Association of Body Dysmorphia with Anxiety Among Female Youths with Immigrant Backgrounds: Exploring the Moderating Effect of Excessive Smartphone Use

Background/purpose: Adolescence is a period characterized by significant physical and psychological changes, including an increased focus on body image. Societal norms that favor a thin body can negatively influence adolescents’ self-perception of their bodies, potentially leading to body dysmorphia (BD). This, in turn, can intensify anxiety (AX). This study investigates these dynamics among female youths with immigrant backgrounds, who are more vulnerable to negative body image due to unique challenges associated with skin colors, appearances, and body shapes. These challenges can lead to negative social interactions that exacerbate BD. Furthermore, excessive smartphone use (SU) is hypothesized to have a moderating effect, possibly intensifying exposure to slim body biases and thus influencing the severity of BD and its impact on AX. Therefore, this study aims to explore how SU moderates the relationship between BD and AX in this demographic.

Methods: This study utilized data from 858 female youths with immigrant backgrounds from the 19^th Korea Youth Risk Behavior Web-based Survey. Frequency and descriptive analyses were performed to identify the study participants’ demographics. Correlation coefficients between major variables were examined. Lastly, linear regression analysis (LRA) explored the relationship between BD and AX, considering the moderating effect of SU while controlling socio-demographic factors. AX and SU were measured using a 4-point Likert scale, consisting of 7 items for AX (Cronbach α=.92) and 10 for SU (Cronbach α=.89). BD variable was generated with a single question regarding subjective body image (‘1=very thin’ to ‘5=very overweight’) and body mass index (BMI). Individuals with a BMI between the 5th and 85th percentile who perceive themselves as being overweight to very overweight, as well as those with a BMI below the 5th percentile who perceive themselves as average to very overweight, were considered to have BD, coded as ‘1=experiencing BD’ and ‘0=not experiencing BD’.

Results: BD was positively correlated with both AX (r=.10, p=.00) and SU (r=.07, p=.04), while SU also showed a positive correlation with AX (r=.34, p<.001). LRA model without an interaction term of BD and SU was significant (F=23.80, p<.001) with 14% explanatory power. Both SU (β=.34, p<.001) and BD (β=.07, p=.03) were significantly associated with AX. With the interaction term, the model remained significant (F=20.38, p<.001), maintaining the same explanatory power. However, the interaction term itself was not significant.

Conclusions/Implications: The findings of this study are significant as they illuminate the relationship between BD, SU, and AX among a unique and underrepresented group—female youths with immigrant backgrounds. Although the interaction term between BD and SU with AX was not significant, identifying BD and SU as crucial factors provides essential insight for designing mental health interventions. Given the profound impact of BD, especially among those with visible differences, this research underscores the urgent need for measures tailored to support this demographic’s mental health. Lastly, the results can be applied to many countries experiencing an expansion of migration and an increase in immigrant youth populations. Based on these findings, countries can develop programs to support the mental health of these young people.