Positive Environments and their Associations with Adolescent Appearance Dissatisfaction

Research output: Working paper


Importance. Adolescents' dissatisfaction with their appearance is a modifiable risk factor of multiple negative health and wellbeing indicators (including eating disorders). Evidence on whether positive environments could play a role in reducing appearance dissatisfaction across the world is lacking
Objective. To estimate the prevalence of appearance dissatisfaction globally and determine the extent to which positive home, neighbourhood, and school environments are associated with appearance dissatisfaction in early adolescence.
Design, Setting, and Participants. Existing cross-sectional self-report data from the Children’s World Survey were analysed. Data from 35 countries in 4 continents (Africa, Asia, Europe, and South America) were used. Data were analysed from approximately 85,000 adolescents between 10- and 12- years old in mainstream schools between 2016-2019. Questionnaires were administered by local teams in local languages. Multilevel regression models were fitted to the data. Analyses were pre-registered.
Exposure. Adolescents reported on their perceptions of care, support, safety, respect, and participation at home, school, and in their neighbourhoods using a 17-item self-report scale. Mean scores were generated for positive home, neighbourhood, and school environments, which were used as the primary exposure variables.
Main Outcome. Appearance dissatisfaction was the main outcome variable and was measured using a single item asking adolescents to report how satisfied they are with the way that they look.
Results. Appearance dissatisfaction ranged considerably across the world. Whilst, on the whole, girls and 12-year olds had higher levels of appearance dissatisfaction than boys and 10-year olds, this was not the case in all countries. Additionally, whilst all three positive environments were associated with lower appearance dissatisfaction, with adolescents’ home environments being the strongest predictor followed by schools and neighbourhoods.
Conclusions and Relevance. Positive home, neighbourhood, and school environments are all associated with lower levels of appearance dissatisfaction. These findings suggest that interventions within homes, schools, and neighbourhoods might lead to lower levels of appearance dissatisfaction amongst adolescents.
Original languageEnglish
PublisherPsyArXiv Preprints
Publication statusPublished - 15 Mar 2024

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