hypotheses on gender differences, the perception of mothers’ weight-loss behavior significantly influenced boys’ (but not girls’) drive for thinness. This gender difference conflicted with findings of earlier research (McCabe and Ricciardelli, 2003; Phares et al., 2004; Rodgers et al., 2009a). One explanation for this may be that girls have many same-gender models concerning weightloss behaviors, such as peers and their mothers (Mukai, 1996). However, the results of a previous study indicated that mothers’ dieting status was not related to weight-related behaviors in children (Fulkerson et al., 2002), which corroborates our findings about girls. In addition, this suggests that boys are not interested in their mothers’ behavior due to gender differences. This may be a methodological problem that needs to be addressed. Several limitations of this study must be noted. First, the cross-sectional nature of the data does not allow us to draw concrete causal associations between maternal thin-ideal internalization and children’s drive for thinness. Second, the characteristics of our study participants may not be representative of the population as a whole, since they were recruited from only two public elementary schools in Tokyo. It is possible that mothers and children in urban areas are exposed to stronger pressure to be thin than those residing in suburban areas. Our findings must be confirmed by longitudinal research with large samples from urban and rural areas. Finally, this study has some methodological problems. The use of self-reported questionnaires may not produce empirical evidence. Moreover, participants, particularly children, may have misunderstood the intended meanings of items on the questionnaire. Various types of methods, such as observation and interviews, must be conducted to corroborate these attitudes and behaviors. In the near future, researchers must examine familial influences in conjunction with other factors, such as media exposure, because the
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sociocultural theory of the thin-ideal involves strong influences beyond families (Heinberg, 1996). For example, given the recent increase in the number of fashion magazines targeting young adolescents in Japan (Yano Research Inst., 2002), media might increasingly influence children’s body images. Few studies have delineated the influence of the media on Japanese preadolescents and adolescents. Future studies should examine the effects of a variety of sociocultural factors on body image and dieting to better explain why the thinness trend continues to grow in Japan. Despite several limitations, our results are especially significant because we found relationships between mothers’ thin-ideal and their children’s body image. Although mothers vary in their attitudes and behaviors regarding body shape and weight, our results suggest that one of the sociocultural factors that explains children’s drive for thinness is the influence of mothers’ thin-ideal internalization. Maternal attitudes seem to be a risk factor affecting mental health. Previous studies have demonstrated that mother’s comments and behaviors predict eating disorders in their daughters (Davis et al., 2005; Linville et al., 2011). Given the ages of this study’s participants, it appears that psychologists must introduce psychological education for not only children but also their mothers long before the children reach puberty to prevent physical and psychological health problems during adolescence and later in life. Funding This research received no specific grant from any funding agency in the public, commercial, or not-forprofit sectors.
References Ahern AL, Bennett KM and Kelly M (2011) A qualitative exploration of young women’s attitudes towards the thin ideal. Journal of Health Psychology 16: 70–79. Anschutz DJ, Kanters LJA, Van Strien T, et al. (2009) Maternal behaviors and restrained eating and body dissatisfaction in young children.
International Journal of Eating Disorders 42: 54–61. Baker CW, Wiseman MA and Brownell KD (2000) Studying intergenerational transmission of eating attitudes and behaviors: Methodological and conceptual questions. Health Psychology 19: 376–381. Bennesse Education Research and Development Inst. (2001) Kodomo no yase ganbou [Drive for thinness among young children]. Monograph of A Schoolchild Now. Vol. 21, 1 November. Tokyo, Japan: Bennesse Education Research and Development Inst. Bojorquez-Chapela I, Unikel C, Mendoza M, et al. (2013) Another body project: The thin ideal, motherhood, and body dissatisfaction among Mexican women. Journal of Health Psychology. Epub ahead of print 16 May 2013. DOI: 10.1177/1359105313484783. Bollen KA (1989) Structural Equations with Latent Variables. New York: John Wiley & Sons. Brown R and Ogden J (2004) Children’s eating attitudes and behavior: A study of the modeling and control theories of parental influence. Health Education Research 19: 261–271. Byrne BM (2010) Structural Equation Modeling with AMOS: Basic Concepts, Applications, and Programming. New York: Routledge. Cordero ED and Israel T (2009) Parents as protective factors in eating problems of college women. Eating Disorders 17: 146–161. Cusmano DL and Thompson JK (1997) Body image and body shape ideal in magazines: Exposure, awareness, and internalization. Sex Roles 37: 701–721. Davis C, Blackmore E, Katzman DK, et al. (2005) Female adolescents with anorexia nervosa and their parents: A case-control study of exercise attitudes and behaviors. Psychological Medicine 35: 1579–1587. Dunkley TL, Wertheim EH and Paxton SJ (2001) Examination of a model of multiple sociocultural influences on adolescent girls’ body dissatisfaction and dietary restraint. Adolescence 36: 265–279. Fulkerson JA, McGuire MT, Neumark-Sztainer D, et al. (2002) Weight-related attitudes and behavior of adolescent boys and girls who are encouraged to diet by their mothers. International Journal of Obesity 26: 1579–1587. Haebara T (2011) Ryouteki kenkyuu hou [Quantitative Methodology for Researching on
Downloaded from hpq.sagepub.com by guest on November 17, 2015
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Yamazaki and Omori Clinical Psychology]. Tokyo, Japan: University of Tokyo Press. Hashimoto R and Murata M (2011) Gakureikishouni no taikakuhyoukasohyou tositeno ro-reru sisuu ni kansuru kentou [Research on Rohrer index as an index to evaluate physical status of school aged children]. Japanese Journal of Auxology 17: 25–31. Heinberg LJ (1996) Theories of body image disturbance: Perceptual, developmental, and sociocultural factors. In: Thompson JK (ed.) Body Image, Eating Disorders, and Obesity: An Integrative Guide for Assessment and Treatment. Washington, DC: American Psychological Association, pp. 27–47. Heinberg LJ, Thompson JK and Stormer S (1995) Development and validation of the sociocultural attitudes towards appearance questionnaire. International Journal of Eating Disorders 17: 81–89. Hill AJ, Weaver C and Blundell JE (1990) Dieting concern of 10-year-old girls and their mothers. British Journal of Clinical Psychology 29: 346–348. Hu L and Bentler PM (1998) Fit indices in covariance structure modeling: Sensitivity to underparameterized model misspecification. Psychological Methods 3: 424–453. Huon GF and Walton CJ (2000) Initiation of dieting among adolescent females. International Journal of Eating Disorders 28: 226–230. Huon GF, Lim J and Gunewardene A (2000) Social influence and female adolescent dieting. Journal of Adolescence 23: 229–232. Jackson CJ and Furnham A (2000) Analysing the results. In: Jackman CJ and Furnham A (eds) Designing and Analysing Questionnaires and Surveys: A Manual for Health Professionals and Administrators. London: Whurr Publishers, pp. 153–181. Keery H, van den Berg P and Thompson JK (2004) An evaluation of the tripartite influence model of body dissatisfaction and eating disturbance with adolescent girls. Body Image 1: 237–251. Lavin MA and Cash TF (2001) Effects of exposure to information about appearance stereotyping and discrimination on women’s body image. International Journal of Eating Disorders 29: 51–58. Linville D, Stice E, Gau J, et al. (2011) Predictive effects of mother and peer influences on increase in adolescent eating disorder risk
factors and symptoms: A 3-year longitudinal study. International Journal of Eating Disorders 44: 745–751. McCabe MP and Ricciardelli LA (2003) Sociocultural influences on body image and body changes among adolescent boys and girls. Journal of Social Psychology 143: 5–26. Marchi M and Cohen P (1990) Early childhood eating behaviors and adolescent eating disorders. Journal of American Academy of Child and Adolescent Psychiatry 29: 112–117. Mask L and Blanchard CM (2010) The protective role of general self-determination against “thin ideal” media exposure on women’s body image and eating-related concerns. Journal of Health Psychology 16: 489–499. Matsuda E (2012) Hutotteiru kotowo kini siteimasu: Kodomo no sinntaizou heno fuman kodawari ni taisuru ninnti koudou kaunserinngu [Worry about their body shape: Cognitive and behavioral therapy for body dissatisfaction among young adolescents]. Child Study Journal 66: 112–116. Moriyasu K, Moroi K, Maehara S, et al. (2011) Drive for thinness and social comparison (1): Moderating effects of thin-ideal internalization. DWCLA Human Life and Science 45: 29–36. Moroi K and Kokirima M (2008) Josi seinen ni okeru daietto koudou ni oyobosu sousin moderu no eikyou [Effects of exposure to thinness in models on dieting behavior in female adolescents]. Bulletin of Institute for Interdisciplinary Studies of Culture, Doshisha Women’s College of Liberal Arts 25: 58–67. Mukai T (1996) Mothers, peers, and perceived pressure to diet among Japanese adolescent girls. Journal of Research on Adolescence 6: 309–324. Mukai T and McCloskey LA (1996) Eating attitudes among Japanese and American elementary school girls. Journal of Cross-Cultural Psychology 27: 424–435. Nakai Y (2012) Sesshokushougai no ekigaku [Epidemiology of eating disorders]. Journal of Clinical and Experimental Medicine 241: 671–675. Okuda K (2004) Hahaoya no diet ni kannrennsuru isiki ya koudou ga kodomo no diet koudou ni oyobosu eikyou [An influence of mothers diet behavior and belief on children’s diet behavior]. Setouti Junior College Bulletin 35: 1–9. Phares V, Steinberg AR and Thompson JK (2004) Gender differences in peer and parental influence: Body image disturbance, self-worth, and psychological functioning in preadolescent
Downloaded from hpq.sagepub.com by guest on November 17, 2015
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children. Journal of Youth and Adolescence 33: 421–429. Rodgers RF, Faure K and Chabrol H (2009a) Gender differences in parental influences on adolescent body dissatisfaction and disordered eating. Sex Roles 61: 837–849. Rodgers RF, Paxton SJ and Chabrol H (2009b) Effects of parental comments on body dissatisfaction and eating disturbance in young adults: A sociocultural model. Body Image 6: 171–177. Saito C (2004) Sesshoku shougai keikou ni okeru kojinteki, shakaiteki, eikyou no kentou [Studying personal and social effects on tendencies toward eating disorders]. The Japanese Journal of Personality 13: 79–90. Sands ER and Wardle J (2003) Internalization of ideal body shapes in 9-12-year-old girls. International Journal of Eating Disorders 33: 193–204. Santoncini CU, Martin VM, Garcia FJ, et al. (2012) Disordered eating behavior and body weight and shape relatives’ criticism in overweight and obese 15- to 19-year-old females. Journal of Health Psychology 18: 75–85. Shroff H and Thompson JK (2006) Peer influences, body-image dissatisfaction, eating dysfunction
and self esteem in adolescent girls. Journal of Health Psychology 11: 533–551. Smolak L, Levine MP and Schermer F (1999) Parental input and weight concerns among elementary school children. International Journal of Eating Disorders 25: 263–271. Stanford JN and McCabe MP (2002) Body image ideal among males and females: Sociocultural influence and focus on different body parts. Journal of Health Psychology 7: 675–684. Stice E (1994) Review of the evidence for a sociocultural model of bulimia nervosa and an exploration of the mechanisms of action. Clinical Psychology Review 14: 633–661. Stice E (2002) Risk and maintenance factors for eating pathology: A meta-analytic review. Psychological Bulletin 128: 825–848. Tabachnick BG and Fidell LS (1996) Using Multivariate Statistics. Boston, MA: Allyn & Bacon. Yano Research Inst. (2002) Bubble junior kara chuukounen zassi no soukan rasshu [A rush to publish magazines directed at “bubble junior girl”, “middle-aged women”, and “elderly women”]. Yano Report. Report no. 1119, 10 June. Tokyo, Japan: Yano Reseach Inst.
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HPQ0010.1177/1359105314522676Journal of Health Psychology X(X)Yamazaki and Omori
Article
The relationship between mothers’ thin-ideal and children’s drive for thinness: A survey of Japanese early adolescents and their mothers
Journal of Health Psychology 1–12 © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav DOI: 10.1177/1359105314522676 hpq.sagepub.com
Yoko Yamazaki and Mika Omori
Abstract We examined the association of mothers’ thin-ideal internalization and children’s drive for thinness. Early adolescents (175 girls and 198 boys) completed a questionnaire to assess their drive for thinness and perceptions of mothers’ attitudes and behaviors related to body shape. The questionnaire for mothers (n = 206) measured mothers’ thin-ideal internalization. Mothers’ thin-ideal internalization was associated with girls’ drive for thinness through the perception of mothers’ attitudes directed to girls, and with boys’ drive for thinness through mothers’ weight-loss behavior. The findings suggest the possibility that mothers transmit social standards on body shape to their children.
Keywords drive for thinness, early adolescents, gender differences, maternal influences, thin-ideal internalization
Introduction Scholars have reported that many young children express the desire for thinness (Brown and Ogden, 2004; Hill et al., 1990; Marchi and Cohen, 1990; Smolak et al., 1999). Although the drive for thinness at an early age may not be immediately harmful, this attitude can result in various physical and psychological problems during adolescence and adulthood (Hill et al., 1990; Marchi and Cohen, 1990). Empirical findings on the development of the drive for thinness among young people would provide useful information for health-care providers developing preventive interventions for physical and psychological problems. This study was designed to investigate the association of mothers’ thin-ideal internalization with their children’s drive for thinness.
It has been argued that social influence, such as media, peers, and family, is very important to the development of body image during adolescence (Huon et al., 2000; Huon and Walton, 2000). Previous studies have found that parents, particularly mothers, play an important role in the development of the drive for thinness and weight-loss behaviors among children (Phares et al., 2004; Rodgers et al., 2009a; Smolak et al., 1999). Mothers’ attitudes and behaviors Ochanomizu University, Japan Corresponding author: Mika Omori, Department of Psychology, Ochanomizu University, 2-1-1 Otsuka, Bunkyo-ku, Tokyo 1128610, Japan. Email: [email protected]
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toward their own and their children’s body shape and weight—such as their comments and criticisms on body shape or weight, pressure on their children to be thin, and their own weightloss behaviors—can have a substantial influence on their children’s body image (Cordero and Israel, 2009; Hill et al., 1990; Mukai and McCloskey, 1996; Phares et al., 2004; Rodgers et al., 2009b). A logical question relates to how mothers’ attitudes and behaviors about body shape and weight are determined. Women’s attitudes and behaviors concerning body shape and weight— such as the drive for thinness, weight-loss behaviors, and body dissatisfaction—have often been explained by sociocultural theory, which asserts that Western culture has adopted the thin-ideal as an acceptable standard of physical beauty for women (Heinberg, 1996). The thin-ideal posits that thin women are idealized because thinness connotes not only attractiveness but also goodness. As a consequence, thinideal internalization reflects cultural values regarding women’s body shape, leading women to become dissatisfied with their own bodies and develop the desire for thinness (Cusmano and Thompson, 1997; Lavin and Cash, 2001). In other words, sociocultural theory posits that women’s thin-ideal internalization determines their attitudes and behaviors toward their own bodies (Sands and Wardle, 2003). We further assume that mothers display attitudes and behaviors toward their children concerning body shape and weight, which are based on their judgments of thinness as good. Several recent studies found that mothers’ attitudes and behaviors influenced thin-ideal internalization in adolescents (Keery et al., 2004; Rodgers et al., 2009b; Santoncini et al., 2012). For example, one study showed that the perceived messages from parents were consistent with the individual’s ideal image (Stanford and McCabe, 2002). In addition, it has been reported that children’s internalization of the thin-ideal was related to their drive for thinness and weight-loss behaviors (Ahern et al., 2011; Bojorquez-Chapela et al., 2013; Mask and Blanchard, 2010; Shroff and Thompson, 2006).
In line with sociocultural theory (Cusmano and Thompson, 1997; Lavin and Cash, 2001), these findings suggest that mothers appear to transmit their internalized thin-ideal to their children via their attitudes and behaviors. Therefore, we decided to examine the mechanisms in the development of children’s drive for thinness, focusing on the effect of mothers’ thin-ideal internalization on their attitudes and behaviors regarding body shape and weight. This study includes both boys and girls to investigate gender differences in the relationship between mothers’ thin-ideal internalization and children’s drive for thinness. Previous research has found evidence of gender differences in mothers’ influence on body image (Baker et al., 2000; Rodgers et al., 2009a; Smolak et al., 1999). However, much of the research on maternal influences on body image has neglected the mothers’ internalized beliefs about body shape and weight. Therefore, this study aims to explore gender differences in the association between mothers’ thin-ideal internalization and the drive for thinness in their children. Since the thin-ideal mainly applies to women, as mentioned above, mothers may transmit it more to their daughters than to their sons. Thus, we assume that mothers’ attitudes and behaviors toward their daughters would be based on the mothers’ thin-ideal internalization that being thinner is good for women, whereas the thin-ideal internalization would not serve as the basis for their attitudes and behaviors toward their sons. Furthermore, previous research among young adults suggested that females perceived strong messages from parents about the overall ideal body and rated messages from parents as more important than did males (Stanford and McCabe, 2002). Accordingly, we supposed that girls’ drive for thinness would be more influenced by mothers’ attitudes and behaviors. Surveys of body image among Japanese elementary-school students revealed that over half of girls and almost half of boys in the fifth and sixth grades (10- to 12-year-olds) expressed a desire to lose weight (Bennesse Education Research Inst., 2001: 9; Matsuda, 2012; Okuda, 2004). The drive for thinness and new cases of
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Yamazaki and Omori eating disorders have been increasingly reported in young children (Nakai, 2012). Empirical studies on the drive for thinness among Japanese children are needed to obtain a better understanding of their dieting behaviors. Similar to European or North American societies, Japanese society seems to value thinness of women’s body shape as a sociocultural ideal (Moriyasu et al., 2011; Moroi and Kokirima, 2008). It is worth exploring how the sociocultural thin-ideal impacts children’s drive for thinness. This study aimed to expand the understanding of maternal influences on their children’s body image among Japanese early adolescents. This study will extend this line of research to examine influences of mothers’ thin-ideal on their children’s drive for thinness; the majority of previous research was limited to mothers’ attitudes and behaviors toward their children. The hypotheses focus on the relationships between mothers’ thin-ideal internalization and their children’s drive for thinness. Furthermore, we explored the gender differences in these relationships. We hypothesized that mothers’ thin-ideal internalization would be related to their children’s drive for thinness, through mothers’ own weight-loss behavior or mothers’ attitudes and behaviors about their children’s body shape and weight. On the basis of the findings with adolescents and early adolescents (Phares et al., 2004; Rodgers et al., 2009a), the link between mothers’ thin-ideal internalization and their attitudes and behaviors toward their children’s body shapes and weight was expected to be stronger for daughters than for sons. Additionally, we expected girls’ drive for thinness to be more influenced by mothers’ attitudes and behaviors. Our model also involved the child’s actual body shape as a control variable because previous studies have shown that the magnitude of children’s drive for thinness (Stice, 2002) and mothers’ attitudes toward their children’s body shape and weight were influenced by the children’s actual body weight (Anschutz et al., 2009). We also examined the role of children’s
perception of their mothers’ attitudes and behaviors. A previous study with university students and their parents showed that children’s perceptions of their mothers’ attitudes and behaviors influenced children’s body image more than did mother-reported attitudes and behaviors (Baker et al., 2000).
Method Participants and procedures The participants of this study were children aged 10–12 years (fifth and sixth graders) and their mothers. The participants were recruited from two public elementary schools in a major city in the Tokyo area. In all, 373 students (198 boys, 175 girls) completed anonymous questionnaires under the supervision of their homeroom teachers during morning assemblies. Students brought home packets containing the mothers’ questionnaires and sheets with information on the study. Mothers sealed the completed questionnaires and returned them to their children, who put them into collection boxes placed around the school buildings. Of the 259 mothers contacted, 207 returned the questionnaires (103 mothers of boys, 104 mothers of girls; 79.9% response rate). One questionnaire was eliminated because the household had no mother; therefore, 206 mothers (102 mothers of boys, 104 mothers of girls; 79.5% valid response rate) became participants in our investigation.
Children’s measures Drive for thinness. We measured drive for thinness with 3 items on a 5-point scale that asked about the desire to lose weight, dislike of being overweight, and experiences of weight-loss behavior. These items were used to assess the desire to be thin in a relatively large-scale survey with 1097 Japanese elementary-school children (Bennesse Education Research Inst., 2001). Question 1 was “Do you want to lose weight?” and was scored from 1 (I don’t want to lose weight at all) to 5 (I want to lose weight very much). Question 2 was “Do you want to
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avoid gaining weight?” and was scored from 1 (I don’t want to avoid gaining weight at all) to 5 (I want to avoid gaining weight very much). Question 3 was “Have you ever done anything to lose weight?” and was scored from 1 (I have never done anything to lose weight) to 5 (I’m constantly doing something to lose weight). We chose these 3 items so that our young participants could easily understand our intended meaning. Higher scores indicated a stronger drive for thinness. The Cronbach’s alpha coefficient for the drive for thinness scale was .65 in this study. Although this coefficient is slightly low, it is an allowable level because of the small number of items in the scale (Haebara, 2011). Perceived weight-loss behaviors of mothers. We assessed perceived frequency of the mother’s weight-loss behaviors with a question asking with what frequency the respondent thought that his or her mother had engaged in weight-loss behavior. The respondent rated the mother’s weight-loss behavior on the following scale: 1 (I don’t think she has ever engaged in weight-loss behavior), 2 (I think she has engaged in weightloss behavior just once before), 3 (I think she has engaged in weight-loss behavior two or more times), 4 (I think she is constantly engaged in weight-loss behavior), and 5 (I don’t know). Since “I don’t know” might signify that the participant did not recognize any weight-loss behavior by his or her mother, we combined responses 1 and 5 for the analyses. The Maternal Influence Scale. The Maternal Influence Scale (MFS, Mukai, 1996) was translated into Japanese to measure how often children feel their mothers express attitudes and behaviors concerning body shape and weight. Experts in psychology and proficient in English reviewed the translation; we used the translation that was judged appropriate by these experts. The MFS consists of 15 items in two subscales that measure “mutual monitoring and modeling” (e.g. “How often does your mother bring up the topic of food in your conversation?”) and “perceived expectations and pressure” (e.g. “How
often have you been encouraged to diet by your mother?”). Respondents assessed the frequency with which they observed the display of maternal attitudes and behaviors on a 4-point scale ranging from 1 (not at all) to 4 (very often). Higher scores indicated higher frequency of perceived occurrence. In a study of 7th to 11th graders, a Cronbach’s alpha value of .83 was reported as evidence of the scale’s overall internal consistency (Mukai, 1996). Furthermore, it was reported that MFS was a significant predictor of eating problems characterized by the drive for thinness and weight-loss behaviors across grades. We examined the factor structure of the MFS due to the translation and the age difference of our participants (fifth and sixth graders) and the participants from the original study (seventh through eleventh graders; Mukai, 1996). A series of factor analyses on the MFS from this study extracted a two-factor structure. The first factor (eigenvalue = 3.57) accounted for 39.71 percent of the variance, and the second factor (eigenvalue = 1.41) accounted for 15.70 percent of the variance. The items that loaded onto each factor in our study were different from those in the original study (Mukai, 1996). We speculated that several of the words translated from English in the modified scale may have been difficult for fifth and sixth graders to understand despite the successful pilot test of this scale with several children. The Cronbach’s alpha coefficients were .80 and .64 for subscales loading on Factors 1 and 2, respectively; the internal consistency of the second factor is low (Jackson and Furnham, 2000). Therefore, we decided to use only the scale comprising items loading on Factor 1 as the variable “MFS Attitudes and Behaviors toward Children,” which measured perceived maternal attitudes and behaviors toward their children concerning body shape and weight. Table 1 shows the results of our factor analysis.
Measures for mothers Sociocultural Attitudes Towards Appearance Questionnaire. We employed the Japanese version
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Yamazaki and Omori Table 1. Summary of factor loadings of MFS “Attitude and Behaviors.” Factor loadings How often have you been encouraged to diet by your mother? How much overweight does your mother think you are at current weight? How many times have you been suggested by your mother to go on a diet together? How often does your mother think that you eat too much? How often does your mother bring up the topic of dieting in your conversations?
.86 .81 .66
.61 .41
MFS: Maternal Influence Scale.
(Saito, 2004) of the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ; Heinberg et al., 1995) to measure the magnitude of a mother’s internalization of the thin-ideal. The SATAQ was originally developed to measure levels of women’s recognition and internalization of thinness as a standard of beauty in society. It consists of 14 items in two subscales: “awareness/acknowledgment” of the importance that society places on beauty and “internalization/acceptance” of these beauty standards. Participants were asked to rate to what extent they agreed with each statement on a 5-point scale, from 1 (Does not apply at all) to 5 (Applies very much). Higher scores indicated higher magnitudes of thin-ideal internalization. In developing the scale, Cronbach’s alpha values of .71 for “awareness/acknowledgment” and .88 for “internalization/acceptance” were obtained as evidence of internal consistency (Heinberg et al., 1995). Evidence of good construct validity (a significant positive correlation between measures of body-image distortion and eating disorders) has also been reported (Heinberg et al., 1995).
In this study, the Cronbach’s alpha coefficient of the internalization/acceptance subscale of the SATAQ was .79, which indicates good internal consistency, but that of the awareness/ acknowledgment subscale was .39, which is not acceptable. Therefore, we decided to analyze only the internalization/acceptance subscale, labeled “SATAQ Internalization,” to represent the mother’s thin-ideal internalization. Demographic information. Mothers were asked to provide information about their children’s height and weight because we felt that children would prefer not to disclose their weight. Using this information, we computed the children’s Rohrer index to estimate their body shape (Rohrer index = weight (kg)/(height (cm))3 × 107). We adopted this index because it is widely used in Japanese school health programs (Hashimoto and Murata, 2011). Higher Rohrer indices indicate more rounded body shapes.
Data analyses We performed a simultaneous path analysis for boys and girls to test our hypothesized multigroup model. The model was analyzed using an observed variable model because it was necessary to take into account young participants’ physical and mental test burdens; therefore, we could not include a sufficient number of items to form a latent variable model (Tabachnick and Fidell, 1996). In addition, because Cronbach’s alpha coefficients of the MFS Attitudes and Behaviors factor and SATAQ Internalization demonstrated reasonable internal consistency (Table 2), we judged that these could be used as observed variables (Bollen, 1989). We analyzed the results using IBM SPSS Statistics version 19 and AMOS 19.
Results Descriptive statistics Descriptive statistics, including the means and standard deviations of the variables measured for mothers and children, are shown in Table 2.
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Table 2. Means, standard deviations (SD), and gender differences in children’s and mothers’ variables. Total (N = 373) Children Mothers
α Drive for thinness Perceived mother’s weight-loss behavior MFS Attitudes and Behavior Rohrer indexa SATAQ Internalization
M (SD)
Girls (n = 175)
Boys (n = 198)
M (SD)
M (SD)
t-value
.65 –
3.03 (.86) 1.96 (1.13)
3.20 (0.79) 2.10 (1.15)
2.87 (0.89) 1.83 (1.11)
3.83*** 2.32*
.80
1.55 (0.66)
1.61 (0.63)
1.50 (0.68)
0.62
– .79
120.29 (16.06) 2.66 (0.69)
117.86 (14.14) 2.57 (0.72)
122.63 (17.47) 2.75 (0.65)
−2.08* −1.84
MFS: Maternal Influence Scale; SATAQ: Sociocultural Attitudes Towards Appearance Questionnaire. aRohrer index = weight (kg)/(height (cm)3 × 107). *p < .05; ***p < .001.
Table 3. Correlations between child’s drive for thinness, child’s weight-loss behavior, perceived mother’s dieting behavior, MFS, SATAQ, and child’s Rohrer index.
1. Children’s drive for thinness 2. Perceived mothers’ weight-loss behaviors 3. MFS Attitudes and Behaviors 4. SATAQ Internalization 5. Children’s Rohrer index
1
2
3
4
5
– .31** .58** .10 .54**
.20* – .23** .28** .17
.48** .23* – .06 .67**
.07 .42** .18 – .09
.52** .10 .47** .01 –
MFS: Maternal Influence Scale; SATAQ: Sociocultural Attitudes Towards Appearance Questionnaire. The cells at the upper right: girls; the cells at the lower left: boys. *p < .05; **p < .01.
Gender differences were examined for each variable using t-tests. As seen in Table 2, among the children’s variables, the means of drive for thinness and perceived mother’s weight-loss behaviors were significantly higher for girls than for boys (t(370) = 3.83, p < .001 and t(368) = 2.32, p < .05, respectively) while Rohrer index scores were higher among boys than among girls (t(192) = −2.08, p < .05).
Influences of mothers’ thin-ideal internalization on children’s drive for thinness We conducted a simultaneous path analysis on the 206 mother–child pairs (mother–girl: 104; mother–boy: 102) extracted from our sample of 373 students. Table 3 presents the correlation
matrix that served as the basis for the path analyses. We hypothesized that children’s perceived maternal attitudes and behaviors (as measured by MFS Attitudes and Behaviors and perceived mother’s weight-loss behaviors) would mediate mothers’ thin-ideal internalization (as measured by SATAQ Internalization) and children’s drive for thinness. The exogenous variables of our model were the mothers’ SATAQ Internalization and the children’s Rohrer index. Endogenous variables included children’s perceived maternal attitudes and behaviors toward their children concerning body shapes and weight (as measured by the Attitudes and Behaviors subscale of the MFS), perceived weight-loss behavior of mothers, and children’s drive for thinness.
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Figure 1. Path diagram of the influence of mother’s thin-ideal internalization on child’s drive for thinness (girls). a“Mother”
refers to mother’s variables. refers to child’s variables. *p < .05; **p < .01; ***p < .001. Note: Values at the upper right of rectagles refer to multiple correlation coefficient. b“Child”
The indices of fit of our multigroup model were χ2(14) = 9.07 (not significant) goodnessof-fit index (GFI) = .983, comparative fit index (CFI) = .994, and root mean square error of approximation (RMSEA) = .026. The GFI is an absolute index that indicates the extent the model fits the data and is suitable for a simple model (Hu and Bentler, 1998). The CFI and RMSEA are non-centrality-based indices, which compare the model with a saturated model; these are preferable with small sample sizes (Hu and Bentler, 1998). For the GFI and CFI, values closer to 1 indicate a better fit of the model and the data, with index values above .90 indicating an acceptable fit (Hu and Bentler, 1998). For the RMSEA, values closer to 0 indicate a better fit between the model and the data; values below .05 and .05–.08 are considered to represent good and fair fits, respectively (Hu and Bentler, 1998). The observed values of these indices indicated that the hypothesized multigroup model fit the data well for both boys and girls. This implied that the structures of our model did not differ across gender (Byrne, 2010); however, gender differences in the parameters of our model were present in the path coefficients. Figures 1 and 2 illustrate the path coefficients for girls and boys, respectively. The path coefficient between mothers’ SATAQ Internalization and
maternal attitudes/behaviors (as measured by the Attitudes and Behaviors subscale of the MFS) was significant for girls, but not for boys. On the other hand, the path from perceived maternal weight-loss behaviors to children’s drive for thinness was significant for boys, but not girls. Furthermore, two paths from the children’s Rohrer index—those to MFS Attitudes and Behaviors and children’s drive for thinness—were significant for both boys and girls. In conclusion, compared with boys, girls reported a greater drive for thinness and higher levels of perception of mothers’ weight-loss behaviors; these observations were consistent with the results of previous studies (Phares et al., 2004). Mothers’ thin-ideal internalization was significantly associated with the drive for thinness through their children’s perception of maternal attitudes and behaviors concerning body shapes and weight in girls, but not in boys. Meanwhile, mothers’ thin-ideal internalization was significantly associated to boys’ drive for thinness through boys’ perception of their mothers’ weight-loss behaviors, but not girls’ perception. Children’s perceived maternal attitudes/behaviors concerning body shape and weight were more strongly related to children’s drive for thinness among boys than among girls.
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Figure 2. Path diagram of the influence of mother’s thin-ideal internalization on child’s drive for thinness (boys). a“Mother”
refers to mother’s variables. refers to child’s variables. *p < .05; **p < .01; ***p < .001. Note: Values at the upper right of rectagles refer to multiple correlation coefficient. b“Child”
Discussion An underlying premise of this study was that mothers’ thin-ideal internalization would explain the development of the drive for thinness in adolescents. We hypothesized that mothers’ thin-ideal internalization led to children’s drive for thinness through the mediating factor of mothers’ attitudes and behaviors concerning their own and their children’s body shapes and weight. Although our results confirmed that our hypothetical model applied to girls and boys, interesting gender differences were observed in the relationship between mothers’ thin-ideal internalization and children’s drive for thinness. We hypothesized that mothers’ thin-ideal internalization would be related to their daughters’ perception of mothers’ attitudes and behaviors more than their sons’ perceptions. Consistent with our hypotheses, we found that mothers’ thin-ideal internalization was significantly related to girls’ perceptions of their mothers’ attitudes and behaviors, but not to boys’ perceptions, after controlling for the effect of actual body shape. This gender difference in the effects of mothers’ thin-ideal internalization implies that mothers’ attitudes and behaviors are based on the idea that a thin body shape is ideal for women under any circumstance
because mothers’ thin-ideal internalization was related to their attitudes and behaviors only toward their girls. Mothers appear to share ideas about body shape and weight—which are based on the thin-ideal internalized by their mothers— more with their daughters than with their sons through their attitudes and behaviors toward their children. Physical attractiveness, including the thin-ideal, is considered an important part of women’s gender role and represents women’s success (Lavin and Cash, 2001; Stice, 1994). Thus, we speculate that mothers implicitly inculcate their daughters with the social value of appearance to secure their daughters’ happiness as females in society. Furthermore, previous studies focusing on adolescent girls illustrated that girls’ thin-ideal internalization mediated the relationship between their mothers’ influence and their own body dissatisfaction, drive for thinness, and weight-loss behaviors (Keery et al., 2004; Rodgers et al., 2009b; Santoncini et al., 2012). Although our study did not assess the magnitude of children’s internalization of the thin-ideal, our results seem to indicate that mothers transmit the thin-ideal to their daughters through their attitudes and behaviors. Future research that includes a measure of children’s thin-ideal internalization could confirm the influences of mothers’ thinideal internalization.
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Yamazaki and Omori In contrast, the perception of mothers’ attitudes and behaviors was more strongly correlated with actual body shape in boys than in girls. This result implies that mothers’ attitudes and behaviors concerning body shape and weight may be based on their boys’ actual body shapes rather than the thin-ideal. It also suggests that mothers may think that sons do not have to be thin in order to be attractive; alternatively, they may believe that an attractive appearance is not as important for male gender roles and success as it is for female ones. Mothers’ approach to their boys seems to be based on health. Furthermore, we expected that the perception of maternal attitudes and behaviors toward their children would affect the drive for thinness more among daughters than among sons. Surprisingly, inconsistent with the results of previous studies and our hypothesis, the perception of mothers’ attitudes and behaviors regarding ideal body shape were strongly associated with increased drive for thinness in boys. However, our result supports previous research (Dunkley et al., 2001; Fulkerson et al., 2002) that found a significant association between children’s weightloss behaviors and mothers’ encouragement to diet in boys, but not in girls. These previous studies suggested that the influences of mothers’ encouragement may not increase the already existing high level of weight concerns and dieting behaviors in girls. We supposed that mothers and boys worried about their boys being overweight and boys, too, wanted to remove excess fat because boys’ actual body shape was strongly related to perceived maternal attitudes/behaviors toward boys and boys’ drive for thinness. In addition, since our participants were younger than those in previous studies, their mothers may have a greater effect on their body image development (Anschutz et al., 2009). We also hypothesized that the impact of mothers’ perceived weight-loss behaviors on children’s drive for thinness would be stronger among girls than among boys. The striking finding of this study is the results on the relationship between mothers’ weight-loss behavior and children’s drive for thinness. Consistent
with our hypotheses, mothers’ thin-ideal internalization was positively associated with children’s (both boys and girls) perception that the mother engaged in weight-loss behavior. On the other hand, inconsistent with our hypotheses on gender differences, the perception of mothers’ weight-loss behavior significantly influenced boys’ (but not girls’) drive for thinness. This gender difference conflicted with findings of earlier research (McCabe and Ricciardelli, 2003; Phares et al., 2004; Rodgers et al., 2009a). One explanation for this may be that girls have many same-gender models concerning weightloss behaviors, such as peers and their mothers (Mukai, 1996). However, the results of a previous study indicated that mothers’ dieting status was not related to weight-related behaviors in children (Fulkerson et al., 2002), which corroborates our findings about girls. In addition, this suggests that boys are not interested in their mothers’ behavior due to gender differences. This may be a methodological problem that needs to be addressed. Several limitations of this study must be noted. First, the cross-sectional nature of the data does not allow us to draw concrete causal associations between maternal thin-ideal internalization and children’s drive for thinness. Second, the characteristics of our study participants may not be representative of the population as a whole, since they were recruited from only two public elementary schools in Tokyo. It is possible that mothers and children in urban areas are exposed to stronger pressure to be thin than those residing in suburban areas. Our findings must be confirmed by longitudinal research with large samples from urban and rural areas. Finally, this study has some methodological problems. The use of self-reported questionnaires may not produce empirical evidence. Moreover, participants, particularly children, may have misunderstood the intended meanings of items on the questionnaire. Various types of methods, such as observation and interviews, must be conducted to corroborate these attitudes and behaviors. In the near future, researchers must examine familial influences in conjunction with other factors, such as media exposure, because the
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sociocultural theory of the thin-ideal involves strong influences beyond families (Heinberg, 1996). For example, given the recent increase in the number of fashion magazines targeting young adolescents in Japan (Yano Research Inst., 2002), media might increasingly influence children’s body images. Few studies have delineated the influence of the media on Japanese preadolescents and adolescents. Future studies should examine the effects of a variety of sociocultural factors on body image and dieting to better explain why the thinness trend continues to grow in Japan. Despite several limitations, our results are especially significant because we found relationships between mothers’ thin-ideal and their children’s body image. Although mothers vary in their attitudes and behaviors regarding body shape and weight, our results suggest that one of the sociocultural factors that explains children’s drive for thinness is the influence of mothers’ thin-ideal internalization. Maternal attitudes seem to be a risk factor affecting mental health. Previous studies have demonstrated that mother’s comments and behaviors predict eating disorders in their daughters (Davis et al., 2005; Linville et al., 2011). Given the ages of this study’s participants, it appears that psychologists must introduce psychological education for not only children but also their mothers long before the children reach puberty to prevent physical and psychological health problems during adolescence and later in life. Funding This research received no specific grant from any funding agency in the public, commercial, or not-forprofit sectors.
References Ahern AL, Bennett KM and Kelly M (2011) A qualitative exploration of young women’s attitudes towards the thin ideal. Journal of Health Psychology 16: 70–79. Anschutz DJ, Kanters LJA, Van Strien T, et al. (2009) Maternal behaviors and restrained eating and body dissatisfaction in young children.
International Journal of Eating Disorders 42: 54–61. Baker CW, Wiseman MA and Brownell KD (2000) Studying intergenerational transmission of eating attitudes and behaviors: Methodological and conceptual questions. Health Psychology 19: 376–381. Bennesse Education Research and Development Inst. (2001) Kodomo no yase ganbou [Drive for thinness among young children]. Monograph of A Schoolchild Now. Vol. 21, 1 November. Tokyo, Japan: Bennesse Education Research and Development Inst. Bojorquez-Chapela I, Unikel C, Mendoza M, et al. (2013) Another body project: The thin ideal, motherhood, and body dissatisfaction among Mexican women. Journal of Health Psychology. Epub ahead of print 16 May 2013. DOI: 10.1177/1359105313484783. Bollen KA (1989) Structural Equations with Latent Variables. New York: John Wiley & Sons. Brown R and Ogden J (2004) Children’s eating attitudes and behavior: A study of the modeling and control theories of parental influence. Health Education Research 19: 261–271. Byrne BM (2010) Structural Equation Modeling with AMOS: Basic Concepts, Applications, and Programming. New York: Routledge. Cordero ED and Israel T (2009) Parents as protective factors in eating problems of college women. Eating Disorders 17: 146–161. Cusmano DL and Thompson JK (1997) Body image and body shape ideal in magazines: Exposure, awareness, and internalization. Sex Roles 37: 701–721. Davis C, Blackmore E, Katzman DK, et al. (2005) Female adolescents with anorexia nervosa and their parents: A case-control study of exercise attitudes and behaviors. Psychological Medicine 35: 1579–1587. Dunkley TL, Wertheim EH and Paxton SJ (2001) Examination of a model of multiple sociocultural influences on adolescent girls’ body dissatisfaction and dietary restraint. Adolescence 36: 265–279. Fulkerson JA, McGuire MT, Neumark-Sztainer D, et al. (2002) Weight-related attitudes and behavior of adolescent boys and girls who are encouraged to diet by their mothers. International Journal of Obesity 26: 1579–1587. Haebara T (2011) Ryouteki kenkyuu hou [Quantitative Methodology for Researching on
Downloaded from hpq.sagepub.com by guest on November 17, 2015
11
Yamazaki and Omori Clinical Psychology]. Tokyo, Japan: University of Tokyo Press. Hashimoto R and Murata M (2011) Gakureikishouni no taikakuhyoukasohyou tositeno ro-reru sisuu ni kansuru kentou [Research on Rohrer index as an index to evaluate physical status of school aged children]. Japanese Journal of Auxology 17: 25–31. Heinberg LJ (1996) Theories of body image disturbance: Perceptual, developmental, and sociocultural factors. In: Thompson JK (ed.) Body Image, Eating Disorders, and Obesity: An Integrative Guide for Assessment and Treatment. Washington, DC: American Psychological Association, pp. 27–47. Heinberg LJ, Thompson JK and Stormer S (1995) Development and validation of the sociocultural attitudes towards appearance questionnaire. International Journal of Eating Disorders 17: 81–89. Hill AJ, Weaver C and Blundell JE (1990) Dieting concern of 10-year-old girls and their mothers. British Journal of Clinical Psychology 29: 346–348. Hu L and Bentler PM (1998) Fit indices in covariance structure modeling: Sensitivity to underparameterized model misspecification. Psychological Methods 3: 424–453. Huon GF and Walton CJ (2000) Initiation of dieting among adolescent females. International Journal of Eating Disorders 28: 226–230. Huon GF, Lim J and Gunewardene A (2000) Social influence and female adolescent dieting. Journal of Adolescence 23: 229–232. Jackson CJ and Furnham A (2000) Analysing the results. In: Jackman CJ and Furnham A (eds) Designing and Analysing Questionnaires and Surveys: A Manual for Health Professionals and Administrators. London: Whurr Publishers, pp. 153–181. Keery H, van den Berg P and Thompson JK (2004) An evaluation of the tripartite influence model of body dissatisfaction and eating disturbance with adolescent girls. Body Image 1: 237–251. Lavin MA and Cash TF (2001) Effects of exposure to information about appearance stereotyping and discrimination on women’s body image. International Journal of Eating Disorders 29: 51–58. Linville D, Stice E, Gau J, et al. (2011) Predictive effects of mother and peer influences on increase in adolescent eating disorder risk
factors and symptoms: A 3-year longitudinal study. International Journal of Eating Disorders 44: 745–751. McCabe MP and Ricciardelli LA (2003) Sociocultural influences on body image and body changes among adolescent boys and girls. Journal of Social Psychology 143: 5–26. Marchi M and Cohen P (1990) Early childhood eating behaviors and adolescent eating disorders. Journal of American Academy of Child and Adolescent Psychiatry 29: 112–117. Mask L and Blanchard CM (2010) The protective role of general self-determination against “thin ideal” media exposure on women’s body image and eating-related concerns. Journal of Health Psychology 16: 489–499. Matsuda E (2012) Hutotteiru kotowo kini siteimasu: Kodomo no sinntaizou heno fuman kodawari ni taisuru ninnti koudou kaunserinngu [Worry about their body shape: Cognitive and behavioral therapy for body dissatisfaction among young adolescents]. Child Study Journal 66: 112–116. Moriyasu K, Moroi K, Maehara S, et al. (2011) Drive for thinness and social comparison (1): Moderating effects of thin-ideal internalization. DWCLA Human Life and Science 45: 29–36. Moroi K and Kokirima M (2008) Josi seinen ni okeru daietto koudou ni oyobosu sousin moderu no eikyou [Effects of exposure to thinness in models on dieting behavior in female adolescents]. Bulletin of Institute for Interdisciplinary Studies of Culture, Doshisha Women’s College of Liberal Arts 25: 58–67. Mukai T (1996) Mothers, peers, and perceived pressure to diet among Japanese adolescent girls. Journal of Research on Adolescence 6: 309–324. Mukai T and McCloskey LA (1996) Eating attitudes among Japanese and American elementary school girls. Journal of Cross-Cultural Psychology 27: 424–435. Nakai Y (2012) Sesshokushougai no ekigaku [Epidemiology of eating disorders]. Journal of Clinical and Experimental Medicine 241: 671–675. Okuda K (2004) Hahaoya no diet ni kannrennsuru isiki ya koudou ga kodomo no diet koudou ni oyobosu eikyou [An influence of mothers diet behavior and belief on children’s diet behavior]. Setouti Junior College Bulletin 35: 1–9. Phares V, Steinberg AR and Thompson JK (2004) Gender differences in peer and parental influence: Body image disturbance, self-worth, and psychological functioning in preadolescent
Downloaded from hpq.sagepub.com by guest on November 17, 2015
12
Journal of Health Psychology
children. Journal of Youth and Adolescence 33: 421–429. Rodgers RF, Faure K and Chabrol H (2009a) Gender differences in parental influences on adolescent body dissatisfaction and disordered eating. Sex Roles 61: 837–849. Rodgers RF, Paxton SJ and Chabrol H (2009b) Effects of parental comments on body dissatisfaction and eating disturbance in young adults: A sociocultural model. Body Image 6: 171–177. Saito C (2004) Sesshoku shougai keikou ni okeru kojinteki, shakaiteki, eikyou no kentou [Studying personal and social effects on tendencies toward eating disorders]. The Japanese Journal of Personality 13: 79–90. Sands ER and Wardle J (2003) Internalization of ideal body shapes in 9-12-year-old girls. International Journal of Eating Disorders 33: 193–204. Santoncini CU, Martin VM, Garcia FJ, et al. (2012) Disordered eating behavior and body weight and shape relatives’ criticism in overweight and obese 15- to 19-year-old females. Journal of Health Psychology 18: 75–85. Shroff H and Thompson JK (2006) Peer influences, body-image dissatisfaction, eating dysfunction
and self esteem in adolescent girls. Journal of Health Psychology 11: 533–551. Smolak L, Levine MP and Schermer F (1999) Parental input and weight concerns among elementary school children. International Journal of Eating Disorders 25: 263–271. Stanford JN and McCabe MP (2002) Body image ideal among males and females: Sociocultural influence and focus on different body parts. Journal of Health Psychology 7: 675–684. Stice E (1994) Review of the evidence for a sociocultural model of bulimia nervosa and an exploration of the mechanisms of action. Clinical Psychology Review 14: 633–661. Stice E (2002) Risk and maintenance factors for eating pathology: A meta-analytic review. Psychological Bulletin 128: 825–848. Tabachnick BG and Fidell LS (1996) Using Multivariate Statistics. Boston, MA: Allyn & Bacon. Yano Research Inst. (2002) Bubble junior kara chuukounen zassi no soukan rasshu [A rush to publish magazines directed at “bubble junior girl”, “middle-aged women”, and “elderly women”]. Yano Report. Report no. 1119, 10 June. Tokyo, Japan: Yano Reseach Inst.
Downloaded from hpq.sagepub.com by guest on November 17, 2015
