Appearance Self-Attitudes and Health and Well-Being of Bulgarian Adolescents

Anna Alexandrova-Karamanova


Objective − The study aims to explore the associations between adolescents’ appearance self-attitudes and their self-rated health, psychosomatic complaints and psychological well-being. A number of covariates known to impact health and well-being are also being investigated.

Materials and Methods − The study utilizes data from the Bulgarian 2013/2014 Health Behaviour in School-Aged Children (HBSC) study. The national representative sample included 3204 adolescents aged 13 and 15. The methods used were the Body image feelings and attitudes subscale of the Body Investment Scale (BIS), the HBSC psychosomatic complaints scale, the KIDSCREEN-10 index as a measure of psychological well-being, and single-item measures for appearance satisfaction and self-rated health. Results: Adolescents’ appearance satisfaction and positive feelings and attitudes towards body and appearance were significantly associated with better self-rated health, absence of or little psychosomatic complaints and better psychological well-being. These associations remained significant after the addition of a large number of covariates, including sociodemographic characteristics (gender, age, and family affluence); chronic health conditions; health behaviours (healthy eating, physical activity, smoking, alcohol consumption, and dieting to lose weight); overweight/obesity; and peer victimization. Adolescents’ appearance self-attitudes explained the largest proportions of the variances in self-rated health, psychosomatic complaints and psychological well-being, compared to the other groups of independent variables.

Conclusion − The results demonstrate the great significance of appearance self-attitudes for physical and mental health and well-being in adolescence. They are important for medical practice, health education and health promotion among adolescent populations, where appearance self-attitudes should be considered as crucial risk factors for health.


Appearance Self-Attitudes; Self-Rated Health; Psychosomatic Complaints; Psychological Well-Being; Adolescents

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