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

BACKGROUND: 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). METHODS: The study was cross-sectional. It took part between December 2023 and January 2024 among 336 adolescents. RESULTS: 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. CONCLUSION: Findings preliminarily suggest that the relationship linking these conditions seems to be complex and bidirectional.