Relationship between Social Media and Body Dysmorphia - Meta-analysis

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Relationship between Social Media and Body Dysmorphia - Meta-analysis

https://doi.org/10.21203/rs.3.rs-5092386/v1

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The current research aimed to study the relationship between social media and body dysmorphia. This paper adopted a systematic review process to synthesize existing studies published in peer-reviewed journals, from the Pub Med and Google Scholar search engines. Social media and body dysmorphia were used as keywords to conduct a systematic search. The inclusion criteria required the study to be quantitative and include sample size and correlation coefficient, which were based on the selection of research articles from 2013–2023. Qualitative studies or articles lacking correlation coefficients were excluded. After refining the articles, 20 studies were exported to Jamovi, using the MAJOR module, and a meta-analysis was carried out. The PRISMA model was used for sample selection to report the study process and findings. The analysis revealed that social media and body dysmorphia were positively related to heterogeneous effect size. The study also revealed that self-objectification, compulsive online behaviour, and body dysmorphia were significantly related. Further research is required for screening assessment techniques, emphasizing the necessity for body image and media literacy initiatives to address the influence of social media.

Psychology

Social media

body dysmorphia

youth

meta-analysis

research articles

Social media play a vital role in shaping our perspectives on the world and impacting our culture and economy. It has influenced every aspect of young people's lives (Richards et al., 2015). These can be divided into groups based on the goals they serve as well as the interests of their users (Musiał & Kazienko, 2012). Finding common ground with others online has made the world more accessible and connected for many people (Haythornthwaite, 2005). While it provides a platform for promoting goods and services, it has evolved into a weapon used by terrorists, sexual predators, and criminals to carry out illegal activities (Amedie, 2015). Social media may also lead to false perceptions of virtual connections and friendships that might cause emotional and psychological issues; addiction: depriving users of their family and personal time; weakening their social skills; and encouraging disruptive antisocial behavior (Pantić, 2014). In this context, this study aims to synthesize the existing research on the relationship between social media and body dysmorphic disorders.

Social Media and Body Dysmorphic Disorders

Studies have also revealed that frequent use of social media is linked to a variety of mental health issues, including depression, eating disorders, body image issues, and externalizing disorders (O'Reilly et al., 2018). One possible explanation could be that excessive content is coupled with images generated by AI over social media at any given time for the brain to process. Beck and Clark (1988) suggested that information be screened, encoded, managed, stored, and recalled according to underlying ideas rather than at random. As a result, information that supports pre-existing views is expanded upon and encoded, while contradictory or irrelevant information is overlooked, misinterpreted, or forgotten until it is consistent with beliefs (Wilhelm & Neziroglu, 2002).

Moller et al. (2010) suggested that a restricted capacity for contextual understanding or "big picture" viewing leads to selective attention being drawn to perceived appearance faults rather than to processing body or facial inputs holistically. People can also be more likely to recall data that support their preconceived notions. Biassed perceptions, processing, and memory of information from their immediate environment are common in patients with body image issues (Neziroglu et al., 2008). This bias could influence how early experiences are interpreted and remembered, which could eventually lead to the emergence of problems with body image. Thus, maladaptive beliefs may be key factors in the development and maintenance of BDD (Lavell et al., 2014).

Social media can set off obsessive thoughts about looks in individuals with body dysmorphia (Laughter et al., 2023). The abundance of "perfect" pictures in their feed may serve as a constant reminder of their perceived imperfections. The use of social media has led to social comparisons among the young people. People commonly participate in selective self-presentation (Fox & Vendemia, 2016) on social media. This may cause some young people to make negative social comparisons about their accomplishments, abilities, or looks (Nesi, 2020). Increased usage of social media platforms was associated with increased body image concerns and eating disorder symptoms (Rodgers & Melioli, 2015). Furthermore, people who suffer from body dysmorphic disorder frequently engage in obsessive behaviors such as comparing their body parts to those of others, leading them to believe that their body parts are less appealing (Neziroglu et al., 2008). Adolescent females expressed greater dissatisfaction with their bodies than adolescent males did (Mayville et al., 1999), whereas muscularity dissatisfaction was found to be related to favorable connections across a variety of social media platforms among men (Griffiths et.al, 2018). Irrespective of gender, body image comparisons on social media prevail over a consistent period. Thus, a meta-analysis that compiles the various studies that have been conducted examining the relationship between social media and body dysmorphia is necessary to understand its prevalence on a wider scale. There is a significant amount of variation in the relationship between social media and body dysmorphia. A more accurate understanding can be obtained by pooling study results using meta-analytic techniques.

The authors adopted a systematic review to study the relationship between social media and body dysmorphia. In August 2023, a systematic review was performed in databases including PubMed and Google Scholar, using the search keywords "social media" and "body dysmorphia". The search was limited to articles published in peer-reviewed journals, and written in English. In total, the search resulted in 7,085 articles (Fig. 1). Due to the large volume of studies, title screening was carried out manually to select quantitative studies for the current article. This resulted in 109 articles. The studies with correlation coefficients (r values for both parametric and nonparametric) were retained, and the remaining studies were excluded from the final analysis. Data such as Author, Year, Study, Sample Size, and Correlation value from 20 articles were extracted and recorded in the MS Excel datasheet for further analysis in Jamovi 2.3.21. The authors used the MAJOR module in Jamovi for the meta-analysis. We performed fixed-effect and random effect analyses with the module measure Fisher's z-transformed correlations. The 95% confidence interval (CI) was calculated for each of the articles. Fisher’s r-to-z test was used to transform the correlation coefficient as the outcome measure, and fixed-effects and random-effects models were used to analyse the data. The Q-test for heterogeneity (Cochran 1954) and the I² statistic were utilized to assess the heterogeneity among the studies. Studentized residuals and Cook's distances are used to examine whether studies may be outliers and/or influential in the context of the model.

A total of k = 20 studies were included in the analysis. The characteristics of the participants are presented in Table 1.

Table 1

Study characteristics
Sl. No	Author (Year)	Sample Size (r)	Sample	Sampling Type	Ethnicity	Country	Age Group
1	Melvin & Kaylan, 2023	407 (0.143)	Adolescents	Convenience	Multiple	USA	12–18
2	Jien, Lee Wee; Nie, Kho Suet, 2022	387 (0.527)	Youth male	NA	Malaysian	Malaysia	15–35
3	MurrayStuart, McLeanSiân, 2018	2733 (0.1)	Sexual minority men	NA	Australian, New Zealand, North Western Europe, South East Asian	Australia	18–78
4	Wagner et al., 2021	161 (0.26)	College Students	NA	Multiple	USA	18–37
5	Waqar et al., 2022	200 (0.75)	Females	Convenience	NA	Pakistan	17–35
6	Verrastro et al., 2020	621 (0.169)	High school students	NA	NA	Italy	13–21
7	du Rocher et al., 2023	396 (0.59)	NA	NA	NA	United Kingdom	All
8	Vuong et al., 2021	1153 (0.2)	Adolescents	NA	Multiple	Australia	11–17
9	Isufaj & Sara, 2020	152 (-0.19)	Young adults	Convenience	NA	Ireland	18–29
10	Nicholson & Emma, 2020	67 (-0.13)	Young adults	Convenience	Multiple	Ireland	18–29
11	Hildreth & Tresa Lynn, 2020	119 (-0.29)	UG Male Students	Random	Multiple	USA	18–20
12	Ersson, Sofia Holvik & Rebecca, 2020	206 (0.78)	Swedish citizen	Snowball recruitment and convenience sampling	Swedish	Sweden	16+
13	Warren, Cortney, Rios & Ricardo, 2013	93 (.043)	Youth	Purposive sampling	Hispanic/Latino	USA	21
14	Sotiriou, Elysia & Georges, 2021	224 (.03)	Women	Purposive sampling	Multinational	USA	18+
15	Prejban & Alexandru, 2021	168 (0.97)	Youth	Convenience	NA	Ireland	18–29
16	Xu et al., 2023	139 (-0.34)	Youth	Purposive and snowball sampling	White/Asian	USA	18–25
17	Mahon & Ciara, 2021	795 (0.622)	Youth	Convenience	Multinational	Ireland	18–30
18	Imperatori et al., 2022	721 (0.179)	Young Adults	Convenience	Italian	Italy	18–34
19	Kaewpradub, et al., 2017	620 (0.102)	Adolescents	Stratified and simple random sampling	Thai	Thailand	15–19
20	Boroughs & Thompson, 2014	364 (0.4)	Males	Convenience	Multinational	USA	18–44

The observed Fisher r-to-z transformed correlation coefficients ranged from − 0.3507 to 2.0923, with the majority of estimates being positive (80%) (Fig. 2). The estimated average Fisher r-to-z transformed correlation coefficient based on the fixed-effects model was 0.2965 with a 95% confidence interval (CI = 0.2766 to 0.3165). Hence, it is concluded that the average outcome differed significantly from zero (z = 29.1552, p < 0.0001).

The Q-test indicated that there is heterogeneity (Fig. 3) among the true outcomes of the studies (Q(19) = 1293.9603, p < 0.0001; I² = 98.5316%). This finding suggested that the studies included in the analysis had varying effect sizes and the differences are not due to random chance alone. The rank correlation test did not show evidence of correlation (p = 0.9745), which suggests that the order of publication of the studies did not significantly influence the results.

Random Effect

From Fig. 4, it can be observed that the estimated average Fisher r-to-z transformed correlation coefficient based on the random-effects model was 0.3755 (95% CI: 0.1322 to 0.6187). Therefore, the average outcome differed significantly from zero (z = 3.0253, p = 0.0025).

Funnel plot asymmetry was assessed using the rank correlation test and the regression test, and did not show significant evidence of funnel plot asymmetry indicating no publication bias in the selected study (Fig. 5). According to the Q-test, the true outcomes appeared to be heterogeneous (Q(19) = 1293.9603, p < 0.0001, tau² = 0.3034, I² = 99.2664%). The 95% prediction interval for the true outcomes ranged from − 0.7312 to 1.4821. Hence, although the average outcome is estimated to be positive, in some studies the true outcome may be negative. Hence, it can be concluded that there is a significant correlation between social media and body dysmorphia, but there is substantial heterogeneity across the selected studies.

Our study focused on the relationship between social media and body dysmorphic disorders. We considered these two variables to determine how they are related to each other. This study aimed to quantify the relationship between social media and body dysmorphic disorders through the use of studies published in peer-reviewed journals. The overall effect was significant with a positive small effect size. Our study also revealed that social media usage, self-objectification, compulsive online behavior, and body dysmorphia were significantly related. One study on social media and body dissatisfaction (MurrayStuart & McLeanSiân, 2018) with a sample size of 2733 had a relatively large weight compared to the rest of the studies. An examination of the studentized residuals revealed (the following: Social Media Addiction and Eating Disturbance; Internet Usage and Body Image; Social Media Use with Body Dysmorphia; Fitness related content and Body Dysmorphia; Social Media and Body Dissatisfaction; Appearance related consciousness and Body Dysmorphia; Beauty Stereotype and Body Image; Body Consciousness and Body Dysmorphia; Social Media Use and Body Dysmorphia; Social Media Use and Body Image Satisfaction; Social Media and Social Comparison and Body Dysmorphia; Social Media and Social Comparison and Body Images; Problematic Appearance Comparison and Body Dissatisfaction; Body Image and Tiktok Image Filters; Social Media Usage and Self-Objectification; and Compulsive Online Behavior and Body Dysmorphia). These studies included values larger than ± 3.0233 and may be potential outliers in the context of this model.

Most of the studies were carried out using nonprobability sampling techniques reported in clinical settings. A diagnosis could discourage people from seeking medical or surgical treatments that do not address the underlying problem. Nevertheless, there are several efficient treatment options available after diagnosis, and these options have shown promising results (Minty & Minty, 2021). Preoccupations with perceived flaws may significantly impact self-esteem, and body image, and potentially lead to psychological distress or influence decisions about seeking cosmetic or medical interventions (Rumsey & Harcourt, 2004). In light of these findings, it is evident that while social media offers unparalleled connectivity and opportunities, its impact on mental health, particularly body image perceptions, requires critical examination.

Our study synthesized the findings on the relationship between social media and body dysmorphic disorders. There is a need for holistic education and the promotion of healthy use and consumption of social media content. Further research is required for screening assessment techniques and models to develop a psychoeducation model in this field, emphasizing the necessity for body image and media literacy initiatives to acknowledge and address the potential influence of social media.

We declare that this is original work carried out by us and all the authors have contributed equally.

We do not have any conflicts of interest.

We declare that no funding was received for this research work.

We have no relevant financial or nonfinancial interests to disclose.

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The authors declare no competing interests.

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Relationship between Social Media and Body Dysmorphia - Meta-analysis

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Social Media and Body Dysmorphic Disorders

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Random Effect

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