Appearance comparison, fear of negative evaluation, and attitudes toward cosmetic surgery in adults Authors Rabia Jameel Riphah Institute of Clinical and Professional Psychology, Riphah International University, Lahore, Pakistan Sahrash Jahangir Riphah Institute of Clinical and Professional Psychology, Riphah International University, Lahore, Pakistan Mah Noor Riphah Institute of Clinical and Professional Psychology, Riphah International University, Lahore, Pakistan DOI: https://doi.org/10.47391/JPMA.20572 Keywords: Body Image, Attitudes, Cosmetic surgery, Fear of negative evaluation Abstract Objective: 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. Method: 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). Conclusion: Appearance comparison related to body image was found to be significantly associated with fear of negative evaluation and attitude towards cosmetic surgery. Key Words: Body image, Attitudes, Cosmetic surgery, Fear of negative evaluation. Downloads Full Text Article Published 2026-04-20 How to Cite Jameel, R., Jahangir, S., & Mah Noor. (2026). Appearance comparison, fear of negative evaluation, and attitudes toward cosmetic surgery in adults. Journal of the Pakistan Medical Association, 76(05), 652–656. https://doi.org/10.47391/JPMA.20572 More Citation Formats ACM ACS APA ABNT Chicago Harvard IEEE MLA Turabian Vancouver Download Citation Endnote/Zotero/Mendeley (RIS) BibTeX Issue Vol. 76 No. 05 (2026): MAY Section RESEARCH ARTICLE License Copyright (c) 2026 Journal of the Pakistan Medical Association This work is licensed under a Creative Commons Attribution 4.0 International License.