Gender Differences in Body Appreciation and Its Associations With Psychiatric Symptoms Among Chinese College Students: A Nationwide Survey

BACKGROUND: Body appreciation (BA hereafter), which reflects approval, acceptance, and respect for one's body while also rejecting media-promoted appearance ideals as the only form of human beauty, is an important aspect of positive body image. Much of the BA literature has been conducted on samples from Western nations but less is known about BA or its correlates in Asian cultural contexts wherein concerns with body image are also common. Toward addressing this gap, we examined gender differences in BA and its associations with common psychiatric symptoms (i.e., depressive symptoms, anxiety symptoms, and suicidality) within a national college student sample from China. METHOD: This cross-sectional, nationwide study was conducted between December 27, 2020, and January 18, 2021, based on snowball sampling. Aside from measures of demographics and background factors, Chinese versions of the Body Appreciation Scale-2 (BAS-2), Patient Health Questionnaire (PHQ-9), Generalized Anxiety Disorder Scale-7 (GAD-7), and a standard item on suicidal ideation and planning were administered to assess BA, depressive and anxiety symptoms, and suicidality, respectively. RESULTS: In total, 2,058 college students (665 men, 1,393 women) in China were assessed. An analysis of covariance revealed that the men had a significantly higher average BA level than did women [F((1,2058)) = 13.244, P < 0.001, Cohen's d = 0.193]. Hierarchical multiple regression analyses revealed BA was negatively associated with symptoms of depression, anxiety, and suicidality within the entire sample (depressive symptoms, β = −0.129, P < 0.001; anxiety symptoms, β = −0.101, P < 0.001; suicidality, OR = 0.788 P = 0.020) and among women (depressive symptoms, β = −0.172, P < 0.001; anxiety symptoms, β = −0.131, P < 0.001; suicidality, OR = 0.639 P = 0.001) but not men. CONCLUSION: Chinese college women reported lower BA than their male peers did. Furthermore, among women but not men, elevations in BA corresponded with protective mental health experiences including lower levels of depressive symptoms, anxiety symptoms and suicidality. Findings underscore the potential utility of including BA in mental health assessments of Chinese college students, especially women. Findings also provide foundations for continued research on interventions to increase BA among at-risk young women in China.