Research has consistently shown that more physically attractive individuals are perceived by others to be better psychologically adjusted, happier, more intelligent, and more socially competent than those perceived as less attractive (Rennels,
2012). This has been termed the “attractiveness halo effect” (Dion et al.,
1972) whereby people attribute other socially desirable traits and qualities (i.e., success, intelligence, happiness) to those they perceive to be physically attractive. Although there is an abundance of evidence supporting the halo effect, research has inconsistently examined whether physical attractiveness is associated with actual mental health and wellbeing outcomes, and importantly, whether self-perceptions of attractiveness (subjective) are more important for enhancing these outcomes than ratings of attractiveness by others (objective). Of the research that has investigated the link between objective and subjective attractiveness and psychological outcomes, much of it is outdated, cross-sectional, unidirectional, and has been conducted in adult samples. As the internalization of socially sanctioned beauty ideals occurs during early adolescence (Lawler & Nixon,
2011), and adolescence is a particularly vulnerable period for the onset of internalizing disorders (Rapee et al.,
2019), more research investigating the links between objective and subjective attractiveness and internalizing symptoms in youth is imperative to inform prevention and early intervention.
The current study sought to address these research gaps by investigating whether objective and/or subjective physical attractiveness were prospectively associated with life satisfaction and internalizing symptoms from early to mid-adolescence. Although studies investigating internalizing symptoms typically focus on depression and anxiety, the development of eating disorders shows very strong similarities to the development of anxiety and depression, as they share common risk and maintenance factors (Sander et al.,
2021), commonly co-occur (Blinder et al.,
2006), and are most likely to first emerge during the adolescent period (Rapee et al.,
2019). The three disorders have also been grouped together in theoretical models of social-emotional distress (Rapee et al.,
2019) and empirically derived classification systems based on interrelated symptom manifestations of internalizing psychopathology (Kotov et al.,
2017). Therefore, the current study measured all three forms of internalizing distress via a latent factor that modelled common variance indicated by symptoms of depression, social anxiety, and eating pathology.
Attractiveness and Links to Mental Health
The direction of the association between subjective and objective attractiveness and mental health outcomes has not yet been systematically researched, despite being predicted by a range of theories. For example, socialisation and social expectancy theories such as Status Characteristics Theory (SCT; Berger et al.,
1977) assert that physical attractiveness is an observable status characteristic, much like age, sex, and ethnicity, that people use to form expectations about the competence of others. SCT maintains that those with high status characteristics (e.g., male, attractive) are perceived by others to have more influence and be more competent than those with low status characteristics (e.g., female, unattractive), particularly in social situations (Rennels,
2012). According to SCT, and social expectation theories generally, physically attractive individuals should experience better mental health because over time they internalize the positive judgements and preferential treatment of others, positively influencing attractive individuals’ self-perceptions, thoughts, and behaviors (Langlois et al.,
2000). Hence greater attractiveness should predict better mental health and life satisfaction in the future.
Theory also predicts a link between self-perceptions of one’s own attractiveness and mental health. For example, the socio-cultural tripartite theoretical model (e.g., Thompson et al.,
1999) suggests that our appearance-focused culture has resulted in the internalization of unrealistic and unattainable societal beauty ideals. The internalization of these ideals can create a discrepancy between one’s actual and ideal appearance, which depending on the degree of internalization, can result in body dissatisfaction, low self-esteem, and consequent increases in internalizing symptoms (Lawler & Nixon,
2011). Hence, one’s self-perceived attractiveness can be influenced by factors quite separate from their actual physical attributes, often resulting in inconsistencies between subjective and objective physical attractiveness ratings and subsequently leading to greater emotional distress.
While the above theories suggest a unidirectional association from subjective and objective attractiveness to mental health, a range of clinical theories of internalizing disorders suggest that the relationship may also operate in the opposite direction. Theories of depression point to the importance of positive reinforcement and social interactions in forming self-perceptions (Lewinsohn et al.,
1980) and negative cognitive biases (Orchard and Reynolds,
2018). These cognitive biases can negatively affect perceptions of the self, including self-perceptions of attractiveness (Van de Vliet et al.,
2002) which may serve to undermine any protective effect of others preferential treatment of attractive individuals. Further, social anxiety is primarily characterized by concerns about public scrutiny and negative evaluation in social situations (Spence & Rapee,
2016) and evidence shows that socially anxious individuals often perceive themselves to be less attractive when compared to ratings from others (Rapee & Abbott,
2006).
While much of the theory in this area has focused on internalizing symptoms in terms of anxiety and depression, lower perceptions of attractiveness may also lead to a range of dieting and related efforts to change appearance, in turn increasing risk for eating disorders (Reynolds & Meltzer,
2017). In addition, in those with eating pathologies, self-evaluations of attractiveness tend to be overly influenced by body shape and weight concerns and sufferers often judge themselves as less unattractive than objective observers (Cash & Deagle,
1997), again suggesting a possible bidirectional relationship. Therefore, the repeated positive social reinforcement and lack of negative evaluation provided to those who are more attractive may protect against internalizing symptoms (Feingold,
1992). Conversely, internalizing disorders may have characteristics and symptoms that in turn make a person appear less attractive to others. For example, depression is often associated with poor self-care (DiMatteo et al.,
2000) and a lack of positive social skills (Verboom et al.,
2014), eating pathology is characterised by significant weight loss or gain (Micali et al.,
2014), and social anxiety can be associated with self-handicapping behaviors such as poor eye contact, quiet voice, and closed posture (Howell et al.,
2016).
Finally, the link between attractiveness and internalizing symptoms may also differ as a function of sex, as it is well established that there are marked sex differences in the prevalence of internalizing disorders (Altemus et al.,
2014) and socially sanctioned beauty ideals (e.g., thinness for girls versus muscularity for boys; Lawler & Nixon,
2011) that typically emerge during adolescence. Girls have been found to internalize socially prescribed body ideals more than boys, and feel a greater pressure to adhere to them (Knauss et al.,
2008). Objectification theory (Fredrickson and Roberts,
1997) has also been used to describe how women’s early socialization and sexual objectification experiences translate into mental health difficulties, particularly internalizing disorders such as depression and eating disorders (Moradi & Huang,
2008). Further, girls are also more likely to engage in appearance-focused conversations with friends and be the target of appearance-based victimisation (Lawler & Nixon,
2011). Therefore, it is possible that the links between both subjective and objective attractiveness and mental health outcomes are stronger in girls than boys. In sum, theoretical predictions suggest that either, or both, subjective and objective attractiveness may be a result of, or lead to low life satisfaction and internalizing disorders, and that these associations may be stronger in girls.
Attractiveness and Mental Health in Adolescence
Positive stereotypes about attractive individuals may particularly resonate with adolescents, increasing their risk for internalizing disorders. For example, research shows that appearance concerns increase markedly during early adolescence, which coincides with the cognitive, social and physical changes associated with the onset of puberty (Stice,
2003). Further, appearance-focused conversations with peers and appearance-based peer victimization are common in adolescence, and can consolidate unattainable societal beauty norms and ideals (Lawler & Nixon,
2011).
Early to mid-adolescence also marks a period of vulnerability for the onset of a particular subset of internalizing disorders such as social anxiety, eating pathology, and depression, which have been collectively referred to as “social-emotional disorders” (Rapee et al.,
2019). Finally, the documented decreases in life satisfaction and self-esteem from early to mid-adolescence (Goldbeck et al.,
2007), may also make adolescents particularly vulnerable to stereotypes linking attractiveness and happiness. These characteristics unique to adolescence suggest that early to mid-adolescence (pre to post puberty) may be an important developmental period in which to examine the prospective bidirectional associations between physical attractiveness, internalizing symptoms, and life satisfaction. Despite this, there has been surprisingly little research, especially longitudinally, that assesses life satisfaction and internalizing symptoms in relation to both objective and subjective aspects of attractiveness, and none that measured all of these factors bidirectionally in an adolescent sample.
Empirical Research Investigating Objective Attractiveness and Mental Health
Most of the research examining the links between objective attractiveness and psychological outcomes in adolescents has been correlational, and results have been relatively inconsistent. Further, much of this research was carried out more than two decades ago, and with few exceptions, has not been revisited. This is surprising considering the rise of social media and adolescents’ increased exposure to not only attractive celebrities but also the abundance of attractive everyday people flooding their news feeds as popular and financially successful “influencers” (Khamis et al.,
2016). This increased exposure to ordinary people reaching “celebrity” status based on their appearance may perpetuate existing stereotypes surrounding the social benefits of attractiveness to which adolescents may be particularly vulnerable due to their developing self-concept and heightened social sensitivity (Somerville,
2013). Despite this, the association between attractiveness and adolescent mental health has received very little attention in the current digital appearance-focused climate.
Some early research found that objectively-rated facial attractiveness was associated with better overall psychosocial functioning in pre-adolescents, although specific associations with depression and anxiety were not statistically significant (Perkins & Lerner,
1995). However, other research has found no significant associations between objective attractiveness and self-worth/esteem, anxiety, or depression in early adolescence (Lerner et al.,
1991). Similar inconsistency can be found in research examining social anxiety and objective attractiveness, with one early meta-analysis reporting non-significant concurrent associations (e.g., Feingold,
1992), whereas a later meta-analysis including both correlational and longitudinal evidence found significant positive associations (Langlois et al.,
2000). However, both meta-analyses included mostly adult samples and when younger samples were included, adolescent subgroup results were not reported making it difficult to determine whether these results were replicated in adolescents. Finally, the associations between objective attractiveness and eating disorders have been largely overlooked. This is surprising considering the large literature linking body dissatisfaction and the risk of eating disorders (e.g., Stice,
2002). Although not examining eating disorders specifically, one study found that objectively-rated facial attractiveness was associated with greater weight preoccupation in young women (Davis et al.,
2000), with the authors concluding that this was due to physically attractive individuals feeling greater pressure to maintain their attractiveness. Although this study was also correlational and has not been investigated among adolescents.
The existing research reviewed above provides several hints that objectively-rated attractiveness may have associations with life satisfaction and internalizing symptoms in adolescents, but the evidence is far from consistent. Further, the rarity of longitudinal evidence means that the direction of the associations cannot be determined. Of the few longitudinal studies conducted, one found that objectively rated attractiveness based on high school yearbook photographs significantly predicted greater well-being and lower depression in late adulthood (Gupta et al.,
2016). Further, a two-wave prospective study found that higher teacher, parent, and peer rated attractiveness in Grade 3 significantly predicted lower levels of depression in girls in Grade 6 (Cole et al.,
1997). Although providing some evidence for a prospective association between objective attractiveness and mental health, the longitudinal evidence above is limited by only examining the unidirectional association from objective attractiveness to mental health, and by utilizing only two waves of data. Thus, to date, there has been no longitudinal research specifically examining these bidirectional changes across the critical period from early to middle adolescence.
Empirical Research Investigating Subjective Attractiveness and Mental Health
The empirical evidence relating to the associations between subjective attractiveness and mental health is much more consistent and well supported by the larger literature on body image and mental health (e.g., Walker et al.,
2018). Correlational research specific to physical attractiveness and mental health in adolescence has consistently found that high subjective attractiveness is associated with less generalized anxiety and greater self-worth (Jovanovic et al.,
1989), lower social anxiety (Neto,
1993) and depression (Raible-Destan et al.,
2021), less loneliness (Moore and Schultz,
1983), higher life satisfaction (Neto,
1993), and fewer eating disorder symptoms (Smink et al.,
2018). What remains unclear is the direction of the association as most of the research in this area has been cross-sectional and/or has investigated subjective attractiveness as a predictor of adolescent mental health outcomes (e.g., Ehlinger & Blashill,
2016).
However, it is equally plausible that the negative cognitive biases associated with internalizing difficulties (Orchard & Reynolds,
2018) alter adolescents’ perceptions of their appearance. While there is some correlational evidence that people with internalizing problems rate themselves as less attractive than their counterparts (Rapee and Abbott,
2006), there is very little longitudinal research assessing the direction of this association. One of the few studies examining these associations bidirectionally, found that depressive symptoms predicted lower subjective attractiveness 6-months later over three successive years spanning pre to early adolescence, however, there was little support for the opposite direction of association (Cole et al.,
1998). In contrast, although not assessing subjective attractiveness specifically, a longitudinal study with adolescents at ages 13, 15, 18 found that poor body image served as an antecedent to depressive symptoms, but found no evidence of a prospective association from depression to body image (Holsen et al.,
2001). Thus, it remains unclear whether subjective attractiveness is predictive or reflective of mental health difficulties and to date, this question has only been addressed by a very small number of relatively old studies.