نقش نارضایتی از بدن به عنوان یک عامل خطر برای افسردگی در دختران نوجوان: آیا تفاوت ها سیاه و سفید است؟

Body dissatisfaction, disordered eating and depression differentially affect adolescent girls (compared to boys); however, these variables have not been examined in relation to ethnicity. A review of the literature finds that Black adolescent girls are more satisfied with their bodies than White adolescent girls and engage much less frequently in dieting or disordered eating than do White girls in the US. A central question raised by this review is whether body dissatisfaction and pubertal timing are as relevant to our understanding of the etiology of depression in Black girls as they appear to be in White girls. Based on the available data, it does not seem that a risk factor model supporting the role of early pubertal timing, weight increases and body dissatisfaction in the development of depression applies to Black adolescent girls. This review underscores the need for future research with a variety of ethnic minority groups to better understand the etiology of adolescent depression.

Improving the scientific knowledge base regarding the mental health of ethnic minority populations, adolescents in particular, and ensuring the provision of culturally competent services have been identified as public health priorities [1]. Detailed reviews of the empirical literature focusing on specific mental disorders are needed to determine the prevalence of and risk factors for specific disorders as a basis for establishing the clinical services and preventive intervention needs for adolescents from culturally diverse groups. Such reviews also may identify gaps in knowledge and point to further research needs. Moreover, much of what we know about adolescent mental disorders is based on largely White samples. Research agendas and treatment approaches are often developed from this vantagepoint, which may be inappropriate or unwarranted for minority populations. Thus, a better understanding of ethnic differences in the disorders common to adolescents will broaden the scope of research and assist in the development of appropriately tailored treatment and prevention strategies.

Returning to the first of the two conceptual questions initially posed, the preponderance of data finds few differences in the prevalence rates of depression for Black and White adolescent girls. In contrast, the studies on body dissatisfaction and disordered eating provide ample evidence that Black girls are significantly more satisfied with their weight and shape and engage in less disordered eating than White girls. Black girls may be protected from body dissatisfaction by powerful familial and peer influences as well as the role of the culture in acceptance of larger body size. We also asked whether body dissatisfaction and early pubertal development are as relevant for an understanding of depression in Black girls as they seem to be for White girls. The answer to this question appears to be a qualified “probably not.” Although Siegel's study [73] found that decreases in body satisfaction over time resulted in greater depression for Black girls, both her earlier study and Ge et al.'s recent and larger study [82] suggest that when pubertal timing is added into the model, the relationship between pubertal timing, body dissatisfaction and depression differs for Black and White girls. For White girls, early maturation appears to lead to greater body dissatisfaction resulting in increased risk for depression. However, for Black girls, there does not seem to be a mediational relationship between early puberty and depression. Although weight gains in puberty result in greater body dissatisfaction relative to on-time peers [34], this dissatisfaction does not predict depression [81] and [83]. Thus, this review raises a cautionary note regarding current etiological models of depression, which may need to be reconceptualized and re-evaluated in consideration of ethnic and cultural factors.