Appearance-related social media behavior and eating disorder pathology: evidence from the german social media appearance preoccupation scale in nonclinical and clinical samples

Abstract Background Image- and video-based social media have been linked to body dissatisfaction and eating pathology, partly through increased appearance-based social comparison and self-focused attention. The Social Media Appearance Preoccupation Scale (SMAPS) assesses three behaviors relevant in this context: Online Self-Presentation, Appearance-Related Activity, and Appearance Comparison. Higher scores on these dimensions have been linked to more intensive social media use, increased anxiety, depressive symptoms, and disordered eating. However, research has largely relied on English-speaking, non-clinical samples. The present studies therefore aimed to translate and validate a German version of the SMAPS and to compare appearance-related social media behaviors between individuals with eating disorders and healthy controls. Methods The scale was translated in a systematic translation-back-translation procedure and then examined in two cross-sectional studies. In Study 1, N = 363 young adults completed a survey with the aim of testing the factor structure of the German SMAPS and its associations with eating disorder pathology, general psychological distress, and problematic internet use. In Study 2, multivariate analysis of variance was used to compare German SMAPS scores between n = 21 outpatients with diagnosed eating disorders and n = 37 healthy controls. Results The three-factor structure of the German SMAPS showed acceptable model fit. All subscales exhibited good internal consistency (ω = 0.83-0.88). Of the three dimensions, Appearance Comparison was most strongly associated with eating disorder pathology and showed the most consistent associations with psychological distress and problematic internet use. It also significantly differentiated patients with eating disorders from healthy controls ( p = .004, η² p = 0.14, 90% CI [0.03, 0.29]). Conclusions The German SMAPS is a reliable and valid tool for assessing appearance-related social media behaviors in German-speaking populations. The findings suggest that the three dimensions may differ in clinical relevance, with appearance comparison warranting particular attention in future research.