From body image to paranoia: the role of self-evaluative processes and body-focused attention

Background Negative body image has been linked to paranoia through reduced self-esteem. Body-focused attention may further influence this relationship. This study examined whether self-esteem mediates the association between body image and paranoia and whether this indirect effect is moderated by body-focused attention.Method A total of 2,605 non-clinical Polish participants (51.6% female; mean age = 46.96) completed measures assessing body image, self-esteem, paranoia, and body-focused attention. Most participants had secondary (46.0%) or higher education (35.6%) and were employed (58.0%).Results The moderated mediation model was significant (p < .001). Body image positively predicted self-esteem, whereas body-focused attention showed a negative association. Their interaction was significant, indicating that the positive link between body image and self-esteem strengthened with higher body-focused attention. The relationship between body image and paranoia was fully mediated by self-esteem. Bootstrap analyses confirmed that the indirect effect of body image on paranoia through self-esteem was significant at all levels of body-focused attention, with a significant index of moderated mediation (95% CI [−0.0383, −0.0051]).Discussion Body image was associated with lower paranoia indirectly through higher self-esteem, and this indirect effect was stronger among individuals with greater body-focused attention. Findings highlight the interplay between self-evaluative and body-related processes in paranoia.