Beyond the Skin: Dysmorphic Concerns and Self-Objectification as Predictors of Emotional Distress in Individuals with Dermatological Conditions

Abstract

Visible skin conditions can expose people to appearance-related distress, yet the psychological processes that link appearance cognitions to emotional distress remain little studied in South Asian clinical samples. This cross-sectional study examined dysmorphic concern and self-objectification as predictors of emotional distress (depression, anxiety, and stress) among people with dermatological and aesthetic conditions in Pakistan, and explored group differences by gender, family system, family history of skin conditions, and posting of photographs on social media. A purposive sample of 200 adults (82 men, 118 women) from dermatology departments and aesthetic clinics in Islamabad and Rawalpindi completed the Dysmorphic Concern Questionnaire, the Self-Objectification Questionnaire, and the Depression Anxiety Stress Scales-21. Dysmorphic concern was significantly associated with emotional distress (p<.05), and self-objectification (p<.05). Together they accounted for 46% of the variance in distress, and each made a unique contribution (dysmorphic concern β = .63; self-objectification β = .17). The unique contribution of self-objectification was clearest for anxiety (β = .20) and stress (β = .17) and was not significant for depression. Women reported higher depression, anxiety, and stress than men (d = .50–.71) but did not differ in dysmorphic concern or self-objectification. Participants who did not post photographs online reported higher dysmorphic concern and distress, and those living in joint families reported more distress and anxiety. The findings support routine psychological screening and culturally sensitive, family-inclusive psychological care within dermatology services.