Mental Imagery of the Self in Body Dysmorphic Disorder: A Mixed‐Methods Systematic Review

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Main Authors: Sean Hill, Matthew Hotton, Martha Wallace, David Veale, Alex Lau‐Zhu
Format: Artículo Open Access
Published: Wiley 2026
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author Sean Hill
Matthew Hotton
Martha Wallace
David Veale
Alex Lau‐Zhu
author_facet Sean Hill
Matthew Hotton
Martha Wallace
David Veale
Alex Lau‐Zhu
Sean Hill
Matthew Hotton
Martha Wallace
David Veale
Alex Lau‐Zhu
collection Wiley Open Access
contents Mental Imagery of the Self in Body Dysmorphic Disorder: A Mixed‐Methods Systematic Review Sean Hill Matthew Hotton Martha Wallace David Veale Alex Lau‐Zhu Clinical Psychology & Psychotherapy 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. 10.1002/cpp.70229 http://creativecommons.org/licenses/by/4.0/
doi_str_mv 10.1002/cpp.70229
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id wiley_oa_10_1002_cpp_70229
institution Wiley Open Access
license_str_mv http://creativecommons.org/licenses/by/4.0/
publishDate 2026
publisher Wiley
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spellingShingle Mental Imagery of the Self in Body Dysmorphic Disorder: A Mixed‐Methods Systematic Review
Sean Hill
Matthew Hotton
Martha Wallace
David Veale
Alex Lau‐Zhu
Clinical Psychology & Psychotherapy
Mental Imagery of the Self in Body Dysmorphic Disorder: A Mixed‐Methods Systematic Review Sean Hill Matthew Hotton Martha Wallace David Veale Alex Lau‐Zhu Clinical Psychology & Psychotherapy 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. 10.1002/cpp.70229 http://creativecommons.org/licenses/by/4.0/
title Mental Imagery of the Self in Body Dysmorphic Disorder: A Mixed‐Methods Systematic Review
topic Clinical Psychology & Psychotherapy
url https://onlinelibrary.wiley.com/doi/10.1002/cpp.70229