The meaning of beauty: implicit and explicit self-esteem and attractiveness beliefs in body dysmorphic disorder

Ulrike Buhlmann, Bethany A Teachman, Eva Naumann, Tobias Fehlinger, Winfried Rief
Journal of Anxiety Disorders 2009, 23 (5): 694-702
Body dysmorphic disorder (BDD) is characterized by imagined or slight defects in one's appearance. We evaluated implicit and explicit biases among individuals diagnosed with BDD (n=21), individuals with subclinical BDD symptoms (n=21), and healthy control participants (n=21). Specifically, we used the Implicit Association Test [IAT; Greenwald, A. G., McGhee, D. E., & Schwartz, J. L. K. (1998). Measuring individual differences in implicit cognition: the implicit association test. Journal of Personality and Social Psychology, 74, 1464-1480] to examine automatic associations related to self-esteem, associations between attractive and important, and a physical attractiveness stereotype (associations between attractive and competent). BDD participants had significantly lower implicit self-esteem, relative to control participants, and the subclinical BDD participants were intermediate between these groups. Although no group differences were observed on the implicit Attractive Important IAT; as predicted, BDD participants had significantly stronger implicit associations between attractive and competent than the other groups, in line with a common stereotype about physical attractiveness. Both the Attractive Competent IAT and Self-Esteem IAT were significant predictors of BDD symptom severity, and distress and avoidance during a mirror exposure task. Findings are discussed in light of cognitive-behavioral models of BDD.

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