ORIGINAL RESEARCH published: 29 March 2018 doi: 10.3389/fpsyg.2018.00429 Edited by: Antonios Dakanalis, Università degli Studi di Milano-Bicocca, Italy Reviewed by: Andrea Wyssen, University of Fribourg, Switzerland Samantha Jane Brooks, University of Cape Town, South Africa *Correspondence: Bernadetta Izydorczyk b.izydorczyk@interia.pl Specialty section: This article was submitted to Eating Behavior, a section of the journal Frontiers in Psychology Received: 17 November 2017 Accepted: 14 March 2018 Published: 29 March 2018 Citation: Izydorczyk B and Sitnik-Warchulska K (2018) Sociocultural Appearance Standards and Risk Factors for Eating Disorders in Adolescents and Women of Various Ages. Front. Psychol. 9:429. doi: 10.3389/fpsyg.2018.00429 Sociocultural Appearance Standards and Risk Factors for Eating Disorders in Adolescents and Women of Various Ages Bernadetta Izydorczyk * and Katarzyna Sitnik-Warchulska Institute of Applied Psychology, Jagiellonian University, Kraków, Poland The main aim of the present study was to verify the level of impact of sociocultural appearance standards (passive awareness and active internalization) have on body dissatisfaction, the desire to engage in a relentless pursuit of thinness, the adoption of a perfectionistic attitude toward the body, and the development of a tendency to engage in bulimic eating behavior, which can develop in adolescent girls and women of varying ages. The study group comprised 234 individuals: 95 secondary school girls, 33 high school girls, 56 female students, and 50 employed women, all of whom were living in southern Poland. Participants were not diagnosed with any psychiatric disorders (including eating disorders). The variables were measured using the Polish version of Garner’s Eating Disorder Inventory and the Polish Sociocultural Attitudes Towards Physical Appearance and Body Image Inventory [based on the SATAQ-3 (Sociocultural Attitudes Towards Appearance Questionnaire Scale-3)]. The findings revealed that the youngest Polish girls (aged 12–15) reported the highest level of risk factors for eating disorders. Among the entire study group, the internalization of appearance standards and the pressure associated with various media messages were determined to be predictors of the pursuit of thinness, regardless of age and body mass index values. The second most significant variable explained by the internalization of sociocultural standards was body dissatisfaction. The internalization of sociocultural norms provided a significant explanation of bulimic tendencies only in the youngest girls. Perfectionism proved not to be affected by the sociocultural impact of mass media. The adult women had the lowest average scores over the entire study population regarding exposure frequency to body images in mass media and regarding the experience of pressure exerted by sociocultural norms. The high level of internalization of sociocultural appearance standards seems to be significantly linked to body satisfaction in women aged 30 and older. Young adolescent girls constitute a high-risk group for a specific psychological proneness to developing eating disorders as a result of the sociocultural influence exerted by mass media. The obtained study results can prove helpful in creating education programs in preventive healthcare aimed particularly at the youngest adolescents. Keywords: body-image, eating disorders, mass media, girls, women Frontiers in Psychology | www.frontiersin.org 1 March 2018 | Volume 9 | Article 429

Izydorczyk and Sitnik-Warchulska Sociocultural Appearance Standards in Women INTRODUCTION Previous literature reviews have confirmed the importance of sociocultural messages in highly industrialized countries in regard to strengthening the perception that “thin female bodies” are attractive ( Levine et al., 1994 ; Bearman et al., 2006 ; Benton and Karazsia, 2015 ). Such sociocultural standards concerning body image and evaluations of attractiveness are commonly propagated in mass media. In particular, the need for obtaining social approval concerning how one looks and whether one’s body is considered “attractive” is important for adolescent girls and young women in terms of their self-esteem ( Clark and Tiggemann, 2008 ; Izydorczyk and Rybicka-Klimczyk, 2009 ; McCabe and Ricciardelli, 2009 ; Cash, 2011 ; Ferguson K. et al., 2011 ; Finne et al., 2011 ; Mond et al., 2011 ; Gajtkowska, 2013 ; Józefik, 2014 ; Izydorczyk, 2015a ; Czepczor et al., 2016 ; Glogowska and Zatorska, 2016 ). Many studies have confirmed that women more strongly and regularly feel dissatisfaction with their appearance and, as a result, many intensely pursue the sociocultural ideal of the female body, based on slenderness and thinness, that is promoted in the media ( Grabe et al., 2008 ; Cash, 2011 ; Ferguson C.J. et al., 2011 ); it has been shown that such an unrealistic ideal of a slim figure can result in body dissatisfaction and disordered eating ( Rodgers et al., 2011 ). In fact, studies have found that there is a positive correlation between exposure to mass media (TV and magazines) and body dissatisfaction, thin- ideal internalization, and disordered eating ( Thomsen et al., 2002 ; Levine and Murnen, 2009 ). The influence of the media has a key impact on appearance satisfaction in terms of thinness and fatness ( Levine and Murnen, 2009 ). Levine and Smolak (2006) indicated that women’s dissatisfaction with their bodies is a derivative of three components: the idealization of slenderness and leanness, an irrational fear of fat, and a conviction that weight and shape are central determinants of one’s identity. Factors such as body-image dissatisfaction, the restrictive pursuit of thinness, the adoption of a perfectionistic attitude toward the body, and the development of bulimic tendencies are often indicated in scientific research as predictors of eating disorders ( Stice et al., 1994, 2013 ; Tiggemann, 2003 ; Garner, 2004 ; Jones and Crawford, 2006 ; ˙ Zechowski, 2008 ; Striegel-Moore et al., 2009 ; Izydorczyk, 2015b ). However, most researchers focus on selected risk factor. The clinical experience of the authors indicates that the risk factors of eating disorders should not be considered separately. These factors seem to constitute the specific syndrome, related to the culture of thinness. It would be a great simplification to say that mass media has a direct impact on the occurrence of eating disorders, and research results are ambiguous in this respect ( Stice et al., 1994, 1998 ; Tiggemann, 2003 ). Rodgers (2016) proposed a theoretical model that suggests the existence of two possible mechanisms behind the relationship between promoted appearance standards and behaviors that are considered risk factors for eating disorders. The first mechanism is based on the assumption that sociocultural discourse on healthy weight promotes the internalization of anti-fat attitudes (in regard to oneself and toward others) and the need to control weight. The second mechanism concerns the formation of the belief that lifestyle factors (such as diet or physical activity) play an important role in weight control. As a consequence, this can lead to a preoccupation with weight, which is then followed by disordered eating and excessive exercise. Models of media influence argue that normative beliefs concerning society, such as those shown in media, become attitudes about the self ( Levine and Smolak, 1996 ; Levine and Murnen, 2009 ). For example, Levine and Murnen (2009) , in their critical review, indicated that mass media should be treated as a variable risk factor that might later become a causal risk factor. In their meta-analysis, they indicate that when considering the relationship between the media and eating disorders, variables such as awareness of the importance in society of a thin ideal, the internalization of this ideal, and perceived pressure from the media to be thin should be examined. It is also worth highlighting that contemporary research has applied a large variety of methods to measure the variables presented above. One valid measure for these variables is the Sociocultural Attitudes Towards Appearance Questionnaire (SATAQ; Knauss et al., 2009 ; Sánchez-Carracedo et al., 2012 ). However, many researchers use this scale mainly to study the relationship between sociocultural appearance standards, promoted in the media, and selected risk factors concerning eating disorders (e.g., body dissatisfaction; Stice and Whitenton, 2002 ). Definitions of these factors also differ; some researchers use the Eating Disorders Inventory (EDI) in their research, but this is not a standard. Moreover, there is a lack of research on the relationships between sociocultural standards of appearance and the entire team of risk factors involved in eating disorders. Efforts to identify sociocultural predictors that contribute to the development of body-image distortion as a result of eating disorders are not very common in studies conducted on adult women (aged 30 and older) when compared to studies on adolescents. Further, as mentioned above, there is also a lack of studies focusing on broad populations of women (young and adult) with the goal of measuring the differences between them and the strength of the correlations between factors commonly considered risk factors for eating disorders. There is also doubt concerning whether the sociocultural standards of appearance are universal. The culture of thinness is common in Western Europe, the United States, and more often on the other continents. Nielson et al. (2013) indicate that exposure to Western models in the media has likely contributed to a rejection of stereotypical Asian facial features. The European findings show that young people from the United Kingdom seem to demonstrate the most intense internalization of the thin ideal and pressure from the media to look a certain way ( Argyrides, 2013 ). Swami et al. (2010) found that the heavier bodies may be preferred in low-socioeconomic-status sites compared to high- socioeconomic-status sites in Malaysia and South Africa, but not in Austria. However, the cross-cultural explorations suggest that overall differences are limited and mainly associated with differences in socioeconomic development ( Swami et al., 2010 ). Considering the above, it seems important to analyze girls and women of different ages and from the same sociocultural area. Further, in Frontiers in Psychology | www.frontiersin.org 2 March 2018 | Volume 9 | Article 429

Izydorczyk and Sitnik-Warchulska Sociocultural Appearance Standards in Women (TV, radio, magazines and newspapers, advertisements, etc.) promoting body-image standards. - Exposure to body images promoted in mass media: a variable describing the frequency of consumption of various information promoted in mass media pertaining to body-image standards and norms of appearance. An additional control variable used in the study was BMI, which comprises a value derived from the body mass divided by the square of the body height in meters ( Menzel et al., 2011 ). On this index, optimal weight is assumed to range from 19.5 to 24.5, with values below the average indicating underweight or a pathological loss of weight, and values above indicating overweight. Participants The study involved initially 250 girls and women, 16 of whom were excluded, after the clinical interview. There were six girls aged 12–15 treated for anorexia, five girls aged 16–20 treated for anorexia and binge eating disorder, and five women over 30 treated for chronic depression. The study group finally comprised 234 individuals: secondary school girls, high school girls, female students (full-time and part- time students attending courses in the fields of humanities, social studies, and biological science), and employed women, all of whom were living in southern Poland. The research group was homogeneous in terms of sociodemographic conditions (place of residence, age, gender). The following subgroups were created: Subgroup I (95 adolescent girls aged 12–15; these represented early adolescence; mean age = 14.0, mean BMI = 19.0) Subgroup II (33 adolescent girls aged 16–20; these represented middle and late adolescence; mean age = 18.2, mean BMI = 20.0) Subgroup III (56 women aged 21–29; these represented young adulthood; mean age = 25.5; mean BMI = 23.0) Subgroup IV (50 women aged 30 and older; these represented middle adulthood; mean age = 35.5, mean BMI = 24.4) The criteria applied when selecting participants for these subgroups included: participants’ ages (12–50 years), BMIs (optimal BMI values at a given age), and the absence of any eating disorders (e.g., anorexia nervosa and bulimia nervosa) that required treatment. The BMI values of all the adolescent girls and women participating in the study were within normal limits and corresponded to the optimal weight (18.5–24.9). Compliance With Ethical Standards This study was conducted in accordance with the recommendations of an institutional research committee (Research Ethics Committee of the Institute of Applied Psychology, Jagiellonian University, Krakow) and was determined to conform with the 1964 Helsinki declaration and its later amendments or comparable ethical standards, as written informed consent was obtained from all subjects. Informed consent was also obtained from the parents or legal guardians for all participants under the age of 16. The protocol was approved by the Research Ethics Committee of the Institute of Applied Psychology, Jagiellonian University, Krakow. Instruments The clinical interview was used to select study participants. The interview questions concerned the objective indicators, such as age, body weight, and height (to estimate the BMI), the presence of disabilities and related visible deformities of the body, previous diagnosis of eating disorders (anorexia, bulimia, or other types of eating disorders), and mental disorders associated with the development of distorted body image (body dysmorphic disorder, psychotic disorders, personality disorders, depression, bipolar disorders). The predictor variable, and its components, were measured using the Polish Sociocultural Attitudes Towards Physical Appearance and Body Image Inventory (SATPABI), which was developed by Izydorczyk (2014) . It is based on the SATAQ- 3 developed by Thompson et al. (2004) ; the SATAQ-3 is a measure of the internalization of appearance ideals and appearance pressures. To create the SATPABI, a 24-item Polish-language questionnaire was drafted based on a double back-translation of the English version of the SATAQ-3. The said questionnaire was used in a pilot study on a population of 140 Polish females who did not manifest traits of eating disorders. The items employed in the pilot study described basic manifestations of assimilated sociocultural appearance standards regarding the following variables: internalization, pressure, and exposure to body images promoted in mass media. The obtained pilot study results were then subjected to a reliability analysis, in which sampling adequacy was estimated at KMO = 0.983. Bartlett’s test results allowed the authors to disprove the identity matrix hypothesis ( χ 2 = 3046.280; df = 276; p < 000). Further, in order to verify and estimate statistical indicators for all positions in the questionnaire, a factor analysis was conducted and the identified factors were subjected to varimax rotation with Kaiser normalization. The SATPABI, like the SATAQ-3, has three subscales, assessing internalization (general, athlete; nine items), pressure (seven items), and exposure to body images promoted in mass media (eight items); each item on each scale is given between one and five points. For each scale, the higher the sum of points, the greater the severity of the indicator. The criterion variable and its components were measured using the Polish version of Garner’s EDI, which was developed by ˙ Zechowski ( Garner, 2004 ; ˙ Zechowski, 2008 ) (Psychological Assessment Resources granted permission for one of the authors to conduct research using the EDI). The total scores for the dissatisfaction with the body, drive for thinness, bulimia, and perfectionism scales in the EDI questionnaire were used as indicators of risk factors for eating disorders. For each scale, the higher the sum of the points (body dissatisfaction: nine items, pursuit of thinness: seven items, bulimic tendencies: seven items, and perfectionism: six items; each item of each scale is scored between zero and three points), the greater the severity of the indicator. Frontiers in Psychology | www.frontiersin.org 4 March 2018 | Volume 9 | Article 429

Izydorczyk and Sitnik-Warchulska Sociocultural Appearance Standards in Women Statistical Methods The examined subgroups differed in terms of the number of members, but the size of each subgroup was sufficient to conduct the planned statistical analyses. The first stage of the statistical analysis contained measurements of mean values relating to the severity of each variable (perfectionism, body dissatisfaction, leanness, bulimic tendencies), and mean values ( M ) and standard deviations ( SD ) concerning the intensification of explanatory variable factors: internalization, pressure of sociocultural norms, and searching for information about body image in mass media. The significance was measured using one-way analysis of variance (ANOVA) with the least significant difference (LSD) test applied post hoc . Further, a stepwise regression analysis was applied to determine the extent to which sociocultural appearance standards explain the development of excessive body dissatisfaction, the pathological and relentless pursuit of thinness, bulimic tendencies, and perfectionism in the studied subgroups of girls and women. RESULTS Characteristics of the Dependent Variable in the Participants Figure 1 shows the statistically significant differences between the various subgroups in terms of the average severity of FIGURE 1 | Statistics concerning the differences between the subgroups regarding the severity of risk of developing eating disorders. TABLE 1 | Descriptive statistics of the criterion and predictor variables ( n = 234). Age (group) Perfectionism Pursuit of thinness Bulimic tendencies Body dissatisfaction Internalization of sociocultural norms Exposure to body image in mass media Pressure of sociocultural norms M ( SD ) M ( SD ) M ( SD ) M ( SD ) M ( SD ) M ( SD ) M ( SD ) 12–15 (I) 3.82 (3.76) 4.56 (4.98) 1.82 (3.87) 9.87 (7.84) 23.80 (7.773) 23.76 (6.253) 17.61 (5.23) 16–20 (II) 1.18 (0.39) 1.52 (0.51) 0.15 (0.36) 1.85 (0.36) 19.91 (3.574) 25.30 (4.081) 19.61 (4.19) 21–29 (III) 1.11 (0.31) 1.70 (0.46) 0.00 (0.00) 2.20 (0.77) 22.82 (4.577) 25.11 (5.376) 17.70 (5.40) 30 and older (IV) 1.36 (0.48) 2.50 (0.51) 0.00 (0.00) 2.78 (0.42) 22.08 (3.300) 24.54 (3.945) 16.04 (4.01) ANOVA F (3,230) = 21,79 *** F (3,230) = 13,33 *** F (3,230) = 9,78 *** F (3,230) = 42,60 *** F (3,230) = 3,86 ** F (3,230) = 1,10 ** F (3,230) = 3,53 ** Post hoc ( LSD ) p -value < 0.001 Group I > 2,3,4 < 0.001 Group I > 2,3,4 < 0.001 Group I > 2,3,4 < 0.001 Group I > 2,3,4 < 0.010 Group I > II, and group II < III Non-significant < 0.016 Group I < II, and group II > IV M, mean; SD, standard deviation. ** p < 0.01, *** p < 0.001. Frontiers in Psychology | www.frontiersin.org 5 March 2018 | Volume 9 | Article 429

Izydorczyk and Sitnik-Warchulska Sociocultural Appearance Standards in Women from various media messages than girls in late adolescence. Meanwhile, women in middle adulthood showed the lowest level of sociocultural pressure. The variable “exposure to body images promoted in mass media” did not differ between groups. Characteristics of the Sociocultural Predictors of Eating Disorders Statistical analyses and regression models for the tested variables showed that sociocultural appearance standards have a varied impact on the development of the risk factors for eating disorders. Based on the obtained adjusted R 2 and beta ( β ) coefficient values, presented in Table 2 , one can conclude that only seven models for the sociocultural appearance standards variable explain the significant impact internalization and pressure have on selected constituents of the variables for risk factors for eating disorders (body dissatisfaction, pursuit of thinness, bulimic tendencies). Together with the Fisher test results and coefficients estimated based on the said results (at p < 0.001), the models presented in Table 2 were found to be statistically significant. In regard to summarizing the significant regression models, one ought to note that, in subgroup I, variables associated with the various risk factors for eating disorders (body dissatisfaction and pursuit of thinness) were most strongly affected by sociocultural appearance standards. Further, among the verified constituents of the sociocultural appearance standards variable, internalization (in groups I, II, IV) and pressure (in groups I, III, IV) proved to be significant. Among the entire study group, sociocultural appearance standards were determined to be predictors of the pursuit of thinness, regardless of age and BMI values. The obtained values suggest that the pursuit of thinness variable is positively correlated with the pressure associated with various media messages (in girls aged 12–15 and women aged 21–29) and the internalization of appearance standards (in girls aged 12–15 and those aged 16–20). Moreover, the conducted analysis indicated that women in middle adulthood engage in a stronger pursuit of thinness, provided they have less internalized sociocultural appearance standards and experience less sociocultural pressure (trend). The second most significant variable explained by the internalization of sociocultural standards is body dissatisfaction. The regression analysis conducted for the body dissatisfaction variable in subgroup I and subgroup IV revealed high levels of assimilation of appearance standards (internalization) to be a significant predictor. In the case of bulimic tendencies, only internalization of sociocultural norms provided a significant explanation of this tendency in subgroup I. In the other subgroups, the sociocultural impact did not provide a significant explanation for bulimic tendencies. No significant forward stepwise regression models were identified in the measurement of the impact exerted by the sociocultural appearance standards on the development of perfectionism among the participants. DISCUSSION The present research proves the existence of a relationship between the occurrence of risk factors for eating disorders (body dissatisfaction, pursuit of thinness, bulimic tendencies) and the sociocultural appearance standards (internalization and pressure), promoted in mass media, in the studied girls and women. The results of conducted research also indicate that the relationship between sociocultural standards of the appearance and risk factors of eating disorders is specific to the developmental period. In particular, the findings revealed that the youngest Polish girls reported the highest level of risk factors for eating disorders. Girls aged 12–15 were found to be the least satisfied with their own bodies; meanwhile, compared to older adolescents and young and mature women, the youngest participants also reported significantly higher levels of efforts to become thin, bulimic tendencies, and perfectionism. These results concerning the young adolescent girls support research conducted by other authors ( Stice et al., 2008 ; ˙ Zechowski, 2008 ; Izydorczyk and Rybicka-Klimczyk, 2009 ; Striegel-Moore et al., 2009 ; Brytek- Matera and Rybicka-Klimczyk, 2012 ; McCabe et al., 2012 ; Izydorczyk, 2015a,b ); most of these previous studies focused on body dissatisfaction and the pursuit of thinness. Meanwhile, Ata et al. (2007) indicated that as many as 70% of adolescent girls would like to have a smaller body size. On a related note, many studies have reported that dissatisfaction with appearance is more prevalent among adolescent girls than adolescent boys ( Neumark-Sztainer et al., 2002 ; McCabe and Ricciardelli, 2004 ; Ata et al., 2007 ; Xu et al., 2010 ; Lawler and Nixon, 2011 ; McCabe et al., 2012 ); girls seem to be more interested in losing weight, in contrast to boys, who have a greater desire to increase muscle ( Mellor et al., 2009 ). The body dissatisfaction and pathological pursuit of thinness identified among the youngest adolescents might be motivated by psychosexual development processes and self-esteem based on the principle “I am what I look like.” Furthermore, the said life stage is characterized by body-image evaluation (particularly among peers, but also parents) adopting an increased role in social environments. McCabe and Ricciardelli (2003) indicated the most significant influences for these factors; however, clinical observations have indicated that mass media is becoming an increasingly important part of the lives of today’s children and adolescents ( Comstock and Scharrer, 2007 ; Hayes and Tantleff-Dunn, 2010 ; Lamb and Peterson, 2012 ). According to Gajtkowska (2013) , in teenagers’ opinions, the media are currently the most common source of information about appearance (78.67%). However, Field et al. (2001) , in an examination of a group of over 6,900 girls aged 9–15 years, obtained contrasting results. Here, their analyses did not clearly show that there was a correlation between the media (frequency of reading women’s fashion magazines, use of diets to achieve a weight consistent with common standards) and dissatisfaction with appearance. Thus, it seems that exposure to mass media is not a sufficient explanatory factor; the assimilation of sociocultural standards may also play a Frontiers in Psychology | www.frontiersin.org 7 March 2018 | Volume 9 | Article 429

Izydorczyk and Sitnik-Warchulska Sociocultural Appearance Standards in Women key role. This hypothesis is confirmed by the results of the present research. The regression analysis of the body-image dissatisfaction variable for subgroup I revealed the internalization of appearance standards to be a significant predictor in this regard. The greater the body-image dissatisfaction among the youngest adolescent girls, the greater the internalization of sociocultural norms regarding body-image standards. It is interesting to note that internalization also proved to be the only predictor of bulimic tendencies, and only for subgroup I. Pressure and the internalization of sociocultural appearance standards were also found to be significantly positively correlated with the pursuit of thinness in this subgroup. Supporting this finding, Botta (2003) , Shroff and Thompson (2006) , and Mäkinen et al. (2012) all found a similar dependence between the internalization of sociocultural norms and body dissatisfaction among the youngest girls. This could be explained by the fact that, at the beginning of adolescence, girls are significantly affected by biological and psychosocial processes. The age of 12–15 is a developmental period, the purpose of which is to determine one’s own identity. During this period, it is particularly important to define one’s self and reconcile the private self and the public self. The youngest adolescents are influenced by society to adjust to the new tasks they must fulfill while concurrently playing their psychosocial roles as teenagers (a daughter, a student, a girlfriend, a colleague, a friend). Consequently, at this point in their development, it is possible that they only develop their psychological reactions to teenage angst, and do not endeavor to negate the presence of image-related pressure exerted by social norms. It was observed that the youngest and older adolescents showed significantly different levels of pressure in terms of sociocultural norms regarding the binding standards of appearance. In the analysis of the results for subgroup II, the level of internalization of sociocultural norms was found to be significantly lower than that for all other subgroups. These results correspond with the higher levels of pressure experienced by these participants as a result of sociocultural norms. It is worth considering whether adolescents in the so-called “teenage angst” stage (16–20 years) do not manifest a general negation of the impact the environment can have on their behavior, which would be reflected in their decisions to negate the social pressure experienced. Furthermore, subgroup I showed a level of pressure as a result of sociocultural norms that was similar to that experienced by subgroup III. The higher the level of pressure, the greater the body dissatisfaction. It is worth noting that young women of this age are usually beginning to fulfill numerous new psychosocial roles that are imposed on them (university student, employee, romantic partner, wife, mother, etc.); therefore, they can feel similar social pressure to the youngest girls. Adolescents and young women react in a particularly strong manner as a result of the psychological conflicts experienced in their life stages (identity crises, psychological separation, and individualization contrasted by a strong need for social acceptance and self-esteem; Clark and Tiggemann, 2008 ; Izydorczyk and Rybicka-Klimczyk, 2009 ; Ferguson K. et al., 2011 ; Mond et al., 2011 ; Izydorczyk, 2015a ). Halliwell (2013) suggests that showing appreciation to young women protects them from negative environmental appearance messages. On the other hand, Bair et al. (2012) indicated that young adults use the Internet as their primary news source and, for this reason, they are more likely to internalize appearance standards; as a consequence, they are at a greater risk of engaging in disordered eating ( Bair et al., 2012 ). The results obtained from women aged 30 and above are particularly interesting. There is a lack of research on body image and desire for thinness among adult women. Bulimic tendencies among the adult participants (aged 30 and older) proved to be insignificant; adult women also had the lowest average scores over the entire study population regarding exposure frequency to body images in mass media and regarding the experience of pressure exerted by sociocultural norms. The regression analysis also indicated an interesting correlation: the more intensified the internalization of sociocultural appearance standards, the less thinness is pursued among women aged 30 and older. A similar trend can be observed between pursuit of thinness and pressure from sociocultural appearance standards. These results are surprising, especially because previous studies have indicated a reverse relationship in this regard ( Dittmar and Howard, 2004 ; Kilpela et al., 2015 ). Kilpela et al. (2015) noticed that body image may be more complex for adult women than for younger women. Aging-related physiological changes shift the female body further away from the thin-young ideal; further, life priorities and psychological factors also evolve with age. Pregnancy, employment, household obligations, and child care are factors that can protect self-image (see Kilpela et al., 2015 ). Additionally, according to Fredrickson and Roberts (1997) , middle-aged women may experience decreased objectification as they age. These results could be also explained by the fact that the life stage of over 30 years is characterized by higher psychological and social maturity. The women of this age in the present study underwent upbringing and performed socialization for many years under the cultural conditions of a highly industrialized country, Poland. Given the fact that their personalities were well structured and that they reported no mental disorders, it can be stated that mature women are capable of opposing the excessive sociocultural influences that promotes unhealthy behavior, e.g., an overly thin body image. On the other hand, the oldest of the participants were born and grew up in times when access to the media was not so common. Perhaps, they have not assimilated the sociocultural standards of appearance promoted in contemporary media. Perfectionism proved not to be affected by the sociocultural impact of mass media. Bardone-Cone et al. (2017) highlighted maladaptive perfectionism as a complex structure related to both disordered eating and anxiety; meanwhile, Petersson et al. (2017) claimed that it is important to investigate patients’ definitions of perfectionism, which the psychometric measures do not reflect. The present study was performed on a Polish population of girls and women. The results of the SATAQ-3 scale obtained in our study seem to be slightly lower in terms of internalization and exposure, compared to the results achieved by respondents from other European countries ( Argyrides, 2013 ). This observation Frontiers in Psychology | www.frontiersin.org 8 March 2018 | Volume 9 | Article 429

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This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Frontiers in Psychology | www.frontiersin.org 11 March 2018 | Volume 9 | Article 429