Personal and appearance-based rejection sensitivity in body dysmorphic disorder

• We examined associations between personal and appearance-based rejection sensitivity and body dysmorphic disorder.
• Both personal rejection sensitivity and appearance-based rejection sensitivity were elevated in individuals with BDD.
• Both personal rejection sensitivity and appearance-based rejection sensitivity were associated with more severe BDD and depressive symptoms.
• Personal rejection sensitivity appears to have more associations with domains of health-related quality of life than appearance-based rejection sensitivity in individuals with BDD.

Although rejection sensitivity may be an important feature of body dysmorphic disorder (BDD), no studies have examined rejection sensitivity in a clinical sample and compared types of rejection sensitivity in individuals with BDD. Personal and appearance-based rejection sensitivity scores in forty-six patients diagnosed with BDD were compared with published norms. Associations between rejection sensitivity, BDD severity, and other clinical variables were examined. Personal and appearance-based rejection sensitivity scores were 0.6 and 1.1 standard deviation units above published norms, respectively. Greater personal rejection sensitivity was associated with more severe BDD and depressive symptoms, poorer mental health, general health, and physical and social functioning. Greater appearance-based rejection sensitivity was associated with more severe BDD and depressive symptoms, and poorer general health. Appearance-based rejection sensitivity contributed more unique variance to BDD severity than personal rejection sensitivity did; however, personal rejection sensitivity contributed more unique variance to general health than appearance-based rejection sensitivity did.