Early Menarcheas aPr ecursorto Body Dissatisfact ionand
Dietary Re s t r a i nt By g Rhonda G.Hac kett
Athesi s su bmitt e d toth e Schoo l ofGr ad ua te studiesinpa r tia l ful f ilme nt of the
requirementsfor thedegree of Master of Sc i ence
Depar t men t of Ps yc ho log y Me morial Un i v e r s i t y of Newf ound l a nd
Jul y, 199 2
St.John ' s Newfoun d l an d
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The mai ngoal ofthis stud ywa s tote st the hypothesi s that chronological or sUbjectiveearly menarche re s u lts in increased body dissatisfaction and consequently increased dietary restraint. One hundredand ten gradese v e n and grade eight girls from a loca l junior high school completed que s tionna i r e s duringcl a s s time toasse s sdieta ry restra in t andself-esteem . AI '.girl s were personallyinterviewed us!uq a str uctured inter vie w schedule to det e rmi ne thei r puberty stat us, pr epa r at io n fo r menarch e, fe e l ing s to w<lr d monurc ho , and amou nt of so c i a l su p port received. ttcIqht- .1nd wolrjht measures were alsoob tai ned.
Forwardstepwisere gre s sio n analysisrevealedthata non- significant amount of bod y dissatisfa cti on va r-Lance was attributable to act ua l or perceived earlymenarche. Body Mass Index ac c o unt ed _ea r the largest amount of variance, whi ch suggests overweight ind iv iduals are mor e dLesetIstIc ct with their body thannormalor under weiqhtindividual s . PUbcrt nJ statuswas the onlyotherindependentvaria blewhi c hac c ou nt.c d for a signific a nt amou ntofthebody dIseetLefnctIcn ve rlenco . This indic ate s that bodydi ss a t isfactiontnor e ase «aspube r ty progresses. Neither body dis sat i sfacti on or carl ymun archc were significant predictorsof the lev el ofdict ilryrostru Jnt re po r t e d . Ti me since menarche accounted for the Lorqest amount of th e var iance, wh i c h suggeststhe onset of menarche
iii is as sociatedwith an inc r e a s e inrestr a i nt and the le vel of restra i ntcont inuesto increaseafter menarche has occurred.
Bod yMass Ind e x was the only ot h e r vari a bl e whichcontri but ed to a significantamount of the restraint varia nc e. This findi ngreplicatesthat of previous studieswhichdemonstrated overweightindiv idua lsweremorehi g hl y restra inedeater sthan norm alofunde rwe ig h t individuals.Implications of allresults arediscussed.
iv Acknowledgements
To Dr.Da v i d Hart who has been invaluable Inhelping me complete this work.His t ime, inputanddedLcat.Ic n arc qrct\tly appr-ec Le tied , To thestudentsandt.c acnc rn ofxacucna t dDrivu JuniorHighSchool for givingtheirtime to eervcilH subjCl·tn for the study. To Dr.AndreeLiddell and Dr. 't'e d Ha nrurh for serving on my supervisory committee. Finally, I want to express my thanks to mygo od frien d Tlevo r Penney ror hi~;
conti nuedsupport ove r the pasttwo years.
Table of Conten t s
Page Abst r ac t
Acknowledgements List ofTab l esand Fi gures Introdu ct i o n
Dietary Re st raint
Development ofthe theory Dis inhibitio n Mea sureme nt ofrestrai nt The rol eof di e tary re s trai nt in eatingdisorde r develo pment Preva lenc e allong ado l es cents
i i iv vii
BOdy Dissatis fac tion 10
Defini tion 10
Measure tlent 11
Paper and pencil questionnai res 11
Figu redr awings method 13
Socioc ultura l infl uences in the de velopment ofbody dis sat isfact ion 16 pre veIenec andexpr ess ionamo ng 18 ado lesce nts
Menarch e 20
Ea r lymatu rat i o n 21
The Present Stud y 26
Me t h od Subjects Measures Procedure Resul ts
Effec t sofear l y menar c he Pr e/po s t menarc he compa risons Feel ingstoward mena r ch e Discussion
Future research References
AppendixA.Parental Consent t'o r m
26
28 31
' 6 '0
"
51 '~JI (,0
v!
Appendi x B.Physical DevelopmentSc ale Appen d h : C. Socia l Suppo r t and prepa ration
Inventory: Pos t-menar ch e 69 AppendixD. soci a l Suppo rt and Prepa r a tion
Inve nt o ry : Pr e-mena r c he 7'2 Appe nd i xE. Body Dissati sfaction Assessme nt 74 Appendix F. The Rosenberg Self-Es teemscale 76 Appen d i xG. Dutch E?ti ngBeha v iour 77
Questionnaire
Appendix H. Tea ch e rs Introd uc ti o nto Stud y 78 Appendi xr. Investigat ors jnt rc d uc t. J c n to
Personal Int e rvie w "/9 Appe ndi xJ. 're a ch ers Introdu c t ory sta temen t
totheDEBQ- Rand the RSE AppendixK. correlation s ofallVa ri abl e s
Included in Re g r e s s ionEq ua t ion IJ1
vii Listof Tables and Figures
Table 1. Demographic summary and mean scores on standardisemeasuresfor pre andpost-menarche gir ls.
'l'ab l e 2. Stepwi seregression of independent variableson body dissatisfaction and dietary restraint.
Figure1. MeanDEBQ- Rsc o r e s for pre and post-menarche girls.
Figure 2.Frequencyofpreand post-menarchegirlsin DEBQ-R ca tieqor-des,
Figure 3. Me an bodydi s s a t i s f act i on scores forpreand post- menarche girls.
Figur e 4.Mea nRos e nb e r gSe l f-e s t e em scorefor preClod poet.-nenarc negirls.
t'igure 5. Frequenc y of posi t ive and negativefeeling stowar d menarchein post-menarche gir ls .
In recentdeca des pub lic and profe s siona l attention h.1S bee n focu s ed on body we ight . More and more Lnd Iv Id unls , fe male sin particular ,experiment wit h dietingandexerc i si ng in anat t e mpt toachieve animp ol!si b l y thinsoc iet a l sta nd.lnl (Cashand Green, 1986). It ha s been suggested thatweigh t co nc e rnsanddi e ti ngareso perva siv eclmongfe mal e s today tllilt they hav e become nor mati v e (Str .iqol-Moor c, sLtvo rc co ln <lntl Rodin, 1986). Alarg enumber ofwomencurre ntlyrc,C'Itaul;l t re g a r dles s of their actualsize.
Weightand physic alappear a nc e conce r ns ,and inv o lveme nt in dieti ng ,arenotunusualinado lescen t po pu l atto n s . Rec ent.
inves tiga tions ind i c a te a large propor ti on of pretee n and tee na ge girls feel the y ar e fat and su bsequent l y enqnqc in var ious dieting pr a c t i ses (Ha c ke t t, 1989; Leon, Perry , Mangels dorf and Tell,19 89). Othe r studieshave demonetrotcu a direct relationsh ip between die t i ng pra c ti s e s dur-inq adolescence and the devel op ment of more se rious cntinq diso r d ers du ringlate ado lesce nceand iluu lt hoou (no r-nor-ilnd Garfin ke l , 1981 ).Considering cho s efi nu lngl.l thep r-oucrrt::tlldy is designed to explor e a dev e l o pmen tal staqc tillr'inq ~JhiI'll concerns wit h di e ti ngand appea r an c e maybegin.
As body dissat isfaction ha s be en sh own to be hiqh lY co r re la ted with eati ngdis t u r b a nce (Zankin,19 88 ) , effo rtmust be ma de to is olate fac to rs which may contrib ute to the
deve Lcpment; of di s s a t i s fact i o n wit:, ones body. Early menarchehas beendemonstrat e dto beQneg ati ve event for many yo unggirl swho expe rie nceit (arcexs-cunn, 1984). Further to this findi ng.girl s who perceivetheti meofthe ir men a rcheto beear ly, repor t fe e l i ng s and attitudes regard ing menarc he which are si g n ifica nt l y more negati ve thanthos e who do or perceive the ms elve s to expe r i e nce me narch e ontime (Broo ks- Gunn, 1984 ) . This stUdy will inve st i g ate wh e t he r early me na rc he or thepe r c ep ti onof earlymenarc he issigni f i c a nt l y corre la ted wit hthe le ve l of bod y dissatisfaction re po r t e d. Theinv estiga tion willbeextendedto explorethere l at i o ns hi p of these factors with the level of dietary restraint exper-Lenced,
Diet ary Re..:t ra int
Developmen t of the the ory Dieta ry re strain t refers to the int e nti o n to di ettoac h i e veormaint ai nade s ired weigh t.The conce pt was or i g i nall y de velo ped to de s c ribe and explain differencesin eati ngpatte r ns betwe enobe s epe o p l e and pe o pl e ofnormal weight (He rnan and Mock, 1975). Hi s toricall y , the re stra int hypotheses ha ve their roots in Schacte r 's (1968 , 1971) und Nisbe t ts (1972)tne c r te eof obe s ity. Upuntilthe early 1980's the interna l - ex ternal theory as proposed by scbecccr (1968, 197 1) was the mos twi del y heldaccountofthe
diff e r ences betwe en ob e s e and nOI1ll2l1 weight indi vi d uals ' eating pattern s .
Scha cte r' s orig i nal proposa l asserted that the Coltll1'1 be ha vioursof normalweightpeoplewas cont ro lledby inte rn al physiologi cal cues , such asga s t ric contra ctions. The eatinq behav i ou r s of obesepeople however , were thought to be mo re sig n i f ica n t l y inf l ue nc ed by externa l cues , suc h as sight , smell and te.ste of food. As thi s theory developedI the differences be tw eennormalweightand obese ind i vi d u als we re fo rmu l a t e d In more generalte r ms . It was sugge s t e d thatobe s e pe o ple weremore-respons i ve ingenera l to environmentalcuee tha nwere no rlllal we i ght pe op l e.
sinc e its development,an abunda nteno unt; of re-seercuha n beencompleted tes tingSchacte r' s the o ry (LeonandRoth, 19·/"/;
Woo l e y and Wooley, 1975 ). The re s ul ts reported toda te arc indee dvari ed, withamajorityfail ing tooffer sup port for the theory. This ma s s of re s ea r ch has succe e ded in ide nt i fy i ng a numberof flawsandshortcoming s withSchactor's theory. For exampl e it has be en di f fi c u l t to es t abli s h adequa te de finitions ofexterna l and internalcu es (Ruder m<ln, 1986)•
Giventhe apparent sho r tcomingswi t hscneceerce the o r y ; '{
otherresearch ensue d . Ni s bett(197 2)propo s ed a "set point "
mode l of obesit y to explainwhythe extern a lrespo nsivenessof obese and normal weig ht peopl e mightdiffer. Nisbett pr op os e d tha t eachindividualha s a predetermined ideal weight or"set point",addi ngthatobe se peoplehave hi g he r than averageset points. IIe furthe rproposed tha t obesepeop leoften triedto suppress the i r weightbe l ow theirset poi nt, in re s po ns e to the value society places on slimness. This lead to the conclusionthatoverwe ightpeople were starving according to biologica l standards.
Support for Nisbett's the o r y hasbeen equivocal. Similar to Sch a c te rIs theor y,Nisbe t t'spredic tstha t ove rweight and normalweightpeople differ inext e r na l responsiveness. As notedprevious l y , resultsof studies investigating thisthe o r y ha ve be e n inconsistent(Ruderman, 1986).
Although Nisbett 's (1972) theory has beendifficult to test, it did encourage awa ve of research in attempting to define the rol e of dieting in determining eatingpatterns.
The most widely referre d to research of this type is that originatedbyHe r man and Mack(1975). Accepting theargume nt tha t dieting is a key factor in food regulation , Hermanand Mac k (1975) developed the concep t of res t rai nt. Rest raint
refe rsto acogn i ti v e l ytled i at e d effort tocombat the urgeto eat (HermanandHa c k, 1975).Ind iv idual s vary in the extent to which they exe r cise re st ra int. At one end of the pr esu me d con tinuu m are high l y re stra i ned eaters wh o wor ryaboutwhat th ey eat and strugg le to di e t and re s ist fo od regul arly . Un r estra ined eaters, falling at th e otner- end of the continuum, eat free ly asthe desire strikes them .
Ama jor hypo t hesisconcerning restraint proposou thilt dif fe r ence s ill level of re stra i nt underlie ouosc- uor-mat c'lj.ffe r e nces in eating behaviour (Herma n and polfvy , l<HlIl) . Specifica l l y,obesepeopleareexpectedtoha vehi g hertevctu ofrestr a i n t thantheir normal-weightcou n t erpa rts. Simil.lr to Nisbet t(197;;1:).Herman an d polivy (1980)argu ed that obe s e individualsexpres s edsignificantlyhigher levels of recc ralnt, specifical lyinres pons etoth e highval u e andesteemsocie ty
~laceson slillne s s.
pisinhibi tion. Early onit becameevidentthatind ividua lswho re s t r i c t e d their food intake inan ..ttempt to lose orma in ta i n weigh t , oftenexper-Lenc ed lapses frolllthe re str ai nt, uurlnq whichti methey consumed a signific an tl yla r ge r amount; 01toou thanwas usual. It became a ba si c hypo thesi s 01 rcctrninl theory that when self-c o nt r o l of re etrni.ne d eaters is di srupted, overea tin g ens ues (Herma n and Polivy, 1975;
Ruderman, 19 8 6 ). Disr upting events, refe rre d to dislnhibitors, includepez'cep't Lcnof having ove r e a t en, strong emotional states, and alcohol.
M.sti!.!iYrementof Restrain t Once the restraint theoryhad been developed, Herman and Mack proceeded to design a self- adminis te red ques tion naire to me a s ure level of re s t r a i nt experienced. The Restraint Scale(Herman and Mack, 1975 ) has become a standard tool for measuring restraint. Initially, the Restraint Scale was used in all studies of restraint theory, however there was little published information concerning its psychometricpr ope rt i e s. The scale'sab i lit y to predict behavicur in experimental settings (Herman and Mack, 1975; Herman and Polivy, 1975) provides some evidence for its predictive and construct validity. However, the evidence is li mi t e d as it was found in studies using all normal weightindivi duals as subjects.Other inves tigationsof the psychometric properties of the Restra i nt Scale have presentedsomepoint s for conside ra tion.
Most concern is expressed over the findingtha tthe eeate contains two factors, 'concern for dieting ', and 'weight fluctuation' (Ruderman, 1983). As a result, it is difficult to is ol a t e Whether a particu larfacto r orth e combination of thetwo factors resul tsindietary restraint. Anotherconcern
with the scale ar i s e s fro m the find ing tha t obese people obtain highrestraintscoreswhen in facttheyarenot chronic diet ers (Drewno ski, Ri s keyand Des or , 1982) . Thi s effect is tho ughttoresu lt fromhigh scores onthe'wei g ht fluc tua tio n' items,as weigh tfluctuatio nappe a r sto berel ativel yrrcq ucnr among obese people. Heathe rto n , He r ma n, Pollvy, Klnq <lnll xccre e (1988) have re vi ewed these criticisms and a rquc that the y are unwarra nt ed . They state "t hefa c t or structure 01'the Restraint Scale will chang eif the sample characteristi cs change in a systematic way, and that th e sample-based variation in a fac to r structure is not a probl em with the sc a le , but rath er a gener al issue in the interpretation of factor analys isder ivedfr omunusua tsamples" (Ilcathe rton , ct a1., 1988 ). They alsosu ggest:. tha t the obese actuall y do obtain highe r rest raint scores th a n do nor mal weight individuals. They propose that evjdence for th is in the consistentlysignificantcorrelati ons betw een thl!pcn.:c ntiH1"
overwf!! igh tandres trai nt. Insp iteof theseceaunt o r-a rqumcnt-u, it re mains unc learwhe the r obe s e individuals ' highe r dcqr-oo or restra int is duetoth eircon ce r n fordi et ing ortheirwa i q ht fluctuation. As a result, some resea rchers re ma in srceptiic a l of the psycho metric pr opertie s of the Rest r aint Sc a l e and of t en opt touse alte r natemeas u res,suchas theDutc h Eotinq Beha vio urQue st i onnaire- Restraint Scale (DE BQ-R ) (Strian, Frijters, Ber g e rs and Defares, 1986 ).
TheDEBQ-Ris desi gned with three scales. 'r e strained eating','emot i onal eat i nglan d'ext e r nal eating' . Th e scale has demonstrated high inte r n a l cons isten c yas we ll as hig h fact o r i al validi t y (st r i en, etaI. , 198 6). The DEBQ-Rhas been employed in studi es inv estiga tingdi e tary restr ai ntin adol e s c ent popul a t i ons (Hack e t t, ~98 9; Wardl e and Beales , 1986). Wa r dl e an d Bea les(1 986) dec i ded to use the DEBQ-R over the Rest ra in t Scale because it s quest i ons werejUdged to be more comprehensible for an adolescent popu la tion. In addit ion, it does not re qui r e facts abou t weight history, facts whic h mayno t be easi l yre member ed by adolescents.
Further, we i ght fluctu a tion is re l at i v ely co mmon among adolescents, th erefor e, restrai n t ma y be inappropriatelyinflatedbythe•....eig ht fluct ua t ion' scores.
For th ereasons discuss e d the DEBQ-Risthe pre f erredme asure of restrain t foranadol escen t popu 1a tion .
The rol e of die tary r€!s traint in eatin g dis or de r deyel 9p meDt Several st udies have indicat edth at temp or ar y res trai nt viol ations often lead to epi sode s of gross overeating, or 'binging', 'Bi nge eat i ng ' re f er s distur bedeati ng pattern with an ex cessiv e food intakeand abnor ma liti esof hunger and satiety (War d le ,1987). In its mostex t r eme form, anindi vi dual becomes preoccup ied wit hfood onanalmostcontin u ousbas i s,often cravi ng pert.L c uter foods.
In som ecases a bingeis followed by self-inducedvOllit i ngor abus e of laxa tives, inan atte mptto avertweightgain. Whl'n thebif19inq issevere an d acc o mpanied by a profou ndte a ror fatness.the clinicalsyn drom e, bulimianervosa, isdiag nosed (05H- l11;APA, 198 0). Xnd Lvidual s wi t hbulbi a anorex ia nervos a ha ve high sc ores on ee e eu eee of di e t ary restraint and a grs atmajor!ty repor t th at an epi s od oof di et ingprec ededtheonset ofthe i r eati nq dis or d er(Mallick , Whippl e and Huerta, 1987) .
Pr evale nceamongado l es c ents Research on bodyima ge,dLotlnq and. fo odatt i tude shas general lybeen conducted on r.ubiC' ct ~In the i r lat eteens andear l y twenties . However .recantovi.dl'l l'~(·
sugge ststhat cultura l infl uenc es toward thinno zs have' been incr ea s i ngly filte ringdownto younge r age groups . NyLender (H71) found 8l of the14 yea r ojds , 23\ of the15ye a r ol l1s and 31.%of the16 year aIdsin his sample haddi eted. Dieting concer nswere not evident alllOng boys incl u d e din th e sampl e . Morerecent su rve ys dellonstratedieting .ot i v a ti o n in 12-ye(Jr oids i scomp a ra ble tothatof older girls and that 12- yc.1r oids want to weigh les s . de s p ite being of avera g e or below
~'''era g ebody we ig ht (Hack e t t ,1989 1Wardleand Beales ,19 11 6).
Scale s (1991 ) demonstrato d si milarre eu tee wi t hgirls iJ5yo unq as six.
10 Restric t i ng fo o d inta ke at a young age i s of great co n c e r n , parti c ul arl y as i tis a time of mar kedphysicaland ps ychologi cal cha ng e. It hasbeen ar g ued thatweightco n t ro l at thisage mayca use avar i ety ofhea l t hpro blemsincluding, retarda tionof gr o wt h , de v e l opme nt, mental functioning, and re p r od u c t i v e capacity(Mal l ic k , 1983). Ast u dyof 14 childron aged 9 to 17, who engaged in self-imposed restrict io n of caloric intake, described short stature in 12 and delayed pUberty in seven (Puglie s e , Llfschitz, Grad, Fort andMarks- Katz, 1983). These phy s i ca l probl e ms were sig nificantly re v e r s e d up on institut ion of a well bala nced diet. Co nver s e l y. i thas been demons tra t ed thatlonger perio d s of dietary restraintamong individ ualsin this age group, have resultedin prolonged delays inpube r t y (Russell, 1985 ).
BodyDissatisfaction
Previous studies ha v e de monstrated high cox-erec rcns between leve l of dietary rest rai ntand ones attitudetoward their body (Zankin, 19 8 8) . The impo r t anc e of body dissatisfactioninthe developmentofrestra int and subsequent eat i ngdisord e r sha s become the focus ofre s ea r ch in re c e nt years.
~ Body ima ge is defined by Powers, Schulman, Gleghornand Pr a nge (1987) ,astheinner mentalimage of ones
11 bod y and the sum. of ones elilot ional att itude s toward thilt ima ge. Genera l ly, re s earche rsdescr ibe two separateaspects of body imag e : an emot i onal or attitudinal component pertaining toattitudes toward bo d ysh :ejwe i g h t ,spe c ificbody parts or ove rall phys ical ap peara nce , an d a per ceptua l co mponen t , conunonl y ref e r red to as body- s iz e pe rcept i on accuracy (Cas h and Brown , 1987). A disturbance DC tho at titud ina lco mpone nt has a cognitive and affectivenaturo.
Indiv idua lspresent ingwith this problemu!'H Ii'll l y <"t'cllr ,ltcly ass ess the i r bod y's size but theyreact to thoi r body with extreme disparagemen t. Alt hough the majority of rcooe rcn conducted to date has focused on disturbances of the pe rcept ua l compone n t, mo r e re cent InveetIqatLonu hnvo demonstrated di st urb ances ofthe attitudina l componenttobe a :mor esi gnif i cant fac t or inthe deve l opment andma i nten a nce of vario usea t i ngdiso r ders (Hsu andSobk iewic z , 19 91) .
Measureme nt A number of attitudl nal measures have boon developedto assessbodydissatlsfi:l.iJt ion . 'rheuo Inclw!cp'lp" r an d pencil questionnai res a ncr va z-Lcus nlotho d f1 usinll si 1hou et tesof femalefigu re s rangIng fromverythinto v(Jr y fa t .
Paper and pen cil question na i res Th e majorlty of tec hniq ues curre nt l y being employed to as~el'J!l botly
dis s atisfa ction involves selr-repo r t ratingsor ones ~ee lin q 5 towa r daparti cul arpar tof the bodyor the bodyas a whol e . Thes e Jlea s ure s are us uall y presen t ed as pape ran d peneiI questi onna i re s.
The first suchscale de velopedwas the BodY- Cathexis Sca le (seco r dandJour a rd , 1.953). Responde nts arep resent e d with al i s tof bodyparts eachhavin<Ja five-point Liker t scal e,ran g i ng from 'neveIltrongnegative feel i ngsl to'he ve st ["o n g positive fe eli ng s '. The mo r ene gativ e a score the gre aterthedeq r eeof thed is sat i s f acti o nexp erienced. In devising thi s ins trume n t the authorsas sumedtha tbod y esteem could beex press edas a sInqLescore bas e d onth esum ofthe indiv idulll•sresponses tobodyitems.Howeve r, investiga tl on~
sinc e then havecas tse rious doubts ontheass umpti on ofthe unidimensionaUtyofbodyima ge(F isher , 1964; Gunders on an d Johns on , 1965). In response to these doubt s , franZ:!land SI.ield s(19 8 41.octifled theBody-Cat hedsScal etodevelopthe Body-EsteemSca l e . Afa c toranalys i softheBody -Esteemscale indi c ated there are three distinct scales representing Sllpara teaspect sofvomen'Ibo dy-es teell:se )(ualat tracti vene s s (13 items) ; weight co ncern/satis facti o n (ll items): and physi calcondition(8items) . Allthr eescalesha veexhi bited satis fac t ory rnliabllity and validi ty(Fra n'loi andesne ue e, 198 4)•
I
f i !
t
I,I \
I
, t
i
Kendel sonand White (1985) devel oped a sillil arinv e ntor y foradoles cents. However . insteadofrequ e sting sUbje c tsto rate ho wthey fee l aboutpartiCU la rpar t s of the i rbody, thC'y are asked to rate their degre eoC ilqre ement wit h va ri ous stateme ntsaboutth e irbOdy. Thescaleincludes su c hitomsas
"1: li ke what I look like in pic t ur e s", an d "Kids my own.1 t! C!
l ikemy look s" (Me nde l so nand White,1985). The scalahan be e n found to have acceptabl e rel.t ab i li ty [nplit- hillI reliab i l i t yr e,83, Mend leson and White ,19 85).
Figur eDrawingsmet h g d The1II0st wi delyusedmeth o dsof detemini nqanevee au level of body diss atisfa c tionare the schemat icfigures of sil houettes of dif ferent body sizes, ranging fro m very thin tove ry fat (1'hompso n, Penner all l!
AJ.tabe . 1990) . Generally. subjectsar e requested to se lec t .1
figu re wh i ch most cl osely resembles hi s/h e r cvn bod y shillft.', fo llowedbya sel ectionof anideal fiq ur e. orthe one he / shu wou l d re all ylik etobel ik e. The discrepa ncybetwccn thetwo is co nside r e d an indicat ion of the level of body dis satisfactio n exp e rienced.
Fa llonand Rozin's(1 985 ) meth od otfig u re selectionhae been a wi d e l y us ed mea sure of body di s sat i sfacti on.
Respond en tsare pre sentedwithninefiguredrawingscrd Lnartlv ranging fr olll verythi nto veryhe avy. Eachfigure isa~s i qned
14 a number fromone to nine (one=thinnest). SUbjects asked to indicate the figur e (a) th a t approximates their currentfigure, (b) they would most like to be like, (0) that theythink wouldbe most at tractiveto the oppositesex.and Cd)of theopposit e sexthey findacs.t;attractive (Fallonand Rozin, 19as).
Williamso n, Davis, Gorecznyand Bl oui n (1989 )I mod i fied Fa ll on and Rozin's procedure tc deve.lop tne Cody Irni.lCJe Assessment. The Body Image Aeeessraent te chnique use s nine cards each containinga silhouette of a woman whose bod y size ranges from very thintovery obese. Each cardis assigned a numberfrom one to nine . Th.e cards arepl a c e d in randomorder in front of the sUbject whois requestedto selectthe card Whi ch most accuratelydepictsthe i r current body size. The number on the back becomes the sUbject's current body si ze score (CBS). The cards are thenreshuffledand presenteda second time for sUbjec tsto select th e card with the fiq ure theywould most 1 ike to be like. Th i s selec tionbecomes the subjectsidealbod y-si ze score (lBS). The discrepa ncybetween the CBS and the IBS is ind i c a t i ve of the level of body diss atisfa c t i on experienced. prelim inaryresearch ha s shown the proc edu r e to have an ade q ua te te s t -re t e s t reliabili ty, r=. 92 for the CBS and r=.79for theIBS (Williamson,et aL, 1989 ).
15 It has be en suggested tha t sUbjllct 's se r ect Ione of figuresmay be biasedtowa rd ala r ge r fi gurethantheirac tuat one,if the y overestimate their actual body size('fhompso n, ut.
al., 19 9 0 ) . The perceptual ov e r e s t i mat i on may lead the SUbj ect s tochoos e a figu re larg e rthan he/she actua ll y is.
This wouldin f l at e the di ffe re nc e betweenthe actu al andideal figure s, re sulting in an ina ccura te bod y dissatis f action However , i f one is assessi ng the lev e l of body dissatisfaction, i t shou Ld not matter whether the ~ubj('ct ove res t imatesandchooses a figurl'! that isla r g e r t.hun hO/ I~ h u ac t ual l yis. In thiscase th e SUbject is selecting 11 fl qur-o Which ap p rox i mates how he/she perce i v e s theirown body s l xe , Thediscrepancybetweenthis selection and the ide a l hotly sixc indi cate d would the n be a rea s o n a b l e measureof thoJa v e l 01 bodydis sa tisfactionexperienced.
The Wil liamson at aL (19 8 9 ) re vi s i o n of Fallon and RozinIs met ho d se ems to be the better meas ure to use. Randomly pr e s en ting the figures on individua l cards and reshuffli ngth emafter eachselection ,possib lyeecreaec s tho li ke l ih o odof sub'[ect; selections being bteacd by fiqurr~~:
app eari n g at op posite ends of the scere . SUbjec.:t's' ide;ll bod ysize 'choice isnotl ikel y tobe asinrtucnccdby rnelr 'c ur r e n t body size ' choi c e as is pr-c b e bl e when all of the figuresare presentedat once in a r-ankedorder.
16 Soc ioc u l tura l influences 1n the devel opm ent of bod y diSSAtisfact i o n Wide spread bod y dissatis f acti o namongyou ng womenin themodern world hasbeco me the focusof cons iderab l e re sea r c h inre c e ntye a r s (Baily,Goldberg,Swap, Chomitzand Ho u s er , 1990 ). Numerousstudies have found that women are dis s ati s fied with theirwe i g ht andphysica l appearance, and of tenengage inred ucingdiets , evenwhe nthe ir weight is at or below establishedstanda rds(Hacket t , 1989;str l ge l-Moore , at a1.,198 6 ) . Sever al argumentshave bee n of fered at tempting to expl ain the 'drive for thinne s s' and overconcern with physical appe a rance expe rienc ed by an abundan t number of today' sfemal es. Among thesocioc u l tu ra lvariabl esconside red impo r ta n t is the va l ue our so c i ety attaches to being attrac tive and thin, whil e it views obesLtiy as a highly stigmatized condition (Boskind -white and Whit e, 1983). Nume r ous studies suggest tha t Whileth isat t itude eeemfnqjy affectspeople ofall ages,it appe arstobemore consistent ly di r ec ted toward women tha n it is to ward me n (strige l-Moore, et a1.,1986).
Fur the rmore, it appea rs thatthere arecerta lnwome n wh o dee ply internali zethe socioc uitural mores ab o utthinne s s and attra ct i vene s s. Suc hwome nconst an t ly strivetowardthin ness and areconseq u entlydist r essed about fatness. Strigel-Moore et a1. (1986) ass ertthat some wome nint e rnalize the s e val u es
17 because of the influ ences of the subc utture in whichthey live. Although attitudesaboutthinnessand obes i typervade our ent ire soci e ty , th e y are inte ns if i e d insome insta nc e s. Women of higher socio e c ono mi cstat usare more likely to be aff ected by soc i e tal pres s ur e stobe slim. consequent ly ,they exh i bit greaterwe i ghtpreoccupa ti on andengage inreduci Ilg diets more frequentl ythanth e i rpeersof lower socfcec cn cmLc status (Do rnbusch, Carlsmith. Duncan, Gr o ss, Murtin, ntttor- and siegel -Goru lick, 1984) . In addition, it nao beenstr ewn that certain envi r o nme nt s appear to encourage greater preo ccu pa tion with weight and ap pearance . ror examplo, board i ngschool s andcol le ges ha ve beenfoundto contributeto the devel opmentof ea t i ng di s orders such as bul imia (squire, 198 3 ). This ma y be a fun ction of the fact that qenc ru L'ly women ofhig her socioeconomic statu s at te ndthe s e types of ins t i tutions. Alterna t ively, as st ressf uland semienc losed environments, campuses may serve to intens iry so c ic tnl pr e s sur e s tobe slim.
Many pr of e s s ions suchas dancing, modc l ILnq,act Lnqilnd at hletics spe c i f y an optimal weight , tnu c ampIiryi nC) socio c ul t u r a l pre ssuresto be slim. Ofte n famales Lnt.erest.e d inany of these profe s s i ons areconsta ntl y preoccupi e dwi t h theirweight and appear a nce, andregU l arlyengage inwoi ght redu c i ngre g i me n s. Not surprisingly,an increas i ngnumberof
18 individual s , femal esinpa r ticul a r, purs uingpro fe s s i ons such as the s e. exp r e s shi g h levelsof body dissat isfact ionand are more frequent l ydiagn o s e d witheat ing disor d e rs(Yates, Leehay an dSh is s lak, 19 8 3 ).
Prevalenc e and expr essio n amo n g adolesce n ts From earl y childhoodgirl s learn fromdiverse sou rces that appearance is especiall y important to them as girls and the y should be concerned wit h it (S trigel -Moore, at aL,, 198 6 ). Family members encou rage li tt l e gir l s to "p ret.t y up" and seem to st r-eae the importance ofbe ing neat and attract ive . Beyond thefa mil y , schoolsadvocatethissocietal message.Girls se em to be po s i ti v ely reinforced for activities directedtoward neatnes s, whe rea s boys are more r-equ La'r-Ly posit ively reinfor cedfor the inte ll ectua l aspects of theirperfo rma nc e (Dweck, Davidson, Nels o n and Enna, 1978). The mass med ia, inc lUdi ngteenmaga zinesandtelev i s i o nprog ra ms deve loped fo r teen ag e audienc es , als o stres s th e va lue and impo r t ance of being slim and attra ct i ve. Again , these effo r ts co nsi s tently dire cted mo re stronglytoward femal es.
Girls appear to .int e r na l i z e the se values concerning appearance . De vel o pme ntal st Udieshave documentedthatgir l s ar e more concerned than boys about looking attractive (Coleman, 1962; Douva nandAde lson, 1966). Studi e shave shown
19 that eve n as children girls aremore dissat isfiedwith their bodies than arema l es. Al tho ug hnon-obe s e girl s have a mot-e pos it i ve atti t ude toward their body tha n obese qir ls, they st illexpressmore dissa tisfaction wi t h it thi.1ll boys ('l'o bin- Rl_;'d.rds , Boxerand Petersen, 1983). 'r tiese res e arche r s etsc found that perce ived we igh t and body satisfaction ato"
ne gat i v e l y correlated wi t h wei ght for girls, Whereas boys valued being of norma l weight and expressed aqua1 dissatisfacti onwit hbeingunderweight or overweight.
Although girls seem to le a rn and inter na lize ec c Lct;ar values to be slim and attr a c t i v e as earlyas childhood, tile major influence andresponseto the pressure appears tooccur duri ng adolescence . The self-image of ad ol e s c e nt roncjcc seems to be more interpersona llyoriented thana r-c those o!
boys (Chodorow, 1978). Girlsalso seem to worry moreaocue what othersthink of them. Hill and Lynch (1 983 ) aa s ort; t.hut, in response to feeling insecure and in an er rcct. to uvo ld ne ga t i v e evaluationfrom ot hers ,the adolescentgirl becomes incre a s ingly se ns i t ive to and compliantwithsocial demands and sex-roleappropriate standards. This inturnle a ds toa desi r e and dri vefor thi n ness,andhe i g ht en ed dissatiSfaction withbody shape and appearance.
20 Re c en t inves t igations hav eind i cated tbe ph y s i ca l changes wh ich occur du r i ng puber t y resu l t in mor e pronounced bo d y dissatisfaction than is found among prepubertal girls (Do r n bu s ch, et a1., 1984). In particular, th e phys i ca l and emotio nalchangeswhi ch occ ur duri ngthe menstrual cyc lehave bee n found to contrib ute to increasedbody dissatisfaction (Al tabe and Thompson, 1990). For th i s reason it becomes importantto study re l e v a n t li t e r a t u r e on the impact of the men arc he al exper ie nce.
Menarche
There are certai n trans ition points in an individuals life whichare imbued with psychologica l and sociocultUral sig n if ica n ce be c a usethe ysignal a ne ed for cha nge in self- identity (Brooks- Gunn, 198 4 ). Early adol e s c e nc e is a deve l opment alperiod inwh ichmu.lt.Lp Le and oft e n simu l ta neous changes occur within the individual. Pe r ha ps the most dramatic changes evident to theadolescen tand to those around the m are the ph ys i cal changes that occur as part of tho pUbe rta l process. During puberty, the transition from a ch il d 's bodyto an ad ul t 'soccurs. Rapidinc r ea sesinweight and he i g ht occur , gen ita li a develop, axillary,pUbicandbod y hair appear, and ingirls the menstrua l cycle beg i ns at an average ageof 12.6 yea rs (Frisch, 1976).
21
As first menstruation, or menarche, is a concrete symbo l of a tr a ns i t i o n ,from girl to woman, i t is of par-tLculrn- importance for girls. In many cultures menarche is regarded as a major rel igiousor communi tyevent,markedby elaborate ritualsand ceremon ies(paigeandpaige,1981 ) . Hor e commonly in our cu t ture, menarche is gene rallyconsideredin terms of the impactit ult i mately has ona girlsself-definitionas a female and her sUbsequent behaviour as a woman (arcck s-cunn , 1984). At a minimum, it requiresagirlto determine whati t mean s to be a menstrua t i ng wo man , and sheis no w fac e dwi th coping withmany physical and(m o t io n al changes , au well '-15 int e r preting ot hers' re s po nses toher nowl yacq uI r-ed st " t \ l ~l
(Br oo ks-Gunn , 198 4) .
Early matur at ioD In the la s t decade the psychol ogi cal significance of menarche has been studied extensivel y.
Studies have investigatedthe extenttowhich menarcheejIcitn anxiety,is consideredtraumaticandhasintegrativepositive aspects(arcoke -cunn,1984). Inge ne r a l , menarch e is reg arded as a positive experience as it adds to a girl' s soclal maturity,peer prestigeand self-esteem(Faust,1960 : Garwood andAllen,1979) , anditis often viewedOleaco nf irmationof womanhood (Brook s-Gunn , 15164). Ruble andnr c ok s-cunn (198 7.1 conducted an investigationinwhic h they eskedpcsu-ecna rc he.u gi rlsduringface-to-faceinterviewsaboutwhat theypercciVC'U
22 tobeposit ive aboutmen s t r ua t ion. Themos t freque ntpos i t ive itemwas si g n of maturing (72'). other po s i t ive aspe c t s incl uded ab ility to hav ech ildren(30%);part ofbeing a woman (26%); and being liked by friends (221&: ) (Ruble and Brook s- conn, 198 2 ). Themost frequentnega tiveaspect wastheha s s l e (46%: ), for example, car r yi ng supplies or messiness. ot he r neg a ti v e aspects inc l u ded physic al dis com f o rt (30 %:) , behav ioral limita tions (20'), and emotiona l changes (17%) (Rubleand Bro ok s-Gunn,19 82 ) .
Girl s who experi e nc e men ar c he at anearlier age than ave r a g e , report more ne g a t i v e exper iences tha nthe i r on-time pe er s (Brooks-Gunn, 1984; Ruble and Br o ok s - Gu n n , 1982). They reportmorenegative initia lrea c tions,more symptoms and mor c negat i ve sel f-ima ges (Rub le and Bro o ks-Gun n , 198 2). Early mature rs have been found to be les s sat isfi ed with their weightthan la t erma.t uring girl s (Simmons,Blythand McKinney, 198 3). ot herfind i ng sshowe d thatearlie r mat uri nggi r lshad les s pos i t ive body imag e and feel ings of at tract iveness (Tob i n-Rich a r ds , et 031., 1983 ) .
Anumbe r of hypotheseshavebeen developedto exp lainthe fi nd ings which ind i c ate that menarch e is appare ntl y a more negative experienc efor girls'....ho have it beforethe average onsetage. Experiencing early development may mean that girls
will not feel comfortabledisclosingtheirnew physical status to their peers. As the y are early, they will have fewer people to sha re and compa re the ir experiences with. In add it i on, early maturingmay generateins e curi t y about bei ng differentfrom the group.
Inves tig at ors interested in the studyof the human 11rc cyclehav e be enpe rs ua de dthat it isno t only tho cvontuwh ic.;h people experienc e, butal s othe ti ming of cncso evc nts, thflt i(RierdannfluenceandtheKofsubjectivef, 1985). Neugartensense of
.
(19well-be70 )has distingui sh edi ng or stress betweentwo typ e s ofti mi ng : objectivE> timing, when an event occurs re l a t i ve to a person's actual ch r on ologica l age , and SUbject i ve timing, when an eve nt oc c ur s in a person 's life relative to social norms for the timi ng of its oc c urrenc e.She has suggestedthatitis a person'sSUbjec t ivetimingor eve nts which is the more important in determining the psych ol og icalsigni f icanceofdeveLopmer rtaI event s.
It appe a r s thatby early edc re s c e nc e chIIdr-cnhoweboqun to fo r mula t e a"socie Iclock " with respec tto evcnt;c cc c u r rinq in childhood and adolescence (Rierdan and Koff, 1985 ).
Seventh-graders are ab leto characterize theirown rate oC pubertal development as earlyI on time, or la t e (Tobin- Richardset al.,1983). Thissubjectivesense ofbeing early,
ontill eorlate inone s pubertalde ve lopment seens to be of psychol ogical significance. For example,Tobin-Richa r dset ar, (19 B3) fou nd thatgirl swho perce ive themselves as ontime ha d ec z-e pos itive body images and greater feelings of at tractivenes sthan thos e wh o perc e i vethemse l v e s as earlyor late.
The suejeceIve se ns e of pubertal devel o pment and the obj ect i v e normsarenot alwa y sco ngruen t. One study rep ort e d onl y a 60\ overla pbe t weensUbjectivenndobject i Ve! pub l!r t a l timing fo r girls , as indi c a t e d by such things as br e a st deve lopment, amo unt of body hair, growt hspurt and age at mena r che (Wile n, 1980) . co nsideri ng thi s lac k of cor respondence,it becomes nece s sary todete rmine there l a t i v e importa nce of SUbjectiv e ve r sus objective timi ng of these eVentson psychological development. Wilen (1980) fou nd that qi rlswho perceivedthemselvesas on ti Dlefeltmo r e pos it i v e abo ut their rate of devel o pme nt than girls who perceive d the ms e l v e s as earlyorlate.
Ri crdan and Ko ' f (1985) exte nde d Wilen' s rese a r c h , es s e nti a ll ysup po r ting his conclusion s. They determinedina ret rospectivestUdyof col legewoman,that SUb j ect i ve, rather thanobje ctive timingof pUbertymorest r o ngly determi ne d the affecti ve impac t ofpubertal develo pment. Inadd i tion , the ir
25 data indicated that girls who experience themselves as on time or late had a more favourable response to menarche than q l ejs who perceived themselves as early. Although the maj ority01 research completed in this area has been designed do
retrospective studies, recent prospective investigationshove demonstrated similar results (Ruble and Brooks-Gunn, 1982) .
Another variable hypothesisedto affect initialmenstrual experienceis one concerned with cognitive statusin rela t i on to a girl's adequacy of preparation for menarche (Rierdan, Kaff and stubbs, 1989). Significantrelationshipshavebe en found repeatedly between preparation for menarche and the experienceofit. Incross-sectional and prospective at udics of earlyadolescents(RubleandBrooks-Gunn, 1982 ), aswall un in retrospective st ud i e sof late auotccccntsand young adu lt s (ue v e a ux, 1991: Gol ub and Catalano , 198 3 ) bet.t or prc pn r,...rt indiv idualshave reportedmorepos i t i veeenerche etexp er l cnccu than more poorly prepared individuals . Ruble and nrccxs-cunn (1ge2) found that girls who have reported feeling totally unprepared for the menarcheal experience, expressed considerably more negative feelings, less positive feelings and more surprise than girls who felt they were adequately prepared for the expez-Lence , The unpreparedgirls expressed more negative self-images,and greater frequency and severity of symptoms than the prepared girl s.
26 The pr•••Dt study
Previous studies ha ve demonst r a ted tha t bOdy dis s at i s fa c tionan ddieta r y re stra intexist among pre pub e rta l girls,and the r e is someevide r.ce wh i c h indicates bo thbecome morepr e vale nt and extre meat pUberty. Alth ough th i s evidence ex ists, research to date ha s not investigated pu b e r t y in enough detailtodetermineexactlywhy appeara nceconcerns and dietingpractisesinc r e ase in frequency and intensitydur in g thllt dev elopmental aeeq e• The main goal of thepre se nt stud y isto inve stiga t esomefeatur es of th epuberta l pr o cess which may lead to an increase in thele ve l of bedy dissatiSfa ct i on anddietary restraintexperi enced.
Cons idering pre viou s res e arc h which demonstrates tha t early menarche is re ported as a ne gative event and often involvesso me level ofbod y dissatisfacti onbe in~ex perience d , thepre s en t study hypothe s ise s thatgirlswh oexper-Ien c e ear ly menarche will report significantly highe r lev els of body dissatisfacti o n thangirls who ex periencemenarche ontimeor la te. As SUbj e ctive timi ng of menarch ehasbe enshownto be more high ly cor re late d with negati ve menarche al ex pe r ienc e tha n object ive timing, it is expected to have a mo r e significant effect on the degree of bod y dissatisfaction experie nced.
Indiv i duals who are dissa tis fied with their bod y like l y to re s pond in a number ot ways with one possLb l e responsebe ing re stricting food int a ke. Food re strict io nis a common responsewhen individ ua ls areatte=pt in gtoachi eve an ide a l fiqure. Forthis reason indi v idua lswhoexpre s sbod y dissatisfactionare expectedt.o report slgn 1fica nt ly hig her le v el s of dietary re str a int than those who re po r t littl e dissatisfaction.
Recent rese ar c h has demonstratecl thdt qlrjuwho r-nporf- ear l y menarche are les swell preparocl<..Illdrecclvel£'HH~; o \~ i,,1 sup po r t forthe mena rc heal exper i e nc e than qirl nwho dev el op on time or late. Considering th ese finding !: the amount of preparatio n and social support re c e i ved for ae ncrchc arc expe c t e d to contribute to a signlficd ntamo unt or the bocly dissa tis fa c t ionand diet ary restra i nt var i ance .
cons ideringthe expe c t e d impor t anc e of eenarcnc it Iu hypothesised that post-menarcheal girls will express signif i c a ntl y hlqhe r lev els of body dissatisfa ct i on , dl c t., ry restra i nt andlower sel f-est e em thanpe e-uenereneer qLr-Lu ,
28 Ma th eIS
~One hundredand tensc h o o l g i r ls rangingin agefrom 12 to 15yea r s served as sUb j e cts . The y were obtained by firs t gettingapprova l forthe invest igat ionfr omthe Av al on Conso lida t e d School Board, the school princ ipal , and thr e e physicaleducation instructors . Follow ing thi sapprova l ,210 parentalconsentforms were distributed tothe grade seven and eightfemalepopul a tionof MacDona ldDr ive Junior HighSc h o o l in st. Joh n 's (See Appendix A). Of the 160 (76\ ) who
res po n ded 137 (8 6 \) gav e con s e n t fo r their da ughters to part ici pa t e inth e inv est i ga t i o n.
~ Pubertalde v e lopmentwasmea s ured wit hthePhysi c a l Deve l opme nt Sc a le (Pe te rsen , Croc ke tt, Richa rd s and Boxe r, 1988 ) (See APpendix B). The scal e includes quest .Ions pe r tai n i ng togrowt hspurt inhe i ght, pubic ha i r gr owt h ,skin chan g e ,breas t de velopme nt and menarche . Individ ualISweight and height arealso recorded. Since this scal e basonly bee n recentlydeveloped,it hasnot been widelyused todate. The Pubertal Development Scale has been showntobe reliableand vali d (Pe te r s e n,etal., 1988 ).
Two sets of que st ions de vel oped by th e aut ho r for ass ess i ngkn owl e d g e andpr e p a r a tio n of menarche ,and th e level of social support rec eivedpriortoand during menarche ,were also inc l uded. The Soc ial sup portandpr ep a rati onInv en t ory-
29
Post-Menarche, wa s designed for those indi viduals who have experie ncedmenarche(SeeAppendix C) while the So cial Sup p o r t and Preparation Inventory- Pre-Menarche,wasdeveloped for ind i v i duals who had not expe ri e nc e d menarch e todate (sec Appendi x D). The maLn goa l of the ques tio n ing wa s to determi ne the amount and so u r c e of prepar a t i on [or the' mena rchea l expe rience, and the content of <lilY lnro rmarton acquired . We were al sointe r ested indeterm i ninqthe amount and type of soci a l suppo r t re c e i ve d befo re and during menarche. Cho ice ofspe ci f i c que s tio nswasguidedbyil re v i e w of therel evantlitera t ure.Th ese que st i on swere thenrevie wed by a secon d individ ua l who had also comple ted a lite r a t u r e re vi ew . Asache ck forword knowledgeandcompre hens ibili ty, the initial questionnaire was ad ministe red to six fe male adol e s c e nts ranging inage fro m12 to14. Mino r revte lcns we r e made and che ck e d with thepi l o t sample again to ensure comp re hensibility.
Bod y dissa tis f ac tionwas assessed with thr> Aody Jmil 'j('
Assessment (Williams o n et aL,, 1989) (See Appendix EJ. serie s of sev e n card s (instea d of 9 as had been used by Wi l li ams onet aL,,1989 , beca us ethe de s i gn e rof the cardswa s unabl e topre pa reninedistinctfigu r es)of fe malesilhouet tes ranging ona scale from very th in(c a r d one) tovery fat (card seven) are presentedinfrontoftheSUb jectinrandomorder.
Each SUbject is asked to "Plea s e choose the card withthe
30 figure youth i nk looks mostli ke youright now."(cu rre nt bod y siz e ) and the scale positio n of thecardis rec orde d. Next , the cards are re shu f fl ed and th e sUbject isAske d to "Plea s e choose the ca r d with the figure you most want to be li ke."
(i de a l body size). Again the sc ale positionofthe card is recorded. Todetermi neth elev elofbo dydissat i s fa c t i o n , the Id e a l BodySizescoreis sub tracted fromthE!CurrentBod ySize
The Ros e nberg Sel f Este e mScal e is ame a s ur e ofthe 5elf- acceptance aspe c t of se l f-e s tee moft e n consid e red "g lo bal"
self - esteem (Rosenbe rg, 1965) (Se e Appendix F). It consists of 10 items all answeredon afour-point scale rangi ng from
"strong lyeq r ee « to"s trong l y disagre e". The scalehas been found to be a re l i a b l e, validmeasure in previousst ud ies of adoles c ents (O'Bri en , 1985 ) .
Die t ary re s tr a int was as s e s s ed with the Dutch E<tting Be haviourQuestionnaire-Re strai ntSc ale (DEBQ-R) (Strien,et al., 198 6) (See AppendixG). It cons i sts of te n questions, each having a four-poi ntratingscaleranging fr om"ne ve r"to
"alw a ys". The scaleha s beendemonst r a t e d to be are lia b l e, va lid me a sure of dietary re s t rai nt in ot her studi es of ado lesc ents(Hac ke t t, 1989:War dleandBeal es, 19 86). As the scale wa s or ig i na lly develope d for adul tsminor alte r at ions were ma de to improve comprehen sibility for adoles c e nt and
31 preadolescen t populations (Hackett, 19 8 9). The DEBQ-R fo u nd tohave a high inte rnal co ns i s t e n c y with a Cronbach'f1 alphaof 0.94.
~ One week priorto datacollectionte a c hers were asked to give a bri ef de s c r ipt i o n of the investigation, prepared by the autho r, to th e i r home room cla s s e s (See Appe nd i x H). Parenta l consent forms were distributedto ilny studentsinte restedin par ticipati ng. All data werc collected betwe en May 22 and June 11,199 1.
So as not to disrupt academi c classe s allSUbjec t s worc interviewed during thei rall-girlphyaLcu I educat ion clauuen , which has100 per cent enrolment fr o m the populati onsamplprl.
Atth e beginningofea c h class everyonewas asked to Lnolc u t.c whohad rec e i ved parental conse nt fo r participat ion by i'I
showing ofha nds. Subjectswe rechosen fr omth i s sub-groupon a ba s i s of conve nie nce, whe n they wer e not engaged in any class activi ty . An average of four girlspe r class period wer e inte rvi e we d. Due totim~co ns t r a i nt s, only 110 of the 137girlswh ohadre ceiv ed conse nt were interviewed.
Each interviewwas startedwith a brief int r oduc ti o n to thety pe s of questions to be asked and explanation thatnlI responses wcuLd be kept str i ct.l y con fi de nt ia l (See Appon d l a I) . An identificati on code~Ja s generated for eac h subj,..c t
32 (firstlette rofla s t name; dayofbir thd a ye.g. 1,10;number of sisters ; la st let t e r of first na me ; numberof brothers). Use of the code ensured anonymity and permitted matching of theinte rview informationwith ques t ionna i r es to be compl e ted dur ing classtime.
Any questions or concerns were dealt with , then the questions from the.phys Lce I Development Scale were asked. To mai nta i nrapportandthe comfortof the SUbject, weightand heightmea su r eme ntsweremad e atthe end ofthe int erview.
Either the Soc i al suppo rt and pr epa r at i on Inve ntory- Post-Menarcheorthe SocialSupportand pre para tio nInventory - P;::oe-Menarchewas presen ted nex t. As same ofthe SUbjects did not unders t a nd or misunde rstood some of the items, questions were somet imes re worde d in ord e r to improve comprehensibility. For some items, pro bes were made to cl arify SUbjects ' responses. Upon compl et ion of this question ing, the Body Image Assessment wasadministered.
Finally, the SUbject wa s weig he d and measu red on a ba lancescal e(Heal th-O-Me t e r ,Continenta lScalecorp o ra tio n).
Each interview lastedappr oximat(ily15 minutes.
The DE8Q-R and the Rosenberg Sel f - Esteem Scale were int roduced to al l home room classe s by the teacher with a
JJ st atement prepared by the inve sti gator (See Appe ndix J). Prior tocompletingthequesti onna ir e s , te a chers instr ucted the sUbje cts to gene r a t e ind ividual identifica tion cod e s fol lowingthe sameprocedureusec:linthe pers o nal inte rvle ws.
Thequesti onn aireswere administered a se cond daytoanyo ne who had not comple tedthemduringthe firs t adminis t ra tion.
"
Re.ult.s
Thesample consisted of 110 girls,92 of whom had rea ched menarche at the ti me of interviewing and 18 whoha d not.
Deta iled demographic in forma t ion fo r bothgrou psis available fro mTa ble1. The age of menarche wa s availab le for 88 ofthe 92post- men archeal subjects. Themeanmen arche ag e was 12.2
years whi c h is sligh t ly bel o w theave rageof 12.6 years as determined by Frisch (1976 ). The pre-me narcheal cohort is absent from the average mea n , mak i ng the sample inc omple t e . When the pr e-me na r c he al sUbjects' menarc he age becomes ava i l able, the ave ra ge age for the combi ned group will increase. since the figu r e dete rmined by Frisch was demonstrated 16 years ago , i t is possible that average mena rche agecontinuesto followthe de creas i ngtrend of the past number of decades.
The sample 's mean Body Hass Index of 19.71 closely matches the mean Bod yMass Index of 19. 7 3 fo r asimilar age group reported in the Physical Fi t ness of Ca na dia n Yout h (1985).Thepost-mena r c he al sUbjec ts'meanBody MassInde x was 21. 54, whiletha t ofthepre-menarchealgroup was 17.99 (See Table1).
as Table 1
Dea09 r a p b io 8uaaary and K. uIc or•• onStandardisedH••sure ll tor
Pre and Post. -llIen a rche Girls
A•• Pr e
"
Post Pre13 Post Pre14 Post PreAllPostN 6 11 10
4.
32 ae 92wt 45 .7 56.8 45.6 53.9 43. 0 58.1 45 . 4 5~ .(j
k.
ht 156. 5 16 0.6 16 0 .1 160. 3 159.5 161.2 158 . 8 16 0 . 6
BM18.67 21.81 17.81 20.97 16.89 22.38 17.9 9 21. 54 DE12.17 20.45 11.40 18.02 ••0 20.4 4 11.06 18.9 9 DQ
BD1.17 1.55 1.1 1.3 1.0 1.. 1.11 1.4 5
R8 17.17 16.27 15. 5 16.8 1 19.0 17.2~ 16.44 If.. C);?
Holl.
N- number of SUb j ec ts
\it- weight inkilog ra ms ht- height in ce ntimetres BM- BodyMas sInde x
DEBQ- Dut chEating BehaviourQuestio nna i r e BD- BodyDissatisfaction
RS- RosenbergSelf-e ste e m score
36 Ef fe c t s of Ear l y Me n arch e .Us i ngcri t e ri afor objective timing of menarche asdes c .:-i b ed by Tanner(1972)and Rierd anandKoff (1985) post-me narc he a l subjec b e ....ere categorized as be i ng ear l y if th ey re a chedmen arc he be f ore 12 ye ars (41.6%:), on timei fthey reached men a r che be t wee n 12years and 13 years 11 mon t hs (58.3'), and late i fthey ex p e r i e nced mena r cheat 14 years or later (0%:). The age of menarche ranged from 9.83 yecr-s to 13.75 years. The lower quartil e was 11.7 yee r's
(:~40 . 4 months ) and the top qua r tile was 12 . 83 year s (1 54 mont hs) ,with a median of12. 08 years (145month s ).
Althoug hthecorrelatio nbetweenobjective and sUbjective timing ofme na r c he is sig nificant (r=.56), it is re l ati ve l y low, indicating a wea k correspondence betwe e n th'9 two var iables . Ob j e c t i ve timi ng of menarche did no t correspond with euejece tveti mi ng in35 \of the post-menarchea l girls. Twentypercentof the sUbjects wh o reportedth e ms elve s as on timewere actually early and28.2% of the sUbjectswho were chronologica llyon time reported themselvesas early. Si xt y two per cent ofthe subjectswho were chro nolog i c a l l y late report edthemselves as on time.
To test thehypothe s is that actual or perceivedearly men arc here s u l t sinhig herbodydissat isfactionand consequent increased di eta r y restrai nt, fo r wa r d stepwise regression
analysis (using NCSS 5.01, 1987) was used. The forwar d stepwise re g r e s s i o n techniquewasusedbe c a us e , although we hypot hesized that sUbjective ti ming wou ld explain more bod y dissatisfactionvariancetha n·objectivetiming, we did not ha ve any specific expectations regarding the rela t iv e importance of the othe r variab les in explaining body dissatisfactionand consequentdietaryrestra i nt . One ofthe advantages of the forward stepwise re g r e s s ion technique is that it adds va r i a b les intotheregre s s ion equa tio n intho order in Which they contribut e to the predi c t i on of ,I
dependant variable (Hosmer and Le me s ho w, 19(19). stnco t.ho pre s e nt stud y is exploring the ability of a numbe r or inde pe nde nt variables without a predetermined rank or der in explainingdependentvariablevariance , the forwilrd st.epwiae technique is the preferred analy sis to us e (Hos me r and Lemeshow, 1989).
Indepen dent va riables inthe forward stepwise regression equations included: objective and subjective tim ing of menarc he , diet aryres t r ai nt as measuredby the DEBQ-R, Bod y Mass Index, pUberta l status as measureu by tho Pl1 y ~:Iell! Development Scale, self-esteem as measu r ed by theIlo u e"nbe,,1'(1 Self-esteemScal e , timeelapsedsincemenarc he , andamou nt;01 prep ara t i on for menarche. Time elapsed since menarc he WiH~
determined by calculating the numbe r of months between
3B menarche and the monthof datacollection. During pe r s o nal interviewssubjects were asked "What did you know aboutth e menstrual cycle before you experienced it?". Based on the answers to this questionsuef eceswere<ls signe da pr e pa r a tion score ra ng i ng from 1 (not at all prep ared ) to 7 (extremel y wel l prepared). Answers to the preparation for me n a r c he quest ionwere scoredbytwo independent ra t e r s and interrater reliabilitywes found to be 84%.
The analysisrevealed that both objectiveand SUbj e c t i v e timing of menarcheaccountedfor an insignificantamountof the body dissatis factionvariance, lassthan three per cent combined (See Table 2). Thus our hy p ot h e s i s was no t supported. Body MassIndex which accounted for14.8 3% of the variance was the best predicto r of body di ssa t is fa c t ion (t=3.30.P<.01) (See Table 2). followe d by pube rt al atietus which accounted for 7.J \ of the va ria nce (t=- 2.J, p<.OS ).
None of the remaining
ir<d~end ent
Va ri abl e s weresi g ni f ica nt. The combinedindep e nde nt va r iable s included inthe stepwise regressi on equationaccounted for 24.6%of the total bod y dissatisfact ionvariance.In explanation of the dietary restraint variance the regression analysis revealedbod y di s s a t i Sf act i o n accounted for an ins i gnific a nt amount (1.7%)as didSUbjectiveand
Table 2
stepwise Roqressionor Ind.ependent Varllll:l1eaon BOd.y DbsatielaClUoD
andDietary Restraint
Sta ndard
Estimate na
J9
Dependant7ar ! ahl e : Body dis s a tisfa ct i o n
variable :
8MI 0.40 3.3'''' O,I'1H
Puberty -0. 28 -2 .3- 0. 071
Me na r c he time 0.44 1.8 O.U4!.i
Agestart 0.33 1.' 0. 02 "
Time 0.' 0.00 2
RSE 1.0 0.013
pr e p a r at i on 0. ' 0.002
Dependent Variable:
DietaryRestraint Variable ;
Me narc he Time 0.32 2.5''''' 0.091
8MI 0.3 0 2.2* 0.072
puberty -0.2 2 -1.7 0.0'13
RSE 0.18 1.' 0.029
BodyDi s -0.1 5 -1.1 0.017
Time 0. ' O.OO?
Agesta r t 0.3 0.0 0 1
prep arat ion 0.1 u.eoc
.p<.os
··p<.Ol HQ..t.g.
Me narc h eti me- number of months since menarche 8MI - Body Mass Ind e x
PUbe rty- pubertal sta t us RSE- Rosenberg Sel f -esteemscore Bod y dis- bodydi s s at i s f a cti on score Ti me- eubjecti Lv etimingof menarche Age start- obj e cti vetimingof men a r c he Prepara t i on -amountofpre parat i o n for mena rche
4.
objecti ve timing whIchcombined accounte dfo r les s th a none per cent (See Table 2). Thus our hypothesis that bod y di s sati s fa ct i on wou ld exp lain a signif i c ant amount of the dietary restra Int var ianc e was notsup ported. The forward st e pwi se regression analy sis revea led tha t time si nce mena r c he, which accounted fo r 10.2\ of the va ria nce (t..2.S,p<.Ol), andBody Ha ssInd e x, wh ichaccountedfor 7.2' of the variance, wer e the only va r iable s expl ain ing sig ni f i c a nt dietary restraint varianc e as measured by the DEBQ-R. The co mb i ne d independen t variab les accounted fo r 23.27\ of the to tal diet ary restra in t va ria nce.
Int e rcorr e l a t l ons of al l dep end an t and ind ependent va ria ble s areavailable in AppendixK.
Pre / Po stMena rchecompa risons. Seve nt y per cent of the post- me nar c h ea l gir ls re portedthe yeither had dIeted in th e past or we r e currently dietIng_ Fifty per cent of the pre- menarchealsUbjectsreportedtheyhadeng aq ed insomedie ti ng pr a ct i s e s .
Seventy- fiv e pe r cent of the post-men archea l SUbjects select e d ideal figurasil ho ue t t e swhichweresma l le r tha n the figure the ysel ect e das corresponding to the ir cur r e nt body size. A signif icantlysmaller numbe r of the pr e-mena rchea l
"
sample, 33.3%, sel e c t ed thinner fi gures as the i r idea l (Chi square (2 , N=110 ) =1 2.62 ,p<.05).
It wasexpectedthat po s t-menarche algirl swouldexh ibit a sig n i f i c a nt l y hig her de g r eeof di eta r yrestraintas meaeur-cd bythe OEBQ- R, than pre-mena r c heal girl s. A GLM ANOVA(us ing NeSS 5.01, 1987 ) wi t hag e covaried out, re vea led th e post- menarcheal groupDEBQ-Rmean ~f18 . 99 (s d9.B ) (See'retn c 1) is sig ni f i c an t l y greaterthan the pre-m enarchealgroupDEDQ-R mea nof11.06 (sd 8.9) (F( 1 , 107)= 9. 9 9,p< .0 5) (See Figu r e 1).
There are no ind e pend ent criteria ava fLa bIe for ca tego r i z i ng restrain t scor es as me a sur e dby the OEDQ- R. As an approximationit issuggested that scores on the Dt;OQ-R from zero to ni ne be categori z ed as 'no rmal' concer n Cor dieti ng,those be t ween10an d19be classedas'lIdl d'con cern , scoresbetween20and 29as'h i gh 'conc ern ,andtho~cabove10 becategor i zedas "exuee ne' conce r n (Hacke t t, 1989). 1'0 be cl asse din eitherof thelatter two cat e goriesallindivid ual would need to report either many 'sometimes' re s t ra i n t pr a c t i s esor several 'o f te n' or 'v ery of t e n ' rigid re stra int practi ses.
Usi ng thesecrit eria, 18 (19.6 %) post-menarchea l l)lrlr:
and 9 (50 \ ) of the pr e-mena r c h e a l girl s reported 'normal'
"
'0
42
Fig ur e 1.Mea nDEBO~Rscore s tor pre andpost.-me narche goir ls.
concern tordie ti n g;J1 (J3.7\ ) post-menarchealand 5 (27.0 t ) pre-menarchealgirlsreported 'mild' concern129 (30.4%)post - menarchea l and4(22.2\) ofthepre-menarchealsamplereported 'h i g h 'con c e r n;while15(16.3\ ) ofthe post-menarcheal and 0 (0%)of thepre-menarchea lgirls reported 'extreme' concern for dieting (SeeFi gur e 2). chisquare analys isrevealedthe post-menarcheal group obtained sco res in the 'hig h' and 'extremeI categoriessign ifica ntl y mo r e fre quen tl yth an the pre-menarchealgroup (Chi sq ua r e(3, N=1J.0)=9.13,p<.05).
Post-menarchealgirl sdid notde monctrut;o signif ica nt ly high er level s of body dissati s f a ct ionas was ox pccted, 'rho post-menarchealgroupBodyIma geAs se s s men t mean of 1.015(!~d
.a s ) (See Table1) was no t significantlygreatertha nthe pr-o-.
menarchea lgroup meanof 1.11 (sd.68 ) (F( l,lOa )=1.01 01 , p:>.(5) (See Figur e 3) . Thus, ourhypothes iswas not supported .
Thehypothesis that post-menarcheal gi r ls'Would exhibit signif icantlylowerlevelsofse lf - esteem,asmeasur ed bythe Rosenbergself-esteemScale,wa s al sonot supported(F(l,lOB) 0.05, p>.05) (see Figure 4).
Feelinas toward Menarche. Duri ng the personal intervi ew SUbjectswereas ke d UWhat were yourfeelings whe nyou hadyou r first period?". Responsesto this quest ion werecnt.e qo r laccl
44
.0...,-- -- - - -- - - ,
Pt. Manarohe
• NO'lIIl1eono ....
CJHI,II CoMor.
Po.1 Menlrolle g MIIII COlleen, _ IxlrollloCon,,,.
Figure2. Frequencyof pre andpost-m enarche 'lI t I s in DEBO-Rcategories.
.0'
45
8D U' OIlScore
Fi gur e 3.Heanbod y dissatisfaction scores forpre and post~Dlen archegirls .
46
'0 .;.::..c:= = -=- ..,
'0
Ago
Figure 4.MeanRosenbe rgSelf-esteemscores fo r pre andpost- menarchegirls,
47
as either positive, negative, or indifferen t . positive responses were those which indicated in same way 'h a pp i n ess' that menarche had started. Exa mpl es of pos i t ive roapc nuou in clud e d til \o,'as excited", "I was happy becauseI would be li ke all of my friends who already had it", and "I kne w I wa n finallybec omi ng a woman".Negativeresponseswere thosewhich suggEsted the SUbje ct was not happy about hayIng st ar t od menst ru ation. Such respons esincl uded "I hatedIt", "I wiah it never ha d to happen to me", and "It was gross and I was scared" . Ind i f f e r e nt respo nsesincluded thos e whichsuqqost.cd i tdidnot matter one way or the otherwhethermenst ruat i on had occurred. Examplesof anindifferentresponseinc l ud e''It di d not matter, I knew it had to happen someti me"and "It did not both e r me when it ha ppened ".
categorized by two ind e p e nd en t raters and the re \11m ·; '1 ~'I.
agreementbetween sco r e rs. Fi fty-n ine (Gil") of th e subj cl.:1"f1 reported feelingswhich were class ifiedas ne g at iv e ; 1J (14%) reported fe e l i n g s which were positive; and feeling s of indi fferencewere reported by 20 (2211) of the SUbjec ts. 'rho negativepreponderance was significa nt (Chisquare (2 ,N:::ll O) '"
40.10, p<.01 ).
Subjectswere alsoasked to rate the degree towh l chthey experienced a number of specific posit i ve and noqctivo feel ing s toward their me n a rch e a l exp er'Ie ncc. A!1 shown in
48 Fig u re 5, sUbjects mo r e fr e q ue nt ly reported expe rie nc ing emot i on s whichare classif i edasne g ati ve . SUbjec ts frequen t l y reported feeling "no t at al l " to the posit ive emotions of 'e xc i t e d ', 'gro wn up' and 'pleased ', While they more frequen tl y re port ed 've r y' to the negative emotions of 'surprised ' , 'scared' , 'emba r rassed ' and 'g ross '.
In responseto the quest ion"Whatwa s the most positive thingabo ut having you r. period?", 33%of the SUb j ect s stated they could no t re c a ll anypositive aspects. at tho s e who reportedsome positiveaspects , themost frequen t responsewas that it vee a sig n of ma t u ring (31. 5i ). Ot her po sit i ve respons e s Inc ludedbeing lik ed byfriends (13.1%) ;itwa spart of being a woman (a); and it enab ledone to nave children
(1%)•
When asked "Wha twa s themo s tne ga t i ve thingabouthav ing your period?", 100\ of the SUbje cts responde d with some ne gati ve aspect. The most common ne gati v e respons e was related to the hassl e invo lve d (e.g., ca r r ying supplies, messiness) (26\). Ot he r negat iverespo nsesincluded phy s i c a l discomfort (17.Hi); behav i o r al limi ta tions (e.g., cannotgo swimming or pla y spo r ts) (16.3-%): and emot iona l changes (8.6 \ )•
..
Frequency
40
30 20 .-
.0
'urprll" lur. ...~.,r...Q,...
Feenng
natln,
• •(noll 00. 0 3 • • 0 1(..
,,1
Figu re5. Frequenc yof positive andnegative fe eli ng s tovardlIlenarche in po s t - men ar c h e girl s.
The mean prepa r at i on
50 for mena r c h e was 2.35 (sd 0.97) , which indica tes tha t over,l lthesub ject swere not very well prepa redfor theme narchea l expe r ienc e.
How well SUbjects were ableto ta l kto thei r mot hez-s , fathers , si bl i ngs, friends and teachers bef o r e thei r menarcheal experience was taken to indi cate the amoun t of socialsupport they hadreceived for thei r menarc h e. Scores ranged from 1to 5, asco r eof 1indicate d the SUbject was abl e to talk tothe so urce ve r y we ll , and a sc o re of 5 ind icated theSUbjec twas una b leto talk at al l to the scu rce about menarche. Mo st SUbjects were able to talk to the i r mot he rs abou t menarche (mean scor e 2.2), howeve r th ey were
unabl e to discussthe ma tterwiththe i r fat h ers (mean score 4.9). SUbjects we r e also abl eto talkto th e i r fr i e nds abo ut menarc he (mean scor e 2. 1 ) , howe ver they were unabletotalk to the i r siblings(mean sc o r e4. 3)or tea c hers (mean score 4.2). In summa ry ,po st-menarchea l girlsrepor t ed eece tvLnqsup port for theme narcheal experiencefromtheir mothersand frien ds but little suppo rtfr om their fathers siblings orte ac her s .
