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Evidence for a Transdiagnostic Factor Underlying Disorder-Specific Measures of Physical Appearance Concerns

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Abstract

Concerns about physical appearance are a salient feature of several psychiatric conditions, and various self-report-based measures of appearance concerns have been developed for different disorders. An important question, with implications for understanding comorbidity and processes underlying it, is whether these different measures may in fact be indexing a common construct. Using confirmatory factor analysis (CFA) in a large mixed-sex undergraduate sample (N = 704), the current study found evidence for a higher-order factor accounting for substantial shared variance in measures of appearance concerns devised for use with eating disorders, social anxiety disorder, and body dysmorphic disorder. Hierarchical mediation analyses revealed that this general factor accounted for much of the variance shared between each appearance concerns measure and scale-assessed symptoms of its affiliated disorder. Additionally, the general appearance concerns factor accounted for most of the variance in a shared disorder factor representing the comorbidity among eating, social anxiety, and body dysmorphic symptoms. Collectively, these findings suggest that appearance concerns are general and transdiagnostic rather than disorder specific and may contribute to the systematic comorbidity evident among appearance-related psychopathologies.

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Data Availability

The data that support the findings of this study are openly available in at https://osf.io/cqd63/?view_only=a69a6ff5163f463c8d168e6cdec2b523.

Notes

  1. Modeling the BAAS at the item-level instead of the item-parcel level did not meaningfully affect the pattern of results presented. See the Supplemental Materials for full results from this model.

  2. Exploratory follow-up analyses indicated that the residual variance specific to the AAI factor was primarily associated with low-level item characteristics (i.e., wording effects) rather than construct-relevant content.

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Authors and Affiliations

  1. Department of Psychology, Florida State University, 1107 W Call St. Tallahassee, Tallahassee, FL, 32304, USA

    Rochelle A. Stewart, Danielle N. Jones, Katherine A. McDermott, Jesse R. Cougle & Christopher J. Patrick

  2. Department of Psychology, University of California, Berkeley, Berkeley, CA, USA

    Keanan J. Joyner

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  1. Rochelle A. Stewart
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  2. Danielle N. Jones
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  4. Katherine A. McDermott
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  5. Jesse R. Cougle
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Correspondence to Rochelle A. Stewart or Christopher J. Patrick.

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Stewart, R.A., Jones, D.N., Joyner, K.J. et al. Evidence for a Transdiagnostic Factor Underlying Disorder-Specific Measures of Physical Appearance Concerns. J Psychopathol Behav Assess (2023). https://doi.org/10.1007/s10862-023-10101-4

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