Qinliang Zheng,1– 3,* Meng Chen,4,* Jennifer Hu,5 Ting Zhou,5 Peipei Wang6 

1Department of Pediatrics, Affiliated Hospital of Jining Medical University, Jining, Shandong, People’s Republic of China; 2Shandong Provincial Key Medical and Health Discipline of Pediatric Internal Medicine, Affiliated Hospital of Jining Medical University, Jining, Shandong, People’s Republic of China; 3Jining Key Laboratory for Prevention and Treatment of Severe Infection in Children, Affiliated Hospital of Jining Medical University, Jining, Shandong, People’s Republic of China; 4Department of Cardiology, Affiliated Hospital of Jining Medical University, Jining, Shandong, People’s Republic of China; 5Department of Medical Psychology, School of Health Humanities, Peking University, Beijing, People’s Republic of China; 6Sleep and Psychosomatic Medicine Center, Sanya Central Hospital/The Third People’s Hospital of Hainan Province, Sanya, Hainan, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Ting Zhou, Department of Medical Psychology, School of Health Humanities, Peking University, N0.38 Xueyuan Road, Haidian District, Beijing, 100191, People’s Republic of China, Email zhouting.92@bjmu.edu.cn Peipei Wang, Sleep and Psychosomatic Medicine Center, Sanya Central Hospital/The Third People’s Hospital of Hainan Province, No. 1154 Jiefangsi Road, Sanya, Hainan, 572000, People’s Republic of China, Email peipeiwang@pku.edu.cn

Objective: This study aimed to examine the association between appearance comparison and adolescent depressive symptoms, the mediating role of body appreciation, and the moderating roles of gender and body-mass index (BMI) among adolescents in different age groups.
Methods: A cross-sectional sample of 2645 Chinese students aged 12– 16 years (44.7% girls) participated. The measurements included depressive symptoms, appearance comparison, body appreciation, weight, and height. Multigroup path analysis was used to examine the moderated mediation model.
Results: Compared with boys, adolescent girls presented greater levels of appearance, which increased with age. Body appreciation mediated the association between appearance comparison and depressive symptoms in girls, whereas appearance comparison directly correlated with depressive symptoms in boys. Body appreciation decreased with increasing BMI in boys but remained relatively stable in girls. Similar patterns were observed among junior and senior high school students.
Conclusion: This study underscores the significant relationship between appearance comparison and adolescent depressive symptoms, suggesting varied mechanisms based on gender and BMI levels.

Keywords: appearance comparison, body appreciation, adolescent depressive symptoms, gender difference, age group difference, body-mass index