Safety behaviours in body dysmorphic disorder extend to the digital world.

INTRODUCTION Body Dysmorphic Disorder (BDD) is a mental health condition characterised by clinically significant preoccupation with appearance, resulting in distress and functional impairment. Safety behaviours such as checking, adjusting and comparing one's appearance are proposed to maintain BDD symptoms, with newer safety behaviours emerging through modern technology. However, our current gold-standard interview for assessing these behaviours has not been updated for the digital age.

OBJECTIVE We aimed to establish whether people with BDD engage in safety behaviors assisted by digital tools.

METHODS Via a clinical interview, we gathered frequency data from 37 individuals with BDD about whether they engaged in these additional behaviours.

RESULTS Our findings suggests that classic safety behaviours, particularly appearance comparison behaviours, also occur in digital contexts. Additionally, a cluster analysis revealed that participants who report engaging in classic safety behaviours also tend to endorse digital behaviours such as checking their image via photo taking, comparing themselves to others online and editing images of themselves.

CONCLUSIONS These findings highlight the need to assess and treat digital safety behaviours when working with individuals with BDD.