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Childhood Beauty Pageant Contestants: Associations with Adult Disordered Eating and Mental Health

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This study evaluated the association between childhood beauty pageants and adult disordered eating, body dissatisfaction, depression, and self-esteem. Eleven women who participated in childhood beauty pageants were matched on age and BMI with 11 non-participating women. Childhood pageant participants scored higher on body dissatisfaction, interpersonal distrust, and impulse dysregulation than non-participants, and showed a trend toward greater ineffectiveness. There were no significant differences between groups on measures of bulimia, body perception, depression, and self-esteem. These findings suggest childhood beauty pageant participation may influence adult body dissatisfaction, interpersonal distrust, and impulse dysregulation, but not bulimic behaviors, body perception, depression, and self-esteem.
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291
Eating Disorders, 13:291–301, 2005
Copyright © 2005 Taylor & Francis
ISSN: 1064-0266 print/1532-530X online
DOI: 10.1080/10640260590932896
Eating D isorders133Taylor & FrancisTaylor and Francis 325 Chestnut StreetPhiladelphiaPA191061064-02661532–530XUEDITaylor & Francis 5570110.1080/ 106402 60590932 8962005119A. L. Wonderlich et al.Childhood Beauty Pageant Contestants
Childhood Beauty Pageant Contestants:
Associations with Adult Disordered Eating
and Mental Health
ANNA L. WONDERLICH
University of Minnesota, Minneapolis, Minnesota, USA
DIANN M. ACKARD and JUDITH B. HENDERSON
Private Practice, Golden Valley, Minnesota, USA
This study evaluated the association between childhood beauty
pageants and adult disordered eating, body dissatisfaction,
depression, and self-esteem. Eleven women who participated in
childhood beauty pageants were matched on age and BMI with 11
non-participating women. Childhood pageant participants scored
higher on body dissatisfaction, interpersonal distrust, and impulse
dysregulation than non-participants, and showed a trend toward
greater ineffectiveness. There were no significant differences
between groups on measures of bulimia, body perception, depres-
sion, and self-esteem. These findings suggest childhood beauty
pageant participation may influence adult body dissatisfaction,
interpersonal distrust, and impulse dysregulation, but not bulimic
behaviors, body perception, depression, and self-esteem.
A variety of biological, psychological, and environmental risk factors have
been linked to disordered eating behavior and negative body image (Stice,
2002). Two environmental risk factors of particular interest are the sociocul-
tural emphasis on thinness and internalization of the thin ideal (Stice). Over
the last century, the ideal of female attractiveness in western culture has
shifted towards thinness. Pressure to achieve this standard is thought to cause
a self-internalization of the thin ideal (Stice). Therefore, individuals who are
Parts of this article were presented as an oral paper presentation at the Academy for Eat-
ing Disorder’s International Conference on Eating Disorders, April 2004, Orlando, Florida.
Address correspondence to Diann M. Ackard, 5101 Memorial Highway, Suite 4001,
Golden Valley, MN 55422. E-mail: Diann_Ackard@mindspring.com
292 A. L. Wonderlich et al.
unable to achieve the internalized ideal may exhibit negative affect and feel-
ings of body dissatisfaction that may contribute to eating pathology (Stice).
Such a drive to pursue thinness may stem from sociocultural messages
presented in popular media. For example, Garner and colleagues (Garner,
Garfinkel, Schwartz, & Thompson, 1980) reported the trend toward thinness
among Playboy centerfolds from 1960 through 1978 by noting that the Body
Mass Index (BMI) values were decreasing across time, whereas there was a
significant increase in the general population of females’ actual weights, cre-
ating a large discrepancy between ideal and actual weights. A follow up of
the Garner et al. study included two time periods: 1979–1988 for Playboy
centerfolds and 1979–1985 for Miss America contestants (Wiseman, Gray,
Mosimann, & Ahrens, 1992). Results indicate a continued decrease in body
size and weight among groups. Furthermore, 60% of Miss America contes-
tants and 69% of Playboy centerfolds across the 10-year study period
reported weights at or lower than 85% of the weight reported by the Society
of Actuaries for their age and height (Wiseman et al., 1992). Singh (1993)
reported the longest temporal examination of body size among both Play-
boy centerfolds (1955–1965 and 1976–1990) and Miss America contest win-
ners (1923–1987). For both groups, the percentage of ideal weight
decreased as years progressed, with both groups averaging less than 90%
ideal weight by the 1980s. It is important to note that Singh’s study only
included Miss America contest winners, not all contest participants.
It is possible that the select group of women who win the Miss America
contest are among an elite group representing the female cultural body
ideal. However, the trend toward decreased weight across time has been
found among all contestants, not just pageant finalists. Rubinstein and
Caballero (2000) examined BMI values among Miss America contestants
from 1922 to 1999. They found that BMI values of pageant contestants dra-
matically decreased over the 80-year study period to a value considered
underweight. BMI values were generally within the normal range (between
20–25) among contestants in the 1920s, but were below normal (less than
18.5) among more recent contestants.
Aside from temporal changes in body size among idealized women,
there is a dearth of research on the association between beauty pageant
participation and mental health. Only one study examined cross-sectional
associations among pageant participation, body image, eating disturbances,
and self-esteem (Thompson & Hammond, 2003). Of the 131 females who
participated in beauty pageant contests, 48.5% reported a desire to be thin-
ner, 57% stated they were trying to lose weight, and 26% had been told or
were believed to have an eating disorder. Furthermore, increased level of
competition (such as progressing from local to international events) was
associated with higher scores on a measure of self-esteem.
The purpose of the current study is to examine the relationship between
childhood pageant participation and adult mental health, specifically disordered
Childhood Beauty Pageant Contestants 293
eating behaviors and related pathology, body dissatisfaction, depression,
and self-esteem. The authors hypothesize that women who participated in
beauty pageants as a young child would be more likely than their peers
who did not participate in beauty pageants to report disordered eating
behaviors and associated concerns, body dissatisfaction, depression, and
lower self-esteem. To reduce the effect of age and current BMI on the
dependent variables, individuals were matched on age and BMI across
beauty pageant category.
METHODS
Participants
Participants in the current study were 22 females selected from a larger
study sample of 560 female university students (Ackard, Steffen, Schafer,
Howe & Kearney-Cooke, 1998). All females (n = 11) who indicated that
they had participated in beauty pageants as a young girl were selected. An
additional 11 females who had not participated in beauty pageants were
selected from the remaining sample. The additional participants were
matched on age (within one year), and Body Mass Index (BMI) within one
point of the standard formula [weight in kilograms divided by squared
height in meters]. Thus, the total sample consisted of 11 females who had
participated in beauty pageants as a young girl and 11 who had not partici-
pated, matched on age and current BMI.
The average age of participants was 20 years (SD = 1.5; range 19–25).
Height and weight means were 5'6" (SD = 2.6 inches) and 137.5 pounds
(SD = 19.1) respectively, corresponding to an average BMI of 22.5 (SD = 2.9).
Participants were single (73%) or in a partnership (27%), Caucasian (82%) or
Black (18%), and of various religions (27% Catholic, 27% Protestant, 9%
Jewish, 36% other/none). There were no significant differences among
beauty pageant categories by race (p = .27), religion (p = .25), or marital
status (p = 1.0).
Procedure
The current study was reviewed by the Institutional Review Board and
Human Subjects Committee at the institution where it was conducted. Due
to the anonymous nature of the study questionnaires, this study was exempt
from needing Human Subjects approval.
Female students were recruited for the larger study using sign-up
sheets. The sheets indicated the date, time, and location of study administra-
tion and the incentives for participation, and were posted in a hallway of
the psychology department. At the time of administration, the research was
described to the participants, and they provided their written consent. All
294 A. L. Wonderlich et al.
participants were free to withdraw from the study at any time. They were
asked to refrain from discussing the study with other university students
until the end of the school year to prevent selection bias and avoid influencing
others’ responses.
Instruments
BEAUTY PAGEANT STATUS
All participants were asked one question to ascertain if they had partici-
pated in beauty pageants. “As a young girl, did you ever participate in any
of the following…?” One of the response choices was “beauty pageants.”
B
ODY MASS INDEX
Current body mass index was calculated by asking participants to report
their height and weight. With these values, BMI was calculated. Ideal body
mass index values were calculated using each participant’s response to the
question “Indicate your ideal weight in pounds (what you would like to
weigh)” as the weight value within the formula.
BULIT-R
The Bulimia Test-Revised (BULIT-R; Thelen, Farmer, Wonderlich, & Smith,
1991) is a 28-item self-report Likert scale measuring symptoms of bulimia.
The BULIT-R has established reliability and validity, and internal consistency
(Cronbach’s alpha) was .90 for the current sample.
EDI-2
The Eating Disorders Inventory-2 (EDI-2; Garner, 1991) is a valid and reli-
able self-report instrument that assesses characteristics of anorexia and
bulimia nervosa. The EDI-2 consists of 11 subscales for a total of 91 ques-
tions. Participants use a 6-point Likert scale to indicate how often they
engage in the eating disordered characteristics. Scores are then weighted
from 0–3. Higher scores indicated worse symptomatology. Internal consis-
tency (Cronbach’s alpha) for the current sample ranged from a low of .52
(Bulimia subscale) to a high of .92 (Body Dissatisfaction subscale).
B
ODY IMAGE ASSESSMENT
The Body Image Assessment (BIA) is an instrument with established reli-
ability and validity that assesses perception of current and preferred body
shape (Williamson, Davis, Bennett, Goreczny, & Gleaves, 1989). From a set
Childhood Beauty Pageant Contestants 295
of nine silhouettes, participants select one female body silhouette perceived
to represent her current body size, and one silhouette for the preferred
body size. Silhouette figures range from 1 (thinnest) to 9 (heaviest).
CES-D
The Center for Epidemiological Studies-Depression scale (CES-D; Radloff,
1977) is a reliable and valid 20-item self-report scale measuring symptoms
of depression in the general population. For the current sample, internal
consistency (Cronbach’s alpha) was estimated at .94.
R
OSENBERG SELF-ESTEEM SCALE
The Rosenberg Self-Esteem Scale (RSES; Rosenberg, 1965) is a 10-item ques-
tionnaire that assesses overall self-esteem. Reliability and validity estimates
have been published elsewhere (Fleming & Courtney, 1984). Internal con-
sistency for the current sample was estimated to be .82.
Statistical Analyses
Data were analyzed using SPSS for Macintosh, Version 6.1. For descriptive
analyses, frequencies and percentages were used to describe the sample.
Continuous scores were examined with means and were compared using
ANOVA across beauty pageant category. Alpha was set at .05 for each sta-
tistical test. Both significant and non-significant p-values are listed in
tables. We believe that this alpha level is appropriate given the nature of
this exploratory pilot study with a small sample size. Techniques to con-
strain alpha would have resulted in an extremely stringent test of our
hypotheses.
RESULTS
Eating Disorders
Females who had participated in beauty pageants scored higher on the
BULIT-R and slightly lower on the EDI-2 Bulimia subscale than their peers
who did not participate in pageants. However, none of these results were
significant (see Table 1).
For all other EDI-2 subscales, scores for those who had participated in
beauty pageants were higher than scores for those who had not partici-
pated. On the EDI-2, significant results were found for the following sub-
scales: Body Dissatisfaction, Interpersonal Distrust, Impulse Regulation. In
addition, there was a trend for significance on the Ineffectiveness subscale.
296 A. L. Wonderlich et al.
These results indicate a significant association between childhood beauty
pageant participation and increased body dissatisfaction, difficulty trusting
interpersonal relationships, and greater impulsive behaviors, and indicate a
trend toward increased feelings of ineffectiveness.
Body Image
As mentioned earlier, individuals who participated in childhood beauty pag-
eants scored significantly higher on the EDI-2 Body Dissatisfaction subscale
than their peers who had not participated in beauty pageants (see Table 1).
As additional measures of body image, the BIA was administered and ideal
BMI was calculated (see Table 2). Despite being matched on BMI, females
who had participated in beauty pageants perceived their current figure as
larger, and preferred their figure to be smaller than females who had not
participated in beauty pageants. Furthermore, the calculations of their ideal
BMI also were smaller. However, none of these results were statistically
significant.
Mental Health
Depression scores were higher, and self-esteem scores lower, for those who
had participated in beauty pageants compared to those who had not, but
none of the results reached statistical significance (see Table 2).
T
ABLE 1 Means (Standard Deviations) of Scores on Eating Disorder Scales by Beauty Pag-
eant Category
Beauty Pageant
Scale Yes No F-test p-value
BULIT-R 55.9 (15.8) 52.3 (19.7) .2277 .6384
EDI-2 subscales
Asceticism 4.5 (3.9) 3.4 (2.8) .6760 .4207
Body Dissatisfaction 19.4 (6.7) 12.0 (8.6) 4.9932 .0370*
Bulimia 0.8 (1.7) 0.9 (1.8) .0150 .9037
Drive for Thinness 7.6 (6.9) 4.8 (5.5) 1.1169 .3032
Interpersonal Distrust 4.2 (2.8) 1.8 (2.1) 4.9057 .0385*
Impulse Regulation 8.1 (8.3) 1.4 (1.7) 6.9194 .0160*
Ineffectiveness 6.1 (6.4) 2.1 (2.5) 3.6989 .0688
Interoceptive Awareness 4.9 (6.5) 2.5 (2.2) 1.4172 .2478
Maturity Fears 4.6 (4.4) 2.4 (2.3) 2.2995 .1451
Perfectionism 4.9 (5.0) 4.5 (3.2) .0646 .8019
Social Insecurity 4.8 (3.5) 3.1 (3.3) 1.4113 .2488
* p < .05.
statistical trend toward significance at p < .05.
Childhood Beauty Pageant Contestants 297
DISCUSSION
Results from the current study indicate that women who participated in
childhood beauty pageants scored significantly higher on measures of body
dissatisfaction, interpersonal distrust, and impulse dysregulation than
women who did not participate in childhood beauty pageants. Also, there
was a trend for childhood beauty pageant participants to report greater feel-
ings of ineffectiveness than non-participants. There were no significant dif-
ferences between the two groups on measures of bulimic behavior, body
perception, depression, or self-esteem.
The significant impact of childhood beauty pageant participation on
body dissatisfaction, interpersonal distrust, impulse dysregulation, and inef-
fectiveness can be linked to findings in past research related to media expo-
sure. Beauty pageant participation and viewing mass media are similar
because they both expose individuals to thin female ideals. Exposure to
feminine beauty ideals in mass media has been found to be associated with
negative affect (Pinhas, Toner, Ali, Garfinkel, & Stuckless, 1999), general
feelings of body dissatisfaction (Field et al., 1999), and body dissatisfaction
as mediated by internalization of the thin ideal (Stice, Schupak-Neuberg,
Shaw, & Stein, 1994). Moreover, the impact of beauty pageant participation
on interpersonal distrust may be related to social comparison. Specifically,
women who were exposed to music video clips that depicted the thin ideal
reported higher levels of social comparison than those exposed to videos
that did not emphasize appearance (Tiggemann & Slater, 2004). Individuals
who engage in social comparisons may feel distrust among individuals
because of their general feelings of insecurity, as well as specific feelings of
insecurity if they believe they do not represent the thin ideal. The associa-
tion between beauty pageants and varied affect is similar to the findings of
Pinhas et al. (1999) who reported both increased anger and depression
among women who viewed slides of fashion models when compared to
women who viewed slides neutral in content. Strong affects such as anger
T
ABLE 2 Means (Standard Deviations) of Scores on Body Perception, Ideal BMI, Depression,
and Self-Esteem Scores by Beauty Pageant Category
Beauty Pageant
Scale Yes No F-test p-value
Body Image Assessment (BIA)
Current figure 4.2 (1.4) 3.9 (0.9) .2866 .5983
Preferred figure 2.5 (1.0) 2.9 (0.8) 1.2887 .2697
Ideal Body Mass Index 20.0 (1.2) 20.6 (1.6) .8344 .3719
Depression (CESD) 21.3 (14.3) 15.8 (10.7) 1.0299 .3223
Self-Esteem (RSES) 27.2 (5.6) 29.1 (4.3) .8140 .3777
298 A. L. Wonderlich et al.
and depression, when not managed in a healthful manner, have been found
to be associated with the use of externalized behaviors even in children and
young adolescents (Whalen, Jamner, Henker, & Delfino, 2001; Zeman, Ship-
man, & Suveg, 2002). Therefore, the competition and exposure to thin ideals
present in beauty pageants may contribute to feelings of body dissatisfac-
tion, interpersonal distrust (potentially related to social comparisons), and
poor impulse control.
Feelings of ineffectiveness also were found among childhood beauty
pageant participants. Harrison and Cantor (1997) found that college
women’s media use (notably what they describe as thinness-depicting and
thinness-promoting media) was associated with ineffectiveness, as well as
disordered eating, drive for thinness, and body dissatisfaction. Therefore, it
is possible that participants in the current study were exposed to thinness-
promoting media, such as magazines within their childhood or adult house-
hold, such as could mediate the association between pageant participation
and ineffectiveness. Furthermore, there are aspects of beauty pageant par-
ticipation, such as the general competitiveness and ranking of individuals,
that may elicit feelings of ineffectiveness.
Among findings from the current study, there were no significant asso-
ciations between childhood beauty pageant participation and bulimic
behavior, body perception, depression, and self-esteem. The lack of signifi-
cance among these findings may be due to a variety of factors not assessed
in the current study. For example, Stice (1998) found that reinforcement of
thin ideals by peers and family members was associated with bulimic symp-
toms. In the current study, family and peer reinforcement of the sociocul-
tural ideal was not assessed, yet this factor may have been influential
toward the expression of bulimic symptoms. Furthermore, parental pressure
may influence the association between beauty pageant participation and
psychological health. Levey’s (2002) thesis, which studied beauty pageant
participation among children six years of age and their mothers, found
that many mothers enroll their children into beauty pageants because
they believe pageants to be a positive, beneficial experience. Specifically,
these mothers believe that their children will gain better social skills, lis-
tening skills, confidence, independence, poise, and talent. Also, these
mothers believe that the competitive nature and service aspect of pag-
eantry taught their daughters important life lessons. These findings sug-
gest that beauty pageant participants may differ whether they were
exposed to beauty pageants as a childhood extracurricular activity, or as
means to teaching life etiquette and values. Specifically, parents who
believe beauty pageants are a way of teaching values and etiquette may
put more pressure on their daughters to obtain the ideals of pageantry
than parents who allow their children to participate for simple enjoy-
ment. Also, Levey (2002) noted that pageant mothers become more seri-
ous on winning as the pageant participation increases. Thus, increased
Childhood Beauty Pageant Contestants 299
pageant participation may be associated with increased parental pressure
creating stronger pressure towards thin ideals.
The implications of the current study’s results do not definitively associ-
ate childhood beauty pageant participation with disordered eating. How-
ever, risk factors associated with disordered eating were linked with
participation. Therefore, these findings may suggest that participating in
beauty pageants as a child may lead to associated risk factors of eating dis-
orders, but that other factors such as internalization of the thin ideal and
parental pressure, may mediate the association between beauty pageant
participation as a child and adult psychopathology. Important preventative
measures would be to decrease the emphasis placed on obtaining the thin
female ideal and to offer alternative body ideals that include broader popu-
lations of women.
Several strengths were represented in the current study. The current
study is one of a few investigating the associations between childhood
beauty pageant participation and psychological and behavioral health, and
indicates that this is an important area of research. Another noteworthy
strength is that the sample was matched on age and BMI, controlling for
confounding variables. Also, the current study used psychometrically sound
measures for assessment of dependent variables.
However, several limitations should be considered. Qualitative factors,
important in understanding potential risk and protective factors associated
with pageant participation, were not collected. Collecting qualitative assess-
ments regarding the participants’ level (e.g., local, international) and type
(e.g., hobby, circuit) of involvement in beauty pageants, internalization of
the thin ideal, and parents’ and peers’ reinforcement of the thin ideal may
help to elucidate the findings. These factors are important because they
generate dosage variables that may impact the associations between vari-
ables. Another limitation is the small sample size and the use of college stu-
dents as subjects. It is possible that the impact of childhood beauty pageants
on adult disordered eating and mental health may not be fully realized by
the college years. Also, the cross sectional nature of the design does not
rule out the possibility that young girls that are prone to have eating disor-
ders might be more inclined to enter beauty pageants. In addition, the
design does not allow for clarification of the temporal order among vari-
ables of interest.
Future researchers may want to assess factors such as age of participa-
tion, number and type of beauty pageants entered, parental pressure, num-
ber of years in pageants, and familial history in pageantry. This would allow
for dosage control between participants. Specifically, individuals could be
matched on dosage variables to allow a parallel comparison. Furthermore,
internalization of the thin ideal and parental/peer reinforcement of the thin
ideal may be mediating factors important to clarifying any potential relation-
ship between beauty pageant participation and psychological and behavioral
300 A. L. Wonderlich et al.
health. Also, the use of a larger sample would offer greater power for statis-
tical analyses. Longitudinal data also would be useful to assess temporal
order among variables. Finally, childhood beauty pageant participants
should be followed into their thirties or forties to understand if pageant par-
ticipation has a more full impact on eating, body image, and mental health
concerns.
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