Exaggerated Self-Referencing in Body Dysmorphic Disorder

The self-prioritisation effect demonstrates that people have a bias to learn and process self-relevant information compared to other-relevant information. This tendency may provide a tool to understand how body image and perception become disrupted in people with such a preoccupation with self-related perceptions, behaviours, and affect (body dysmorphic disorder [BDD]). Using an associative learning matching paradigm, participants were presented with geometric shapes that were paired with either themself, a named friend, or an unnamed stranger. Participants were presented with different label-shape pairings and indicated 'match' or 'mismatch' to the original associations. In Experiment 1, higher Body Dysmorphic Disorder Questionnaire (BDDQ) scores were significantly associated with improved accuracy in identifying the self-related association compared with the Stranger association; Friend was intermediate. Experiment 2 showed that higher BDDQ scores were significantly associated with improved accuracy in identifying 'You' matches compared to 'Friend' matches as well as an effect found in reaction time that was not found in Experiment 1. Across both experiments, higher BDDQ scores were significantly associated with overall faster reaction times. In study 2 we assessed whether the reaction time effects were related to impulsivity and depression, for which we found no evidence. We discuss these results in relation to the exaggerated salience that person-centred cues may play in BDD and show how this process extends to new learning of self-related cues.