The bidirectional association between body dysmorphic symptoms, body image inflexibility, and appearance-related safety behaviors in young Chinese women.

OBJECTIVES

Previous studies and theories have shown a bidirectional association between body dysmorphic disorder (BDD) symptoms, body image inflexibility, and appearance-related safety behaviors. Most previous studies are cross-sectional studies, lacking longitudinal studies. We aimed to explore the roles of body image inflexibility and appearance-related safety behaviors in BDD symptoms through a longitudinal study.

METHODS AND MEASURES: A questionnaire-based method was employed to conduct three follow-up measurements with a three-month interval among 325 female college students in China.

RESULTS

Cross-lagged panel model (CLPM) revealed that there are bidirectional associations between BDD symptoms and body image inflexibility, between BDD symptoms and avoidance behaviors, and between avoidance behaviors and body image inflexibility to some extent. The random intercept cross-lagged model (RI-CLPM) showed that at the within-individual level, avoidance behaviors at T1 can positively predict body image inflexibility at T2.

CONCLUSIONS

The findings suggest that the chronicity of BDD arises from the dynamic association between the trait vulnerability of body image inflexibility and the process of behavioral reinforcement. The treatment of BDD needs to block avoidance behaviors and modify such trait vulnerability.