Social-evaluative versus self-evaluative appearance concerns in body dysmorphic disorder

Body Dysmorphic Disorder (BDD) is characterised by significant preoccupation and distress relating to

an imagined or slight defect in appearance. Individuals with BDD frequently report marked concerns

relating to perceived negative evaluation of their appearance by others, but research specifically

investigating such concerns remains limited. This study investigated the extent and nature of

appearance-related social-evaluative and self-evaluative concerns in individuals with BDD and healthy

controls. BDD participants, in comparison to controls, reported high levels of importance and anxiety

associated with perceptions of others’ views of their appearance, in addition to their own view. No

differences were observed in the level of importance and anxiety associated with their self-view in

comparison to others’ views. These findings support existing evidence indicating that appearance-related

social-evaluative concerns are a central feature of BDD. Cognitive-behavioural treatment implications are

discussed.