Appearance comparison in individuals with body dysmorphic disorder and controls

•Self-reported appearance comparison in BDD and controls was investigated.•Levels of appearance comparison were significantly higher in BDD participants.•BDD participants focused more on disliked features relative to overall appearance.•Controls focused more on overall appearance relative to disliked features.•People with BDD were markedly less satisfied with their appearance after comparing.

Research investigating appearance comparison in body dysmorphic disorder (BDD) remains very limited, despite the fact that this is one of the most commonly observed behaviors in individuals with the disorder. The present study investigated the self-reported extent and nature of appearance comparison in 35 BDD participants relative to 45 controls using a newly devised and a standardized appearance comparison measure. The results showed that BDD participants reported significantly higher levels of appearance comparison than controls. Individuals with BDD also reported greater levels of comparing in terms of the specific feature(s) of their appearance they were most concerned about as compared to overall appearance, whilst controls showed the opposite pattern. Levels of comparing in BDD participants increased as targets increased in terms of attractiveness, and individuals with BDD rated themselves as being markedly less attractive than targets, and feeling markedly less satisfied with their appearance after comparing. Cognitive-behavioral treatment implications are discussed.