Investigating the Relationship Between Psychological Well-Being and Social Appearance Anxiety in Adolescents in Türkiye: A Cross-Sectional Study

Nurs Open. 2026 Jun;13(6):e70627. doi: 10.1002/nop2.70627.

ABSTRACT

AIM: This study examined the relationship between social appearance anxiety and psychological well-being in adolescents.

DESIGN: A cross-sectional, descriptive design was used.

METHODS: Data were collected via an online survey using snowball sampling between July and December 2020. The sample comprised 727 adolescents aged 12-18 years residing in Türkiye. Ethical approval procedures followed age-specific consent requirements. Participants aged 18 years provided their own informed consent, while those aged 12-17 years provided assent with parental consent. Participants completed a researcher-developed data collection form, the Flourishing Scale (FS) and the Social Appearance Anxiety Scale for Adolescents (SAAS-A). Data were analysed using independent t-tests, one-way ANOVA, Pearson correlation and hierarchical multiple regression. The study adhered to STROBE guidelines for reporting.

RESULTS: The majority of participants were female (66.4%) and between 15 and 18 years old (76.1%). The mean psychological well-being score was 40.12 ± 8.99, while the mean social appearance anxiety score was 37.91 ± 14.98. Adolescents aged 12-14 years reported significantly higher psychological well-being compared to those aged 15-18 years, while social appearance anxiety did not differ by age. Social appearance anxiety was negatively correlated with psychological well-being (r = -0.391, p < 0.001), indicating that higher anxiety levels were associated with lower psychological well-being. In the hierarchical regression model, demographic and activity-related factors (age, school attendance status and participation in regular social activities) were associated with 10.5% of the variance in psychological well-being. The addition of social appearance anxiety to the model was associated with a significant increase in the proportion of variance explained (ΔR² = 0.091), bringing the total explained variance to 19.6% (p < 0.001).

CONCLUSIONS: Social appearance anxiety is consistently associated with lower psychological well-being in adolescents. However, active participation in school, educational, social, or physical activities relates to higher psychological well-being and reduced appearance-related anxiety. These findings highlight the importance of everyday developmental contexts in shaping adolescent mental health. Appearance-related distress warrants close attention within adolescent healthcare. Integrating healthcare, educational, and family settings through collaborative, prevention-oriented efforts can significantly promote adolescents’ psychological well-being. Future longitudinal and intervention-based research is needed to clarify causal pathways across diverse contexts.

PATIENT OR PUBLIC CONTRIBUTION: Adolescent participants voluntarily completed the online survey but were not involved in the study’s design, analysis, or conduct.

PMID:42249725 | DOI:10.1002/nop2.70627