The body matters : understanding social differences in mental health

Document Type



Doctor of Philosophy (PhD)


Global and Sociocultural Studies

First Advisor's Name

Lilly M. Langer

First Advisor's Committee Title

Co-Committee Chair

Second Advisor's Name

William R. A vison

Second Advisor's Committee Title

Co-Committee Chair

Third Advisor's Name

Eric F. Wagner

Fourth Advisor's Name

R. Jay Turner

Date of Defense



This doctoral dissertation illuminates the salience of body image to sociological investigations of mental health. It is argued that concerns over body-appearance evident in America embody a dimension of distress over the physical self that may be appropriately considered a mental health outcome, called body dysphoria. Using cross-sectional data from a sample of 1,183 young adults comprising Hispanic, African American, and non-Hispanic white males and females of varying social classes, a valid and reliable measure of body dysphoria is developed and demonstrated to be a distinct dimension of psychological distress.

From the standpoint of the sociology of mental health, the social distribution of body dysphoria makes known individual consequences of the stratified arrangements of society based on gender, race/ethnicity, and social class. Results reveal significant social differences in body dysphoria that are both consistent with and contrary to clinical studies attributing eating disorders to white, upper-class females. Body dysphoria is substantially greater among females supporting that unrealistic cultural ideals and standards of body- appearance remain disproportionately targeted at females in the development and presentation of self. Compared to non-Hispanic whites, Hispanics exhibit higher average levels of body dysphoria while African Americans exhibit lower levels of comparable proportion. The question is addressed whether identification with the dominant (white) culture influences distress over body-appearance among racial/ethnic minorities. A small inverse association is revealed between social class origin and body dysphoria suggesting that individuals from lower social class backgrounds are as greatly affected by body image concerns generally presumed to preoccupy upper social classes.

The stress process is a widely used theoretical paradigm for explaining structurally driven social differences in mental health outcomes. New evidence is introduced that the stress process may contribute to understanding body image problems. Regression analyses reveal that stress exposure has a significant positive association with body dysphoria that is mediated by varying psychosocial resources. Overall, the stress process explains the effects of social class origin and African American race/ethnicity on body dysphoria but does not account for the larger effects of being female or Hispanic.



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