Effects of safety behavior fading on appearance concerns and related symptoms.

Abstract

Appearance-related safety behaviors (SBs; e.g., mirror checking, grooming) have been implicated in body dysmorphic disorder (BDD), eating disorders, and social anxiety disorder. The proposed project aimed to extend previous research efforts by exploring the experimental effects of reducing engagement in appearance-related SBs on appearance concerns and related symptoms. Eighty-four undergraduate female participants with elevated appearance concerns were randomly assigned to a SB fading group or a no instructions control group. For 2 weeks, participants in the SB fading condition were sent daily reminders via text message to decrease their engagement in appearance-related SBs, whereas participants in the control group completed assessments only. Self-report assessments of study variables of interest were administered at baseline, midmanipulation, postmanipulation, and 2-week follow-up. Participants also completed an appearance-related in vivo stressor task at post, during which participants rated their reactivity to having their photographs taken from various angles. Compared to the control group, the SB fading group exhibited significantly lower social anxiety, BDD symptoms, body dissatisfaction, and maladaptive cognitions at the postmanipulation and follow-up assessments. SB fading had stronger effects on BDD symptoms at postmanipulation among those high versus those low in baseline BDD symptoms. The SB fading group also showed less reactivity to some aspects of the in vivo appearance-related stressor task. This study provides strong evidence for the importance of appearance-related SBs in the maintenance of BDD and other disorders characterized by body image disturbances. Findings point to the potential utility of decreasing appearance-related SBs as a transdiagnostic treatment strategy. (PsycINFO Database Record (c) 2019 APA, all rights reserved).