Sensitivity to Rejection Can Be Dangerous: BPD, Rejection Sensitivity, & Eating Disorders

The episode where I propose a theory that connects BPD to one of the more widely held Impulsive Habits: Eating Disorders…. And you may have guessed it, it comes down to Rejection Sensitivity. A specific type called Appearance-based Rejection Sensitivity, in fact. The past week I’ve been talking about Rejection Sensitivity and how people with Borderline Personality Disorder have the big markers to make them more prone to being Highly Rejection Sensitive.

Sensitivity to Rejection Can Be Dangerous

By RICK NAUERT PHD Senior News Editor

Reviewed by John M. Grohol, Psy.D. on January 26, 2007

A series of new studies provide evidence that individuals who have a heightened sensitivity that they will be rejected by others because of their physical appearance, can be at risk. Three studies suggest the sensitivity, if not mitigated, can have serious implications for the individuals’ mental and physical health.

“Appearance-based Rejection Sensitivity: Implications for Mental and Physical Health, Affect, and Motivation” by Lora Park, Ph.D., is currently in press for publication in Personality and Social Psychology Bulletin.

According to the author, appearance-based rejection sensitivity is a personality-processing system characterized by anxious concerns and expectations about being rejected based on one’s physical attractiveness.

When motivation for looking attractive is rooted in anxieties about being rejected by others, the consequences can be deleterious to health and well-being. The research also suggests that there may be ways to mitigate these negative effects, by having people think of their strengths or their close relationships with others.

In the first study, Park developed and validated an appearance-based rejection sensitivity scale (ARS scale) with 242 college students, to measure the extent to which people anxiously expected rejection from others based on their physical attractiveness.

She found that those who scored high in appearance-based rejection sensitivity were likely to have low self-esteem, high levels of neuroticism, insecure attachment styles, to base their self-worth on their appearance and to rate themselves as physically unattractive.

[Sound fairly Borderline-ish to you?]

The study also showed that people who are highly sensitive to appearance-based rejection reported increased symptoms of disordered eating.

[Intro the Eating Disorders]

“Both men and women who reported being sensitive to appearance-based rejection were preoccupied with their body and weight in unhealthy ways. They avoided eating when they were hungry, exercised compulsively and engaged in binging and purging,” says Park.

People with high appearance-based rejection sensitivity also were more likely than people low in appearance-based rejection sensitivity to compare their physical attractiveness with others and to feel bad about themselves when making such comparisons. These results were found regardless of the subjects’ levels of self-esteem, attachment style, general sensitivity to rejection, neuroticism, self-rated level of attractiveness and the degree to which they based self-worth on appearance.

Interestingly, Park found that both appearance-based rejection sensitivity and basing self-worth on appearance independently predicted eating disorder symptoms and the tendency to make appearance-based comparisons.

“These findings suggest different pathways through which people may develop and maintain behaviors such as excessive dieting, compulsive exercising, binging and purging, and comparing one’s attractiveness with others” Park says.

“Some people engage in such behaviors because they are ultimately worried about being rejected by others if they don’t measure up to looking a certain way,” says Park.

“For others,” she says, “the underlying motivation for such behaviors may be less about interpersonal anxieties and more about maintaining and enhancing personal self-esteem.”

In the second study, Park found that people with high levels of appearance-based rejection sensitivity reported feeling more alone and rejected when asked to list negative aspects of their appearance than when asked to think of a neutral topic (listing objects they saw in a room). On the other hand, subjects with low levels of appearance-based rejection sensitivity were not negatively affected when listing aspects of their appearance with which they were dissatisfied.

“Simply having people list what they didn’t like about their appearance, whether it was their weight, their height, having acne or some other facial or body feature, was sufficient for people high in appearance-based rejection sensitivity to feel lonely, rejected, unwanted and isolated,” says Park.

[All things in my Borderline experience, how about you?]

If appearance-based rejection leads to negative outcomes, are there ways to attenuate these effects? Park conducted a third study to examine this possibility.

In the third study, all participants first were asked to write an essay about a negative aspect of their appearance.

Next, they were randomly assigned to one of three intervention conditions: a Self-Affirmation Condition, in which they listed their greatest personal strength; a Secure Attachment Prime Condition, in which they listed the initials of a close, caring relationship partner; or a Neutral Condition, in which they listed an object they saw in the room.

Results showed that those who were sensitive to appearance-based rejection experienced lower self-esteem and more negative mood, but only when asked to think of an object in the room.

“Being reminded of an object in the room did nothing to improve people’s self-esteem or mood following the appearance threat,” Park says.

“However, a reminder of one’s strengths or close relationships was enough to reduce the damaging effects of thinking about negative aspects of one’s appearance,” explains Park.

“These findings,” she says, “emphasize the power of self-affirmation and of having close relationships in helping people cope with insecurities regarding their appearance.”

Source: University of Buffalo

My own extended hypothesis:

If you have difficulty maintaining close affirming relationships and are even more prone to being highly sensitive to rejection, as is seen in BPD, it can create the condition where these impulsive and compulsive habits used to control and develop body image approval, can become ingrained, lifelong dysfunctional problems.

For me, this could explain why one concerned conversation from my parents, triggered a life time of eating disorders which I still struggle with, compulsive exercising, and self-loathing when I consider my body and appearance. Of course this isn’t the only reason why eating disorders develop. There are many hypothesis including a need for control, attempting to fill an emotional void, etc. Personally I think this is an eloquent connection to explain one potential cause.

It also demonstrates just how pervasive a problem that being highly sensitive can be. My example: When I was 12/13 my parents noticed my body changing (thank you puberty) and how of what I’m sure they thought was a standard concern for my health they approached me privately and in a way I’m sure they thought was sensitive and caring. Me? I was heartbroken. I was devastated. I began an almost 20 hear nose dive into bulimia. Every eye, every comment, every compliment has been suspect to my mind and feels like a judgment, and not merely what they are; human interaction. Don’t get me wrong, some things have been quite malicious. Evil-Ex used to play off of my body sensitivity. A few of his comments still stick with me to this day and make me self-conscious. They don’t stop me, but I have the awareness of them in situations where they’re relevant. My poor body image has had an enormous impact on my life. At times it’s completely incapacitated my ability to function socially. The mere thought of going out in public would reduce me to a puddle of panic attacks and hyperventilation. I don’t blame my parents for this. I know they meant well.

The effects of something so seemingly meaningless, delivered in a careful way, can have a massive impact. It’s not maliciously intended, but the perception and reception… how it affects the person receiving that information, is vast. I think this could be very meaningful for our loved ones to keep in mind when, and meaningful for us to keep in mind when we interact.

For them: That our hypersensitivity is an issue, and that what we are reacting to, could be different than what they intended or assume.

For us: That what we perceive may not be what was meant.  

Something to consider anyways.