Impact of Helping Behaviors on the Course of Substance-Use Disorders in Individuals With Body Dysmorphic Disorder*

Abstract

Alcoholics Anonymous and 12-step facilitated treatments for substance-use disorders (SUDs) encourage individuals with SUD to consider the needs of others and engage in helping behaviors as a method to become sober. SUDs are one of the most common comorbid disorders among individuals with body dysmorphic disorder (BDD). The purpose of this study is to examine prospectively the relationship between helping behaviors and the likelihood of SUD and BDD remission. Data on 163 individuals during the course of 3 years were derived from the Prospective Study of Body Dysmorphic Disorder, a longitudinal investigation of patterns and predictors of the course of BDD. Kaplan-Meier survival estimates were used to calculate probabilities of time to BDD and SUD remission. Cox regression analyses were conducted to calculate the relative likelihood of levels of helping behaviors as time-varying predictors of remission from both SUD and BDD. The course of SUD and BDD was chronic for most subjects; the estimated probability of remission from an SUD across 3 years was .29 and .17 for a full BDD remission. Results indicated that increases in helping behaviors were significantly predictive of SUD remission (hazard ratio [HR] = 2.59, p = .0134). Helping behaviors were also predictive of BDD remission among those with or without SUD but at a trend level of significance (HR = 1.51, p = .0676). These findings extend previous work reporting significant relationships between helping behaviors and positive long-term SUD outcomes. Implications of the mechanisms involved in the link between helping behaviors and remission from SUD and BDD are discussed.