An Ecological Momentary Assessment Study of Appearance-Related Safety Behaviors - Project Summary. Appearance concerns are a common component of several psychiatric disorders including body dysmorphic disorder (BDD), eating disorders (EDs), and social anxiety disorder (SAD)1-3. Given the transdiagnostic nature of these concerns, it is crucial to identify key targets that can improve these concerns. Appearance related safety behaviors (ARSBs), or maladaptive behaviors aimed at checking, concealing, or fixing perceived flaws in appearance have been shown to be strongly related to appearance concerns, symptoms of BDD, ED, and SAD, as well as depression4,7. Additionally, experimental research has demonstrated that instructions to reduce these behaviors led to lower appearance concerns and symptoms of BDD, ED, and SAD, demonstrating their transdiagnostic importance14. Consistent with the NIMH Research Domain Criteria (RDoC) initiative, ARSBs represent a transdiagnostic construct relevant to multiple psychiatric disorders that can potentially be targeted to yield improvements across an array of highly comorbid disorders. While there is a growing body of research on ARSBs, little is known about how these behaviors vary within a day and their potential causes and consequences. This is a crucial gap in the literature that the present study aims to fill. The present proposal will be a novel examination of these behaviors using ecological momentary assessment (EMA). Specifically, this study will (a) use EMA to examine what situational or contextual triggers precede ARSB use, (b) examine how within day ARSB use will precede and predict increases in appearance concerns as well as symptoms of BDD, EDs, and SAD, (3) determine how these relationships vary between individuals who are high in appearance concerns compared to those low in these concerns, and (4) examine how symptoms of BDD, EDs, and SAD moderate these relationships. Results of the present study would advance the knowledge on the processes surrounding ARSB use and provide a better understanding of how these behaviors contribute to the risk for body dysmorphia, eating pathology, and social anxiety. This proposal has important implications for the prevention and treatment of these appearance-related disorders. Through this proposed study, the applicant will acquire additional training and experience in the design and execution of intensive longitudinal study design, advanced statistical techniques, and professional development crucial for an independent clinical researcher. The experience that can be gained from this fellowship will lay the foundation for the applicant to become an independent clinical scientist who investigates transdiagnostic pathology. Coupled with extensive education in computerized treatments gained from the applicant’s lab, the experience from this fellowship will enhance the applicants ability to identify and target malleable mechanisms of psychopathology. This fellowship will provide crucial experience to bolster the applicant’s goal of identifying targets for the development of more efficacious treatment for psychopathology.
