Characterizing gender differences in appearance-related safety behaviors and their relationship with clinical symptoms

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Abstract

Concerns with one’s physical appearance is a core feature of multiple psychiatric disorders including body dysmorphic disorder and eating disorders. Recent research has evaluated smartphone-based interventions for appearance targeting appearance-related safety behaviors (ARSB), maladaptive strategies that individuals use to avoid being negatively evaluated due to their appearance. These studies have largely focused on women and excluded men representing a major gap in the literature. The present study sought to examine the relevance ARSBs in two studies. In Study 1, we examined the invariance of ARSBs in a large sample (N = 840) of young adults. We found evidence of partial scalar gender invariance of ARSBs, which also showed similar relationship with clinical symptoms between genders. In Study 2, we evaluated the efficacy of targeting ARSBs in an open trial of men with elevated appearance concerns (N = 40), most of whom identified as a sexual minority (97.3%). Participants showed reductions in appearance concerns, eating disorder symptoms, social anxiety, and overvaluation of appearance that were maintained one-month after treatment. Taken together, the present investigation suggests that ARSBs are also clinically relevant in men, and ARSB fading shows similar efficacy in men as it does in women.

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Patel, T. A., & Cougle, J. R. (2026). Characterizing gender differences in appearance-related safety behaviors and their relationship with clinical symptoms. Cognitive Behaviour Therapy, 55(4), 477–495. https://doi.org/10.1080/16506073.2025.2516200

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