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Does self-esteem affect body dissatisfaction levels in female adolescents?*
A autoestima afeta a insatisfação corporal em adolescentes do sexo feminino?
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adolescents?<a class="elsevierStyleCrossRef" href="#fn1"><span class="elsevierStyleSup">*</span></a>" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "236" "paginaFinal" => "240" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Leonardo de Sousa Fortes, Flávia Marcele Cipriani, Fernanda Dias Coelho, Santiago Tavares Paes, Maria Elisa Caputo Ferreira" "autores" => array:5 [ 0 => array:4 [ "nombre" => "Leonardo" "apellidos" => "de Sousa Fortes" "email" => array:1 [ 0 => "leodesousafortes@hotmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff1" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "cor1" ] ] ] 1 => array:3 [ "nombre" => "Flávia Marcele" "apellidos" => "Cipriani" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">b</span>" "identificador" => "aff2" ] ] ] 2 => array:3 [ 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"*" "correspondencia" => "Corresponding author" ] ] ] ] "titulosAlternativos" => array:1 [ "pt" => array:1 [ "titulo" => "A autoestima afeta a insatisfação corporal em adolescentes do sexo feminino?" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><span id="cesec10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle130">Introduction</span><p id="para10" class="elsevierStylePara elsevierViewall">Adolescence is a period comprising the age range of 10 to 19 years old,<a class="elsevierStyleCrossRef" href="#bib1"><span class="elsevierStyleSup">1</span></a> during which several psychological, social, and morphological changes<a class="elsevierStyleCrossRef" href="#bib2"><span class="elsevierStyleSup">2</span></a> occur. Evidence indicates increased responsibility, demands, and changes in friendship among adolescents.<a class="elsevierStyleCrossRef" href="#bib3"><span class="elsevierStyleSup">3</span></a> Scientific investigations also indicate the increased percentage of body fat in females during adolescence.<a class="elsevierStyleCrossRefs" href="#bib4"><span class="elsevierStyleSup">4–5</span></a> These and other modifications may influence body image.</p><p id="para20" class="elsevierStylePara elsevierViewall">Body image refers to a multifaceted construct, encompassing perception, emotion, feelings, and thoughts directed to one's own body.<a class="elsevierStyleCrossRef" href="#bib6"><span class="elsevierStyleSup">6</span></a> Body dissatisfaction, classified as a component of body image, concerns the dissatisfactionx with one's weight, appearance, and physical shape.<a class="elsevierStyleCrossRef" href="#bib7"><span class="elsevierStyleSup">7</span></a> Studies have shown a prevalence of body dissatisfaction ranging from 10% to 40% among adolescents.<a class="elsevierStyleCrossRefs" href="#bib2"><span class="elsevierStyleSup">2,8</span></a> More specifically, it appears that this prevalence may be even higher among female adolescents.<a class="elsevierStyleCrossRefs" href="#bib9"><span class="elsevierStyleSup">9–12</span></a> Body dissatisfaction may be associated with self-esteem. <a class="elsevierStyleCrossRefs" href="#bib13"><span class="elsevierStyleSup">13–14</span></a></p><p id="para30" class="elsevierStylePara elsevierViewall">Self-esteem is related to the set of feelings and thoughts of the individual regarding his/her own worth, competence, and suitability, which results in a positive or negative attitude towards oneself.<a class="elsevierStyleCrossRef" href="#bib13"><span class="elsevierStyleSup">13</span></a> Self-esteem is subdivided into negative and positive. The first refers to feelings of worthlessness and failure and the second is related to the feelings of satisfaction and appreciation of oneself.<a class="elsevierStyleCrossRef" href="#bib13"><span class="elsevierStyleSup">13</span></a> Flament <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib8"><span class="elsevierStyleSup">8</span></a> indicate that the main point of self-esteem is the evaluative aspect, which influences how the individual sets his goals, accepts himself, values others, and projects his expectations for the future.<a class="elsevierStyleCrossRef" href="#bib13"><span class="elsevierStyleSup">13</span></a></p><p id="para40" class="elsevierStylePara elsevierViewall">Self-esteem is considered one of the main predictors of favorable outcomes in adolescence, with implications in areas such as interpersonal relationships and academic performance.<a class="elsevierStyleCrossRef" href="#bib13"><span class="elsevierStyleSup">13</span></a> In contrast, the influence of this characteristic has also been observed in adverse problems such as aggression, antisocial behavior, delinquency in youth, and negative changes in body image.<a class="elsevierStyleCrossRefs" href="#bib8"><span class="elsevierStyleSup">8,14,15</span></a></p><p id="para50" class="elsevierStylePara elsevierViewall">Evidence has shown a positive association between negative self-esteem and body dissatisfaction.<a class="elsevierStyleCrossRefs" href="#bib8"><span class="elsevierStyleSup">8,16</span></a> Similarly, previous studies showed an inversely proportional association between positive self-esteem and body dissatisfaction.<a class="elsevierStyleCrossRefs" href="#bib14"><span class="elsevierStyleSup">14,17</span></a> However, these investigations were developed with populations from Chile, the United States, and Canada. A search was performed with some descriptors (body image, self-esteem and adolescents) in the main scientific databases (SciELO, PubMed, and Scopus), and no research was found that attempted to analyze the influence of self-esteem on body dissatisfaction in Brazilian adolescents. The findings of such a study could assist professionals who work directly with adolescents in the organization of meetings, lectures, and discussions that have body in adolescence as the central focus. Given the above, the aim of the study was to evaluate the association between self-esteem and body dissatisfaction in female Brazilian adolescents.</p></span><span id="cesec20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle140">Methods</span><p id="para60" class="elsevierStylePara elsevierViewall">This was a cross-sectional, school-based study conducted during 2012 and 2013 in the city of Juiz de Fora, state of Minas Gerais, Brazil, with female adolescents aged between 12 and 17 years. According to information from the Education Secretariat of Juiz de Fora, the population of female adolescents aged 12 to 17 years enrolled in municipal schools in 2012 was approximately 41,000. Thus, sample size calculation was performed using the following criteria, following the recommendations of Alves <span class="elsevierStyleItalic">et al</span>:<a class="elsevierStyleCrossRef" href="#bib9"><span class="elsevierStyleSup">9</span></a> 30% prevalence of body dissatisfaction, according to the findings of Fortes <span class="elsevierStyleItalic">et al</span>,<a class="elsevierStyleCrossRef" href="#bib11"><span class="elsevierStyleSup">11</span></a> 95% confidence, 5% sampling error, and the total value was increased by 20% due to possible losses, totaling 387 students necessary for a representative sample. Sample size calculation was performed using EpiInfo software (release 3.5) (Centers for Disease Control and Prevention, Georgia – USA).</p><p id="para70" class="elsevierStylePara elsevierViewall">The proportional sample was stratified according to the location of schools in the sociogeographic regions of Juiz de Fora (North, Central, and South) and the type of school (public or private), and then distributed into primary and secondary education. The selection was performed randomly through simple drawing, in two stages. First the drawing of the schools was performed in each region, and then the drawing of adolescents in these units. The schools were selected from the list provided by the statistics section of the Education Secretariat of the State of Minas Gerais. The final study sample was divided into six different sampling sites (schools) and consisted of randomly selected female adolescents that were present in the schools on the collection days.</p><p id="para80" class="elsevierStylePara elsevierViewall">Only adolescents whose parents or guardians signed the informed consent and who were regularly enrolled in an elementary or high school in the city of Juiz de Fora/MG during 2012 or 2013 were included. A total of 439 girls were chosen to participate, of whom 42 were excluded for not appropriately completing the questionnaire or not participating in anthropometric assessments; thus a final sample of 397 adolescents was assessed.</p><p id="para90" class="elsevierStylePara elsevierViewall">Body dissatisfaction was assessed by the Body Shape Questionnaire (BSQ). The BSQ is a self-reporting tool consisting of 34 questions on the Likert point scale, ranging from 1 = never to 6 = always, which aims to assess the frequency of concern or dissatisfaction that the young individual has with weight and physical appearance i.e., body dissatisfaction. The higher the score, the higher the dissatisfaction with body appearance. This questionnaire has been validated for the Brazilian adolescent population<a class="elsevierStyleCrossRef" href="#bib10"><span class="elsevierStyleSup">10</span></a> and has good psychometric properties. Internal consistency was calculated by Cronbach's alpha for the present sample, yielding a satisfactory value of 0.96. It is also possible to differentiate the assessed adolescents by the cutoffs that classify four levels of body dissatisfaction: less than 80 points, free of body dissatisfaction; between 80 and 110, slight dissatisfaction; between 110 and 140, moderate dissatisfaction; and scores above 140, severe dissatisfaction.</p><p id="para100" class="elsevierStylePara elsevierViewall">Self-esteem was assessed by the Rosenberg Self-Esteem Scale (RSES).<a class="elsevierStyleCrossRef" href="#bib13"><span class="elsevierStyleSup">13</span></a> This scale consists of 10 items, with three choices of answers on the Likert point scale (1 = completely agree; 2 = neither agree nor disagree; 3 = completely disagree). The tool has two factors. The first factor comprises six items related to positive self-esteem; the second factor, four items that refer to negative self-esteem. The higher the score on the scale, the higher the individual's level of self-esteem. Due to the statistical analysis, the RSES median was used to classify adolescents with high and low self-esteem, a methodology that has been used previously.<a class="elsevierStyleCrossRef" href="#bib16"><span class="elsevierStyleSup">16</span></a> Thus, females with a score greater than or equal to 26 were included in the “high self-esteem” group (RSES+). The version of the scale used in the study has been validated for Brazilian adolescents<a class="elsevierStyleCrossRef" href="#bib13"><span class="elsevierStyleSup">13</span></a> and its internal consistency analysis showed an alpha of 0.70. For the present sample, internal consistency was assessed by Cronbach's alpha, yielding a value equivalent to 0.81.</p><p id="para110" class="elsevierStylePara elsevierViewall">Body mass was measured on a portable digital Tanita scale (Tanita Corporation of America, Illinois – USA) with 100 g precision and maximum capacity of 200 kg. A portable Welmy stadiometer (Welmy, São Paulo – Brazil) with 0.1 cm precision and maximum height of 2.20 m was used to measure height. Body mass index (BMI) was obtained using the formula: body mass (kg) / height squared (m²). Since some studies have shown the influence of BMI on body dissatisfaction,<a class="elsevierStyleCrossRefs" href="#bib2"><span class="elsevierStyleSup">2,4</span></a> the authors chose to control BMI in the statistical analyses.</p><p id="para120" class="elsevierStylePara elsevierViewall">The protocol for adolescents developed by Slaughter <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib18"><span class="elsevierStyleSup">18</span></a> was used to calculate the percentage of body fat. The triceps and subscapular skinfolds were measured according to the standardization determined by the International Society for Advancement for Kinanthropometry<a class="elsevierStyleCrossRef" href="#bib19"><span class="elsevierStyleSup">19</span></a> using a Lange scientific caliper (Cambridge Scientific Industries Inc, Cambridge – USA), with a 1 mm precision. Measurements were taken rotationally and collected three times, considering the mean values. In view of the findings of some studies that indicate the influence of body fat on body dissatisfaction,<a class="elsevierStyleCrossRefs" href="#bib4"><span class="elsevierStyleSup">4,11</span></a> the percentage of body fat was controlled in the statistical analyses.</p><p id="para130" class="elsevierStylePara elsevierViewall">The principals of ten schools (five public and five private) were invited to participate in the study, after being informed about the study objectives and procedures. The distribution of private and public schools in the city of Juiz de Fora, MG, is proportional.<a class="elsevierStyleCrossRef" href="#bib11"><span class="elsevierStyleSup">11</span></a> However, only six principals (four private and two public) agreed to allow their students to participate in the study. After the approval, meetings with each of the classes were conducted to explain objectives and procedures for inclusion of students in the study. The informed consent was given to the adolescents and they were asked to return them duly signed by a parent/guardian by the following week, in case of agreement with their voluntary participation.</p><p id="para140" class="elsevierStylePara elsevierViewall">The study was performed in two different stages. In the first stage, the students answered the tools (BSQ and RSES). This step was performed in a group with a single researcher, using standardized verbal explanations. Therefore, after completing the questionnaires, the students were sent individually to the next room to undergo anthropometric measurements (weight, height, and skinfolds).</p><p id="para150" class="elsevierStylePara elsevierViewall">This study was approved by the Research Ethics Committee for Studies in Human Subjects of Faculdade de Filosofia, Ciências, e Letras of Universidade de São Paulo (Edict No. 109 971), according to Decree 466/12 of the National Health Council.</p><p id="para160" class="elsevierStylePara elsevierViewall">The Kolmogorov-Smirnov test was performed to assess the BSQ distribution. Given the absence of parametric violation, parametric tests were used. Central tendency measures (mean), dispersion (standard deviation, standard error, minimum and maximum values), and relative frequency were used to describe the study variables. Stepwise multiple linear regression was performed to analyze the association of RSES subscales (positive and negative) with body dissatisfaction. Only variables with <span class="elsevierStyleItalic">p</span><0.10 were kept in the model. Univariate analysis of covariance (ANCOVA) was used to compare the scores in the BSQ in relation to the dichotomous classifications established for RSES (≥26), as performed in a previous study.<a class="elsevierStyleCrossRef" href="#bib16"><span class="elsevierStyleSup">16</span></a></p><p id="para170" class="elsevierStylePara elsevierViewall">Bonferroni's <span class="elsevierStyleItalic">post-hoc</span> test was applied to identify possible statistical differences. Finally, the effect size was calculated, represented by the letter “d” to highlight the importance of differences from a practical standpoint. BMI and body fat percentage were controlled in all analyses. All data were processed using SPSS 20.0 software (BM Corp. IBM SPSS Statistics for Windows, New York – USA), with a significance level of 5%.</p></span><span id="cesec30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle150">Results</span><p id="para180" class="elsevierStylePara elsevierViewall">The results indicated that 30.6% of the adolescents demonstrated body dissatisfaction, divided as follows: 16.1% with mild body dissatisfaction, 8.9% with moderate body dissatisfaction, and the remaining 5.6% with severe body dissatisfaction. Regarding self-esteem, the findings showed that 56% of the adolescents had low self-esteem (RSES < 26). The descriptive data for all variables in this study is described in <a class="elsevierStyleCrossRef" href="#tbl1">Table 1</a>.</p><elsevierMultimedia ident="tbl1"></elsevierMultimedia><p id="para190" class="elsevierStylePara elsevierViewall">The multiple regression model indicated a statistically significant association of the subscales “positive self-esteem” (F [1, 396] = 32.85, R²=0.16, <span class="elsevierStyleItalic">p</span>=0.001) and “negative self-esteem” (F [2, 395] = 25.63, R²=0.23, <span class="elsevierStyleItalic">p</span>=0.001) with BSQ scores (<a class="elsevierStyleCrossRef" href="#tbl2">Table 2</a>).</p><elsevierMultimedia ident="tbl2"></elsevierMultimedia><p id="para200" class="elsevierStylePara elsevierViewall">The univariate analysis of covariance showed differences in BSQ scores (F (1, 396) = 19.55, <span class="elsevierStyleItalic">p</span>=0.001, d=0.7) in relation to the self-esteem groups (RSES<26.00 = 81.6±3.5; RSES≥26.0 = 56.4±4.4). Regarding the covariates, only BMI showed a statistically significant influence on BSQ scores (<span class="elsevierStyleItalic">p</span>=0.049).</p></span><span id="cesec40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle160">Discussion</span><p id="para210" class="elsevierStylePara elsevierViewall">The findings of this study indicated a prevalence of approximately 30% of body dissatisfaction among Brazilian female adolescents. Other studies have corroborated this result.<a class="elsevierStyleCrossRefs" href="#bib2"><span class="elsevierStyleSup">2,9,12</span></a> Body dissatisfaction affects approximately one-third of the Brazilian female adolescent population.<a class="elsevierStyleCrossRefs" href="#bib2"><span class="elsevierStyleSup">2,10,11</span></a> However, this prevalence has increased in recent years,<a class="elsevierStyleCrossRefs" href="#bib12"><span class="elsevierStyleSup">12,20</span></a> making it a public health problem. According to Flament <span class="elsevierStyleItalic">et al</span>, <a class="elsevierStyleCrossRef" href="#bib8"><span class="elsevierStyleSup">8</span></a> the media is mainly responsible for this fact, as it broadcasts images of skinny bodies associated with success, which tends to keep adolescents distant from reality and, in turn, generates feelings of dissatisfaction with weight, physical appearance, and body shape.</p><p id="para220" class="elsevierStylePara elsevierViewall">Regarding self-esteem, the results indicated a significant association between the “positive self-esteem” subscale and body dissatisfaction. Multiple regression analysis showed that 16% of body dissatisfaction was explained by feelings of satisfaction and self-appreciation. According to Caqueo-Urizar <span class="elsevierStyleItalic">et al</span>,<a class="elsevierStyleCrossRef" href="#bib14"><span class="elsevierStyleSup">14</span></a> girls with high positive self-esteem do not usually internalize the sociocultural ideal of thinness, causing reductions in body dissatisfaction. For instance, Flament <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib8"><span class="elsevierStyleSup">8</span></a> assessed the mediating effects of self-esteem between the internalization of the thinness ideal, body dissatisfaction, and risk behaviors for eating disorders. The authors demonstrated that positive self-esteem decreases female adolescents' susceptibility to body dissatisfaction, which, in turn, reduces the likelihood of triggering risk behaviors for eating disorders. Similarly, Johnson <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib17"><span class="elsevierStyleSup">17</span></a> found that positive self-esteem accounted for the decrease in dissatisfaction with weight and physical appearance among American female university students. Thus, girls who value their personal qualities and feel able to perform tasks as well as other people appear to be less vulnerable to body dissatisfaction.</p><p id="para230" class="elsevierStylePara elsevierViewall">Regarding the negative self-esteem, this was also associated with body dissatisfaction. The results indicated that 8% of body dissatisfaction was explained by the negative self-esteem. Other scientific evidence supports these findings. The study of Flament <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib8"><span class="elsevierStyleSup">8</span></a> suggested that negative self-esteem is a major predictor of body dissatisfaction, second only to the internalization of the thinness ideal. Similarly, De Bruin <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib16"><span class="elsevierStyleSup">16</span></a> demonstrated that low self-esteem was closely related to body dissatisfaction in females. Considering what the scientific literature has found and the findings of this research, it can be assumed that feelings of worthlessness and failure can make adolescents more susceptible to dissatisfaction with their weight, physical appearance, and body shape.</p><p id="para240" class="elsevierStylePara elsevierViewall">Regarding the comparison of scores on the BSQ in relation to the self-esteem groups, the results suggested greater body dissatisfaction in adolescents with low self-esteem compared to those with high self-esteem. Corroborating these findings, Johnson <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib17"><span class="elsevierStyleSup">17</span></a> and Pisitsungkagarn <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib21"><span class="elsevierStyleSup">21</span></a> found greater body dissatisfaction in female university students<a class="elsevierStyleCrossRef" href="#bib17"><span class="elsevierStyleSup">17</span></a> and adolescents<a class="elsevierStyleCrossRef" href="#bib21"><span class="elsevierStyleSup">21</span></a> with low self-esteem than those with high self-esteem. Likewise, De Bruin <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib16"><span class="elsevierStyleSup">16</span></a> and Murray <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib22"><span class="elsevierStyleSup">22</span></a> observed greater body dissatisfaction in female adolescents with low self-esteem. It appears that low self-esteem plays an important role in increased concern with the body among female individuals.</p><p id="para250" class="elsevierStylePara elsevierViewall">As mentioned by Flament <span class="elsevierStyleItalic">et al</span>,<a class="elsevierStyleCrossRef" href="#bib8"><span class="elsevierStyleSup">8</span></a> perhaps the adolescents with low self-esteem more often internalize the sociocultural ideal of thinness, which has a negative effect on body dissatisfaction. The studies by Johnson <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib17"><span class="elsevierStyleSup">17</span></a> and De Bruin <span class="elsevierStyleItalic">et al</span><a class="elsevierStyleCrossRef" href="#bib16"><span class="elsevierStyleSup">16</span></a> were conducted with athletes. Therefore, comparisons with the results presented herein should be analyzed with caution.</p><p id="para260" class="elsevierStylePara elsevierViewall">Although the present study demonstrated interesting and unpublished results for Brazilian literature, it has limitations that should be mentioned. Researchers point out that young individuals might not reliably answer the questionnaire.<a class="elsevierStyleCrossRefs" href="#bib14"><span class="elsevierStyleSup">14,23</span></a> However, Fortes.<a class="elsevierStyleCrossRef" href="#bib3"><span class="elsevierStyleSup">3</span></a> emphasized that in studies with large samples, self-reporting tools can be considered the gold-standard method, as they are easy-to-apply and low-cost tools. Also noteworthy is the use of a doubly indirect method to estimate body fat in adolescents. However, the authors emphasize the difficulty of access to sophisticated equipment and the large financial costs to use this type of equipment. Finally, it is believed this is the first study to be conducted in Brazil assessing the influence of self-esteem on body dissatisfaction in female adolescents.</p><p id="para270" class="elsevierStylePara elsevierViewall">The results demonstrated that low self-esteem was associated with body dissatisfaction among female adolescents in Juiz de Fora, MG. Thus, professionals that work in schools should concentrate on organizing events that aim to discuss body-related aspects during adolescence – for instance, the deleterious consequences to psychological health arising from negative comments made by friends in relation to body morphology. In summary, it is recommended that studies with longitudinal design are conducted to verify the cause and effect association of self-esteem and body dissatisfaction in Brazilian female adolescents.</p></span><span id="cesec50" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle170">Conflicts of interest</span><p id="para280" class="elsevierStylePara elsevierViewall">The authors declare no conflicts of interest.</p></span></span>" "textoCompletoSecciones" => array:1 [ "secciones" => array:10 [ 0 => array:3 [ "identificador" => "xres533973" "titulo" => "Abstract" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "ceabs10" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "ceabs20" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "ceabs30" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "ceabs40" "titulo" => "Conclusions" ] ] ] 1 => array:2 [ "identificador" => "xpalclavsec554351" "titulo" => "KEYWORDS" ] 2 => array:3 [ "identificador" => "xres533972" "titulo" => "Resumo" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "ceabs50" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "ceabs60" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "ceabs70" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "ceabs80" "titulo" => "Conclusão" ] ] ] 3 => array:2 [ "identificador" => "xpalclavsec554352" "titulo" => "PALAVRAS-CHAVE" ] 4 => array:2 [ "identificador" => "cesec10" "titulo" => "Introduction" ] 5 => array:2 [ "identificador" => "cesec20" "titulo" => "Methods" ] 6 => array:2 [ "identificador" => "cesec30" "titulo" => "Results" ] 7 => array:2 [ "identificador" => "cesec40" "titulo" => "Discussion" ] 8 => array:2 [ "identificador" => "cesec50" "titulo" => "Conflicts of interest" ] 9 => array:1 [ "titulo" => "References" ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2014-01-06" "fechaAceptado" => "2014-02-27" "PalabrasClave" => array:2 [ "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "KEYWORDS" "identificador" => "xpalclavsec554351" "palabras" => array:4 [ 0 => "Body image" 1 => "Body dissatisfaction" 2 => "Self concept" 3 => "Adolescents" ] ] ] "pt" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "PALAVRAS-CHAVE" "identificador" => "xpalclavsec554352" "palabras" => array:4 [ 0 => "Imagem corporal" 1 => "Insatisfação corporal" 2 => "Autoestima" 3 => "Adolescentes" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "en" => array:3 [ "titulo" => "Abstract" "resumen" => "<span id="ceabs10" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle20">Objective</span><p id="spara40" class="elsevierStyleSimplePara elsevierViewall">To evaluate the influence of self-esteem on levels of body dissatisfaction among adolescent females.</p></span> <span id="ceabs20" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle30">Methods</span><p id="spara50" class="elsevierStyleSimplePara elsevierViewall">A group of 397 adolescents aged 12 to 17 years were enrolled in the study. The Body Shape Questionnaire (BSQ) was applied to assess body dissatisfaction. The Rosenberg Self-Esteem Scale was used to assess self-esteem. Weight, height, and skinfold thickness were also measured. These anthropometric data were controlled in the statistical analyses.</p></span> <span id="ceabs30" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle40">Results</span><p id="spara60" class="elsevierStyleSimplePara elsevierViewall">The multiple regression model indicated influence of “positive self-esteem” (R²=0.16; <span class="elsevierStyleItalic">p</span>=0.001) and “negative self-esteem” (R²=0.23; <span class="elsevierStyleItalic">p</span>=0.001) subscales on the BSQ scores. Univariate analysis of covariance demonstrated differences in BSQ scores (<span class="elsevierStyleItalic">p</span>=0.001) according to groups of self-esteem.</p></span> <span id="ceabs40" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle50">Conclusions</span><p id="spara70" class="elsevierStyleSimplePara elsevierViewall">It was concluded that self-esteem influenced body dissatisfaction in adolescent girls from Juiz de Fora, MG.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "ceabs10" "titulo" => "Objective" ] 1 => array:2 [ "identificador" => "ceabs20" "titulo" => "Methods" ] 2 => array:2 [ "identificador" => "ceabs30" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "ceabs40" "titulo" => "Conclusions" ] ] ] "pt" => array:3 [ "titulo" => "Resumo" "resumen" => "<span id="ceabs50" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle70">Objetivo</span><p id="spara80" class="elsevierStyleSimplePara elsevierViewall">O objetivo do estudo foi avaliar a influência da autoestima na insatisfação corporal de adolescentes do sexo feminino.</p></span> <span id="ceabs60" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle80">Métodos</span><p id="spara90" class="elsevierStyleSimplePara elsevierViewall">Participaram 397 adolescentes com idade entre 12 e 17 anos. Utilizou-se o Body Shape Questionnaire (BSQ) para avaliar a insatisfação corporal. A Escala de Autoestima de Rosemberg foi utilizada para avaliar a autoestima. Foram mensurados peso corporal, estatura e dobras cutâneas. Esses dados antropométricos foram controlados nas análises estatísticas.</p></span> <span id="ceabs70" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle90">Resultados</span><p id="spara100" class="elsevierStyleSimplePara elsevierViewall">O modelo de regressão múltipla indicou influência das subescalas “autoestima positiva” (R²=0,16; <span class="elsevierStyleItalic">p</span>=0,001) e “autoestima negativa” (R²=0,23; p=0,001) nos escores do BSQ. A análise univariada de covariância demonstrou diferenças nos escores do BSQ (<span class="elsevierStyleItalic">p=</span>0,001) em razão dos grupos de autoestima.</p></span> <span id="ceabs80" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cestitle100">Conclusão</span><p id="spara110" class="elsevierStyleSimplePara elsevierViewall">Concluiu-se que a autoestima influenciou a insatisfação corporal em meninas adolescentes de Juiz de Fora/MG.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "ceabs50" "titulo" => "Objetivo" ] 1 => array:2 [ "identificador" => "ceabs60" "titulo" => "Métodos" ] 2 => array:2 [ "identificador" => "ceabs70" "titulo" => "Resultados" ] 3 => array:2 [ "identificador" => "ceabs80" "titulo" => "Conclusão" ] ] ] ] "NotaPie" => array:1 [ 0 => array:3 [ "etiqueta" => "*" "nota" => "<p class="elsevierStyleNotepara" id="cenpara20">Study conducted at Faculdade de Educação Física e Desportos da Universidade Federal de Juiz de Fora, Juiz de Fora, Minas Gerais, Brazil.</p>" "identificador" => "fn1" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "tbl1" "etiqueta" => "Table 1" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "leyenda" => "<p id="spara20" class="elsevierStyleSimplePara elsevierViewall">SD, standard deviation; BSQ, Body Shape Questionnaire; RSES, Rosenberg self-esteem scale; BMI, body mass index; BF%, body fat percentage</p>" "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Minimum \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Maximum \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Mean \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">SD \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">BSQ \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">34.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">192.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">70.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">36.9 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">RSES \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">30.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">24.9 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">4.1 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">BMI (kg/m<span class="elsevierStyleSup">2</span>) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">29.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">21.2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">8.6 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">BF% \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">5.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">43.1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">22.6 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">6.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">Age (years) \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">12.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">17.0 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">13.8 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1.7 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab858127.png" ] ] ] ] "descripcion" => array:1 [ "en" => "<p id="spara10" class="elsevierStyleSimplePara elsevierViewall">Descriptive values of the study variables. Juiz de Fora, 2013</p>" ] ] 1 => array:7 [ "identificador" => "tbl2" "etiqueta" => "Table 2" "tipo" => "MULTIMEDIATABLA" "mostrarFloat" => true "mostrarDisplay" => false "tabla" => array:2 [ "tablatextoimagen" => array:1 [ 0 => array:2 [ "tabla" => array:1 [ 0 => """ <table border="0" frame="\n \t\t\t\t\tvoid\n \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Variable \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">Block \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">B \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">R \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black">R<span class="elsevierStyleSup">2</span> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><a class="elsevierStyleCrossRef" href="#tbl2fn1">R<span class="elsevierStyleSup">2*</span></a> \t\t\t\t\t\t\n \t\t\t\t</th><th class="td" title="table-head " align="left" valign="top" scope="col" style="border-bottom: 2px solid black"><span class="elsevierStyleItalic">p</span>–value \t\t\t\t\t\t\n \t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">RSES–positive \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">1 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.30 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.40 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.16 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.15 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">≤0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="table-entry " align="left" valign="top">RSES–negative \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">2 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.39 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.47 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.23 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">0.22 \t\t\t\t\t\t\n \t\t\t\t</td><td class="td" title="table-entry " align="left" valign="top">≤0.001 \t\t\t\t\t\t\n \t\t\t\t</td></tr></tbody></table> """ ] "imagenFichero" => array:1 [ 0 => "xTab858128.png" ] ] ] "notaPie" => array:1 [ 0 => array:3 [ "identificador" => "tbl2fn1" "etiqueta" => "R<span class="elsevierStyleSup">2*</span>" "nota" => "<p class="elsevierStyleNotepara" id="cenpara10">adjusted R2; RSES, Rosenberg self-esteem scale.</p>" ] ] ] "descripcion" => array:1 [ "en" => "<p id="spara30" class="elsevierStyleSimplePara elsevierViewall">Multiple linear regression using RSES subscales as the explanatory variables on BSQ variance in female adolescents. 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array:2 [ "titulo" => "Body image among adolescents: association with sexual maturation and symptoms of eating disorders" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => """ MA Conti \n \t\t\t\t\t\t\t\t """ 1 => """ TA Cordás \n \t\t\t\t\t\t\t\t """ 2 => """ MRDO Latorre \n \t\t\t\t\t\t\t\t """ ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:5 [ "tituloSerie" => "Rev Bras Saude Mater Infant" "fecha" => "2009" "volumen" => "9" "paginaInicial" => "331" "paginaFinal" => "338" ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib11" "etiqueta" => "11" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Body dissatisfaction in adolescents: a longitudinal study" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => """ LS Fortes \n \t\t\t\t\t\t\t\t """ 1 => """ MA Conti \n \t\t\t\t\t\t\t\t """ 2 => """ SS Almeida \n \t\t\t\t\t\t\t\t """ 3 => """ ME Ferreira \n 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 October | 37 | 2 | 39 |
| 2024 September | 53 | 9 | 62 |
| 2024 August | 41 | 2 | 43 |
| 2024 July | 48 | 8 | 56 |
| 2024 June | 45 | 13 | 58 |
| 2024 May | 72 | 43 | 115 |
| 2024 April | 86 | 11 | 97 |
| 2024 March | 144 | 16 | 160 |
| 2024 February | 106 | 5 | 111 |
| 2024 January | 103 | 7 | 110 |
| 2023 December | 70 | 19 | 89 |
| 2023 November | 75 | 11 | 86 |
| 2023 October | 46 | 13 | 59 |
| 2023 September | 23 | 4 | 27 |
| 2023 August | 13 | 6 | 19 |
| 2023 July | 16 | 7 | 23 |
| 2023 June | 11 | 4 | 15 |
| 2023 May | 5 | 5 | 10 |
| 2023 April | 12 | 6 | 18 |
| 2023 March | 8 | 1 | 9 |
| 2023 February | 4 | 2 | 6 |
| 2023 January | 8 | 1 | 9 |
| 2022 December | 8 | 4 | 12 |
| 2022 November | 9 | 2 | 11 |
| 2022 October | 11 | 6 | 17 |
| 2022 September | 14 | 6 | 20 |
| 2022 August | 14 | 7 | 21 |
| 2022 July | 15 | 6 | 21 |
| 2022 June | 8 | 5 | 13 |
| 2022 May | 8 | 10 | 18 |
| 2022 April | 4 | 9 | 13 |
| 2022 March | 7 | 3 | 10 |
| 2022 February | 12 | 6 | 18 |
| 2022 January | 8 | 4 | 12 |
| 2021 December | 10 | 7 | 17 |
| 2021 November | 9 | 6 | 15 |
| 2021 October | 12 | 11 | 23 |
| 2021 September | 4 | 10 | 14 |
| 2021 August | 7 | 10 | 17 |
| 2021 July | 7 | 7 | 14 |
| 2021 June | 7 | 11 | 18 |
| 2021 May | 10 | 11 | 21 |
| 2021 April | 21 | 8 | 29 |
| 2021 March | 21 | 14 | 35 |
| 2021 February | 22 | 11 | 33 |
| 2021 January | 13 | 8 | 21 |
| 2020 December | 8 | 6 | 14 |
| 2020 November | 7 | 11 | 18 |
| 2020 October | 5 | 9 | 14 |
| 2020 September | 4 | 9 | 13 |
| 2020 August | 10 | 3 | 13 |
| 2020 July | 8 | 9 | 17 |
| 2020 June | 3 | 8 | 11 |
| 2020 May | 3 | 4 | 7 |
| 2020 April | 1 | 6 | 7 |
| 2020 March | 4 | 4 | 8 |
| 2020 February | 4 | 1 | 5 |
| 2020 January | 5 | 1 | 6 |
| 2019 December | 5 | 7 | 12 |
| 2019 November | 9 | 0 | 9 |
| 2019 October | 2 | 2 | 4 |
| 2019 September | 3 | 1 | 4 |
| 2019 July | 7 | 7 | 14 |
| 2019 June | 3 | 6 | 9 |
| 2019 May | 11 | 16 | 27 |
| 2018 September | 1 | 0 | 1 |
| 2017 January | 17 | 8 | 25 |
| 2016 December | 10 | 7 | 17 |
| 2016 November | 3 | 2 | 5 |
| 2016 October | 2 | 2 | 4 |
| 2016 September | 8 | 4 | 12 |
| 2016 August | 9 | 1 | 10 |
| 2016 July | 6 | 0 | 6 |
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