Body Image in the Social Media era: Analysis of the associations between photo-based behaviors and content available on social media and symptoms of Body Dysmorphic Disorder and Muscle Dysmorphic Disorder

Body image is a complex psychological construct that could be divided in negative and positive. Negative body image is a core feature of Body Image Disorders, which include Body Dysmorphic Disorder (BDD), associated with interest in cosmetic surgery, and Muscle Dysmorphic Disorder (MDD), characterized by exercise addiction symptoms. Positive body image, a protective factor for people’s well-being, is defined by several components including body appreciation and body functionality appreciation. Scholars studied the relation between body image and social media, mostly focusing on photo-based behaviors (e.g., photo investment and manipulation) and social media content (e.g., beauty, body positive, and body neutrality content). In general, they found positive associations between these social media use dimensions and negative body image, including a putative protective role of positive body image; however, not all the studies confirmed these associations. Since studies addressing the relation involving BDD and MDD symptoms, positive body image, and appearance-focused social media use are lacking, the present Ph.D. thesis aimed to: 1) explore the associations between photo-based behaviors, BDD and MDD symptoms, and associated constructs (i.e., interests in cosmetic surgery and exercise addiction) and the protective role of positive body image (i.e., body and body functionality appreciation); 2) address the associations between BDD symptoms, positive body image dimensions, and beauty and body positive content, accounting for the mediation of appearance comparison and internalization of general attractiveness; 3) examine how TikTok creators ascribe meaning to body and appearance in #bodyneutrality content and to suggest the possible utility for BDD and MDD symptoms. In the current Ph.D. thesis, Chapter 1 and Chapter 2 introduced the constructs addressed throughout the thesis. Chapter 3 provided an overview of the objectives pursued. Chapter 4 highlighted that BDD and MDD symptoms were significantly associated with photo investment, while only BDD symptoms were significantly associated with photo manipulation; body appreciation moderated only the relation between photo investment and BDD symptoms. Given the cross-sectional design of the study, the relations could be bidirectional. In Chapter 5, photo investment and manipulation emerged to have indirect effects on the consideration of being involved in cosmetic surgery in the future mediated by BDD symptoms. Photo manipulation demonstrated also a direct effect. Again, body appreciation moderated the relation between photo investment and BDD symptoms. Similarly, photo investment was indirectly associated with exercise addiction symptoms through MDD symptoms. Body functionality appreciation moderated the relation between photo investment and MDD symptoms. In Chapter 6, findings underscored that self-reported frequency of following beauty content had an indirect effect on BDD symptoms, mediated by appearance comparison and internalization processes, while the self-reported frequency of following body positive content was only directly associated. Interestingly, positive body image dimensions were not related to any type of content. In Chapter 7, findings concerning a thematic analysis demonstrated that body neutrality could imply de-emphasizing the importance of appearance, suspending any form of judgment, valuing non-physical attributes, and normalizing body-related insecurities. Finally, in General Discussion and Conclusions, a comprehensive discussion of all the findings related to body image dimensions and social media was provided, leading to possible practical implications, limitations, and future directions. In conclusion, the Appendix will provide information on the Italian validation of the Photo Investment Scale, which was employed in the studies presented in Chapters 4 and 5.