Charismaphobia: Diagnosis and Measurement of the Psychodermatological Symptoms


avatar Waqar Husain ORCID 1 , *

Department of Humanities, COMSATS University Islamabad, Islamabad, Pakistan

how to cite: Husain W. Charismaphobia: Diagnosis and Measurement of the Psychodermatological Symptoms. J Skin Stem Cell. 2023;10(2):e137387.



Psychodermatology is a newly emerging field that associates cosmetic dermatology with psychopathology. It analyzes the psychosocial aspects of beauty and physical attraction. Attractive people, in almost all cultures, are taken positively, and the less attractive ones are ostracized. The social pressure of staying physically attractive may lead to several negative outcomes, which can be placed under a single heading of “charismaphobia” (i.e., the “fear of unattractiveness”).


The current study aimed to assess the diagnostic aspects of charismaphobia by developing and validating a new scale.


This quantitative study was conducted on 2904 participants in 4 phases. The Charismaphobia Scale was developed and validated through exploratory and confirmatory factor analyses (EFA/CFA). The convergent validity of the scale was determined through generalized anxiety disorder, obsessive-compulsive disorder, and narcissistic personality disorder.


The finalized version of the Charismaphobia Scale comprised 19 items in English and reported 4 factors of charismaphobia (i.e., self-exhibition, narcissistic trends, media consumption, and charismaphobic anxiety). Marvelous sampling adequacy (Kaiser-Meyer-Olkin (KMO) = 0.946 and 0.871), highly significant adequacy of correlations between items (P = 0.000), excellent reliability (α = 0.939 and 0.843), strong factor loadings with no cross-loadings, adequate extractions of the items (all between 0.426 and 0.841), highly significant item-scale and item-total correlations (P < 0.001) were observed during the EFA and CFA. The convergent validity of the Charismaphobia Scale was found highly significant with generalized anxiety disorder (r = 0.327; P < 0.001), obsessive-compulsive disorder (r = 0.344; P < 0.001), and narcissistic personality disorder (r = 0.250; P < 0.001).


The Charismaphobia Scale was developed and validated for the ease of clinical psychologists and dermatologists to assess the mental conditions underlying common dermatological problems.

1. Background

The concept of beauty in humans has been explained through different psychosocial dimensions. The psychosocial perspective views beauty in a broader psychosocial context and argues that beauty, especially a stereotype for women, is essential for social recognition and is associated with several positive attributes (e.g., high intelligence, social competence, friendliness, likeability, and leadership skills) (1). Being and staying beautiful and attractive also cause several biopsychosocial problems. People regard such problems as skin-related or medical problems and usually consult dermatologists or cosmetic dermatologists to overcome these problems. The field of cosmetic dermatology has been expanding and realizing the role of mental conditions involved for the patients of cosmetic dermatology. Psychodermatology has been an emerging field in this regard, which merges cosmetic dermatology and clinical psychology. The existing clinical psychology, however, does not address beauty-related specific mental conditions. The current study was initiated after my frequent clinical observations of women with anxiety related to getting unattractive (2). I tried to find a proper label for this condition. While exploring the clinical aspects of “fear of unattractiveness,” I explored the diagnostic and statistical manual for mental disorders, fifth edition (DSM-5) (3) and examined the symptoms of body dysmorphic disorder, other specified obsessive-compulsive and related disorders, and adjustment disorders. Apart from the DSM-5, I also explored 2 other conditions mentioned in the literature: Gerascophobia (4) and Dorian Gray syndrome (5). I concluded that the understudied concept (i.e., fear of unattractiveness due to social pressure resulting in lower self-esteem, anxiety, sense of failure, and sense of being ostracized) was not given an appropriate label and could be explored further. Therefore, the term charismaphobia was coined as a new mental condition that involves all the relevant symptoms prevalent in the patients of cosmetic dermatology (2).

Charismaphobia intends to comprehend all the unattractiveness-related symptoms under 1 label by differentially excluding the related mental conditions (e.g., body dysmorphic and dysmorphic-like disorders, adjustment disorders, gerascophobia, and Dorian Gray syndrome). Charismaphobia, as simply defined in the current study, is the fear of unattractiveness. It can be present in both men and women. It further includes 2 conditions: (a) fear of being unattractive; and (b) fear of getting unattractive (after being regarded as attractive earlier in life). The criterion and judgment for attractiveness, in both these conditions, are obtained through social recognition. The clinical symptoms of charismaphobia (2) include the excessive and persistent presence of the following items:

a. Having a strong desire to be socially appreciated for physical attractiveness and bodily features alone

b. Having a strong desire to dominate others through physical attractiveness alone

c. Having a strong desire to look significantly younger than the chronological age

d. Having a strong belief to be comparatively better than others based on physical attractiveness and bodily features alone

e. Spending unjustified time on the internet to follow the latest fashion trends

f. Being extremely sensitive and selective in dressing

g. Having anxious thoughts about being regarded as unattractive by others

h. Taking medically unjustified measures to get or stay attractive

The excessive nature of the presence of the symptoms discussed above can be calculated by the norms established in the study (Table 1) or by conducting similar studies in one’s own culture. The recommended persistent nature of the presence of the symptoms discussed above is 6 months (i.e., the required symptoms need to be present for the last 6 months to be labeled as charismaphobic). Furthermore, the presence of symptoms g and h is mandatory to label a person with charismaphobia. These symptoms are related to charismaphobic anxiety, which is the main theme of charismaphobia.

Table 1.

Descriptive Statistics of the Charismaphobia Scale

VariablesItemsαMean ± SD%RangeSkewnessKurtosis
Phase 3 (n = 1407)
Charismaphobia190.93970.319 ± 17.11674.02019 - 9519 - 94-1.0580.038
Exhibition30.78411.366 ± 2.94175.7733 - 153 - 15-1.2391.011
Narcissistic trends30.7359.890 ± 3.32965.9333 - 153 - 15-0.497-0.799
Media consumption50.89118.339 ± 5.72773.3565 - 255 - 25-0.873-0.473
Anxiety80.95230.723 ± 8.85176.8088 - 408 - 40-1.1340.133
Phase 4 (n = 988)
Charismaphobia190.84352.167 ± 14.22654.91319 - 9520 - 910.216-0.559
Exhibition30.8028.775 ± 3.66558.5003 - 153 - 15-0.089-1.197
Narcissistic trends30.7569.430 ± 3.49562.8673 - 153 - 15-0.322-1.130
Media consumption50.86015.109 ± 6.35760.4365 - 255 - 25-0.132-1.242
Anxiety80.90418.852 ± 8.71747.1308 - 408 - 400.556-0.724
Phases 3 and 4 combined (n = 2395)
Charismaphobia190.92662.831 ± 18.31366.13819 - 9519 - 94-0.312-1.116
Exhibition30.82010.297 ± 3.50068.6473 - 153 - 15-0.701-0.621
Narcissistic trends30.7459.700 ± 3.40564.6673 - 153 - 15-0.425-0.954
Media consumption50.88217.006 ± 6.20168.0245 - 255 - 25-0.543-1.009
Anxiety80.95325.826 ± 10.56064.5658 - 408 - 40-0.306-1.352

2. Objectives

The current study aimed to develop and validate a scale to measure charismaphobia based on the symptoms already identified.

3. Methods

3.1. Participants

This quantitative study was conducted on 2904 participants from Islamabad and Rawalpindi, Pakistan. Initial interviews were conducted with 62 women (purposively selected women among my clients for psychotherapy), 30 cosmetic dermatologists, and 73 beauticians in the first phase of the study. The second phase of the study (i.e., the development and principal component analysis) involved 344 conveniently selected participants (101 men and 243 women). The third phase of the study (exploratory factor analysis (EFA)) involved 1407 conveniently selected participants (427 men and 980 women). The fourth phase of the study (confirmatory factor analysis (CFA) and convergent validity) involved 988 conveniently selected participants (62 men and 926 women). All the participants were conveniently included in the studies with only 1 condition: They could respond to the questionnaire in English. Participants' educational qualifications ranged from college-level education to a doctorate.

The average educational qualification of the participants was graduation from university. Participants' age ranged from 18 to 75 years. The mean age of the participants was 28 years.

3.2. Instruments

A semi-structured clinical interview sheet was used in the first phase of the study. The main objective of these interviews was to identify the possible habits and psychopathological behaviors in relation to the fear of unattractiveness. Based on the findings of the first phase of the study, a new scale (Charismaphobia Scale) was developed in the second phase of the study and validated in the third and fourth phases of the study. The generalized anxiety disorder assessment 7 (GAD-7) (6), Narcissistic Personality Inventory 16 (NPI-16) (7), and short version of the Obsessive-Compulsive Inventory (8) were used to measure the convergent validity of the Charismaphobia Scale.

3.3. Procedure

Data for the first phase of the study were gathered by me in a private clinic. I did clinical interviews with the purposively selected private clients. Interviews with cosmetic dermatologists and beauticians were also carried out in this regard. I involved some students to gather data for the second, third, and fourth phases of the study. The participants were approached in various public offices, hospitals, clinics, and educational institutions. Data were collected from January 2021 to September 2022. The Departmental Ethics Review Committee of the Department of Humanities at COMSATS University, Islamabad, Pakistan, approved this study. Data collection procedures were in accordance with the 1964 Helsinki Declaration and its later amendments.

3.4. Analysis

SPSS version 23 (SPSS Inc, Chicago, IL, USA) was used to record and analyze the data. Data were cleaned before analysis. The main analyses carried out in the current study were EFA and CFA.

4. Results

The initial scale comprised 37 items and was presented to a panel of 5 clinical psychologists to determine its face validity, which was found accurate. The response format was based on a 5-point Likert scale, including extremely false to extremely true. The participants were requested to provide their answers considering the last 6 months. Eighteen items were discarded in the second phase of the study (principal component analysis) due to their statistical weaknesses. The third and fourth phases of the study (i.e., EFA and CFA) tested and validated the remaining 19 items of the scale.

The EFA and CFA were performed using SPSS version 23. The principal component analysis and varimax method were used for extraction and rotation. Sampling adequacy, using Kaiser-Meyer-Olkin (KMO) values (9), was found marvelous in phase 3 (KMO = 0.946) and meritorious in phase 4 (Table 2; KMO = 0.871). The adequacy of correlations between items was analyzed through the Bartlett test of sphericity (10). It was highly significant in phases 3 and 4 (Table 2; P = 0.000).

Table 2.

Reliability and Data Accuracy of the Charismaphobia Scale

PhaseParticipantsItemsαKMOBTSComponents ExtractedVariance Explained (%)
EFA140719.939.94619203.27 a472.159
CFA98819.843.8718985.71 a464.90

The Cronbach α reliability for the scale was excellent in phase 3 (α = 0.939) and good in phase 4 (Table 2; α = 0.843). Cronbach α values for the subscales ranged from 0.735 to 0.952 in phase 3 and from 0.756 to 0.904 in phase 4 (Table 1). Four factors were extracted with 72.15% variance explained in phase 3 and with 64.90% variance explained in phase 4 (Table 2). These factors were labeled as exhibition, narcissistic trends, media consumption, and anxiety (Table 3). The communalities for all 19 items ranged from 0.426 to 0.841 (Table 4) in phases 3 and 4 and were acceptable as all were above 0.4 (11). The item-total and item-scale correlations were highly significant for all 19 items (Table 4) in phases 3 and 4. The convergent validity of the Charismaphobia Scale with a generalized anxiety disorder (Table 5; r = 0.327; P < 0.001), obsessive-compulsive disorder (Table 5; r = 0.344; P < 0.001), and narcissistic personality disorder (r = 0.250; P < 0.001) was highly significant. The exploratory and confirmatory validations of the scale revealed that the Charismaphobia Scale was sufficiently reliable and valid to be used further.

Table 3.

Factor Structure of the Charismaphobia Scale a

Item No.Item EFACFA
1I want to be liked by all because of my bodily features and physical attractiveness. 0.769 b0.0490.1920.2650.833 b0.0050.0880.150
2I want to be appreciated by all because of my physical attractiveness. 0.808 b0.1180.1510.2530.861 b0.0130.0690.154
3I want others to give me good comments on my physical attractiveness. 0.694 b0.1010.1790.3460.776 b-0.0260.0770.163
4I want to be admired by all.0.0520.849 b0.0930.1500.0060.845 b0.018-0.055
5I want to be the most attractive person.0.0920.845 b0.1640.122-0.0420.875 b0.024-0.009
6I am a special person with a unique attraction. 0.1400.541 b0.3760.2650.0180.734 b-0.005-0.027
7I usually watch advertisements related to beauty and fashion. 0.1210.0630.802 b0.2470.0820.0310.692 b0.164
8I remain interested in finding new beauty products to improve my attraction. 0.1290.1400.824 b0.3340.141-0.0020.823 b0.157
9I usually spend a significant amount of money to buy beauty products. 0.2020.2050.674 b0.3590.0810.0240.808 b0.072
10I have subscribed to many beauty channels and blogs on social media. 0.1570.1250.797 b0.293-0.0100.0060.777 b0.139
11I usually search the internet to find the best beauty products.0.1270.1600.695 b0.1190.014-0.0200.837 b0.084
12I feel worried when I think my physical attractiveness may decline with the passage of time.0.2630.0920.3230.734 b0.207-0.0570.2110.703 b
13I feel annoyed when I think I will be useless when I get older.0.1180.1280.3010.823 b0.0480.0260.0800.823 b
14I feel worried when I think I will lose my value by getting older. 0.1650.1280.2380.846 b0.0580.0160.1030.837 b
15I feel sad when I think people will not appreciate my physical attractiveness when I will get older. 0.2100.1250.2880.835 b0.199-0.0170.1280.791 b
16I am afraid to get older.0.2400.1970.1720.745 b0.005-0.0300.0260.770 b
17It hurts me when I think I am getting older day by day.0.2490.1850.1380.776 b0.0010.0110.0460.788 b
18I cannot think of being unattractive. 0.2450.0680.2550.747 b0.190-0.0680.1960.589 b
19It hurts me when I think I will be considered unattractive in the future. 0.2200.1330.2570.813 b0.187-0.0620.1360.760 b
Table 4.

Communalities, Item-Total, and Item-Scale Correlations for the Charismaphobia Scale

ExtractionItem-Total and Item-Scale CorrelationsExtractionItem-Total and Item-Scale Correlations
10.7010.581 a0.833 a0.7240.464 a0.847 a
20.7540.589 a0.862 a0.7700.468 a0.877 a
30.6430.616 a0.811 a0.6360.444 a0.815 a
40.7540.453 a0.816 a0.7180.165 a0.830 a
50.7650.487 a0.850 a0.7680.191 a0.863 a
60.5240.611 a0.758 a0.5400.160 a0.767 a
70.7230.667 a0.838 a0.5140.541 a0.734 a
80.8260.765 a0.907 a0.7210.615 a0.840 a
90.6660.748 a0.825 a0.6640.534 a0.804 a
100.7620.728 a0.875 a0.6220.535 a0.792 a
110.5390.556 a0.719 a0.7090.530 a0.832 a
120.7200.800 a0.845 a0.5860.676 a0.764 a
130.7980.810 a0.884 a0.6860.645 a0.810 a
140.8160.810 a0.899 a0.7150.667 a0.827 a
150.8410.845 a0.916 a0.6810.687 a0.810 a
160.6810.753 a0.818 a0.5940.569 a0.760 a
170.7170.757 a0.839 a0.6230.596 a0.776 a
180.6880.761 a0.829 a0.4260.580 a0.661 a
190.7930.818 a0.891 a0.6340.662 a0.796 a
Table 5.

The Convergent Validity and Correlations of the Charismaphobia Scale with Its Subscales

ExhibitionNarcissistic TrendsMedia ConsumptionAnxietyGeneralized Anxiety DisorderObsessive Compulsive DisorderNarcissistic Personality Disorder
Charismaphobia0.542 a0.210 a0.688 a0.818 a0.327 a0.344 a0.250 a
Exhibition-0.0200.197 a0.328a0.133 a0.141 a0.217 a
Narcissistic trends0.016-0.0610.047-0.0110.001
Media consumption0.304 a0.208 a0.265 a0.193 a
Anxiety0.308 a0.313 a0.176 a
Generalized anxiety disorder0.520 a0.116 a
Obsessive compulsive disorder0.197 a

5. Discussion

The Charismaphobia Scale revealed 4 factors for charismaphobia (i.e., self-exhibition, narcissistic trends, media consumption, and anxiety). Anxiety is the core ingredient of charismaphobia, whereby a charismaphobic person would get abnormally anxious about missing relevant information on the internet or social media to get the latest updates on fashion and beauty trends. The charismaphobic anxiety can also be due to the lack of social admiration against one’s physical attractiveness. Generalized anxiety disorder, which has been found to be significantly and positively correlated with charismaphobia in the current study, also has similar symptoms, but the object of anxiety in generalized anxiety disorder is usually unknown (3). Charismaphobic anxiety, on the other hand, is a known anxiety developed for being or getting unattractive and involves sociocultural pressures. Having appreciable physical attractiveness and avoiding a disliked body image have been recognized as major health concerns worldwide (12). People who have these concerns at severe levels also develop several other problems, such as frequent dieting (13), bulimic symptoms and dietary restraint (14), weight gain (15), poorer psychological well-being (16), depression (17), and lower self-esteem (18). Studies have also shown that people who are more satisfied with their physical appearances and bodies possess higher self-esteem, psychological well-being, and sexual satisfaction (19). The earlier literature also provides sufficient evidence for a positive connection between several dermatological conditions and mental disorders (12-18, 20-24). The patients who visit cosmetic dermatologists have almost 2 times more psychiatric symptoms than those who visit general dermatologists (20). Dermatologists must be aware of certain beauty-related psychological symptoms, such as body dimorphic disorder (2, 20), and should know about the mental health of their patients (21). Psychodermatology is a rapidly growing field that combines neurology, mind, and skin (25). Charismaphobia and Charismaphobia Scale would be valuable contributions to the field of psychodermatology as well.

The current research revealed that the presence of charismaphobia (i.e., the fear of being or getting unattractive) would also require people to indulge in excessive and persistent media consumption to explore the latest trends in fashion and beauty. Media plays a critical role in the development of body image in both men and women. Media has a proven role in changing perceptions of beauty (26), inducing age-related fear in public (27), constantly showing negative images of growing old to provide the marketed strategies to avoid aging (28), promoting the businesses of anti-aging products with the idea that beauty is strongly associated with youth (29), building rapport between cosmetic producers and consumers (30), presenting females as sex bombs by unrealistically editing pictures and videos of women through software (31), promoting eating disorders (32), decreasing self-reliance and decision making, and promoting body dissatisfaction (33). Media affects men and women (34) directly and indirectly (35). Women, however, take this effect more seriously (36). Media promotes cosmetic surgeries (20), and celebrity idealization is one of the strongest reasons for undergoing cosmetic surgery (37). Social media is more interactive than traditional media in developing beauty standards (34).

Self-exhibition and narcissistic trends are also essential aspects of charismaphobia through which people desire to be socially appraised for their physical attractiveness. The association between pleasing appearances and positive human qualities is also a cross-cultural trend (38). People considered unattractive in society are also regarded to have negative personality traits (1). By labeling individuals as socially unattractive, societies cause several psychosocial issues for those who do not meet the established standards of attraction in society. These issues include low self-esteem (39) and poor physical and psychological health (22). Body image (i.e., how one perceives one's own body) is an important part of a good life, and a negative body image can result in destructive behaviors (12). A positive body image results in better and more efficient outcomes, such as life satisfaction and happiness (40). Therefore, people all over the world spend a huge amount of money on their desire to stay young and attractive (i.e., by purchasing anti-aging products) (41).

The present research brings charismaphobia to the attention of dermatologists and other relevant professionals. It also highlights the importance of being attuned to the mental health of the patients. The Charismaphobia Scale, developed and validated during the current study, would be a useful tool for researchers, clinical psychologists, and cosmetic dermatologists. The scale would enable them to screen out the mental conditions underlying the dermatological problems.


  • 1.

    Langlois JH, Kalakanis L, Rubenstein AJ, Larson A, Hallam M, Smoot M. Maxims or myths of beauty? A meta-analytic and theoretical review. Psychol Bull. 2000;126(3):390-423. [PubMed ID: 10825783].

  • 2.

    Husain W, Zahid N, Jehanzeb A, Mehmood M. The psychodermatological role of cosmetic dermatologists and beauticians in addressing charismaphobia and related mental disorders. J Cosmet Dermatol. 2022;21(4):1712-20. [PubMed ID: 34197675].

  • 3.

    American Psychiatric Association. Diagnostic and Statistical Manual for Mental Disorders, Fifth Edition. Washington, DC: American Psychiatric Association; 2013.

  • 4.

    Perales-Blum L, Juarez-Trevino M, Escobedo-Belloc D. Severe growing-up phobia, a condition explained in a 14-year-old boy. Case Rep Psychiatry. 2014;2014:706439. [PubMed ID: 25610691]. [PubMed Central ID: PMC4283456].

  • 5.

    Brosig B, Kupfer J, Niemeier V, Gieler U. The "Dorian Gray Syndrome": psychodynamic need for hair growth restorers and other "fountains of youth.". Int J Clin Pharmacol Ther. 2001;39(7):279-83. [PubMed ID: 11471770].

  • 6.

    Spitzer RL, Kroenke K, Williams JB, Lowe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166(10):1092-7. [PubMed ID: 16717171].

  • 7.

    Ames DR, Rose P, Anderson CP. The NPI-16 as a short measure of narcissism. J Res Pers. 2006;40(4):440-50.

  • 8.

    Foa EB, Huppert JD, Leiberg S, Langner R, Kichic R, Hajcak G, et al. The Obsessive-Compulsive Inventory: development and validation of a short version. Psychol Assess. 2002;14(4):485-96. [PubMed ID: 12501574].

  • 9.

    Kaiser HF. An index of factorial simplicity. Psychometrika. 1974;39(1):31-6.

  • 10.

    Bartlett MS. Tests of Significance in Factor Analysis. Br J Stat Psychol. 1950;3(2):77-85.

  • 11.

    Osborne JW, Costello AB, Kellow JT. Best Practices in Exploratory Factor Analysis. In: Osborne J, editor. Best Practices in Quantitative Methods. Thousand Oaks, CA: SAGE Publications, Inc; 2008. p. 86-99.

  • 12.

    Cash TF, Smolak L. Body image: A handbook of science, practice, and prevention. . New York City: Guilford Press; 2011.

  • 13.

    Neumark-Sztainer D, Wall M, Guo J, Story M, Haines J, Eisenberg M. Obesity, disordered eating, and eating disorders in a longitudinal study of adolescents: how do dieters fare 5 years later? J Am Diet Assoc. 2006;106(4):559-68. [PubMed ID: 16567152].

  • 14.

    Neumark-Sztainer D, Paxton SJ, Hannan PJ, Haines J, Story M. Does body satisfaction matter? Five-year longitudinal associations between body satisfaction and health behaviors in adolescent females and males. J Adolesc Health. 2006;39(2):244-51. [PubMed ID: 16857537].

  • 15.

    van den Berg P, Neumark-Sztainer D. Fat 'n happy 5 years later: is it bad for overweight girls to like their bodies? J Adolesc Health. 2007;41(4):415-7. [PubMed ID: 17875468].

  • 16.

    Keery H, van den Berg P, Thompson JK. An evaluation of the Tripartite Influence Model of body dissatisfaction and eating disturbance with adolescent girls. Body Image. 2004;1(3):237-51. [PubMed ID: 18089156].

  • 17.

    Mond J, van den Berg P, Boutelle K, Hannan P, Neumark-Sztainer D. Obesity, body dissatisfaction, and emotional well-being in early and late adolescence: findings from the project EAT study. J Adolesc Health. 2011;48(4):373-8. [PubMed ID: 21402266]. [PubMed Central ID: PMC3214691].

  • 18.

    van den Berg PA, Mond J, Eisenberg M, Ackard D, Neumark-Sztainer D. The link between body dissatisfaction and self-esteem in adolescents: similarities across gender, age, weight status, race/ethnicity, and socioeconomic status. J Adolesc Health. 2010;47(3):290-6. [PubMed ID: 20708569]. [PubMed Central ID: PMC2923488].

  • 19.

    Swami V, Airs N, Chouhan B, Amparo Padilla Leon M, Towell T. Are There Ethnic Differences in Positive Body Image Among Female British Undergraduates? Eur Psychol. 2009;14(4):288-96.

  • 20.

    Sobanko JF, Imadojemu S, Miller CJ. Epidemiology of Cosmetic Procedures: An Update for Dermatologists. Curr Dermatol Rep. 2012;1(1):4-13.

  • 21.

    Elsaie ML. Psychological approach in cosmetic dermatology for optimum patient satisfaction. Indian J Dermatol. 2010;55(2):127-9. [PubMed ID: 20606878]. [PubMed Central ID: PMC2887513].

  • 22.

    Mariano da Rocha LMBCR, Terra N. Body image in older adults: a review. Sci Med. 2013;23(4):255-61.

  • 23.

    Ackard DM, Croll JK, Kearney-Cooke A. Dieting frequency among college females: association with disordered eating, body image, and related psychological problems. J Psychosom Res. 2002;52(3):129-36. [PubMed ID: 11897231].

  • 24.

    Wertheim EH, Koerner J, Paxton SJ. Longitudinal Predictors of Restrictive Eating and Bulimic Tendencies in Three Different Age Groups of Adolescent Girls. J Youth Adolesc. 2001;30(1):69-81.

  • 25.

    Tohid H, Shenefelt PD, Burney WA, Aqeel N. Psychodermatology: An Association of Primary Psychiatric Disorders With Skin. Rev Colomb Psiquiatr (Engl Ed). 2019;48(1):50-7. [PubMed ID: 30651173].

  • 26.

    Widdows H, MacCallum F. The Demands of Beauty: Editors' Introduction. Health Care Anal. 2018;26(3):207-19. [PubMed ID: 29987446]. [PubMed Central ID: PMC6061010].

  • 27.

    Singer D, Hunter M. The experience of premature menopause: A thematic discourse analysis. J Reprod Infant Psychol. 1999;17(1):63-81.

  • 28.

    Bernard M, Chambers P, Granville G. Rethinking Theory. Women ageing: Changing Indentities Challenging Myths. In: Bernard M, Harding Davies V, Machin L, Phillips J, editors. Women Ageing: Changing Identities, Challenging Myths. London: Routledge; 2005.

  • 29.

    Petersen A, Seear K. In Search of Immortality: The Political Economy of Anti-aging Medicine. Med Stud. 2009;1(3):267-79.

  • 30.

    Goanta C, Ranchordas S. The Regulation of Social Media Influencers: An Introduction. 2019. Available from:

  • 31.

    Tadinac M. Why do we all want to be young and beautiful (and women especially)? From the evolutionary psychological perspective. Acta Clin Croat. 2010;49(4):501-8. [PubMed ID: 21830463].

  • 32.

    Griffiths S, Murray SB, Krug I, McLean SA. The Contribution of Social Media to Body Dissatisfaction, Eating Disorder Symptoms, and Anabolic Steroid Use Among Sexual Minority Men. Cyberpsychol Behav Soc Netw. 2018;21(3):149-56. [PubMed ID: 29363993]. [PubMed Central ID: PMC5865626].

  • 33.

    Yamout F, Issa J, Ghaddar A. Beauty Standards set by Social Media and their Influence on Women’s Body Image. Politics of the Machine Beirut 2019 (POM2019). 11-14 June 2019; Beirut, Lebanon. 2019. p. 61-9.

  • 34.

    Franchina V, Lo Coco G. The influence of social media use on body image concerns. Int J Psychoanal Educ. 2018;10(1):5-14.

  • 35.

    Trekels J, Eggermont S. "I Can/Should Look Like a Media Figure": The Association Between Direct and Indirect Media Exposure and Teens' Sexualizing Appearance Behaviors. J Sex Res. 2018;55(3):320-33. [PubMed ID: 29095056].

  • 36.

    Cohn JE, Arosarena OA. Perceiving Attractiveness and the Increasing Diversity in Facial Plastic Surgery. JAMA Facial Plast Surg. 2019;21(2):103. [PubMed ID: 30629088].

  • 37.

    Al-Saiari AA, Bakarman MA. Experiences and attitude among Saudi female University students towards cosmetic surgery. J Taibah Univ Med Sci. 2015;10(4):427-31.

  • 38.

    Zebrowitz LA, Wang R, Bronstad PM, Eisenberg D, Undurraga E, Reyes-García V, et al. First Impressions From Faces Among U.S. and Culturally Isolated Tsimane’ People in the Bolivian Rainforest. J Cross Cult Psychol. 2012;43(1):119-34.

  • 39.

    Nelson TD. Ageism: Stereotyping and prejudice against older persons. Cambridge, MA: MIT Press; 2004.

  • 40.

    Tylka TL, Wood-Barcalow NL. What is and what is not positive body image? Conceptual foundations and construct definition. Body Image. 2015;14:118-29. [PubMed ID: 25921657].

  • 41.

    Levy B. Improving memory in old age through implicit self-stereotyping. J Pers Soc Psychol. 1996;71(6):1092-107. [PubMed ID: 8979380].

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