Abstract
Background: Self-focused attention (S-FA), appearance-related comparisons (ARCs)and self-serving appearance-related biases are relevant to cognitive-behavioural
models of, and therefore distress maintenance in, BDD despite them being underresearched. To the author’s knowledge, there are no previous published investigations looking at the nature and specificity of A-RCs, beliefs held about the functions of A-RCs, or experiments investigating self-serving A-RCs biases in people with BDD relative to healthy controls. It was also felt that a more fine grained investigation of self-esteem looking at self-competence and self-liking in people with BDD was warranted.
Hypotheses: Hypothesis 1 explored the nature (frequency, direction (attractiveness
of A-RCs targets) and automaticity) of A-RCs. More frequent, generally more upwards (to more attractive others) and more automatic A-RCs were hypothesised in
people with BDD relative to healthy controls. Hypothesis 2 explored the specificity
of A-RCs in people with BDD relative to healthy controls. It was hypothesised that
the more frequent A-RCs would not be attributable to more general constructs related
to comparing. Beliefs about the functions of A-RCs in people with BDD relative to
healthy controls were also explored. Hypothesis 3 investigated a self-serving A-RCs
bias, hypothesising that healthy controls, but not people with BDD, would hold this
sort of bias contingent on S-FA. Hypothesis 4 investigated self-esteem,
hypothesising that self-liking would be disproportionately lower than selfcompetence
in people with BDD relative to healthy controls.
Method: 23 people with BDD (10 females, 13 males) and 20 healthy controls (10
females, 10 males) matched approximately on age and sex were recruited while using
rigorous screening criteria. Hypotheses 1 and 2 used standardised and newly devised
questionnaires to explore A-RCs in people with BDD relative to healthy controls.
Hypothesis 3 was tested (BDD, n=22; healthy controls, n= 20) using a novel mixed
experimental design to investigate the self-serving A-RCs bias, which included
employing a manipulation of implicit S-FA as a repeated-measures variable.
Hypothesis 4 used the well-established Rosenberg Self-Esteem Scale, divided into
self-competence and self-liking, to look at the extent of between group differences.
Results: Hypothesis 1 was fully supported. A-RCs were significantly more frequent,
generally more upwards, and more automatic in people with BDD relative to healthy
controls. Hypothesis 2 was also fully supported. The significantly higher frequency
of A-RCs in people with BDD, relative to healthy controls, could not be attributed to
general social comparison orientation, upwards social comparison orientation, or
self-esteem. People with BDD also held significantly stronger agreement with beliefs
about A-RCs as serving functions of self-evaluation, self-loathing (a way to confirm
beliefs about physical unattractiveness) and social threat management relative to
healthy controls. Hypothesis 3 was not supported, with no A-RCs bias, contingent on
S-FA, being found in healthy controls or people with BDD. Hypothesis 4 was also
not supported with both self-competence and self-liking being found to be
significantly and equally lower in people with BDD relative to healthy controls.
Discussion: The author discusses results with particular reference to the theory of
social comparison processes as well as literature on clinical anxiety and cognitive behavioural models of BDD. The discussed limitations of the present investigation
include the absence of a clinical control group, not matching groups on objective
attractiveness, and the study’s ecological validity. Clinical implications cover
suggested guidance for addressing A-RCs in cognitive-behavioural therapy and with
mindfulness. More comprehensive investigations of A-RCs biases in people with
BDD are covered as future directions for research.
| Date of Award | 2012 |
|---|---|
| Original language | English |
| Awarding Institution |
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| Supervisor | Martin Anson (Supervisor) & David Veale (Supervisor) |