# Role of Attention Bias as a Moderator and Mediator in the Bi‐Directional Association Between Body Dysmorphic Concerns and Psychotic Experiences Among Adolescents

## TL;DR

This study explores how attention bias influences the relationship between body dysmorphic concerns and psychotic experiences in adolescents.

## Contribution

The study identifies attention bias as both a moderator and mediator in the bidirectional link between body dysmorphic disorder and psychotic experiences.

## Key findings

- Attention bias partially mediates the association between psychotic experiences and body dysmorphic disorder symptoms.
- Attention bias also moderates the relationship, with higher levels intensifying the link between psychotic experiences and body dysmorphic symptoms.

## Abstract

The link between body dysmorphic disorder (BDD) and psychosis remains under‐researched and the mechanisms behind it are still unknown and poorly understood. This study aimed to test the hypothesis that attentional bias moderates and mediates the positive bi‐directional association between BDD and psychotic experiences (PEs).

The study was cross‐sectional. It took part between December 2023 and January 2024 among 336 adolescents.

Attention bias partially mediated the association between PEs and BDD symptoms (indirect effect: Beta = 0.07; Boot SE = 0.02; Boot CI 0.03; 0.13), as well as between BDD symptoms and PEs (indirect effect: Beta = 0.05; Boot SE = 0.02; Boot CI 0.02; 0.09). Moreover, attention bias moderated the association between PEs and BDD symptoms (Beta = 0.02; p = 0.006). At moderate (Beta = 0.31; p < 0.001) and high (Beta = 0.47; p < 0.001) levels of attention bias, higher PEs were associated with greater BDD symptoms.

Findings preliminarily suggest that the relationship linking these conditions seems to be complex and bidirectional.