Download The role of acculturative stress and body dissatisfaction in predicting

The Role of Acculturative Stress and Body
Dissatisfaction in Predicting Bulimic
Symptomatology Across Ethnic Groups
Marisol Perez, Zachary R. Voelz, Jeremy W. Pettit, and Thomas E. Joiner, Jr.*
Department of Psychology, Florida State University, Tallahassee, Florida
Accepted 2 April 2001
Abstract: Objective: This study examines the interactive effects of acculturative stress and
body dissatisfaction in prediction of bulimic symptoms, particularly in non-White females.
Method: We administered questionnaires to White, Black, and Hispanic females on acculturative stress, body dissatisfaction, and bulimic symptoms. Results: Our results show that
among minority women who report low levels of acculturative stress, body dissatisfaction
and bulimia were not correlated. However, among minority women who reported high
levels of acculturative stress, body dissatisfaction and bulimia were highly and signi®cantly
correlated. Discussion: The combination of acculturative stress and body dissatisfaction may
render minority women more vulnerable to bulimic symptoms; the absence of acculturative
stress among minority women may buffer them against bulimic symptoms, even in the
presence of body dissatisfaction. Ó 2002 by Wiley Periodicals, Inc. Int J Eat Disord 31:
442 454, 2002.
Key words: acculturative stress; bulimia; body dissatisfaction; minorities; women
INTRODUCTION
What happens when an individual moves to a different culture? Studies in crosscultural psychology tell us that people change, not only culturally, but psychologically as
well (Berry, 1998). The term acculturation is de®ned as the assimilation of a different
culture to oneÕs own culture, with the ultimate goal of minimizing the differences between cultures. Coupled with this change to a new culture is the inherent stress of
adaptation; thus, the term acculturative stress.
Acculturative stress has been found to be associated with mental illness symptoms
across several cultures, including Cambodian, Vietnamese, Laotian, Hmong, Mexican
American, and other Hispanic populations (Hovey, 1998; Mehta, 1998; Nicholson, 1997).
*Correspondence to: Dr. Thomas E. Joiner, Jr., Department of Psychology, Florida State University, Tallahassee,
FL 32306-1270. E-mail: [email protected]
Published online in Wiley InterScience (www.interscience.wiley.com). DOI: 10.1002/eat.10006
Ó 2002 by Wiley Periodicals, Inc.
Acculturative Stress and Bulimia
443
Elevated levels of acculturative stress have been shown to produce serious repercussions
related to depression (Hovey, 1998; Miranda & Umhoefer, 1998; Neff & Hoppe, 1993),
suicidality (Hovey, 1998), and interpersonal problems (Nicholson, 1997). Within the
female population in general, higher levels of acculturative stress also have been associated with high-risk activity and sexual behavior among Hispanic adolescent girls
(Fraser, Piacentini, Van Rosen, Hien, & Rotheram-Borus, 1998; Corbett, Mora, & Ames,
1991, presented an interesting exception to this general rule, in that lower levels of
acculturative stress correlated with higher levels of alcohol consumption). For females,
then, there may be a wide range of problems associated with high levels of acculturative
stress.
A paucity of research exists on the negative side to acculturating to American culture in
the realm of body image and eating disorder symptoms among females. Body image,
according to Braitman and Ramanaiah (1999 p. 1055), refers to ``personal evaluations and
affective experiences'' regarding oneÕs physical attributes and attractiveness. These ``affective experiences'' are shaped by cultural norms and expectations, which in turn are
assumed to influence body image (Cash & Pruzinsky, 1990). According to the gender
schema theory, people evaluate and change their physical appearance to conform to
cultural standards (Bem, 1981). Each culture has its own view of attractiveness in physical
appearance. A change from one culture to another may affect body image for those who
acculturate to the new culture. Thus, according to Mintz and Betz (1986), a society that
emphasizes female slenderness and satisfaction with oneÕs body as very important to selfesteem may result in disturbances in body image among women. Consequently, one
product of acculturation to American society may be the adoption of a somewhat extreme
ideal body image.
Prior research on eating disorders has demonstrated that oneÕs ideal body image may
serve as a crucial variable that contributes to the development and maintenance of eating
disorders (Rosen, 1995; Showers & Larson, 1999; Waller & Hodgson, 1996; Williamson,
Cubic, & Gleaves, 1993). Additionally, members of varying cultures hold varying conceptualizations of what an ideal body image should be, as suggested by the endorsement
of different silhouettes for ideal body image across cultures (Collins, 1991; Hodes, Jones,
& Davies, 1996; Joiner & Kashubeck, 1996; Lawrence & Thelen, 1995; Lopez, Blix, & Blix,
1995; Molloy & Herzberger, 1998; Ogden & Elder, 1998). With cultural differences in body
image in mind, it is important to recognize that acclimation to American culture may be
accompanied by a potential change in ideal body image. If this change in ideal body
image and attractiveness occurs such that the ideal body image becomes unrealistically
thin, acculturating women may become more vulnerable to eating disorder symptoms.
Past research has shown that the acceptance of an unrealistic ideal of thinness, attractiveness, and perfection is associated with higher risk of eating disorder symptomatology
(Mintz & Betz, 1988; Striegel-Moore, Silberstein, & Rodin, 1986). Consistent with these
findings, Dolan (1991) reported that ethnic minority women who had been exposed to
Western societies exhibited higher prevalence rates of eating disorders than did ethnic
minority women who had not been exposed to Western societies.
Research also suggests that the Western female body ideal is thin (Butler & Ryckman,
1993; Lamb, Jackson, Cassiday, & Priest, 1993; Myers & Biocca, 1992) and steadily thinning (Stice & Shaw, 1994). Women from Western countries may internalize media messages promoting thinness; consequently, slenderness becomes a goal they strive to
achieve (Myers & Biocca, 1992). Western society negatively stereotypes overweight
people as being unattractive (Larkin & Pines, 1979) and positively stereotypes slender
individuals as being more attractive (Dion, Berscheid, & Walster, 1972). These stereotypes
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Perez et al.
may have a detrimental effect on females within American society and may predispose
them to eating disorders (Monteath & McCabe, 1997). These same ideals are experienced
by women acclimating to American society.
Body image dissatisfaction, in combination with other stressors, can have serious
consequences. Vohs, Bardone, Joiner, Abramson, and Heatherton (1999) found that interactions among body dissatisfaction, perfectionism, and low self-esteem predicted
bulimic symptoms in women (see also Vohs et al., in press). Furthermore, in eatingdisordered individuals, it has been shown that body dissatisfaction may be associated
with problematic experiences in gender role identities (Jackson, Sullivan, & Rostker,
1988), individuation (Schupak-Neuberg & Nemeroff, 1993), and general self-concept
(Denniston, Roth, & Gilroy, 1992; Strober & Katz, 1988). Thus, women who acculturate to
American society may face problems in the domains of body image and eating disorder
symptoms.
This pattern of acculturative stress and body dissatisfaction has already been noted in
studies examining Hispanic females in the United States. Lopez et al. (1995) found that
Hispanic women who had not acculturated tended to select larger silhouettes as their
ideal body image from a visual index of female body figures (Female Silhouette Chart;
Bell, Kirkpatrick, & Rinn, 1986) than did Hispanic women who had acculturated. Furthermore, studies show that acculturated Hispanic women are just as likely to exhibit
eating-disordered behavior (Joiner & Kashubeck, 1996) and a distorted body image
(Guinn, Semper, & Jorgensen, 1997) as White females. One study even found that Hispanic females may be more likely to engage in the use of diuretics than White females
when trying to attain desired thinness (Story, French, Resnick, & Blum, 1995). Given these
findings, one could hypothesize that acculturative stress might play a role in the development and maintenance of eating disorders among Hispanic American women (and
perhaps other minority women as well). However, not all studies have found this effect
(Joiner & Kashubeck, 1996; Lester & Petrie, 1995).
Very few studies have investigated the effects of acculturative stress on eating disorders, and those that did obtained mixed results (Joiner & Kashubeck, 1996; Lester &
Petrie, 1995; Lopez et al., 1995; Pumariega, 1986). Moreover, none of the previous research
investigated the relationship of body dissatisfaction to bulimic symptoms as moderated by acculturative stress (e.g., it is possible that body dissatisfaction will not encourage bulimic symptoms in acculturatively unstressed women). Lopez et al. (1995)
investigated body image and acculturation in a sample of older women and found that
the more acculturated women selected thinner silhouettes as their ideal body image
than the less acculturated women. Joiner and Kashubeck (1996) investigated acculturation levels, body image ideals, self-esteem, and bulimic and anorexic symptomatology in a sample consisting of adolescent Mexican American females. They found
that only body dissatisfaction and lower levels of self-esteem were related to eating
disorder symptomatology. They also found that acculturation levels were not related to
self-esteem or body image ideals, which is inconsistent with past research (Davis &
Katzman, 1999; Grubb, Sellers, & Waligroski, 1993; Guinn et al., 1997; Lopez et al., 1995;
Padilla, Wagatsuma, & Lindholm, 1985). Lester and Petrie (1995) investigated body
dissatisfaction, beliefs about attractiveness, and bulimic symptomatology in a Mexican
American college sample. They found that those who highly valued attractiveness
(consistent with norms in Western societies, i.e., thin ideal body image) reported more
bulimic symptoms. Pumariega (1986) investigated eating attitudes and feelings related to
anorexia in an adolescent Hispanic female sample. He found that high levels of accul-
Acculturative Stress and Bulimia
445
turation together with disordered eating attitudes and feelings predicted anorexic
symptoms.
In the present study, our aim was to examine acculturative stress, body image dissatisfaction, and eating disorder symptoms among Blacks, Hispanics, and Whites in the
United States. Interestingly, Black and White women may be at opposite ends of the
spectrum on body dissatisfaction and prevalence of eating disorders. In general, Black
women exhibit a more positive body image (Abrams, Allen, & Gray, 1993; Akan & Grilo,
1995; Casper & Offer, 1990; Kemper, Sargent, Drane, Valois, & Hussey, 1994; Molloy &
Herzberger, 1998; Wilfley et al., 1996; Wilson, Sargent, & Dias, 1994) and lower levels of
disordered eating and dieting behaviors than White females (Abrams et al., 1993; Akan &
Grilo, 1995; Casper & Offer, 1995; Lawrence & Thelen, 1995). Theories addressing the
relatively low prevalence of eating disorders among Black women revolve around the
notion that, although this group may experience acculturative stress, they identify
themselves with their culture and reject the White female ideals of attractiveness (Anderson, 1991; Parker et al., 1995).
In this study, we use an ethnically diverse undergraduate female sample, for two
reasons. First, in order to have found their way to a large, state university, individuals
likely have acclimated to a certain degreeÐto the language, educational system, financial
system, requirements to be successful in school, and way of life. Previous research within
the body image literature shows that females who have acculturated are more vulnerable
to body dissatisfaction. Second, eating disorder symptoms are relatively common among
undergraduate women. Thus, a young adult female population of ethnically diverse
undergraduates is appropriate for the purposes of this study.
Minority women who report body dissatisfaction and who are stressed about acclimating and fitting in may be motivated to engage in bulimic-type behaviors (similar to
White women). Women who report body dissatisfaction but no or low levels of acculturative stress are not stressed about fitting into the culture and thus may not be motivated to engage in bulimic-type behaviors, even if they are not satisfied with their bodies.
For this reason, the main hypothesis of this study involves the interaction between
acculturative stress and body dissatisfaction in the prediction of bulimic symptoms
among minority versus White women. We hypothesize that in White females, body
dissatisfaction will be a significant predictor of bulimic symptoms, but neither acculturative stress nor its interaction with body dissatisfaction will be significant predictors of
bulimic symptomatology. For the Hispanic and Black females, we hypothesize that both
body dissatisfaction and acculturative stress will be significant predictors of bulimic
symptoms, and furthermore, that the interaction between body dissatisfaction and
acculturative stress will also be a significant predictor of bulimic symptoms. We predict
the interaction term to be significant because it conveys our diathesis-stress prediction
that, for minority women, body dissatisfaction may serve as a risk for bulimic symptoms,
only or particularly when combined with acculturative stress.
Although our focus is on the interaction between acculturative stress and body dissatisfaction in the prediction of bulimic symptoms among minority versus White women,
we also developed hypotheses regarding ethnic group differences on acculturative stress,
body dissatisfaction, and bulimic symptoms. With regard to acculturative stress, we
predict that the Black and Hispanic groups will report higher levels of stress than the
White group. Regarding body dissatisfaction and bulimic symptoms, we predict that the
White and Hispanic groups will report more dissatisfaction and symptoms than the Black
group.
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Perez et al.
METHOD
Participants
Participants were 118 female undergraduate university students who participated in
the study to partially fulfill a requirement for their introductory psychology class. The
ethnic composition of the sample was 51% Caucasian (n = 60), 19% Hispanic (n = 22), and
30% Black (n = 36). Within the Hispanic group, 20 of the 22 women were born in the
United States. Regarding their parents, 3 of the 22 Hispanic women reported that both
parents were born in the United States, 5 of the 22 reported that one parent was born in
the United States and one parent was born in a Hispanic country, and 14 of the 22
reported that both parents were born in a Spanish-speaking country.
Procedure
Participants were informed that they would be completing questionnaires about their
personality, emotions, self-concept, and stress. All participants completed written informed consents. Administration was conducted in groups of approximately 20. All
questionnaires were administered in English. Approximately 30 min were required to
complete the instrument and participants were debriefed upon completion of the packets
via a written information sheet.
Materials
The Societal, Attitudinal, Familial and Environmental Acculturative Stress Scale
The SAFE (Padilla et al., 1985), a short version of the original 60-item SAFE scale, was
used to assess levels of acculturative stress as other studies had done (Fuertes & Westbrook, 1996; Mena, Padilla, & Maldonado, 1987). The short version of the SAFE scale
measures acculturative stress in social, attitudinal, familial, and environmental contexts,
along with perceived discrimination toward immigrant populations (Mena et al., 1987).
Participants were required to rate each item that applied to them on a Likert scale,
ranging from 1, not stressful, to 5, extremely stressful (0, not applicable). The possible scores
for the SAFE ranged from 0 to 120. This scale has shown reliability for Asian Americans
and international students (alpha = .89; Mena et al., 1987), for a heterogeneous group of
Hispanics (alpha = .89; Fuertes & Westbrook, 1996), and for Haitian and Haitian Americans (Chrispin, 1999). The SAFE has not been normed speci®cally on a heterogeneous
group of Black college students. However, the alpha coef®cient obtained in this sample
(alpha = .87) is similar to the alpha coef®cients of all the other ethnic populations for
which it has been normed.
The Eating Disorder Inventory
The EDI (Garner, Olmsted, & Polivy, 1983) is a 64-item, self-report measure of eating
behavior and thought patterns. It has eight subscales: Drive for Thinness, Bulimia, Body
Dissatisfaction, Ineffectiveness, Perfectionism, Interpersonal Distrust, Interoceptive
Awareness, and Maturity Fears. The subscales have shown adequate internal consistency
coefficients and have been well validated. In this sample, the alphas were .84 and .93,
Acculturative Stress and Bulimia
447
respectively, for Bulimia and Body Dissatisfaction. Participants were asked to rate items
on a 1 6 Likert scale (1 = never, 2 = rarely, 3 = sometimes, 4 = frequently, 5 = usually, 6 =
always).
Body Image (BI) Scale
Seven female adult figure drawings, obtained from the Stunkard Body Figure Scale
(Stunkard, Sorenson, & Schulsinger, 1983), were used to illustrate body weight ranging
from very thin to obese. The original scale had nine female figures; this scale was
shortened to seven. Participants indicated where on the scale they perceived their own
body image, as well as the ideal body image of females in the United States. Reliability for
these scales was reported as .74 (Sorensen, Stunkard, Teasdale, & Higgins, 1983; Stunkard
et al., 1983). Sorensen et al. (1983) also reported validity coefficients. We will use the
difference between self-image and US ideal body image as an additional index of body
dissatisfaction, to further test our prediction that body dissatisfaction and acculturative
stress will interact to predict bulimic symptoms.
RESULTS
Means and standard deviations for the sample are provided in Table 1. Table 2 presents
the zero-order correlations between all measures. As Table 2 shows, self-reported bulimic
symptoms on EDI-Bulimia were correlated with body dissatisfaction on EDI-Dissatisfaction (r = .62, p < .01), such that the more body dissatisfaction reported, the more
bulimic symptoms endorsed. Similarly, EDI-Bulimia was correlated with the SAFE-Acculturative Stress (r = .27, p < .01), where the more acculturative stress reported, the more
bulimic symptoms endorsed. SAFE-Acculturative Stress and body dissatisfaction (EDIBody Dissatisfaction) were not signi®cantly correlated (r = .10, p = .26). EDI-Bulimia
was signi®cantly correlated with all three BI scales, BI-Self (r = .29, p < .01), BI-US ideal
(r = ).20, p < .05), and BI (Self-US) difference score (r = .33, p < .01), where for BI-Self and
BI (Self-US), the larger the self body image the more bulimic symptoms reported. The
relationship between bulimic symptoms and BI-US was also in the expected direction,
such that the thinner the ideal body image perception, the more bulimic symptoms
reported. A similar pattern of correlations emerged with the three BI scales and body
dissatisfaction (BI-Self r = .46, p < .01; BI-US r = ).37, p < .01; BI (Self-US) r = .56, p < .01).
Among the three BI scales, only the BI-Self signi®cantly correlated with acculturative
Table 1.
Means and standard deviations for measures
Measure
N
M
SD
EDI-Bulimia
EDI-DISSAT
SAFE
BI-Self
BI-US
BI (Self-US)
118
118
118
116
118
116
13.38
30.96
30.48
3.70
3.21
0.50
5.65
12.10
14.16
0.91
0.60
1.10
Note: EDI = Eating Disorders Inventory; EDI-DISSAT = Body Dissatisfaction subscale on the EDI; SAFE =
Societal, Attitudinal, Familial and Environmental Acculturative Stress Scale; BI-Self = participant's self rated
body image on the Body Image Scale; BI-US = ideal body image in the United States as rated by participants on
the Body Image Scale; BI (Self-US) = difference score between BI-Self minus BI-US ideal.
448
Perez et al.
Table 2.
Intercorrelations between variables
Measure
1.
2.
3.
4.
5.
6.
EDI-Bulimia
EDI-DISSAT
SAFE
BI-Self
BI-US
BI (Self-US)
1
2
3
4
5
6
Ð
.623**
Ð
.266**
.104
Ð
.286**
.547**
.242**
Ð
).195*
).365**
.049
).031
Ð
.332**
.563**
.173
.845**
).56**
Ð
Note: EDI = Eating Disorders Inventory; EDI-DISSAT = Body Dissatisfaction subscale on the EDI; SAFE =
Societal, Attitudinal, Familial and Environmental Acculturative Stress Scale; BI-Self = participant's self rated
body image on the Body Image Scale; BI-US = ideal body image in the United States as rated by participants on
the Body Image Scale. BI (Self-US) = the difference score between BI-Self minus BI-US ideal.
*p £ .05.
**p £ .01
stress (BI-Self r = .24, p < .01; BI-US r = .05, p = n.s; BI (Self-US) r = .17, p = n.s.), that is, the
larger the self body image, the more acculturative stress reported.
The In¯uence of Ethnicity on Acculturative Stress, Body Dissatisfaction, and
Bulimic Symptoms
To determine whether ethnicity had any main effect on the dependent variables, we
performed a one-way multivariate analysis of variance (MANOVA) on acculturative
stress (SAFE), body dissatisfaction (EDI-Body Dissatisfaction), and bulimic symptoms
(EDI-Bulimia). The results of this analysis are reported in terms of WilksÕs lambda converted to an exact multivariate F statistic. The MANOVA produced a signi®cant multivariate effect for race, F (6, 226) = 10.30, p < .01. In the context of the signi®cant
multivariate F, the univariate Fs revealed a signi®cant main effect for race on SAFEAcculturative Stress, F (2, 115) = 14.70, p < .01, EDI-Body Dissatisfaction, F (2, 115) = 9.26,
p < .01, and EDI-Builimia, F (2, 115) = 8.76, p < .01. In line with predictions, the Hispanic
(M = 15.09) and White (M = 14.60) groups reported more bulimic symptoms than the
Black group (M = 10.31; Hispanic-Black Tukey HSD, p < .01; White-Black Tukey HSD, p <
.01; White-Hispanic Tukey HSD, p = .93). Also, congruent with predictions, both the
Hispanic (M = 33.10) and White (M = 34.23) groups reported higher levels of body
dissatisfaction than the Black group (M = 24.22; Hispanic-Black Tukey HSD, p < .02;
White-Black Tukey HSD, p < .01; White-Hispanic Tukey HSD, p = .91). A slightly different
pattern resulted with regard to acculturative stress: the Hispanic group (M = 40.83)
reported the most acculturative stress, followed by the Black group (M = 33.83), and the
White group (M = 24.68; Hispanic-White Tukey HSD, p < .01; White-Black Tukey HSD, p
< .01; Hispanic-Black Tukey HSD, p < .11).
The Interaction of Acculturative Stress and Body Dissatisfaction Within Each Ethnic Group
in Predicting Bulimic Symptoms
To test the prediction that acculturative stress, body dissatisfaction, and the interaction
between these two variables would predict bulimic symptoms, we constructed a regression equation with bulimic symptom scores as the dependent variable. We combined
Acculturative Stress and Bulimia
449
Table 3. Summary of hierarchical regression analysis for variables predicting bulimic symptoms
among non-White females (N = 58)
Variable
Step 1
Body dissatisfaction
Acculturative stress
Step 2
Body dissatisfaction
Acculturative stress
Interaction term
B
SE B
b
.12
.25
.04
.05
.31**
.50**
).19
).21
.01
.12
.09
.00
).38
).56*
1.43**
Note: R2 = .43 for Step 1; DR2 = .13 for Step 2 (ps < .01).
*p < .05.
**p .01.
the Hispanic and Black females into one group and the White females into another
group.1
As Table 3 shows, among the non-White women, when body dissatisfaction and acculturative stress were entered into the equation, the equation was significant, F (2, 55) =
20.7, p < .01, and both terms were signi®cant predictors of bulimia (body dissatisfaction
partial correlation = .54, t = 4.71, p < .01; acculturative stress partial correlation = .37, t =
2.91, p < .01). When the interaction term was entered into the equation, the equation was
signi®cant, F (3, 54) = 15.53, p < .01, as was the interaction term (partial correlation = .47, t
= 3.94, p < .01). Not only was the interaction term signi®cant, but the form of the interaction was as we predicted. To show this, we divided the non-White womenÕs acculturative stress scores into two groups (i.e., the top half and bottom half). We then computed
the correlations between the bulimia and body dissatisfaction scores among these two
subsamples. As predicted, among minority women high in acculturative stress, the
higher the body dissatisfaction, the more bulimic symptoms reported (r = .76, p < .01).
Also as predicted, among minority women low in acculturative stress, the relationship
between body dissatisfaction and bulimia was weaker and did not achieve statistical
signi®cance (r = .20, p = n.s.).
To further document this predicted effect, we conducted these same analyses, but
replaced body dissatisfaction with a different variable, body image perception. The body
image perception score is a difference score consisting of participantsÕ self-rated body
image minus their perception of the ideal body image in the United States. Among the
non-White women, when body image difference score and acculturative stress were
entered into the equation, the equation was significant, F (2, 55) = 9.88, p < .01, and both
terms were signi®cant predictors of bulimia (body image difference score partial correlation = .27, t = 2.10, p < .05; acculturative stress partial correlation = .38, t = 3.05, p < .01).
When the interaction term was entered into the equation, the equation was signi®cant, F
(3, 54) = 10.31, p < .01, as was the interaction term (partial correlation = .37, t = 2.91, p <
.01). Not only was the interaction term signi®cant, but the form of the interaction was as
we predicted. To show this, we again divided the non-White womenÕs acculturative
1
The Black and Hispanic groups were combined because our predictions were the same for both. In a
supplemental analysis among minority women, the three-way interaction among race (1 = Black; 2 = Hispanic),
body dissatisfaction, and acculturative stress was not signi®cant, F (7,50) = .07, p = .79, in predicting bulimic
symptoms. This demonstrates empirically that the interaction between acculturative stress and body dissatisfaction in predicting bulimic symptoms does not differ between the Hispanic and Black women.
450
Perez et al.
Table 4. Summary of hierarchial regression analysis for variables predicting bulimic symptoms
among White females (N = 60)
Variable
Step 1
Body dissatisfaction
Acculturative stress
Step 2
Body dissatisfaction
Acculturative stress
Interaction term
B
SE B
b
.26
.11
.05
.05
.57**
.21*
.19
.01
.00
.17
.24
.01
.42
.02
.28
Note: R2 = .43 for Step 1 (p < .01); DR2 = .00 for Step 2 (p = ns).
*p < .05.
**p .01.
stress scores into two groups (i.e., the top half and bottom half) and computed the
correlations between the bulimia and body image difference scores among these two
subsamples. As predicted, among minority women high in acculturative stress, the
higher the body image difference score, the more bulimic symptoms reported (r = .49, p =
.01). Also as predicted, among minority women low in acculturative stress, the relationship between the body image difference score and bulimia was weaker and did not
achieve statistical signi®cance (r = ).01, p = n.s.).
As Table 4 shows, for the White females, when body dissatisfaction and acculturative
stress were entered into the equation, the equation was significant, F (2, 57) = 21.19, p <
.01, and both terms were signi®cant predictors (body dissatisfaction partial correlation =
.59, t = 5.56, p < .01; acculturative stress partial correlation = .26, t = 2.06, p < .05).
However, when the interaction between body dissatisfaction and acculturative stress was
entered into the equation, it was not a signi®cant predictor, as expected, F (3, 56) = .19, p =
.66; partial correlation = .06, t = .48, p = .66.
DISCUSSION
The primary contribution of our study involved the interactive effects between acculturative stress and two measures of body dissatisfaction in predicting bulimic symptomatology in non-White females. To our knowledge, this is a novel conceptualization
and finding. Very few studies have investigated these three variables together, perhaps
due to the low prevalence of body dissatisfaction among Black females and the relative
lack of research in Hispanic samples. But as our results suggest, the relationship between
body dissatisfaction and bulimia may be moderated by acculturative stress among minority women. Indeed, among minority women who reported low acculturative stress,
we found a low, nonsignificant correlation between body dissatisfaction and bulimic
symptoms. The finding that body dissatisfaction and bulimic symptoms are uncorrelated
among any sample of women is, by itself, important, and its importance is enhanced
further by the fact that it conformed to our a priori predictions. The relationship between
body dissatisfaction and bulimia was intensified (i.e., correlation became strong and
significant) among minority women who reported high levels of acculturative stress. The
pattern of body dissatisfactionÐbulimia correlations among low versus high acculturative stress minority women was very clear (i.e., a difference in correlations of more than
.50 in both sets of analyses), lending more support to our conceptualization and findings.
Acculturative Stress and Bulimia
451
The combination of acculturative stress and body dissatisfaction may render minority
women vulnerable to bulimic symptoms; the absence of acculturative stress among minority women may buffer them against bulimic symptoms, even in the presence of body
dissatisfaction.
Although our focus was on the interaction of body dissatisfaction and acculturative
stress in predicting bulimic symptoms among minority women, our findings also add to
the growing consensus that Hispanic females in the United States may be at as great a
risk for eating disorders as White females. Like other investigators (Joiner & Kashubeck,
1996), we found that Hispanics reported similar levels of eating-disordered symptoms as
White females, and both groups reported higher levels than Black females. An additional
contribution of the present study, then, was to replicate past research on eating disorder
symptoms among Hispanic, White, and Black females.
A further contribution of our study involved ethnic differences in acculturative stress.
We predicted that Hispanic and Black females would report similar levels of acculturative stress, with both groups reporting more acculturative stress than White females. We
found that Hispanics reported the highest levels of acculturative stress, followed by Black
females, and then White females. Although our minority sample consisted of undergraduate college students who had acculturated to a certain degree, many women still
reported current stress related to acculturation (i.e., acculturative stress).
Before further discussing some implications of these findings, we first note some
limitations and considerations regarding the present study. First, our sample consisted of
an undergraduate female population. This may limit the generalizability of our results.
Future work should determine whether the interactive effects of body dissatisfaction and
acculturative stress in predicting bulimic symptoms among minority women applies to
non-college student samples. Second, we did not assess the type of acculturation exhibited by these females (e.g., biculturalism, assimilation, acculturation, marginalization;
LaFromboise et al., 1993). Assessment of the type of acculturation along with the level of
acculturation may further refine our conceptualization and results. Third, our sample
consisted of a mixture of Hispanic females. Given the heterogeneity of Hispanics, there
may be higher risks for bulimic symptoms in females from certain Hispanic countries
more so than othersÐanother important avenue for future work. Fourth, our measures
were based on self-reports and no actual measure of body mass index was assessed.
Therefore, our study pertains solely to self-perceptions. We have no way of measuring
the accuracy of the self-perceptions.
Our findings may have clinical implications. First, body dissatisfaction along
with acculturative stress should be assessed among minority women; when both of
these are present, bulimic symptoms may also be present. Second, the possibility of an
eating disorder diagnosis obviously should be considered and assessed, regardless of
patientsÕ ethnicity. Although Hispanic and Black females who show eating disorder
symptomatology should receive empirically validated therapeutics, such as cognitivebehavioral therapy, success may be enhanced by aiming interventions at acculturative
stress issues (e.g., problem-solving regarding acclimation to social and occupational
settings).
In conclusion, the present study predicted and found that acculturative stress intensifies the relationship between body dissatisfaction and bulimia among minority women.
Also, in accord with past research, we found that Hispanic females reported levels of
bulimic symptoms and body dissatisfaction similar to those of White females. These
results may inform therapeutic and preventative interventions to fight a serious physical
and mental health problem in Hispanic and Black ethnic groups.
452
Perez et al.
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