FSU researchers harness new methods to decrease appearance anxiety in women through smartphone-based interventions

Two Florida State University researchers have found that smartphone-based clinical interventions may reduce appearance-related anxiety in women experiencing high levels of concern about their appearance.

The study, by Professor of Psychology Jesse Cougle and clinical psychology doctoral student Tapan Patel, has been published in the Journal of Consulting and Clinical Psychology.

“Technology can lead to negative mental health effects, so one of my biggest driving questions within this research was how I can instead use technology to improve people’s mental health,” said Patel, the study’s lead author and a member of the Cougle Lab in FSU’s Department of Psychology. “One of the most profound things I’ve learned in my work studying anxiety is that the best way to deal with fear is to face it, so this led me to ask: how can we use technology to help people face their anxieties?”

Between 69 and 84 percent of women over the age of 18 experience body dissatisfaction and desire to be a lower weight than they are, according to the National Eating Disorders Association.

Body dissatisfaction’s negative effects, such as irregular eating habits and self-consciousness, can lead to social anxiety and eating disorders, as well as low self-esteem and depressive symptoms.

Cougle and Patel recruited 203 women aged 18 to 65 years old in the U.S. who reported increased appearance concerns. The team then administered two different monthlong interventions and found evidence that their solutions alleviated the women’s appearance concerns without the need for them to meet with a clinical therapist.

“Anxiety about one’s physical appearance is a significant problem that can substantially affect a person’s quality of life,” Cougle said. “Anxiety is common and a symptom of multiple psychiatric conditions including disorders concerning eating, body dysmorphia and social anxiety. We sought to test a brief, passive intervention we developed for appearance anxiety that did not require therapist involvement and was delivered via participants’ phones.”

One of the most profound things I’ve learned in my work studying anxiety is that the best way to deal with fear is to face it, so this led me to ask: how can we use technology to help people face their anxieties?

– Tapan Patel, clinical psychology doctoral student and lead author on the study

The researchers designed two techniques — one monitoring appearance-related safety behaviors, or ARSB, and the other monitoring unhealthy behaviors, or UHB — that were delivered to participants through text messages and provided daily checklists and avoidance reminders throughout the monthlong study.

One intervention asked participants to self-record and reduce how often they engaged in ARSB, which are behaviors that can offer relief from a person’s appearance anxiety, such as checking one’s body in the mirror, avoiding situations where one’s body is exposed, comparing one’s appearance to others’ and more.

The control intervention asked participants to self-record and reduce their UHB — activities that typically maintain low levels of mood and low self-esteem such as frequent napping, allowing dirty dishes to pile up or doomscrolling on social media before bed.

Researchers found that the intervention targeting ARSB led to lower appearance anxiety, eating disorder symptoms, social anxiety and beliefs about the importance of appearance than the intervention targeting UHB.

“Completing a full study with important implications like this, in just a few months, as Tapan did, is an impressive feat — especially for treatment outcome research,” Cougle said. “This study was the culmination of years of research we have been conducting on appearance-related safety behaviors and Tapan’s impressive research on the topic, which he’s published on extensively.”

Cougle and Patel hope to incorporate additional components in their intervention and test their use for the prevention of psychiatric disorders like body dysmorphic disorder, social anxiety disorder and more. They also hope to test its efficacy in men.

“We started this project to determine how to improve treatments by targeting appearance-related safety behaviors, and it has become its own accessible solution for people with appearance-related anxiety,” Patel said. “This study displayed that the idea is sound, and having our research published was an ecstatic feeling. It’s motivating to know that colleagues in the field are encouraging and enthusiastic about our work. It means a great deal to know our research could help people.”

To learn more about research conducted in FSU’s Department of Psychology, visit psychology.fsu.edu.