New research provides evidence that social anxiety affects how people feel about their bodies and that this is related to the fear of being rejected because of their appearance. The new findings, published in Body Image, shed light on the relationship between appearance rejection sensitivity 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 though they may look normal to others. This condition often leads to excessive grooming, comparing their appearance to others, seeking reassurance and avoiding social situations.
“My main scientific interest is rejection sensitivity theory,” said study author Maja Brekalo, a postdoctoral researcher at the Catholic University of Croatia. “Along with researching rejection sensitivity, I have become curious about specific appearance-based rejection sensitivity – a more specific construct than general rejection sensitivity.”
“I have realized that rejection sensitivity is a very important personal disposition and a risk factor for development and maintenance of mental health issues and other maladjustments. The literature gap regarding appearance-based rejection sensitivity is big and longitudinal research is scarce, so there is a lot of unknown that is worthy of research.”
For her new study, Brekalo recruited a sample of 277 undergraduate and graduate students (18 to 29 years old). The participants completed questionnaires at two timepoints that were 5 months apart.
The researchers found that social anxiety symptoms predicted appearance rejection sensitivity, which in turn predicted changes in symptoms of body dysmorphic disorder. In other words, those who agreed with statements such as “I have difficulty making eye-contact with others” were more likely to expect to be rejected based on their physical appearance in various social scenarios, and those with heightened appearance rejection sensitivity tended to experience increases in body dysmorphia over time.
“It implies that individuals who are anxious about the evaluation of others in social situations are also sensitive to rejection due to their appearance, so in turn, they are overly preoccupied with their physical attractiveness,” the researcher explained.
In addition, the remembrance of childhood experiences of appearance-based rejection from peers predicted symptoms of body dysmorphic disorder both directly and indirectly through heightened appearance rejection sensitivity.
“I would like to emphasize to all readers that peers’ rejection based on appearance during adolescence is very harmful and has long-lasting effects in adulthood. We should make effort to prevent it during childhood and early adolescence,” Brekalo told PsyPost.
Individuals who reported more childhood experiences of appearance-based rejection from one’s parents 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 either symptoms of body dysmorphic disorder or appearance rejection sensitivity over time.
“I did not expect that maternal and paternal rejection based on appearance, when examined in a longitudinal model along with social anxiety symptoms and peers’ rejection, would not predict longitudinal changes in body dysmorphic symptoms during adulthood,” Brekalo said.
“To my best knowledge, this was the first study that simultaneously examined peers’, maternal and paternal rejection based on appearance so it is hard to compare obtained results. It is important to add that paternal rejection was not previously examined at all. This should be further investigated.”
“Although we did not find predictivity of parental rejections for body dysmorphic symptoms in young adulthood (but correlations do exist), it is also important to educate parents on how to speak with their children about their appearance in a non-rejective way,” Brekalo explained.
The study, like all research, includes some limitations. For instance, the majority of the sample was comprised of young women. Future research could recruit a more diverse sample.
“Many research questions should be addressed. Especially, longitudinal design studies are needed,” Brekalo said. “We still know little about gender differences, parental rejection and teasing regarding appearance, and other maladjustments related to body dysmorphic symptoms in high appearance-based rejection sensitive individuals.”
“I would like to add that research like this one is valuable because they are starting point in developing preventive and intervention programs. Practical implications in this area are very important and should start in childhood. Also, 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“.