Appearance comparison, fear of negative evaluation and attitudes toward cosmetic surgery in adults

J Pak Med Assoc. 2026 May;76(5):652-656. doi: 10.47391/JPMA.20572.

Abstract

Objectives: To investigate the connection between appearance comparison, fear of negative evaluation, and attitude towards cosmetic surgery, and to find out the mediating role of fear of negative evaluation.

Methods: The cross-sectional study was conducted at the Riphah Institute of Clinical and Professional Psychology, Riphah International University, Lahore, from April to November 2022, and comprised adults aged 19-40 years of both genders from across the country. Data was collected online using a self-designed demographic sheet, the Physical Appearance Comparison Scale, the Acceptance of Cosmetic Surgery Scale, and the Fear of Negative Appearance Evaluation Scale. Data was analysed using SPSS 21.

Results: Of the 405 participants, 337(83.2%) were females and 68(16.8%) were males. The overall mean age was 27.17±5.450 years. Appearance comparison related to body image was positively linked with fear of negative evaluation and attitudes towards cosmetic surgery (p<0.05), while appearance comparison related to body image and fear of negative evaluations significantly predicted attitudes towards cosmetic surgery (p<0.005). Moreover, fear of negative evaluation significantly mediated between appearance comparison related to body image and attitude towards cosmetic surgery (p<0.000).

Conclusions: Appearance comparison related to body image was found to be significantly associated with fear of negative evaluation and attitude towards cosmetic surgery.

Keywords: Body image, Attitudes, Cosmetic surgery, Fear of negative evaluation..

MeSH terms

  • Adult
  • Body Image* / psychology
  • Cross-Sectional Studies
  • Fear* / psychology
  • Female
  • Humans
  • Male
  • Pakistan
  • Surgery, Plastic* / psychology
  • Surveys and Questionnaires
  • Young Adult