The impact of adverse childhood experiences on cosmetic surgery addiction in cosmetic surgery patients.

[BACKGROUND] Previous studies have found that cosmetic surgery patients often exhibit repetitive and compulsive behaviors associated with cosmetic surgery addiction. Adverse childhood experiences have been linked to various psychological and behavioral issues; however, their relationship with cosmetic surgery addiction has not been explored. This study aims to investigate the impact of adverse childhood experiences on cosmetic surgery addiction and its underlying mechanisms, including the mediating roles of insecure attachment and self-alienation, in cosmetic surgery patients. These mediators were assessed based on attachment theory and existential psychology, which posit that childhood trauma disrupts secure relationships and self-integration, potentially driving compensatory addictive behaviors.

[METHODS] We employed a cross-sectional design and recruited 605 cosmetic surgery patients from four tertiary grade A hospitals in Sichuan, China, between April 25th to May 29th 2025. Participants completed questionnaires assessing adverse childhood experiences, insecure attachment, self-alienation, and cosmetic surgery addiction. We tested both direct and indirect effects of adverse childhood experiences on cosmetic surgery addiction using Structural Equation Modeling and Process Model 6.

[RESULTS] Our findings revealed that adverse childhood experiences significantly positively predicted cosmetic surgery addiction in cosmetic surgery patients ( = 0.194, < 0.001, 95% CI = [0.107, 0.281]). Furthermore, insecure attachment (Indirect effects: = 0.079, SE = 0.036, 95%CI = [0.021, 0.152]) and self-alienation (Indirect effects: = 0.066 SE = 0.031, 95%CI = [0.011, 0.133]) exacerbated the tendency toward cosmetic surgery addiction among patients with adverse childhood experiences (Chain effect: = 0.033, SE = 0.013, 95%CI = [0.006, 0.058]).

[CONCLUSION] This study highlights the importance of interventions targeting insecure attachment and self-alienation to reduce the risk of cosmetic surgery addiction in patients with adverse childhood experiences. These findings further emphasize the importance of addressing psychological mechanisms in the care of cosmetic surgery patients to promote healthier psychological outcomes.