Body Dysmorphic Disorder Examination-Self Report Research Articles

Exercise Adherence and Body Dysmorphic Disorder: Chain Mediating Effect of Appearance-Based Rejection Sensitivity and Social Anxiety

We explored the relationship between exercise adherence and body dysmorphic disorder with a convenience sample of 964 Chinese college students. Participants completed the Scale of Exercise Adherence, the Fear of Negative Evaluation Scale, the Appearance-Based Rejection Sensitivity Scale, and the Body Dysmorphic Disorder Examination Self-Report Scale. Exercise adherence was negatively correlated with body dysmorphic disorder. Appearance-based rejection sensitivity and social anxiety had both independent and chain mediating effects on the relationship between exercise adherence and body dysmorphic disorder. The results have revealed the mechanism of the relationship between exercise adherence and body dysmorphic disorder, and they provide a preliminary basis for studying the causal relationship of these variables. Our findings also provide a theoretical basis for the intervention and treatment of body dysmorphic disorder.

Body Dysmorphic Disorder, Psychiatric Symptoms, and Quality of Life in Female Dermatological Patients.

PurposeTo examine the relationships of body dysmorphic disorder (BDD) with psychiatric symptoms and quality of life in dermatological patients.Patients and MethodsA total of 154 female patients with dermatological disease underwent a comprehensive clinical assessment that included the Body Dysmorphic Disorder Examination-Self Report (BDDE-SR), Symptom Checklist 90-Revised (SCL-90-R), and Skindex-29. Dermatological disease was categorized as follows: inflammatory dermatoses (reference category), isolated lesions, and unclassified dermatoses. The BDDE-SR and SCL-90-R scores were used to evaluate BDD and psychiatric symptoms, respectively. Dermatological quality of life was measured with the Skindex-29.ResultsThe BDDE-SR score was significantly associated with the SCL-90-R and Skindex-29 total and subscores, even after controlling for age, body mass index, and dermatological diagnosis. The variables that contributed most to the BDDE-SR score were the SCL-90-R depression score and Skindex-29 emotion scores. Additional analyses revealed that the BDDE-SR score was higher in participants with unclassified dermatoses, but neither the SCL-90-R score nor Skindex-29 score was related to any dermatological diagnosis.ConclusionThe BDD symptoms were especially prominent in the unclassified dermatoses group and were highly related to psychiatric symptoms and a poor quality of life in our dermatological patients. Further research including studies involving psychiatric interviews to confirm the BDD diagnosis and symptoms will improve our understanding of BDD in dermatological patients.

Validation of Spanish Language Evaluation Instruments for Body Dysmorphic Disorder and the Dysmorphic Concern Construct.

Dysmorphic concern (DC) refers to excessive preoccupation with a slight or imagined defect in physical appearance with social avoidance and behavior directed at controlling the defect in appearance. This study attempted to adapt the factor structure of two instruments that cover the DC construct, the Dysmorphic Concern Questionnaire (DCQ) and the Body Dysmorphic Disorder Examination Self-Report (BDDE-SR), to Spanish and establish their psychometric properties. A total of 920 subjects (62.7% women, Mage = 32.44 years) participated. Exploratory and Confirmatory Factor Analysis of both scales found adequate goodness of fit indices. A one-dimensional structure was found for the DCQ and two first-order factors (dissatisfaction/preoccupation with body image (BI) and BI avoidance behavior) were identified for the BDDE-SR. The psychometric test–retest reliability and validity properties (content, convergent, and discriminant) were satisfactory. It is suggested that the DC construct includes both cognitive and behavioral aspects and may represent a continuum of severity with Body Dysmorphic Disorder at the end.

Evaluation of Relationship Between Body Dysmorphic Disorder and Self-Esteem in Rhinoplasty Candidates.

To investigate the relationship between body dysmorphic syndrome and self-esteem in rhinoplasty candidates. A negative statistical correlation was evident between Rosenberg Self-Esteem Scale (RSES) and Body Dysmorphic Disorder Examination-Self Report (BDDE-SR) scores. In terms of responses to the first Body Dysmorphic Disorder Questionnaire (BDDQ) question, which focuses on general attitude toward body dysmorphic syndrome, the average RSES "YES" score was significantly less than the "NO" score. No significant differences appeared between RSES scores and scores for the 4th subgroup of BDDQ questions (subgroups A, B, and C; these questions explore how much time is spent daily on maintenance of bodily appearance). However, significant differences appeared between scores for the 4th subgroup of BDDQ questions and BDDE-SR scores. The average BDD-SR score of subgroup A (less than 1 hour spent on bodily maintenance) was significantly lower than those of group B (1-3 hours) and group C (more than 3 hours). However, no significant differences appeared in average BDD-SR scores between subgroups B and C. In this prospective study, 56 patients (31 females and 25 males) were evaluated preoperatively using the BDDQ, the BDDE-SR, and the RSES. Patients younger than 15 years and those with deformities caused by trauma were excluded. Rhinoplasty candidates had higher levels of body dysmorphic disorder (BDD). Although patients with low RSES scores were more likely to have BDD, rhinoplasty candidates were not notably deficient in self-esteem. However, in rhinoplasty candidates with low RSES scores, the frequency of BDD was elevated. Therefore, the authors suggest that rhinoplasty candidates with low RSES scores should be investigated carefully in terms of BDD.

Physiological and Psychological Changes Following Liposuction of Large Volumes of Fat in Overweight and Obese Women.

BackgroundLiposuction can remove a substantial amount of body fat. We investigated the effects of liposuction of large volumes of fat on anthropometrics, body composition (BIA), metabolic hormones, and psychological measures in overweight/obese women. To our knowledge, this is the first study to examine both physiological and psychological changes following liposuction of large volumes of fat in humans.MethodNine premenopausal healthy overweight/obese women (age = 35.9 ± 7.1 SD, weight = 84.4 kg ± 13.6, BMI = 29.9 kg/m2 ± 2.9) underwent liposuction, removing 3.92 kg ± 1.04 SD of fat. Following an overnight fast, height, weight, waist, and hip circumferences were measured at baseline (one week pre-surgery) and post-surgery (wk 1,4,12). Blood samples were drawn for fasting concentrations of glucose, insulin, leptin, and ghrelin. The Body Shape Questionnaire (BSQ), Body Dysmorphic Disorder (BDD) Examination Self-Report (BDDE-SR), and Zung Self-Rating Depression Scale (ZDS) were administered.ResultsBody weight, BMI, waist circumference, and body fat consistently decreased over time (p < .05). Glucose did not change significantly, but insulin decreased from wk 1 to wk 12 (p < .05). Leptin decreased from baseline to wk 1 (p = .01); ghrelin increased but not significantly. Changes in body fat and waist circumference (baseline to wk 1) correlated positively with changes in insulin during that period, and correlated inversely with changes in ghrelin (p < .05). BSQ scores decreased significantly over time (p = .004), but scores for BDDE-SR (p = .10) and ZDS (p = .24) did not change significantly.ConclusionLiposuction led to significant decreases in body weight and fat, waist circumference, and leptin levels. Changes in body fat and waist circumference correlated with concurrent changes in the adipose-related hormones, insulin and ghrelin (baseline to wk 1), and body shape perception improved. Thus, besides the obvious cosmetic effects, liposuction led to several positive body composition, hormonal, and psychological changes.

No Effect on Body Dissatisfaction of an Interaction between 5-HTTLPR Genotype and Neuroticism in a Young Adult Korean Population.

ObjectiveMany studies suggest an association between the serotonin transporter gene-linked polymorphic region (5-HTTLPR) and anxiety-related personality traits (e.g., neuroticism) in healthy subjects. This study investigated the interaction of 5-HTTLPR genotype on body dissatisfaction by neuroticism and to evaluate the interaction of 5-HTTLPR genotype on self-esteem by body dissatisfaction in a young adult Korean population.MethodsTwo hundred and eighty three subjects were included in this study. The Eysenck Personality Questionnaire-Korean version was used to evaluate neuroticism, the Body Dysmorphic Disorder Examination-Self Report (BDDE-SR)-Korean version was used to evaluate body dissatisfaction, and the Self-Esteem Scale (SES)-Korean version was used to evaluate self-esteem. The 5-HTTLPR genotype by neuroticism (high : low) interaction was assessed according to the total BDDE-SR score, and 5-HTTLPR genotype by BDDE-SR (high : low) interaction was assessed according to the total SES score.ResultsThe analysis of 5-HTTLPR genotype and neuroticism (high : low) with respect to body dissatisfaction showed no main effects of genotype whereas neuroticism did influence the BDDE-SR score and no interaction of the genotype with neuroticism. The analysis of 5-HTTLPR genotype and BDDE-SR (high : low) with respect to self-esteem score showed no main effects of genotype whereas BDDE-SR did influence the self-esteem score and no interaction of the genotype with body dissatisfaction.ConclusionThese results suggest that an interaction between 5-HTTPLR genotype and neuroticism does not affect body dissatisfaction and an interaction between 5-HTTPLR genotype and body dissatisfaction does not affect self-esteem in a young adult Korean population.

Quality of life after severe hand injury

This study explores the quality of life in 118 patients following severe and major hand injury with a Hand Injury Severity Score >50. Each patient answered five different validated outcome measures (DASH (Disability of the Arm, Shoulder, and Hand), FLZ(M) ('Fragen zur Lebenszufriedenheit'), HADS (Hospital Anxiety and Depression Score), BDDE-SR (Body Dysmorphic Disorder Examination-Self Report) and FBeK ('Fragebogen zur Beurteilung des eigenen Körpers'), which were incorporated into a single questionnaire. Each of these questionnaires covered one or more of the established quality-of-life domains. Patients with pain and pressure sensations were significantly less satisfied in life, showed lower levels of health satisfaction, had higher levels of anxiety and depression and showed higher body dysmorphic disorder levels (all p < 0.001). General life satisfaction in this hand-injury study group is highly dependent on the patients` satisfaction with their health and appearance as well as self-confidence. The quality-of-life outcomes improve with time, and despite evidence of continued impairment in the injured hand, the majority of patients had a normal quality of life.

The relationship of hypercompetitiveness and gender roles with body dysmorphic disorder symptoms in a nonclinical sample

This study examined whether hypercompetitiveness was a moderator between body dysmorphic disorder (BDD) symptoms and gender roles in 345 college students. To test this, the Body Dysmorphic Disorder Examination-Self Report (BDDE-SR), the Hypercompetitive Attitude Scale, and the Personal Attributes Questionnaire (PAQ) were used. Significant positive correlations were found between BDD symptoms and hypercompetitiveness in men and women. For men and women, no significant correlation was found between female-valued items on the PAQ and the BDDE-SR. A statistically significant negative correlation was found between male-valued items on the PAQ and the BDDE-SR for both genders. Hypercompetitiveness, however, was found not to be a moderator between BDD symptoms and gender roles.

Improvement of physical and psychological symptoms after breast reduction

This study suggests that women who underwent breast reduction showed a significant improvement in both physical and psychological symptoms associated with macromastia and in their overall quality of life, 12 months postoperatively. Comparing pre- with postoperative scores obtained with the Body Dysmorphic Disorder Examination Self-Report (BDDE-SR23), the Short Form-36 Health Survey and the Symptom Inventory Questionnaire, the study objectively proves that breast reduction increases patient's satisfaction with their body image and improves their lives from both a psychological and relational point of view.

Exercise and body image distress in overweight and obese women with polycystic ovary syndrome: A pilot investigation

Objective. The objectives of the present pilot study were to: (1) examine the prevalence of body image distress in overweight and obese women with polycystic ovary syndrome (PCOS); (2) assess the effects of a low-cost intervention in the form of a self-directed brisk walking program on body image distress; and (3) assess the level of participation, the feasibility of a larger study and the sample size required.Methods. This was an observational study whereby volunteers acted as their own control. Thirty-five women with PCOS (mean age 29.26 ± 7.57 years) with body mass index (BMI) > 25 kg/m2 volunteered for the study. Twenty-three returned six months later for reassessment. Of these, 12 completed the exercise program (completers) and 11 did not (non-completers). Pre and post assessments comprised the exercise tolerance test, the Body Dysmorphic Disorder Examination – Self-Report (BDDE-SR), a questionnaire on self-perceived hirsutism and dietary and activity records.Results. Distress with body size was highly prevalent for the overall sample. However, completers had significantly higher BDDE-SR scores at baseline compared with non-completers (p < 0.005). Pre and post assessments showed a significant reduction in body image distress only for completers (p < 0.01) despite no significant change in BMI.Conclusions. A self-directed walking program is a low-cost intervention that can have psychological benefits for overweight women with PCOS. Specific recommendations for a randomized study are put forward.

Body image dissatisfaction and body dysmorphic disorder in 100 cosmetic surgery patients.

This study was the first empirical investigation of body image dissatisfaction and body dysmorphic disorder in cosmetic surgery patients. Of 132 women, 100 women (response rate, 76 percent) completed two body image measures prior to surgery, the Multidimensional Body-Self Relations Questionnaire and the Body Dysmorphic Disorder Examination Self-Report. Cosmetic surgery patients did not demonstrate greater dissatisfaction with their overall appearance compared with the reported normal values of the measures. However, when asked about the specific bodily feature they were considering for cosmetic surgery, they reported significantly greater dissatisfaction than a normative sample. In addition, 7 percent of the sample met diagnostic criteria for body dysmorphic disorder, a potential psychiatric contraindication to cosmetic surgery. Implications of these findings are discussed with respect to the nature of body image dissatisfaction and the prevalence of body dysmorphic disorder in cosmetic surgery populations.