Safety Behavior Fading Versus Progressive Muscle Relaxation for Appearance Concerns

Individuals randomly assigned to the safety behavior fading condition will receive instructions to decrease or eliminate their endorsed appearance-related safety behaviors. In addition, they will receive daily reminders via text message to decrease these behaviors, along with a safety behavior monitoring checklist in which the participant indicates the extent to which they engaged in each safety behavior over the previous day.

Participants are asked to reduce or eliminate safety behaviors via text message reminders and checklists to monitor progress.

• ARSB Fading

Participants in this condition will be instructed to try and practice progressive muscle relaxation daily for 28 days. To match safety behavior fading they will also receive daily text messages to remind them to practice relaxation and they can log which of the 10 different muscle groups they tensed and released in the past day.

Participants are asked to practice relaxation daily via text message reminder and checklists to monitor progress.

Self-report scale that measures appearance anxiety symptoms. Scores range from 16 to 80 with higher scores indicating higher levels of appearance concerns.

Self-report scale used to measure frequency of engaging in appearance-related safety behaviors. This scale will be used as a manipulation check. Each item is rated on a 0 to 10 scale. Total scores range from 0 to 130 with higher scores indicating greater engagement in appearance-related safety behaviors

Self-report scale that measures of body dysmorphic symptoms. Scores range from 0 to 40 with higher scores indicating higher levels of body dysmorphic symptoms.

Self-report scale that measures social anxiety symptoms. Scores range from 0 to 68 with higher scores indicating higher levels of social anxiety.

Self-report scale that measures eating disorder symptoms. Scores range from 0 to 90 with higher scores indicating higher levels of eating pathology.

Self-report scale for measuring body dissatisfaction for use in clinical outcome studies. Each item is rated on a 0-5 scale with a total score range of 9-54 with higher scores indicating greater drive for thinness, bulimia, and body dissatisfaction.

Self-report scale for measuring treatment expectancy and rationale credibility for use in clinical outcome studies. Three items are rated on a 0-10 scale and one item is rated on a 0-100 scale with higher scores meaning greater expectancy and credibility.

Self-report measure of depression symptom severity. Each item is rated on a 0 to 3 scale. Total scores range from 0 to 30 with higher scores indicating greater depression severity.

Self-report measure of anxiety symptom severity. Each item is rated on a 0 to 3 scale. Total scores range from 0 to 28 with higher scores indicating greater anxiety severity.

Computerized forced-choice task measuring appearance importance relative to other favorable characteristics. The APT randomly presents a series of 33 word pairs and asks the participant to select the concept that is more important to them. Each pair consists of a positive appearance-related adjective and a positive character trait unrelated to appearance (e.g., beautiful-responsible). Higher scores indicate greater endorsement of appearance words.

Single-item self-report scale that the extent to which individuals engage with their social support networks. This question asks: "what percentage of your time awake did you spend interacting with others this past week (0% =No time at all, 100% =all of the time)?"

Self-report scale that measures cognitions related to body dysmorphic disorder. Scores range from 0 to 190 with higher scores indicating higher levels of maladaptive cognitions related to body dysmorphic disorder.