The effect of temperament and character on body dissatisfaction in women with bulimia nervosa: The role of low self-esteem and depression

Objective Although personality traits have been found to be associated with body dissatisfaction for women in the general population, little research has explored these associations for people with eating disorders. Furthermore, it is unknown whether these associations are direct or are mediated by other factors. In this cross-sectional study, secondary analyses of data from two clinical trials were conducted to determine which personality dimensions contributed to body dissatisfaction in women with bulimia nervosa, and whether low self-esteem and depression mediate these associations independently or in serial. Method Participants were 193 women with bulimia nervosa. Participants completed self-report measures of temperament and character, body dissatisfaction, low self-esteem, and depression before receiving treatment for their eating disorder. Results The temperament dimension, harm avoidance, contributed significantly to body dissatisfaction. Serial mediation analyses showed this association was fully mediated, revealing two significant indirect effects. The first was through low self-esteem and the second through depression and low self-esteem in serial. Conclusions Findings suggest body dissatisfaction in women with bulimia nervosa may be indirectly targeted through addressing harm avoidance, depression and low self-esteem.