Social anxiety predicts body dysmorphic symptoms through sensitivity to appearance rejection

New research provides evidence that social anxiety affects how people feel about their bodies and that this is linked to fear of being rejected because of the way they look. The new findings, published in Body imageshed light on the relationship between sensitivity to appearance rejection and body dysmorphic symptoms.

Body dysmorphia is a mental health condition where a person has a distorted view of their body and repeatedly experiences anxiety and stress because of their perceived flaws, even if they seem normal to others. This condition often leads to excessive grooming, comparing your appearance to others, seeking security, and avoiding social situations.

“My main scientific interest is the rejection sensitivity theory,” said study author Maja Brekalo, a postdoctoral researcher at the Catholic University of Croatia. “In addition to researching rejection sensitivity, I was curious about specific rejection sensitivity based on appearance—a more specific construct than overall rejection sensitivity.”

“I realized that rejection sensitivity is a very important personal disposition and a risk factor for the development and maintenance of mental health problems and other maladjustments. The literature gap regarding sensitivity to rejection based on appearance is large and longitudinal research is sparse, so there is a lot of unknown worth researching.”

For his new study, Brekalo recruited a sample of 277 undergraduate and graduate students (18 to 29 years old). Participants completed questionnaires at two time points 5 months apart.

The researchers found that social anxiety symptoms predicted sensitivity to appearance rejection, which in turn predicted changes in body dysmorphic disorder symptoms. In other words, those who agreed with statements like “I have difficulty making eye contact with others” were more likely to expect to be rejected based on their physical appearance in various social settings, and those with greater sensitivity to appearance rejection tended to experience increased body dysmorphia over time.

“This implies that individuals who are anxious about being evaluated by others in social situations are also sensitive to rejection due to their appearance and, in turn, are overly concerned about their physical attractiveness,” explained the researcher.

Furthermore, recall of childhood experiences of rejection based on peer appearance predicted symptoms of body dysmorphic disorder, both directly and indirectly, through increased sensitivity to appearance rejection.

“I would like to emphasize to all readers that peer rejection based on appearance during adolescence is very harmful and has lasting effects into adulthood. We should strive to avoid it during childhood and early adolescence,” Brekalo told PsyPost.

Individuals who reported more childhood experiences of rejection based on parental appearance also tended to have more symptoms of body dysmorphic disorder. But the researchers were surprised to find that these experiences were not a predictor of changes in symptoms of body dysmorphic disorder or sensitivity to appearance rejection over time.

“I did not expect that maternal and paternal rejection based on appearance, when examined in a longitudinal model along with symptoms of social anxiety and peer rejection, would not predict longitudinal changes in body dysmorphic symptoms during adulthood,” said Brekalo.

“To my knowledge, this was the first study that simultaneously examined peer, maternal and paternal rejection based on appearance, so it is difficult to compare the results obtained. It is important to add that paternal rejection was not previously examined. This should be further investigated.”

“Although we found no predictability of parental rejections of body dysmorphic symptoms in young adulthood (but correlations do exist), it is also important to educate parents on how to talk to their children about their appearance in a non-rejective way,” Brekalo explained.

The study, like all research, has some limitations. For example, the majority of the sample consisted of young women. Future research could recruit a more diverse sample.

“Many research questions must be addressed. Especially, longitudinal design studies are needed,” said Brekalo. “We still know little about gender differences, parental rejection and teasing regarding appearance, and other maladjustments related to body dysmorphic symptoms in individuals sensitive to high rejection based on appearance.”

“I would like to add that research like this is valuable because it is a starting point for the development of preventive and intervention programs. The practical implications in this area are very important and must start in childhood. In addition, parents of adolescents should be included in preventive programs”.

The study was titled: “Longitudinal study of social anxiety symptoms and appearance rejection in predicting body dysmorphic symptoms: appearance-based rejection sensitivity as a mediator.”

Social anxiety predicts body dysmorphic symptoms through sensitivity to appearance rejection

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