ROLES OF COSMETIC USE, BODY IMAGE, SELF-ESTEEM AND AGE ON

MENTAL HEALTH OF NIGERIAN WOMEN

Ilorah, Chisom Maria-Goretti

Department of Psychology, University of Nigeria, Nsukka, Nigeria

Correspondence Address:
Ilorah Chisom Maria-Goretti
Department of Psychology
University of Nigeria, Nsukka
Nigeria

ABSTRACT

Context:  Mental health, especially of women, is often neglected in

Nigeria. Mental health of women is anchored on contemporary physical
appearance and self-perception, determined by the factor roles of the
concept of cosmetic use, body image, self-esteem and age. Desire to
achieve the unrealistic image of 'physical perfection' often makes women
feel discontented; thus affecting mental health.
Aims: To investigate the roles of cosmetic use, body image, self-esteem
and age on mental health of women in Enugu, Nigeria.
Settings and Designs: The study was cross-sectional and descriptive,
conducted in University of Nigeria Enugu Campus and Enugu State
University of Science and Technology in Enugu State, Nigeria.
Subjects and Methods: Three hundred and eight (308) women from
University of Nigeria Enugu Campus and Enugu State University of
Science and Technology, Enugu completed the Modified Cash cosmetic
use inventory (CCUI) questionnaire [6][24c] measuring cosmetic use, Body
image acceptance and action questionnaire (BIAA-Q) questionnaire [33]
measuring body image, Rosenberg self-esteem scale (RSE) questionnaire
[31]
measuring self-esteem, Mental health index (MHI) questionnaire [23a]
measuring mental health were instruments used to elicit information from
the participants. Multiple (hierarchical) regression, as well as correlations,
was performed by means of SPSS version 16, with level of significance
set at P=0.05.
Results: It showed that cosmetic use had a significant predictive role in
mental health (β=.15, t=2.53, p<.05). However, body image (β=.08, t=1.37,
p=17) and self-esteem (β=-01, t=-15, p=.88) did not have significant
predictive in mental health in the study. It was also found that age had a
significant predictive role in mental health (β=.12, t=2.01, p<.05).
Conclusion: It was highlighted that body enhancement through cosmetic
use is a way of adding value to individuals’ natural endowments, and this
separates humans as intelligent beings from other organisms. Equally
indicated were directions for further research.

1.0 Introduction
Mental health can be defined as an individual’s psychological, emotional, and

social well-being [1]. Mental health includes subjective well-being, perceived self-

efficacy, anatomy, inter-generational dependence, competence, and self-

[44]
actualization of one's intellectual and emotional potential, among others. A

person struggling with mental health may experience stress, and mood

disorders. Mental health of an individual is connoted by his/her level of

interaction with other people as well as the immediate environment. [45] Mental

health is the capacity of an individual, a group and the environment to interact

with one another in ways that promote subjective well-being, the optimal

development and use of mental abilities (cognitive, affective and relational), the

achievement of individual and collective goals consistent with justice and the

attainment and preservation of conditions of fundamental equality. [45] Being

mentally healthy is important. It is about being able to function well, having

meaningful social connections, positive self-esteem and being able to cope with

change. It is an important part of overall health, and keeping one’s mind healthy
[27b]
is something all persons do on a daily basis.

Cosmetics, also known as make-up, are substances or products used to

[24a]
enhance the appearance or fragrance of the body. Cosmetics serve as a

sign of feminism in their symbolization of stereotypic feminine values. It is

usually seen as a way to enhance female beauty ideals and assist women to

conform to the society's beauty expectations. In the modern day research, it

appears that cosmetics are used in compensating for or hiding something that is

considered unattractive in one’s appearance.[6] Some research also suggests

that cosmetics are used to additionally enhance appearance that is already

 [18b]
considered attractive, as a symbol of elegance and class. In work settings,

the usage of cosmetics unexpectedly seems to have a say in income with the

belief of superior female abilities. [24b] Researches has indicated that women feel

more feminine and romantically involved with men when they make use of
[5][10]
cosmetics. Extroverts evidently make use of less makeup when compared

with introverts; this is because of their high level of self-confidence. Suggesting

that people who display excess makeup might be covering up their obvious

physical flaws.[17a] Many women have a negative feeling when they are not

wearing makeup, and they tend to be more unsatisfied with their bodies

compared to men.[28] The use of cosmetics does affect not only physical

changes but also self-esteem.[21] The reliance on makeup to repair a lack of

inner peace or sense of well-being may lead to an individual feeling ill at ease; a

signal that something is bothering the person. If this problem is not addressed, it

can affect an individual’s complete mental health (USFDA, 2000).

Body image is one's mental picture of one’s self; it is how an individual views

his/her body and the overall appearance. Body image, in psychology, refers to a
[3a]
people’s emotional attitudes, beliefs, and perceptions of their body. Although

some negative mental and physical health findings have been associated with
[3a]
body image, depression is of primary concern among aging populations.

Everyone has a body image. People cannot avoid having feelings about how

they look. It is part of human nature; people are influenced by how they imagine

others might see them. When an individual have a positive body image, one is

happy about the way one looks and feels good about one’s body whereas

negative body image is when individuals feel that their looks do not measure up

to what society, family, friends and media expect. The emphasis of body image
in social media and in the use of social networks has had an effect on

individual’s body esteem. Research has suggested that both males and females
[1] [3b]
have bodily concerns. Due to the socio-cultural focus on women’s bodies,

and the expanding cultural notion that women should strive to minimize the
[35]
aging signs and the fact that aging bodies are often viewed as less capable

and less attractive,[17c] based on the reviews of the previous literature, it is

evident that body image is a multifactorial construct that comprises different

meanings for women in various circumstance/groups. Thus, given that body

contentment is a steady predictor of depression among younger adult women, it

is still unclear if this relationship remains true for older women. The associations

between body image, socio-cultural factors, and depression have been

replicated several times in the literature on younger women’s body image. [9a]
[39]
However, it is not yet empirically tested among the older women population.

Self-esteem, is the way one looks at oneself: if one has good self-esteem, it

means that one likes oneself and has positive feeling as everyone else. If one

has poor self-esteem, it means that one does not have positive feeling about

him/herself or that he/she is inferior to others. [14] Smith and Mackie [37]
defined it

by saying that the self-concept is what we think about the self’s self-esteem. It is

the positive or negative evaluations of the self as in how one feels about it. It is

attractive as a social psychological construct because researchers have

conceptualized it as an influential predictor of certain outcomes such as

[37]
academic achievement, happiness and relationships. Generally, self-esteem

is described as a personal evaluation that an individual makes on him/herself,

their sense of their own worth, value, importance or capabilities. [29] An

individual’s overall positive evaluation of the self. Self-esteem comprises of two

distinct dimensions: competence and worth. [17d] [18a] The competence dimension

(efficacy-based self-esteem) refers to the degree to which people see

themselves as capable and efficacious. The worth dimension (worth-based self-

esteem) refers to the degree to which individuals feel they are persons of value.

Self-esteem is the way one looks at oneself; if one has good self-esteem, it

means that one likes oneself and has a positive feeling like everyone else. If

one has poor self-esteem, it means that one does not have a positive feeling
[14]
about him/herself or that he/she is inferior to others.

Aging is a natural process and something we all go through. Yet for many,

especially those who choose to focus on the physical signs of aging, such as

wrinkles, soft skin, age spots and gray hair, aging can take on negative

connotations.[20] Ageing takes a person’s body away from western societies

cultural ideals of thinness, muscularity and youthfulness.[3] Feingold & Mazzella

suggested that women are likely to benefit from ageing because they reach a

stage where they are no longer exposed to social pressures that emphasize

appearance. [15b]

This observations has necessitated the need to investigate the contributions of

cosmetic use, body image, and age on the mental health of women in Nigeria

2.0 Research Method

The study was descriptive and cross-sectional, conducted among women in the

University of Nigeria, Enugu Campus (UNEC) and Enugu State University of

Science and Technology (ESUT). The participants were selected through a

convenience sampling method based on their availability and willingness to

participate.

Instruments: Five questionnaire instruments were used; Modified Cash

Cosmetic Use Inventory (CCUI), Body Image Acceptance and Action

Questionnaire (BIAA-Q), Rosenberg Self Esteem Scale (RSE), and Mental

Health Index (MHI) and Socio-Demographic Data Collection Sheet.

[6]
CCUI is a cosmetics use inventory developed by Cash and Cash to measure

the use of cosmetics. A self-report matrix on which participants rate the extent

to which they use each of the facial cosmetics products. There is no available

information about its application in this population, to validate the CCUI for use

in Nigeria, the adapted 16-item CCUI was administered in pilot study to one

hundred women aged between 18 years and 61 from Enugu State University of

Science and Technology (ESUT), as pilot study. 99 copies were filled correctly.

These were scored and subjected to item analysis using the Statistical package

for the Social Sciences (SPSS) 16. Result of the analysis showed Cronbach’s

alpha = .98 (Appendix B). This suggests good internal consistency - a measure

of reliability. Further, Factor Analysis (exploratory) resulted in one Factor

(Appendix C). Thus, the adapted CCUI measures cosmetic use as a single

construct.

BI-AAQ [33] is a 12- item, 7 point Likert form scale ranging from (1- never true to

7- always true) measuring psychological flexibility and inflexibility of body-

related thoughts and feelings of an individual. The authors rewrote these items

to focus specifically on body-related content as opposed to psychological

experiences in general. The validity of the BI-AAQ has been confirmed through
[16]
correlation analyses in Portuguese and Persian studies . High internal
[33]
consistency. The researcher re-validated the BI-AAQ to ascertain its

usefulness for the current study. In a pilot study, 100 copies of the BI-AAQ were

administered to women, both staff and students of Enugu State University of

Science and Technology (ESUT), Enugu Campus. 92 items were properly filled.

The resultant Cronbach’s alpha was .82 (Appendix E).

RSE is a 10-item Likert form scale on a four point scale ranging from strongly

agree (3 points) to strongly disagree (0 point). RSE measures self- evaluative

statements such as ‘on the whole I am satisfied with myself’. It was developed
[31]
by Rosenberg. The RSE has high reliability coefficient. Its test-retest

correlations range from .82 to .88 and Cronbach’s alpha were in the range of .
[42]
77 to .88. Has been used in similar studies with high internal reliability and
[9b]
high internal consistency. The RSE was re-validated to ascertain its

usefulness for the current study. In a pilot study, 100 copies of the RSE were

administered to women – both staff and students of Enugu State University of

Science and Technology (ESUT), Enugu Campus. 95 items were properly filled.

These were scored and analysed, resulting in Cronbach’s alpha of .73

(Appendix G).

Mental Health Index (MHI): The Mental health index (MHI) was developed by
[23a]
Immanuel . MHI is a 14-item scale with response options ranging from ‘Not

true’ to ‘Very true’. MHI was designed to measure one’s psychological

adjustment, emotional stability, and mental health in a positive dimension (as

opposed to focusing on psychopathology). The Cronbach alpha reported by

[23a]
Immanuel was .81. The MHI was administered together with the WHO-5

which is a measure of psychological wellbeing, resulting in correlation

coefficient of r = .30, p<.001. It was re-validated to ascertain its usefulness for

the current study. In a pilot study, 100 copies of the MHI were administered to

women – both staff and students of Enugu State University of Science and

Technology (ESUT), Enugu Campus. 96 items were properly filled. These were
scored and analysed, resulting in Cronbach’s alpha of .84. The MHI was

administered together with Warwick-Edinburgh Mental Well-being Scale. The

correlation coefficient was r = .61, p<.001.

Socio-Demographic Data Collection Sheet used to obtain information about the

participants’ socio-demographic characteristics

Procedure: Questionnaire forms were administered and collected back

immediately after the participants had filled them. Three hundred and Twenty

(320) questionnaires were administered and Three hundred and eight (308)

questionnaires were filled correctly and was used for the study. All participants

are aged 18 and above.

Ethical Issues: The participants were selected based on their availability and

willingness to participate. The researcher created rapport with the participants

and assured them that their responses will be treated with utmost

confidentiality.

Analysis: The data were analysed using IBM SPSS for Windows Version 16.

Multiple (hierarchical) regression, as well as correlations, to determine the role

of CCUI, BI-AAQ, RSE and age on MHI were performed to with the confidence

level set at 95% and a p<0.05 adopted as the test of significance.

3.0 Result

Three hundred and eight (308) women from University of Nigeria, Enugu

Campus (UNEC) and Enugu State University of Science and Technology

(ESUT) took part in the study. Single persons were 197 (64%), whereas married

persons were 93 (30.2%), separated/divorced were 4 (1.3%), Missing

information is 14 (4.5%). Participants were drawn from various religious

denominations: Catholics’ 146 (47.4%), Protestants 50 (16.2%), Pentecostals

80 (26%), Islam 9 (2.9%), Missing information 23 (7.5%). Respondents were

also drawn from various ethnic groups, namely: Igbo is 222 (72.1%), Yoruba is

22 (7.1%), Hausa is 19 (6.2%), Others is 16 (5.2%), Missing information is 29

(9.4%). Educationally, respondents were varied, thus: O’Level is 113 (36.7%),

OND is 49 (15.9%), B.Sc. 99 (32.1%), M.Sc. and above is 20 (6.5%), Missing

information = 27 (8.8%). Occupational distribution of respondents were:

Students are 183 (59.4%), Civil Servants are 65 (21.1%), Business persons are

33 (10.7%), Missing information is 27 (8.8%). Age of respondents ranged from

18 years to 61 years; mean age was 29.37(Standard Deviation = 11.89).

Table 1: Multiple regression analysis showing the relationship of the predictor

variables (cosmetic use, body image, self-esteem and age) on mental health

Step 1 Step 2 Step 3 Step 4

 
β β β β
Cosmetic use .15* .14* .14* .15*
Body image   -0.08 -0.08 -0.08
Self-esteem     -0.001 -0.01
Age       .12*
R2 0.02 0.03 0.02 0.04
ΔR2 0.023 0.006 0 0.014
F 6.66** 4.16* *2.77 3.11*
**p<.01 *p<.05

Cosmetic use was a significant predictor of mental health among Nigerian

Women (study participants) (β=.15, t=2.53, p<.01) which suggests that the

higher the cosmetic use the higher the mental health. Therefore, the first

hypothesis was not rejected. This implies that cosmetic usage has a significant

predictive role on mental health. Cosmetic use accounted for 2.3% of the

variance in Model 1. Body image was not a significant predictor of mental health

among Nigerian Women (study participants) (β=-.08, t=-1.37, p=.17). This led to

the rejection of the second hypothesis. This implies that body image did not
have a significant predictive role on mental health. Self-esteem was not a

significant predictor of mental health among Nigerian Women (study

participants) (β=-.01, t=-.15, p=.88). This led to the rejection of the third

hypothesis. This implies that self-esteem did not have a significant predictive

role on mental health. However, age was a significant predictor of mental health

among Nigerian Women (study participants) (β=.12, t=2.01, p<.05). This

suggests that the older a woman gets, the higher the mental health. Therefore,

the first hypothesis was not rejected. This implies that age has a significant

predictive role on mental health. Age accounted for 1.4% of the variance in the

fourth model. [Table 1]

Table 2: Correlation

  Variables M SD 1 2 3 4 5
1 Mental health 52.83 9.92 1        
2 Cosmetic Use 43.63 14.53 .15* 1      
3 Body Image 62.62 15.44 -.10* -.16* 1    
4 Self-esteem 12.94 2.56 -0.02 -0.07 .14* 1  
5 Age 29.37 11.89 0.1 -.11* 0.07 0.08 1
*p<.05

Correlation analysis was conducted to test relationship between mental health,

cosmetic use, body image, self-esteem and age. It was found that cosmetic use

was positively related to mental health, this means that the higher the cosmetic

use, the higher the mental health. On the other hand, body image was

negatively related to mental health, this means that the higher the body image

the lower the mental health. Their correlation coefficient (r) values are .15 and

-.10 respectively at a significant level of p<.05. Body image was correlated

negatively with cosmetic use (r = -0.16, p<.05). This implies that as body image

increases, cosmetic use decreases. Also, self-esteem was significantly related

to body image (r=.14, p<.05), suggesting that higher self-esteem is associated

with higher body image. Furthermore, age was significantly correlated with

cosmetic use. As one gets older, there is increased tendency for one to use

more cosmetics.

4.0 Discussion

This study found that cosmetic use had a significant predictive role in mental

health among Nigerian Women (study participants). This finding is in line with

previous findings which found relationship between cosmetic use and mental
[15a] [36] [46] [10]
health . However, Cox & Glick found negative correlation between
[23b] [24c]
cosmetic use and mental health, whereas, Jürgen et al. and Kiel did not

find relationship between cosmetic use, aesthetic surgery, self-esteem and well-
[36]
being/mental health. Scott observed that increased cosmetic use is

associated with psychopathology (anxiety). Reason for this finding could be that

women who use cosmetics tend to know what they want and go for it.

Ladies/women who use cosmetics to enhance their appearance tend to be

happy and satisfied with their looks. They receive reinforcement - complements

and approval - from friends and peers, making them feel good about

themselves. For many people, looking good is feeling good! And mental

health/psychological well-being is about satisfaction with one’s life - looks,

appearance, achievement and the like.

The study found that body image was not a significant predictor of mental
[8] [19]
health. This finding differed from that of Cash & Fleming, Gupta et al.,
[26] [27a] [22] [43]
Mccauly et al., ; Mehdi et al Honigman et al. Williams et al found a

positive relationship between body image and psychological well-being/mental

health, and correlated negatively with depression. The explanation for this

finding could be that majority of Nigerian Women (study participants) may not

be too preoccupied with their body image. In Nigeria where this study is

conducted, in as much as ladies/women desire to look good, whether one is fat

or thin, short or tall may not have come to a pathological proportion. In fact,

some African cultures value robust body size which some western cultures may

see as overweight, and frown at skinny body structure (which some western

cultures may value). Body image is not a significant issue for the participants of

this study.

The study found that self-esteem was not a significant predictor of mental health

among Nigerian Women (study participants). The finding is not in line with
[12][13] [34]
previous findings which found a positive relationship between self-
[25]
esteem and mental-wellbeing. Mba on the other hand found that persons with

higher self-esteem scored higher in deviant behavior (poor mental health) than

those with lower self-esteem. The reason for the non-significant role of self-

esteem in mental health is that self-esteem is like a double-edge sword. At

some levels, that is when one’s self-appraisal is honest and objective (without

social desirability effect), moderate/high self-esteem could work for an individual

in boosting mental health; but when individuals endorse positive self-statements

that have no bases in reality, it can work against one’s mental wellbeing.
[41]
Baumeister observed that people designated as having high self-esteem are

those who demonstrate a willingness to endorse favorable statement about the

self as a result of an ambitious self-aggrandizing style of presenting themselves.

[41]
Likewise, Tice indicated that only very few people who respond to self-

esteem scales do score near the bottom of the scale, they usually score high. In
other words, respondents tend to rate themselves high when it comes to self-

esteem. This makes it difficult to tease out the actual role of self-esteem in

mental health of respondents. Therefore, response bias may be an issue here.

The study found that Age has a significant role in the mental health of Nigerian
[2][38][11][40]
Women (study participants). The finding is in line with previous findings

which found significant correlation between age and psychological wellbeing. A

reason for this finding may be as an individual becomes older in life and have
[32]
achieved personal growth, positive relationships and purpose in life ,

psychological well-being is improved unlike a younger woman who may be

grappling with ups and downs of relationship in friendships or in marriage,

coupled with the burden of domestic responsibilities associated with the

expected roles of women as homemakers. This is in line with the selective

optimization and compensation theory. [17b] When a woman selects and

optimizes her best abilities and sets attainable goals for herself while

compensating for the declines and losses, she tends to shape her environment

in a way to fit her needs (e.g., setting an active goal to always look good).

5.0 Conclusion

The findings of this research have certain implications in line with a

considerable body of literature. The practical implication of cosmetic use having

a role in predicting the mental health of Nigerian women is that looking good

enables one to feel good. The feminine gender which is made tender, beautiful,

etc., is made to complement the male gender. Therefore, it is important for a

lady/woman to know and appreciate her uniqueness or peculiarity, and

enhance/highlight her best gifts’ her beauty. Body enhancement through

cosmetic use is a way of adding value to individuals’ natural endowments, and

this separates humans as intelligent beings from other organisms. The human

person is a creative being. Since the invention of iron and bronze, to the

industrial revolution of the 19 th century, even unto the contemporary computer

age, humans have created civilization, by adding value to natural resources.

This has enhanced human life greatly, leading to better quality of life, longevity,

and so on. The mammoth growth of cosmetic industry and the enhancement it

has brought to humanity, especially to women, is a testimony to the creative

genius of the human race. The use of cosmetics need not be elaborate. For

instance, brushing of teeth, lovely and fresh hair style, powdered face, using

correct cream for one’s body, applying light perfume, deodorant, etc., are

accessories that every woman adapts to her own advantage. Appropriate use of

such grooming products has an exhilarating effect on one’s mental wellbeing.

Psychologists could organize programs to enlighten women on the need to care

for their bodies, appearance, and present the best of themselves always. This

will hopefully be an antidote in moments of depressive feelings.

Body image was not significant in predicating mental health in this study, it can

be emphasized that women who have high body image flexibility do not

experience body image distress in daily life activities. Appreciation and

acceptance of oneself including one’s body is a task everyone, especially

women has to face with all seriousness. Body appreciation could still be

integrated to women empowerment and enlightenment programs.

Self-esteem was not significant in predicting mental health of Nigerian women.

It implies that self-esteem may not be given as a reason why women would

have a high or low mental health. However, women should be encouraged to

acquire self-acceptance system to be able to accept their weaknesses as well

as their capabilities and talents. Honest self-appraisal will go a long way in

ushering women on the path of sound mental health and relevance in society.

Age have a role in predicting the mental health of Nigerian women. As one gets

older and have attained personal growth and purpose in life it gives a sense of

achievement which increases mental health. Younger women should be

exposed to programs, opportunities to deal with day-to-day challenges so as to

enhance their mental health. Feminist psychotherapy that highlights the peculiar

issues women face like assertiveness, anger management, self-

awareness/regulation, and the like will enable younger women stand strong in

the face of daunting psycho-social stresses of life.

Further studies should consider the limitations encountered in this study, thus:

future researchers should adopt a larger population cutting across other ethnic

groups’ including larger number of people from non-Igbo ethnic groups. The

researchers should conduct both experiment and survey research in their data

collection; series of interviews should be conducted with women who use

cosmetics to determine the sincerity on the part of the participants.

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