People with body dysmorphic tendencies learn and process self-related information more strongly than information about other people, according to new research. This exaggerated focus on the self extends even to neutral, everyday objects that have nothing to do with physical appearance. The findings, published in the Quarterly Journal of Experimental Psychology, provide evidence that a basic bias in how the brain processes self-relevant information might contribute to severe body image preoccupations.
Body dysmorphic disorder, or BDD, is a mental health condition characterized by an intense and distressing preoccupation with perceived flaws in physical appearance. Individuals with BDD often spend hours each day focusing on minor or imagined physical anomalies. This behavior tends to severely disrupt their daily lives, relationships, and social functioning.
“We were motivated to understand what underlying information-processing mechanisms may be contributing to the observed symptomatology of body dysmorphic disorder,” said Maria Richards-Brown, a researcher in the Department of Psychosis Studies at King’s College London. “Through understanding where information processing may differ as one exhibits more body dysmorphic symptoms, we can hopefully identify clinical treatment targets.”
To understand how this intense preoccupation develops, psychologists look at how the brain manages and assigns importance to different types of information. In the general population, people naturally display a “self-prioritization effect.”
“In the general population, individuals show a greater prioritization of processing information about themselves, compared to information about their best friend or a stranger,” Richards-Brown explained. “This is a well-known information processing bias.”
This psychological concept suggests that individuals process, learn, and recall information associated with themselves much faster and more accurately than information associated with other people. For example, if a person is asked to associate a random object with themselves and another object with a stranger, they will consistently recognize the self-associated object with greater ease.
Previous models suggest that BDD might emerge from a hyperactive self-attention network in the brain. This heightened internal focus could cause a person to pay excessive attention to self-related cues, magnifying normal bodily signals into intense preoccupations.
The authors of the current paper designed their research to test whether people with higher levels of body dysmorphic symptoms show an inflated version of this standard self-prioritization effect. They wanted to determine if this bias exists even when the information being processed has no connection to physical appearance.
In the first experiment, the scientists recruited 87 female participants through an online platform. The participants ranged in age from 32 to 71 years old. They completed a standard questionnaire used to screen for the presence and severity of BDD symptoms.
Next, participants completed an associative learning task. The researchers asked them to learn specific pairings between three geometric shapes (a triangle, a circle, and a square) and three personal labels (“You,” the first name of their best friend, and “Stranger”). After a brief learning period, the participants viewed a series of shape and label combinations on a screen.
For each trial, participants had a brief window to press a specific keyboard key to indicate whether the pairing on the screen matched the original associations they had learned, or if it was a mismatch. For instance, if they originally learned that a square represented “You,” they might later see a square paired with the word “Stranger,” which would be an incorrect mismatch.
Across the board, participants demonstrated the standard self-prioritization effect. They were more accurate and faster at correctly identifying matches involving the “You” label compared to the “Friend” or “Stranger” labels.
When factoring in the questionnaire scores, the authors found a specific pattern related to body image concerns. Participants with higher BDD symptom scores were more accurate at identifying the self-related pairings compared to the stranger-related pairings. This gap in accuracy between the self and the stranger was wider for those with higher body dysmorphic tendencies than for those with lower scores.
To confirm and expand upon these initial observations, the scientists conducted a second experiment with a new sample. This group included 173 participants, consisting of 135 females and 41 males ranging from 19 to 71 years old. The procedures were largely the same, but the researchers made the matching task slightly more difficult by flashing the shape-label pairings on the screen for a much shorter duration of 250 milliseconds.
In this second experiment, the researchers also administered two additional questionnaires. One measured symptoms of depression, and the other measured general impulsivity. They included these extra measures to control for the possibility that depression or impulsivity might account for any differences in learning speed or accuracy, rather than BDD symptoms.
The second experiment confirmed the exaggerated self-prioritization effect in individuals with higher body dysmorphic scores. In this iteration, participants with elevated BDD symptoms showed greater accuracy in identifying “You” matches compared to “Friend” matches. The reaction time data also revealed a tailored self-bias.
Participants with more BDD symptoms were disproportionately faster at identifying self-related pairings compared to both friend- and stranger-related pairings. The additional questionnaires provided helpful context for these outcomes. The researchers found that the influence of depression and impulsivity on these processing biases was not statistically significant.
These results point to a core cognitive difference in how people with these preoccupations view the world. “In individuals that have more body dysmorphic symptoms, this bias is even greater, indicating that there is an information processing bias underlying the symptomatic presentations of BDD,” Richards-Brown said.
Relying on an online sample from the general population introduces certain constraints. The participants completed a screening questionnaire that measures body dysmorphic tendencies, but they were not formally diagnosed with BDD by a clinician. Applying these findings directly to clinical settings requires testing patients who have received a formal psychiatric diagnosis.
The study also relied on an uneven ratio of male to female participants, primarily due to sampling constraints in the first experiment. Although the available data did not show sex differences in how people processed self-related information, recruiting a more balanced sample in the future would help confirm that these cognitive patterns operate similarly across all demographics.
Future research might explore how these cognitive biases change during therapeutic interventions. Tracking whether the exaggerated self-prioritization effect diminishes as BDD symptoms improve could offer a new way to measure treatment progress. Adapting these simple computer tasks into training exercises might also help individuals practice directing their attention away from the self, offering a potential supplemental treatment for body image distress.
The study, “Exaggerated Self-Referencing in Body Dysmorphic Disorder,” was authored by M. Richards-Brown, S. Castiello de Obeso, R. Dennison, and R. A. Murphy.