UNIVERSITY OF DETROIT MERCY COLLEGE OF LIBERAL ARTS AND EDUCATION GRADUATE PROGRAM DISSERTATION Submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy TITLE THE RELATIONSHIPS BETWEEN ALEXITHYMIA, PERFECTIONISM, SELF-ESTEEM, ETHNICITY AND BODY IMAGE DISTURBANCE PRESENTED BY WHITNEY ALEXIS KANTACK ACCEPTED BY Steven Abell, Ph.D. 2-24-14 Major Professor Date Barry Dauphin, Ph.D. 2-24-14 Program Director Date Lynn McLean 2-24-14 College of Liberal Arts and Education Date THE RELATIONSHIPS BETWEEN ALEXITHYMIA, PERFECTIONISM, SELF- ESTEEM, ETHNICITY AND BODY IMAGE DISTURBANCE by WHITNEY ALEXIS KANTACK DISSERTATION Submitted to the Graduate School of the University of Detroit Mercy, Detroit, Michigan in partial fulfillment of the requirements for the degree of DOCTOR OF PHILOSOPHY 2014 PROGRAM: PSYCHOLOGY (CLINICAL) Approved by: Steven Abell, Ph.D.__ 2-24-14_ Advisor Date Elizabeth Hill, Ph.D.________ Libby Blume, Ph.D._________ David Schwartz, Ph.D._______ @ COPYRIGHT BY WHITNEY ALEXIS KANTACK 2014 All Rights Reserved Acknowledgements I would like to thank my husband, Geoffrey, for his continual support and my parents for their encouragement and generosity. I would also like to thank my dissertation chairperson, Dr. Steven Abell, for his guidance and my committee members, Drs. Elizabeth Hill, Libby Blume, and David Schwartz, for their helpful suggestions. Lastly, I would like to express my gratitude to Dr. Marvin Margolis for his insight. ii Table of Contents Literature Review…………………………………………………………………………...…1 Body Image……………………………………………………………………………1 Theoretical Perspectives on Development of Body Dissatisfaction…………………..1 Body Dissatisfaction and Body Distortion……………………………………………3 Measurement of Body Distortion……………………………………………...5 Internalization of the Thin Ideal………………………………………………6 Gender and Body Image………………………………………………………8 Alexithymia and Body Dissatisfaction………………………………………………10 Perfectionism and Body Dissatisfaction……………………………………………..12 Multidimensional Models of Perfectionism………………………………….14 Multidimensional Perfectionism Model……………….…………….15 Frost’s Multidimensional Perfectionism Model……………………..16 Other Perspectives on Perfectionism………………………………………...18 Perfectionism, Body Dissatisfaction and Disordered Eating………………...21 Perfectionistic Self-Presentation……………………………………………………..22 Perfectionistic Self-Presentation and Body Dissatisfaction………………………….25 Social Physique Anxiety……………………………………………………..26 Perfectionistic Self-Presentation, Alexithymia and Body Dissatisfaction…...27 Self-Esteem and Body Dissatisfaction……………………………………………….28 Body Esteem…………………………………………………………………31 Effects of Enhancing Self-Esteem on Body Dissatisfaction…………………33 Self-Esteem, Body Image and Eating Concerns……………………………..36 Self-Esteem and Body Image during Adolescence…………………………..37 iii Self-Esteem and Body Distortion……………………………………………39 Ethnicity and Body Dissatisfaction…………………………………………………..40 African American Considerations……………………………………………41 Body Image in Non-Western Cultures……………………………………….42 Body Dissatisfaction in Caucasians………………………………………….44 Evolutionary Perspectives on Body Dissatisfaction…………………………44 Comparing Body Dissatisfaction in African Americans and Caucasians……46 Comparing Body Dissatisfaction in Asians and Caucasians………………...51 Comparing Body Dissatisfaction in Hispanics and Caucasians……………..55 Comparing Body Dissatisfaction in Europeans and Americans……………..57 Comparing Body Dissatisfaction in Middle Easterners and Caucasians…….58 International Studies of Body Dissatisfaction………………………………..59 Ethnicity, Self-Esteem and Body Image……………………………………..60 Cultural Considerations for Perfectionism…………………………………...61 Ethnicity and Perfectionistic Self-Presentation……………………………...65 Ethnic Identity and Body Dissatisfaction……………………………………………65 Ethnic Identity among African Americans…………………………………..65 Multiethnic Comparisons of Body Dissatisfaction…………………………..67 Introduction to Present Study………………………………………………………………...69 Hypotheses…………………………………………………………………………...74 Method……………………………………………………………………………………….76 Participants…………………………………………………………………………...76 Measures……………………………………………………………………………..77 Alexithymia…………………………………………………………………..77 iv Perfectionism………………………………………………………………...77 Perfectionistic Self-Presentation……………………………………………..79 Self-Esteem…………………………………………………………………..79 Ethnic Identity………………………………………………………………..80 Body Dissatisfaction…………………………………………………………81 Body Distortion………………………………………………………………82 Eating Disorders Screening…………………………………………………..84 Procedures……………………………………………………………………………84 Statistical Analysis…………………………………………………………………...85 Additional Analyses………………………………………………………….88 Data cleaning………………………………………………………………...89 Results………………………………………………………………………………………..90 Descriptive statistics…………………………………………………………………90 Preliminary Analyses………………………………………………………………...92 Tests of Hypotheses………………………………………………………………….96 Regression Analyses………………………………………………………..101 Test of Mediation…………………………………………………………...107 Additional Analyses………………………………………………………………...108 ANOVA Exploratory Analyses…………………………………………….111 Independent Samples t-Tests Exploratory Analyses………………………..112 Discussion…………………………………………………………………………………..115 Overview……………………………………………………………………………115 Alexithymia and Perfectionism……………………………………………………..115 v Alexithymia and Self-Esteem………………………………………………………116 Self-Esteem and Perfectionism……………………………………………………..116 Alexithymia and Body Satisfaction………………………………………………...117 Perfectionism and Body Satisfaction……………………………………………….118 PSP and Body Satisfaction…………………………………………………………119 Ethnicity and Body Image………………………………………………………….120 Body Image Models………………………………………………………………...121 Appearance Evaluation……………………………………………………..121 Body Areas Satisfaction…………………………………………………….122 The Role of Body Distortion………………………………………………………..122 Exploratory Findings……………………………………………………………….123 Age and Body Image……………………………………………………….123 SES and Body Image……………………………………………………….124 Ethnicity…………………………………………………………………….126 Religion. ……………………………………………………………………126 Clinical Implications………………………………………………………………..127 Psychodynamic Perspective………………………………………………...127 Sociocultural Perspective…………………………………………………...128 Suggested Changes to Model……………………………………………………….130 Limitations………………………………………………………………………….131 Recommendations for Future Research…………………………………………….134 Conclusion………………………………………………………………………….136 References…………………………………………………………………………………..138 Abstract………………………………………………………………………….………….184 Autobiographical Statement………………………………………………………………...186 vi List of Tables Table 1: Demographic Characteristics of Participants……………………………………...92 Table 2: SES Characteristics of Participants………………………………………………..93 Table 3: Participant Characteristics………………………………………………………...94 Table 4: Intercorrelations among Independent Variables…………………………………...95 Table 5: Intercorrelations among Body Image Variables…………………………………...95 Table 6: Correlations of Independent Variables with Measures of Body Image……………99 Disturbance Table 7: Group Differences for White Participants and Non-White Participants………….100 Table 8: Regression Analysis Summary for Variables Predicting Appearance……………105 Evaluation Table 9: Regression Analysis Summary for Variables Predicting Body Areas…………….105 Satisfaction Table 10: Regression Analysis Summary for Variables Predicting Body…………………..106 Dissatisfaction Table 11: Regression Analysis Summary for Mediational Effect of Body………………….109 Satisfaction Measures between MEIM and Body Distortion Table 12: Correlations of Exploratory Variables with Measures of Body Image………….109 Disturbance Table 13: Correlations of Independent Variables with Participant Characteristics………110 Table 14: Group Differences for Roman Catholic Participants and Participants…………114 of Other Christian Denominations vii 1 The Relationships between Alexithymia, Perfectionism, Self-Esteem, Ethnicity and Body Image Disturbance Literature Review Body Image Body image, as described by Birthchnell, Lacey, and Harte, involves physiological, conceptual, and emotional components (1985). The cognitive ability to recognize size and weight (physiological), capacity to hold a mental image of one’s body in her mind (conceptual), and the attitudes towards the form and weight of one’s body (emotional) contribute to the development of body image (Birthchnell et al., 1985). In modern culture, the primary foci pertaining to body image appear to be on one’s weight and shape of the body (Tiggemann & Lynch, 2001). Recent data suggests that 80 percent of women in the United States are dissatisfied with their appearance (Ross, 2013). This negative attitude towards the body extends to young American girls. For instance, it is documented that 50-70 percent of normal weight girls believe they are overweight, with 81 percent of ten year old girls reportedly feeling afraid of becoming overweight. Additionally, 35 percent of 6-12 year old girls have a desire to diet and 42 percent of first through third grade girls have a desire to lose weight (Ross, 2013). Theoretical Perspectives on Development of Body Dissatisfaction Psychoanalytic theory paints negative views of one’s physical appearance as a reflection of a harsh, critical superego that attacks the self for thoughts and feelings that are perceived to be unacceptable (Freud, 1936). Anna Freud described a defense mechanism employed by the ego known as “turning against the self” which refers to the redirection of these unacceptable, negative emotions towards a person (i.e., anger or criticism) against the self. Holding one’s feelings inside can often feel