The relationship between body dysmorphic concerns and the effects of image suppression: Implications for models of body dysmorphic disorder

A key clinical feature of body dysmorphic disorder (BDD) is the use of avoidance behaviours to minimise discomfort associated with perceived defects in appearance. While overt avoidance, such as avoidance of social situations, has been well-documented (e.g., Phillips, 2005), covert avoidance, such as image suppression, has not been explored. This study investigated the role of suppression of negative self-imagery in the maintenance of dysmorphic concern. Undergraduate participants completed a thought suppression paradigm with an experimentally-constructed negative self-image as the target. Dysmorphic concern was associated with how distressing and vivid an appearance-related intrusion was, although it did not affect whether participants engaged in suppression of the intrusion. Instructions to suppress the image led to reduced intrusion frequency and discomfort but it did not affect the quality (e.g., vividness) of intrusions. In addition, participants high in dysmorphic concern were more likely to internalise distorted appearance-related information and be disgusted by that information. Implications for models of body dysmorphic disorder are discussed.

► We investigate the role of image suppression in dysmorphic concern.
► We induced a negative self-image using a distorted photograph of each participant.
► Dysmorphic concern predicts intrusion discomfort, vividness and disgust.
► Suppression of negative self-images is negatively reinforcing.