Journal article : Review
Mental imagery of the self in body dysmorphic disorder: a mixed‐methods systematic review
- Abstract:
- Mental imagery has been identified as a key feature of the onset, maintenance and treatment of psychological disorders. Research on the role of mental imagery in body dysmorphic disorder (BDD), a condition hallmarked by negative sensory appraisals of the self, has been increasingly recognised in theoretical perspectives and psychological interventions. However, the scope and implications of this work have not yet been reviewed. This systematic review sought to identify the characteristics and proposed mechanisms of imagery in BDD, synthesising qualitative and quantitative data using Meta‐Integration. Quality was assessed using the Mixed Methods Appraisal Tool. Thirty‐seven studies were identified among 33 publications. Study quality was mixed with significant methodological heterogeneity. Mental imagery in BDD is consistently reported to be vivid, emotionally intense, recurrent and important in the maintenance and potentially the onset of BDD. These findings concur with theoretical frameworks of BDD (and other related conditions) which highlight the causal role of imagery and encourage the use of imagery‐based interventions. Crucial areas for future work include stronger causal tests, unpacking mechanisms, attention to individual differences and intersectionality and exploring the potential for imagery‐based approaches for innovations in treatment and prevention across the lifespan, particularly in adolescence when BDD first develops.
- Publication status:
- Published
- Peer review status:
- Peer reviewed
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(Preview, Version of record, pdf, 2.4MB, Terms of use)
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- Publisher copy:
- 10.1002/cpp.70229
Authors
+ Medical Research Council
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- Funder identifier:
- https://ror.org/03x94j517
- Grant:
- MR/Y009460/1
- Programme:
- Medical Research Council Clinician Scientist Fellowship
+ NIHR Oxford Musculoskeletal Biomedical Research Centre
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- Funder identifier:
- https://ror.org/00aps1a34
- Publisher:
- Wiley
- Journal:
- Clinical Psychology & Psychotherapy More from this journal
- Volume:
- 33
- Issue:
- 1
- Article number:
- e70229
- Publication date:
- 2026-02-15
- Acceptance date:
- 2026-01-13
- DOI:
- EISSN:
-
1099-0879
- ISSN:
-
1063-3995
- Language:
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English
- Keywords:
- Subtype:
-
Review
- Source identifiers:
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3762565
- Deposit date:
-
2026-02-16
- ARK identifier:
Terms of use
- Copyright holder:
- Hill et al.
- Copyright date:
- 2026
- Rights statement:
- © 2026 The Author(s). Clinical Psychology & Psychotherapy published by John Wiley & Sons Ltd. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
- Notes:
- This work is related to the thesis Assessment, experience and measurement of body-focused psychological processes across clinical contexts.
- Licence:
- CC Attribution (CC BY)
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