BODY DYSMORPHIC CONCERNS: APPEARANCE-RELATED IMAGERY AND EARLY MEMORIES

Abstract

Background: People with Body Dysmorphic Disorder (BDD) experience recurring distorted images of how they feel they look like. Cognitive behavioural models of BDD posit that appearance-related imagery (ARI) which arises from early aversive memories (e.g. bullying), continue to contribute to the individual's biased body image perceptions. Previous research provided preliminary support for a link between early adverse memory and ARI. However, little is known about the role ARI may play in the maintenance of body dysmorphic concerns (BDC), and how ARI relates to an individual's coping and emotional experience (e.g. body shame, disgust). Aim: This study aimed to investigate the relationships between ARI and early memories, and examine how ARI is linked with coping behaviours, and emotions such as shame and disgust. Method: A sample of N=85 adult participants with high BDC, and N=85 controls with no BDC were recruited through the NUS Research Participation pool and social media support groups for people with BDC. The study design was cross-sectional and data was collected using an online survey containing a series of self-report measures assessing ARI, BDC, coping behaviours and mood. Findings: This study found further evidence for the role of ARI in BDD. As predicted, negative emotions such as disgust and sadness, putative attentional processes such as self-focused attention, and BDD coping behaviours were associated with ARI in those with high BDC, but not in those with no BDC. Early memories were meaningfully linked with present ARI and featured themes of others critiquing, shaming, or judging the person's appearance. Significance of study: The findings support the central role of imagery in BDD described in CBT models and the importance of examining and addressing imagery and related memories in intervention.