The Impact of Adverse Childhood Experiences on Body Image Dissatisfaction in Adolescents: A Narrative Review

This narrative review delves into the intricate relationship between Adverse Childhood Experiences (ACEs) and body image dissatisfaction in adolescents, a pressing public health issue linked to a spectrum of psychological disorders. Body image dissatisfaction among adolescents is a significant public health concern due to its association with depression, anxiety, low self-esteem, and risky behaviours such as binge eating, extreme dieting, and substance abuse. Adverse childhood experiences (ACEs) are highly prevalent and have been associated with negative body image. Based on the identity disruption model, adolescence is characterised by a tumultuous period of exploration of self and identity formation. Experiencing adverse events could result in an identity crisis, leading to cognitive dissonance regarding body appearance and body functionality. Consequently, body image dissatisfaction can lead to negative emotions, low self-esteem, anxiety, stress, social withdrawal, and maladaptive coping mechanisms such as extreme dieting or eating. This review explored evidence-based interventions for preventing and managing body image dissatisfaction in adolescents, such as psychoeducation to address cognitive dissonance, promotion of physical activity, and implementation of digital interventions focusing on behavioural therapy. The review also identified virtual-reality-based interventions as promising tools for addressing ACEs-induced body image dissatisfaction, as they could make behavioural therapies more engaging and realistic for parents and their children. However, this review is constrained by the methodological limitations of the literature utilised, primarily consisting of cross-sectional studies, which limited the ability of the study to present meaningful insights on the long-term effects of the interventions. Furthermore, the focus on family dysfunction, child maltreatment, and emotional abuse in the context of ACEs may not comprehensively represent the spectrum of other adverse experiences such as sexual abuse and neglect. Lastly, cultural differences in the perception of body image and the extent of ACEs experienced are not addressed due to the methodological approach of the reviewed literature, limiting the generalizability of the findings presented in this review. It is therefore recommended that future research aim at addressing these research gaps by incorporating diverse cultural perspectives and longitudinal data to better understand the long-term impact of ACEs on body image dissatisfaction.