Personal and appearance-based rejection sensitivity in body dysmorphic disorder

Association Between Self-Construals, Social Pain Sensitivity, and Gender in Young Adults

We experience pain in response to negative, unwanted social interaction with others (e.g., social rejection), and this type of pain is termed as social pain in the recent literature. While sensitivity to social pain may be beneficial to increase a chance for survival, social pain sensitivity could also be detrimental to elevate the risk of various health issues. Such opposing natures of social pain sensitivity warrants research to better identify factors that are linked to social pain sensitivity. Self-construals show perspectives on how to view oneself in relations to others, characterized as independent and interdependent self-construals, and may be linked to social pain sensitivity. Additionally, pervious data have indicated gender differences in social pain sensitivity, but it is unclear if self-construals explain gender differences in social pain sensitivity. Therefore, this study examined if self-construals were associated with social pain sensitivity, and gender differences in social pain sensitivity were accounted for by self-construals. The participants were 148 college students who completed several self-report questionnaires to evaluate self-construals and social pain sensitivity. The results indicated that interdependent tendency, which showed higher interdependent self-construal than independent self-construal, was associated with social pain sensitivity. While gender differences in social pain sensitivity were confirmed, gender differences in social pain sensitivity were not accounted for by interdependent tendency. The results suggest that interdependent tendency is associated with social pain sensitivity, but is not involved in gender differences in social pain sensitivity.

Appearance-based rejection sensitivity mediates the relationship between Instagram addiction and dysmorphic concerns in young adult women

INTRODUCTION

Dysmorphic concerns refer to excessive preoccupations with one's physical characteristics. There is a need to better understand the factors associated with these experiences, especially in young adult women. Given emergent research suggesting a link between the use of Instagram, dysmorphic concerns, and appearance pressures, we tested a mediation model in which appearance-based rejection sensitivity mediated the relationship between Instagram addiction and dysmorphic concerns.

METHODS

In this cross-sectional study, 300 young adult women from Romania with mean age of 22.19 years (SD = 2.07) and who possessed an Instagram account were asked to complete an online survey consisting of measures of dysmorphic concerns, Instagram addiction, and appearance-based rejection sensitivity.

RESULTS

Correlational analyses revealed that all three variables were positively and moderately inter-correlated. Mediation analysis supported the hypothesis that appearance-based rejection sensitivity mediates the relationship between Instagram addiction and dysmorphic concerns.

CONCLUSIONS

Implications of this study are discussed in terms of the urgency of prevention and intervention strategies, especially given the link between dysmorphic concerns and more extreme manifestations of severity, such as body dysmorphic disorder.

The relationship between personality traits and willingness to undergo cosmetic surgery in the non-clinical population - a systematic review and meta-analysis

Objective

Conducting a systematic review and meta-analysis to synthesize previously obtained results regarding the relationship between interest in cosmetic surgery and personality traits.

Methodology

A series of criteria were applied (at the level of design, independent variables, dependent variable, participants) in order to decide which existing studies could be considered eligible for inclusion in the meta-analytic procedure. The identification of research that met the eligibility criteria was carried out with the help of the electronic search function in the following databases: ScienceDirect, PsycInfo, Web of Science, Scopus, Springer, and PubMed. Following this approach left 13 studies that were then subjected to the final analysis and included in the meta-analysis.

Results

The researchers' expectations were partially supported by the results of the analyses, thus demonstrating the existence of a significant relationship between perfectionism (socially prescribed perfectionism; perfectionistic self-promotion), appearance-based rejection sensitivity, and interest in pursuing esthetic surgery.

Discussions

Identifying these relationships will allow cosmetic surgeons to understand both the mechanisms underlying this decision and the need for psychological assessment/counseling before patients undergo such procedures. It will also allow psychologists to develop best practice guidelines for how they relate to the patient before they perform cosmetic surgery. At the same time, psychotherapists will be able to devise targeted and personalized interventions for each personality profile, so that the decision to undergo an esthetic operation is not made based on a dispositional trait (fear of rejection, stress caused by body dissatisfaction).

Mechanisms of cognitive behavioral therapy vs. supportive psychotherapy in body dysmorphic disorder: An exploratory mediation analysis

Body dysmorphic disorder (BDD) is common, severe, and often chronic. Cognitive behavioral therapy (CBT) is the first-line psychosocial treatment for BDD, with well-established efficacy. However, some patients do not improve with CBT, and little is known about how CBT confers its effects. Neurocognitive processes have been implicated in the etiology and maintenance of BDD and are targeted by CBT-BDD treatment components. Yet, the malleability of these factors in BDD, and their potential role in mediating symptom improvement, are not well understood. Understanding how treatment works could help optimize treatment outcomes. In this secondary data analysis of a randomized clinical trial of CBT vs. supportive psychotherapy (SPT) in BDD (n = 120), we examined whether treatment-related changes in detail processing (Rey-Osterrieth Complex Figure test), maladaptive appearance beliefs (Appearance Schemas Inventory-Revised), and emotion recognition (Emotion Recognition Task) mediated treatment outcome. All constructs improved over time and were associated with symptom improvement. CBT was associated with greater improvements in maladaptive beliefs than SPT. None of the variables examined mediated symptom improvement. Findings suggest that with successful treatment, individuals with BDD demonstrate reduced neurocognitive deficits (detail processing, emotion recognition, maladaptive beliefs) and that CBT is more likely than SPT to improve maladaptive appearance beliefs. More work is needed to understand mechanisms of change and thus maximize treatment outcomes.

Appearance-related concerns in individuals with pathological skin picking-a comparison with individuals with dermatological conditions and skin-healthy controls

Introduction

Pathological skin picking (PSP) is an excessive behavior which characterizes Skin Picking Disorder. Individuals repeatedly pick their skin and cause skin lesions, but are unable to control the behavior, which can cause severe distress. Visible self-inflicted skin lesions can additionally affect individuals with PSP due to emerging appearance-related concerns. However, these concerns and their role in PSP have hardly been studied, especially not in comparison with individuals with dermatological conditions and skin-healthy controls.

Methods

The present cross-sectional study (n = 453, 83.9% female, 15.9% male, 0.2% diverse) aimed at analyzing appearance-related concerns and mental health outcomes between four groups: Individuals with PSP and dermatological conditions (SP/DC; n = 83), PSP without dermatological conditions (SP; n = 56), dermatological conditions without PSP (DC; n = 176) and skin-healthy controls (SH, n = 138). We compared questionnaire data on dysmorphic concerns, appearance-based rejection sensitivity, and body dysmorphic symptoms, as well as PSP-symptoms and mental health outcomes (depression, anxiety, and self-esteem) between groups.

Results

The analyses showed a significant multivariate group effect in the appearance-related variables, F(6, 896) = 19.92, Wilks' Λ = 0.78, p < 0.001, and mental health outcomes, F(6, 896) = 16.24, Wilks' Λ = 0.81, p < 0.001. The SP/DC group had the strongest appearance-related concerns and mental health impairments, followed by the SP group, the DC group and the SH group. The SP/DC group and SP group only differed significantly with regard to dysmorphic concerns, but not in other variables. The DC group was less affected but still showed higher dysmorphic concerns and mental health impairments than skin-healthy controls. In contrast to the PSP groups, the other two groups did not exceed clinically relevant cut-off scores.

Discussion

The present study shows that individuals with PSP exhibit strong appearance-related concerns, regardless of the presence or absence of underlying or comorbid dermatological conditions. These findings shed new light on the importance of appearance-related concerns in Skin Picking Disorder and the role of PSP as a potentially overlooked risk factor in dermatological patients. Therefore, appearance-related concerns should be explicitly addressed in dermatological and psychotherapeutic settings. Future studies should also include longitudinal and experimental analyses to more clearly classify the role of appearance-related concerns in the etiology of PSP and Skin Picking Disorder.

Are you looking at me? A longitudinal vignette study of adolescent appearance rejection sensitivity and coping with peer evaluation

Appearance rejection sensitivity (ARS) refers to anxiously over-expecting rejection because of perceived appearance flaws. ARS has been associated with poorer mental health, which suggests coping with stress may be negatively affected by ARS. In this study, we investigated if ARS was related to adolescents' emotions and ways of coping with negative appearance evaluation two years later (T2). Other potential correlates of emotions and ways of coping were also tested, including peer appearance teasing, social anxiety, and gender, as well as reports of victimization, social status, and attractiveness gathered from peers. At Time 1 (T1), 329 adolescents (M = 13.9 years, 54% girls) self-reported their ARS, experience of appearance teasing, and social anxiety. T1 appearance victimization, popularity, and attractiveness were measured using peer nominations, and peer likeability was measured with peer ratings. At T2, participants' emotions and coping were measured using vignettes portraying appearance evaluation by peers. In regression models, T1 ARS, appearance teasing, social anxiety and female gender were associated with more T2 negative emotions, social withdrawal, rumination, and (except for social anxiety) thoughts about appearance change. ARS was not significantly associated with T2 positive thinking or support seeking. No peer-report measure was significantly associated with T2 outcomes.

Longitudinal study of social anxiety symptoms and appearance rejection in predicting body dysmorphic symptoms: Appearance-based rejection sensitivity as a mediator

Previous findings from cross-sectional studies suggest that social anxiety symptoms and negative peers' experiences regarding appearance were predictors of body dysmorphic symptoms through appearance-based rejection sensitivity. However, little is known about longitudinal relations and parental appearance rejection on body dysmorphic symptoms. Therefore, this study aims to examine the longitudinal mediation of appearance-based rejection sensitivity with social anxiety symptoms, remembered peers', maternal, and paternal appearance-based rejection as predictors, and body dysmorphic symptoms as an outcome. The study included 277 university students who completed questionnaires in two-measurements points 5 months apart. The results indicated that social anxiety symptoms predicted changes in body dysmorphic symptoms through appearance-based rejection sensitivity. In addition, remembered childhood peers' appearance-based rejection predicted both directly and indirectly changes in body dysmorphic symptoms over time. Maternal and paternal appearance-based rejection were not predictors of appearance-based rejection sensitivity or body dysmorphic symptoms. Findings support rejection sensitivity theory and the long-lasting impact of negative peers' experiences for impaired body dysmorphic symptoms. However, further research regarding remembered parental negative experiences is needed.

Association of body dysmorphic disorder with anxiety, depression, and stress among university students

Objectives

This study aims to estimate the prevalence of body dysmorphic disorder (BDD) and identify its association with depression, anxiety, and stress.

Method

We conducted a cross-sectional study in Jeddah, KSA. In 2019, a validated questionnaire with items on sociodemographic characteristics and body dysmorphic disorder, as well as the Depression, Anxiety, and Stress Scale – 21 items (DASS 21) was distributed to 1,112 students of King Abdulaziz University. SPSS version 23 was used for data analysis, which included descriptive statistics, chi-square tests, and binary logistic regression models. The association was presented as an odds ratio (OR) along with its 95% confidence Interval (CI).

Results

The overall prevalence of BDD was 13.9% (95% CI of 11.8–16.2.) with the highest reported sites being the skin (81.6%) and waist (68.8%). BDD was found to be a significant predictor of depression with an OR of 4.2 (95% CI 2.9–6.1), anxiety OR of 2.2 (95%1.6–3.2), and stress OR of 3.2 (2.2–4.7). Females were significantly associated with anxiety, OR of 1.4 (95% CI 1.1–1.9) and stress, OR of 1.5 (1.1–2). Affiliation to the administration, arts, humanities, and social colleges was also a significant predictor of anxiety as reflected by an OR of 1.4 (95% CI 1.1–1.8).

Conclusions

Our study shows that BDD is relatively common among university students in Jeddah and associated with depression, anxiety, and stress.

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BDD is common among university students.

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Skin and Waist circumference were the most reported sites among students.

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BDD is a significant predictor of depression, anxiety, and stress affecting both male and female university student.

Suicidality in patients with obsessive-compulsive and related disorders (OCRDs): A meta-analysis

INTRODUCTION

Previous meta-analyses showed that OCD is associated with a substantial risk of suicidal behaviours. Conclusive rates of suicidal ideation (current and lifetime) and suicide attempts based on pooled prevalence rates have not so far been calculated using meta-analysis for the other DSM-5 Obsessive-Compulsive and Related Disorders (OCRDs).

OBJECTIVES

This meta-analysis aims to separately calculate the pooled prevalence rates of lifetime suicide attempts and current or lifetime suicidal ideation in BDD, Hoarding Disorder (HD), Skin Picking Disorder (SPD) and Trichotillomania (TTM) and to identify factors associated with increased suicide rates.

METHODS

Our protocol was pre-registered with PROSPERO (CRD42020164395). A systematic review and meta-analysis following PRISMA reporting guidelines was performed by searching in PubMed/Medline, PsycINFO, Web of Science and CINAHL databases from the date of the first available article to April 20th, 2020. Stata version 15 was used for the statistical analysis. Given the small number of studies in TTM and SPD, the two grooming disorders were grouped together. Meta-analyses of proportions based on random effects (Der-Simonian and Laird method) were used to derive the pooled estimates.

RESULTS

Thirty-eigth studies (N = 4559 participants) were included: 23 for BDD, 8 for HD, 7 for Grooming Disorders. For BDD, the pooled prevalence of lifetime suicide attempts, current and lifetime suicidal ideation was, respectively 35.2% (CI:23.4-47.8), 37.2% (CI:23.8-51.6) and 66.1% (CI:53.5-77.7). For HD, the pooled prevalence of lifetime suicide attempts, current and lifetime suicidal ideation was 24.1% (CI:12.8-37.6), 18.4% (CI:10.2-28.3) and 38.3% (CI:35.0-41.6), respectively. For Grooming Disorders, the pooled prevalence of lifetime suicide attempts and current suicidal ideation were 13.3% (CI:5.9-22.8) and 40.4% (CI:35.7-45.3), respectively (no data available for lifetime suicidal ideation).

CONCLUSIONS

The OCRDs as a group are associated with relatively high rates of suicidal behaviour. Through indirect comparisons, we infer that BDD has the greatest risk. Comorbid substance abuse, possibly reflecting poor underlying impulse control, is associated with higher rates of suicidal behaviour in BDD. Our data emphasize the need for clinicians to consider the risk of suicidal behaviour in the management of patients presenting with all forms of OCRDs.

A cascade of rejection and appearance preoccupation: Adolescents' body dysmorphic symptoms and appearance rejection sensitivity over 4 years

Adolescence is a high-risk period for body image disturbance and appearance concerns. In a cascade model, we examined interrelations of body dysmorphic symptoms (BDS) with appearance rejection sensitivity (ARS) and tested gender moderation. Participants were 397 Australian adolescents (T1 Mage = 11.7, SD = 0.91; 56% girls) who completed six surveys over 4 years. In a random-intercept cross-lag model, two (of five possible) paths showed ARS predicted higher subsequent BDS, and three (of five possible) paths showed BDS predicted higher subsequent ARS. Girls reported more BDS and ARS than boys, and random intercepts of BDS and ARS were correlated with the correlation stronger in girls than boys. Cross-lag BDD-ARS associations over the six waves were not significantly moderated by gender. Overall, girls are at higher risk of appearance concerns than boys, but BDD-ARS cascade effects do not differ between girls and boys.

Aussehensbezogene Zurückweisungssensitivität bei körperdysmorpher Störung und Essstörungen

Hintergrund

Die körperdysmorphe Störung (KDS) und die Essstörungen (ESS) weisen erhebliche Symptomüberschneidungen auf, was die Differenzialdiagnose erschwert. Die Psychopathologie der beiden Störungen deutet auf die aussehensbezogene Zurückweisungssensitivität („appearance-based rejection sensitivity“, ARS) als mögliches differenzierendes Merkmal hin.

Ziel der Arbeit

Die Studie soll Hinweise zu einer Verbesserung der Differenzialdiagnostik zwischen KDS und ESS geben. Dazu wurden die Störungen hinsichtlich der ARS miteinander verglichen. Auf Basis der bisherigen empirischen Forschung wurde davon ausgegangen, dass bei KDS höhere ARS-Werte vorliegen als bei ESS. Weiterhin sollte eine höhere Varianzaufklärung von KDS an der ARS unter Konstanthaltung von Störvariablen (sozialängstliche Symptome, Body-Mass-Index, Geschlecht) geprüft werden.

Material und Methoden

Eine Verfügbarkeitsstichprobe (n = 736) füllte online die Appearance-based Rejection Sensitivity Scale, die Liebowitz Social Anxiety Scale, den Eating Disorder Examination Questionnaire und ein DSM-5-Screening zu KDS aus.

Ergebnisse

Teilnehmer mit komorbid positivem KDS-ESS-Screening erzielten den höchsten ARS-Gesamtwert aber ähnlich hohe Werte wie Teilnehmer mit positivem ESS-Screening. Beide Gruppen erzielten signifikant höhere Werte als Teilnehmer mit positivem KDS-Screening, welche wiederum signifikant höhere Werte erzielten als symptomfreie Teilnehmer. Die Regressionsanalyse bestätigte eine höhere Varianzaufklärung an der ARS durch ESS als durch KDS bei Konstanthaltung von Störvariablen.

Diskussion

Die ARS konnte nicht als differenzierendes Merkmal zwischen KDS und ESS im Sinne der Hypothesen bestätigt werden. Allerdings könnten hohe ARS-Werte einen Hinweis auf eine ESS oder KDS darstellen, sehr hohe Werte für komorbide ESS-KDS-Symptome. Dies sollte diagnostisch abgesichert und ggf. in der Therapie berücksichtigt werden.

Motives for Illicit Drug Use Among Individuals With Body Dysmorphic Disorder

Drug use disorders (DUDs) are highly prevalent in body dysmorphic disorder (BDD), but motives for illicit drug use in BDD have not yet been explored. This study examined motives for drug use and clinical correlates of drug use motives in a sample of individuals with BDD and lifetime drug use, using the Drug Use Motives Questionnaire and 3 additional body image-specific drug use motives. As predicted, the Drug Use Motives Questionnaire coping motive was positively associated with attempted suicide and a lifetime DUD. All 3 body image-specific motives for drug use were also significantly associated with a lifetime DUD. In addition, they were the only variables that were significantly associated with greater severity of BDD. These results build on previous evidence suggesting that coping motives are related to problematic substance use and suicide attempts in BDD.

Personality as a Predictor of Treatment Response to Escitalopram in Adults With Body Dysmorphic Disorder

OBJECTIVE

Serotonin reuptake inhibitors (SRIs) are the first-line pharmacotherapy for body dysmorphic disorder (BDD), a common and severe disorder. However, predictors and correlates of treatment response are not well understood. A closer examination of baseline personality dimensions and disorders and of changes in personality during SRI treatment is needed to advance knowledge of this clinically important issue.

METHOD

We conducted a secondary analysis of data from a pharmacotherapy relapse prevention trial of the SRI escitalopram in adults with BDD to examine personality dimensions and traits, as well as whether these variables predict and correlate with treatment response. A total of 65 participants with BDD completed the Revised NEO Personality Inventory (NEO PI-R) before starting open-label treatment with escitalopram and 42 participants completed the NEO PI-R after treatment.

RESULTS

At baseline, participants with BDD displayed higher levels of neuroticism and lower levels of extraversion than a normed reference group. Higher baseline neuroticism was a significant predictor of nonresponse to escitalopram treatment, even when baseline depression severity was controlled for. Changes in neuroticism were not associated with treatment response.

CONCLUSION

Our findings underscore the relationship between BDD and neuroticism, and they suggest a link between neuroticism and SRI treatment response.

Borderline Personality Disorder and Disordered Eating Behaviour: The Mediating Role of Rejection Sensitivity

OBJECTIVE

To examine the relationship between disordered eating behaviour and Borderline Personality Disorder (BPD) in a clinical population of adolescent girls. We hypothesized that BPD and disordered eating would be strongly associated and that this association would be partially mediated by rejection sensitivity.

METHOD

Participants were 73 female patients aged 11-18 presenting for mental health treatment at an outpatient psychiatry clinic in a large metropolitan hospital. Measures used in this study include the Diagnostic Interview for Borderline Personality Disorder-Revised, Borderline Personality Questionnaire and The Short Screen for Eating Disorders.

RESULTS

Youth with BPD had significantly more disordered eating behaviour compared to controls. Of the nine facets of BPD, eight were highly correlated with disordered eating, suggesting important shared variance between the constructs of BPD and disordered eating. This study also demonstrated that rejection sensitivity significantly mediated the relationship between BPD symptoms and disordered eating.

CONCLUSIONS

This paper provides a novel association between a diagnosis of BPD in adolescents and disordered eating and the mediation effect of rejection sensitivity. These findings suggest that disordered eating should be screened in BPD samples and interventions targeting rejection sensitivity may be of clinical use.

Appearance Teasing and Mental Health: Gender Differences and Mediation Effects of Appearance-Based Rejection Sensitivity and Dysmorphic Concerns

Appearance teasing is a common phenomenon in social interactions, especially in adolescence. Several studies have shown its negative impact on mental health as well as on body image. While these findings prove stable in various contexts, less evidence is available for possible gender differences in these relationships. In particular, the role of two important body image variables - appearance-based rejection sensitivity (ARS) and dysmorphic concerns - and their contribution to mental health impairments has not been assessed in gender-specific process models. In a cross-sectional survey-study (N = 501; 407 f, 94 m), we retrospectively assessed early appearance teasing experiences, as well as current ARS, dysmorphic concerns, depression, anxiety, and self-esteem. We analyzed gender differences in these variables and their interrelations. We then examined the mediating role of ARS and dysmorphic concerns in explaining mental health variables in adulthood due to early appearance teasing in gender-specific serial-mediation models. The results show high ratios of early teasing experiences, but no significant gender difference regarding the frequency of early appearance teasing. While teasing experiences were significantly related to body image variables in adulthood in both genders (rs > 0.32; ps < 0.010), we observed significant relations with mental health outcomes in women (rs > 0.30; ps < 0.001) but not in men (rs < 0.20; ps > 0.250). Serial mediation models show that ARS and dysmorphic concerns mediate the effects of appearance teasing on mental health in all outcomes in women (ΔR2 > 0.17), but not in men (ΔR2 < 0.03). Findings remained stable when controlling for Body-Mass-Index, age, and relationship-status. The findings show similar frequencies of appearance teasing and associated negative effects on body image in men and women. Specifically, in women, the effects of teasing on mental health were stronger and mediated by ARS and dysmorphic concerns. Overall, the results point to the relevance of ARS for etiological models of body image disorders and female mental health. However, men did not show the same relationships of teasing and mental health. Differential resilience factors regarding the negative effects of early appearance teasing could be an important target for future research.

Pharmacological Treatment of Body Dysmorphic Disorder

Body dysmorphic disorder is a challenging disorder that manifests as erroneously perceived flaws in one’s physical appearance and repetitive behaviors in response to appearance concerns. This disorder is also frequently comorbid with other psychiatric disorders, including major depressive disorder and autism spectrum disorder. It is currently understood to arise from a combination of biological, psychological, and environmental factors. Treatment of body dysmorphic disorder typically consists of a combination of pharmacotherapy and cognitive behavioral therapy. However, not all patients respond to treatment, and BDD symptoms remain even in those who do respond. This review outlines current pharmacological and neuromodulation treatments for body dysmorphic disorder and suggests directions for future studies of novel treatments such as augmentation with atypical antipsychotics and the use of intranasal oxytocin in cases of body dysmorphic disorder that show residual symptomatology even with tailored monotherapy. There is emerging evidence suggesting that non-invasive neurostimulatory techniques, such as repetitive transcranial magnetic stimulation, may be of value in treatment-resistant cases.

Du magst mich nicht, weil ich hässlich bin!

Zusammenfassung. Theoretischer Hintergrund: Viele Personen befürchten Zurückweisungen aufgrund ihres Aussehens. Übermäßige „aussehensbezogene Zurückweisungssensitivität“ (ARS) kann jedoch zur Entstehung und Aufrechterhaltung von – insbesondere körperfokussierter – Psychopathologie beitragen. Fragestellung: ARS ist im deutschsprachigen Raum wenig untersucht, da Erhebungsinstrumente fehlen. Daher war die Validierung einer deutschen „Appearance-based-Rejection-Sensitivity-Scale“ (ARS-D; Park, 2007 ) Ziel der Studie. Methode: Nach Übersetzung des englischen Originals wurde die psychometrische Güte der ARS-D in einer Online-Befragung getestet (n = 391). Ermittelt wurden Itemcharakteristika, Faktorstruktur, Reliabilität und Konstruktvalidität. Ergebnisse: Die ARS-D zeigte bei einfaktorieller Struktur sehr gute Reliabilitätsindizes. Die psychometrischen Eigenschaften ließen sich bei einer auf 12 Items gekürzten Skalenvariante (Original: 15 Items) weiter verbessern. Signifikante Korrelationen mit körperdysmorpher Besorgnis, Essstörungssymptomatik und Depressivität (rs > .30) indizieren Konstruktvalidität. Schlussfolgerungen: Die ARS-D ist zur Erfassung und weiteren Erforschung der Rolle aussehensbezogener Zurückweisungssensitivität bei verschiedenen Störungsbildern geeignet.

Maternal Rejection and Idealized Value of Appearance: Exploring the Origins of Body Dysmorphic Concerns Among Young Adults

Body dysmorphic disorder is a clinical disorder characterized by a preoccupation with an imagined or exaggerated defect in one's appearance (American Psychological Association, 2013), causing impaired functioning. Cognitive-behavioral models of body dysmorphic disorder have been proposed, whereby social anxiety and parental rejection may be predisposing factors, whereas maladaptive cognitive biases, such as appraisals of rejection, may serve as maintenance factors. The primary aim of this study was to test the role that perceived parental rejection in childhood may play in understanding the development of body dysmorphic symptoms. Furthermore, this study examined whether idealized values of appearance act as a mediator between perceived maternal rejection and body dysmorphic symptoms. The sample comprised 239 Australian undergraduate psychology students. Social anxiety, appearance-based rejection sensitivity, maternal rejection, and idealized values of appearance uniquely predicted body dysmorphic symptoms. Furthermore, the relationship between maternal rejection and body dysmorphic symptoms was partially mediated by idealized values of appearance. Findings support cognitive-behavioral models of body dysmorphic disorder.

Victimization, social anxiety, and body dysmorphic concerns: appearance-based rejection sensitivity as a mediator

Body dysmorphic disorder (BDD) is characterized by extreme preoccupation with perceived deficits in physical appearance, and sufferers experience severe impairment in functioning. Previous research has indicated that individuals with BDD are high in social anxiety, and often report being the victims of appearance-based teasing. However, there is little research into the possible mechanisms that might explain these relationships. The current study examined appearance-based rejection sensitivity as a mediator between perceived appearance-based victimization, social anxiety, and body dysmorphic symptoms in a sample of 237 Australian undergraduate psychology students. Appearance-based rejection sensitivity fully mediated the relationship between appearance-based victimization and body dysmorphic symptoms, and partially mediated the relationship between social anxiety and body dysmorphic symptoms. Findings suggest that individuals high in social anxiety or those who have a history of more appearance-based victimization may have a bias towards interpreting further appearance-based rejection, which may contribute to extreme appearance concerns such as BDD.