The Relationship Between Childhood Traumas with Social Appearance Anxiety and Symptoms of Body Dysmorphic Disorder: The Mediating Role of Sociocultural Attitudes Toward Appearance

Background: Body dysmorphic disorder (BDD) and social anxiety are two concepts related to body dissatisfaction. These concepts have been linked to sociocultural attitudes to appearances and painful experiences in interpersonal relationships. Objectives: The present study examines the relationship between childhood traumas with social appearance anxiety (SAA) and BDD through the mediating role of sociocultural attitudes toward appearance (SATA). Methods: This cross-sectional study was conducted on 415 university students in Tehran, Iran using the convenience sampling method in 2019-2020. Data were analyzed using SPSS version 24 and Amos version 21 software. Results: According to our results, while childhood traumas were not directly related to BDD (beta = 0.059; SE = 0.31), SAA seemed to playa statistically significant mediating role (beta = 0.17; SE = 0.005). Moreover, childhood trauma was related to SAA both directly (beta = 0.24; SE = 0.001) and through the mediating role of SATA. In addition, SATA (beta = 0.17; SE = 0.005) significantly predicted BDD (beta = 0.27, P < 0.001). The assumed model was in good fit with the acquired data (CFI = 0.97, GFI = 0.95, NFI = 0.94, RMSEA = 0.046). Conclusions: Children who have had traumatic experiences may experience anxiety and self-doubt. Thus, childhood traumas are ostensibly related to signs of BDD and SAA through the mediation of sociocultural attitudes. Childhood traumas can also predict susceptibility to rejection in interpersonal relationships. However, no results have been found to mediate rejection sensitivity concerning trauma with BDD and SAA.