Body Dysmorphic Symptoms Research Articles

To Explore the Relationship Between Childhood Trauma and Body Dysmorphic Symptoms in Young Adulthood

Abstract: This study is intended to investigate the connection between the child trauma and body dysmorphic disorders as experienced by the youth in 18-25-year-old age-group. Although the research yielded r=0.271 pval < 0.001 for the relationship between childhood trauma and body distortion symptoms, the findings also indicate a non-significant p value of 0.551 which shows the two variables do not have a causal link among this sample. It appears that the cildhood trauma does not have a direct effect on the geness of body dysmorphic symptoms among teenagers. Research into the complex interaction between the developmental period of childhood and the emergence of body dysmorphic symptoms is still necessary, and additionally, one should consider the factors that could affect this engagement positively. Moreover, the range of interventions that addresses body dysmorphic symptoms should move beyond the usual settings to get at the core of the real factors to successfully help the affected individuals.

Enhancing self-esteem in adults with body dysmorphic symptoms: experimental testing and initial evaluation of a brief internet-based training.

Low self-esteem is an important factor associated with body dysmorphic concerns. In treatment, self-esteem cannot always be adequately addressed. Internet-based interventions offer a low-threshold and cost-efficient possibility for treating body dysmorphic disorder (BDD). For this reason, we conducted two studies to explore the effectiveness of an internet-based intervention targeting improving self-esteem in adults with BDD symptoms. The first study investigated the differential effects of a 1-week self-esteem training compared with a 1-week attention-focus training. Two hundred twenty adults with elevated body dysmorphic symptoms were randomly assigned to one of the two trainings. Our second study (n = 58 adults with body dysmorphic symptoms) evaluated an extended 2-week stand-alone self-esteem training. In the first study, self-esteem in different domains (appearance, performance and social), self-focused attention, and BDD symptom severity improved in both groups. Other-focused attention only increased in the attention training group. Participants' overall adherence was high. In the second study we observed significant improvements in self-esteem, BDD symptom severity, and other secondary outcomes, with additional improvements in most outcomes in the second week. Adherence was again high. Together, these findings show that a brief internet-based intervention may be a highly accepted and effective way of improving self-esteem in people suffering from BDD symptoms.

Prevalence and Severity of Social Anxiety Symptoms and Their Relationship With Body Dysmorphic Symptoms.

Background Social anxiety disorder (SAD) is a subtype of anxiety characterized by avoidance, fear, and physical symptoms such as dry mouth, sweating, palpitations, and blushing. SAD is one of the most common mental disorders. Body dysmorphic disorder (BDD) is a mental disorder marked by a distressing or impairing preoccupation with imagined or minor flaws in one's physical appearance. Both disorders share similar symptoms. No satisfactory data have been provided about the prevalence of social anxiety symptoms in our region. In our study, we measured the prevalence and severity of SAD symptoms among adults in Riyadh City, as well as the sociodemographic factors associated with it. Additionally, the correlation between SAD and BDD was assessed. Methods Our study is quantitative, observational, and cross-sectional. It was conducted by administering a translated Arabic version of the Severity Measure for Social Anxiety Disorder scale and BDD scales in five locations in Riyadh, which include two general hospitals and three shopping malls. Data were analyzed using the SPSS version 22 (IBM Corp., Armonk, NY, USA). Descriptive statistical data are presented through mean values, standard deviations, and percentages. Results A total of 752 responses were received, of which 509 (68.32%) were from females with a mean age of 30.12 years. The majority of the sample had a low to middle family income, with 64% earning less than $2555 monthly. The sample possessed a good educational level; 63% had a bachelor's degree or higher. Our study also shows that 233 subjects (30.98%) had scores indicating a moderate to severe form of SAD. Among these participants, 86 (36.9%) had scores indicating a moderate to severe form of BDD. There was a significant positive correlation between SAD and BDD (r = 0.496). Conclusion The prevalence of SAD was 30.98%, which is higher compared to Western countries. Low income, education, and female gender have roles in the disease condition. Moreover, there was a linear relationship between SAD and BDD.

The roles of appearance-based rejection sensitivity and race-based rejection sensitivity in Body Dysmorphic Symptoms

ABSTRACT Rejection sensitivity (RS) is linked to Body Dysmorphic Disorder (BDD), possibly explaining the connection between past trauma and BDD symptoms (BDS). Most literature excludes the effects of specific forms of RS on BDS, and focuses on Western contexts. This study investigates appearance-based RS (RS-appearance) and race-based RS (RS-race) with relation to BDS in 267 Singaporean university students . RS-race was novelly investigated in its relationship with BDS. Indian and Malay minorities reported higher RS-race than Chinese participants. Both RS-appearance and RS-race were positively associated with BDS. RS-appearance predicted BDS when controlling for depressive symptoms, ethnicity, and RS-race. RS-race also predicted BDS when controlling for depressive symptoms, ethnicity, gender, and RS-appearance. These findings highlight potential roles of RS in BDD development.

The Effectiveness of Cognitive Behavioral Therapy on Rumination, and Quality of Life among Girls with Body Dysmorphic Symptoms

The Effectiveness of Cognitive Behavioral Therapy on Rumination, and Quality of Life among Girls with Body Dysmorphic Symptoms

The association between social media use and body dysmorphic symptoms in young people.

Social media use (SMU) is highly prevalent amongst young people and previous research suggests an association with mental health problems, including poor body image. However, the potential relationship between SMU and body dysmorphic disorder (BDD) has received little attention. Furthermore, little is known about the factors that moderate the potential association between SMU and body dysmorphic symptoms. The current study tested the associations between three facets of SMU and body dysmorphic symptoms and explored perfectionism as a moderator in a non-clinical sample. Two-hundred and nine 16-18-year-olds (mean age = 16.5 years, 37% male) recruited from schools in London completed an online survey measuring aspects of SMU, including: frequency of image-and text-based SMU; motivations for SMU (appearance, popularity, connection or values and interests); and active and passive SMU. Participants additionally completed validated measures of body dysmorphic symptoms, perfectionism, and anxiety/depressive symptoms. Linear regression models tested the association of body dysmorphic symptoms with different facets of SMU, with and without adjustment for age, sex and anxiety/depressive symptoms. Frequency of use of image-based, but not text-based, platforms was significantly and positively associated with body dysmorphic symptoms, and this association remained significant in the adjusted models. Appearance-based motivation for SMU was the only motivator uniquely associated with body dysmorphic symptoms across the unadjusted and adjusted models. Passive, not active, SMU was associated with body dysmorphic symptoms in unadjusted models, but this association became non-significant in the adjusted models. Self-oriented perfectionism moderated the association between frequency of image-based SMU and body dysmorphic symptoms. Image-based SMU, and appearance-based motivations for SMU, are positively associated with body dysmorphic symptoms. Self-oriented perfectionism may amplify the relationship between SMU and body dysmorphic symptoms. Our findings highlight the importance of a nuanced approach to examining SMU, and the need for further research to determine whether specific facets of SMU contribute to the development and/or maintenance of body dysmorphic symptoms.

Appearance-related concerns in individuals with pathological skin picking-a comparison with individuals with dermatological conditions and skin-healthy controls.

Pathological skin picking (PSP) is an excessive behavior which characterizes Skin Picking Disorder. Individuals repeatedly pick their skin and cause skin lesions, but are unable to control the behavior, which can cause severe distress. Visible self-inflicted skin lesions can additionally affect individuals with PSP due to emerging appearance-related concerns. However, these concerns and their role in PSP have hardly been studied, especially not in comparison with individuals with dermatological conditions and skin-healthy controls. The present cross-sectional study (n = 453, 83.9% female, 15.9% male, 0.2% diverse) aimed at analyzing appearance-related concerns and mental health outcomes between four groups: Individuals with PSP and dermatological conditions (SP/DC; n = 83), PSP without dermatological conditions (SP; n = 56), dermatological conditions without PSP (DC; n = 176) and skin-healthy controls (SH, n = 138). We compared questionnaire data on dysmorphic concerns, appearance-based rejection sensitivity, and body dysmorphic symptoms, as well as PSP-symptoms and mental health outcomes (depression, anxiety, and self-esteem) between groups. The analyses showed a significant multivariate group effect in the appearance-related variables, F(6, 896) = 19.92, Wilks' Λ = 0.78, p < 0.001, and mental health outcomes, F(6, 896) = 16.24, Wilks' Λ = 0.81, p < 0.001. The SP/DC group had the strongest appearance-related concerns and mental health impairments, followed by the SP group, the DC group and the SH group. The SP/DC group and SP group only differed significantly with regard to dysmorphic concerns, but not in other variables. The DC group was less affected but still showed higher dysmorphic concerns and mental health impairments than skin-healthy controls. In contrast to the PSP groups, the other two groups did not exceed clinically relevant cut-off scores. The present study shows that individuals with PSP exhibit strong appearance-related concerns, regardless of the presence or absence of underlying or comorbid dermatological conditions. These findings shed new light on the importance of appearance-related concerns in Skin Picking Disorder and the role of PSP as a potentially overlooked risk factor in dermatological patients. Therefore, appearance-related concerns should be explicitly addressed in dermatological and psychotherapeutic settings. Future studies should also include longitudinal and experimental analyses to more clearly classify the role of appearance-related concerns in the etiology of PSP and Skin Picking Disorder.

Body Dysmorphia and Selfie Behavior of Filipino Patients With and Without Mild Acne Vulgaris: A Descriptive Cross-Sectional Study

Background: Acne vulgaris (AV) is a chronic inflammatory skin condition that is non-life-threatening but may cause significant psychological morbidity regardless of severity. An extreme case of this is depicted in body dysmorphic disorder (BDD), which is often an undiagnosed condition presenting with excessive preoccupation of perceived flaws not observable by others. With the increasing popularity of social media throughout the years, there has been budding researches exploring its psychological implications, particularly on “selfies” and its possible association with self-image and body dysmorphia. Objectives: To compare body dysmorphic symptoms and selfie behavior between patients with mild AV versus those without AV. Methods This is a single-center, cross-sectional study among patients with mild AV and those without AV seen through a teledermatology platform of a tertiary hospital from April to June 2022. Results: A total of 207 patients were included in this study – 107 patients with mild AV and 100 patients without AV. A significantly higher proportion of BDD symptoms was seen in patients with mild AV using either Body Dysmorphic Disorder Questionnaire-Dermatology Version (BDDQ-DV) (31%) and Dysmorphic Concern Questionnaire (DCQ) (14%). No significant difference was noted in terms of selfie behavior between the groups. Conclusions: BDD symptoms were significantly more prevalent in patients who have mild AV despite having lesions that are negligible and clinically not apparent. This highlights the importance of dermatologists’ knowledge that BDD may cause distress and impairment and should be taken into consideration in terms of management. Interestingly, selfie behavior of patients with mild AV and without AV had no significant difference. Key words: Body dysmorphia, acne vulgaris, social media, selfie behavior, cross-sectional

Interpersonal Attachment Styles and Body Dysmorphic Symptoms in Adolescent Girls: The Mediating Role of Body Image.

Body dysmorphic symptoms are one of the most common problems in adolescent girls. The experience of security or insecurity in childhood attachment can be one of the most important fundamental factors affecting the body image and, consequently, body dysmorphic symptoms. However, the mediator role of the body image in the relationship between body dysmorphic and interpersonal attachment styles has not been studied in previous researches. Therefore, the purpose of this study was to investigate the mediating role of body image in the relationship between interpersonal attachment styles and body dysmorphic symptoms. In a cross-sectional research, 250 adolescent girls from Baqer al-Uloom School in Tabriz, were selected by convenient sampling method. Then, The Multidimensional Body-Self Relations Questionnaire-Appearance Scales (MBSRQ-AS), Body Dysmorphic Metacognitive Questionnaire (BDMCQ) and Collins and Reid's Attachment Styles Scale (RAAS) were used to data collection. The findings showed ambivalent attachment style was positively related to body image (β=-0.91, p<0.01) The direct effect of ambivalent attachment style on body dysmorphic symptom is significant (β=0.76, p<0.01). The pathway between body image and body dysmorphic symptom is negatively significant (β= -0.75, p<0.01). Also, the hypothesized model has an acceptable goodness-of-fit. Based on the results, it can be said that in interventions, it is necessary to pay attention to the important role of interpersonal attachment styles and body image in body dysmorphic symptoms.

Early maladaptive schemas in people seeking cosmetic rhinoplasty and its relationship with body dysmorphic symptoms

Early maladaptive schemas in people seeking cosmetic rhinoplasty and its relationship with body dysmorphic symptoms

Development and evaluation of an acceptance-facilitating intervention for an internet-based cognitive behavioral self-esteem training for adults with body dysmorphic symptoms

BackgroundVarious barriers contribute to low treatment rates in Body Dysmorphic Disorder (BDD). While internet-based intervention is considered a low-threshold option and shows efficacy, studies report acceptance deficits. We first tested predictors of the Unified Theory of Acceptance and Use of Technology for acceptance and secondly evaluated an acceptance-facilitating intervention for an internet-based self-esteem training addressed to individuals with BDD symptoms. MethodWe randomly assigned 110 participants with distinct BDD symptoms to a 6-min animated whiteboard video (n = 50) or a waiting control group (n = 60) before offering them internet-based training. ResultsAcceptance was good before the intervention (87% with moderate/high scores). Performance expectancy, social influence and slightly effort expectancy predicted baseline acceptance (R2 = 0.70). The acceptance-facilitating intervention led to greater improvements of performance expectancy and facilitating conditions compared to the control group. Higher self-reported acceptance was associated with training uptake and higher adherence. DiscussionIn particular, performance expectancy, but also social influence seemed to be valid predictors of acceptance of web-based BDD treatment. The results suggest that a specifically designed, brief video improves acceptance-facilitating factors. Subject to review, the potential benefit of an acceptance-facilitating intervention may be to enhance treatment rates in BDD.

The effectiveness of solution-based therapy on negative meta-emotions and symptoms of body dysmorphic disorder in cosmetic surgery applicants

Objective: This study aimed to determine the effectiveness of solution-oriented therapy on negative meta-emotions and body dysmorphic symptoms in cosmetic surgery applicants. Method: This research was quasi-experimental, with a pre-test, post-test and control group design with a two-month follow-up phase. The statistical population included all surgical applicants who had visited beauty clinics in the city. The statistical sample included 30 of these applicants who were selected purposefully. Then, 15 people were randomly placed in the control group and 15 people in the experimental group. The intervention group received solution-oriented therapy during 8 sessions of 90 minutes once a week. The data were collected using Meta-Emotions Scale (MES) (2009) and Body Image Concern Inventory (BICI) (2005) and analyzed by variance analysis with repeated measurements. Results: The results showed that the main effect of the group was significant for negative meta-emotions (F=94.2, P&gt;0.05, P&gt;0.771) and for body dysmorphic disorder symptoms (F=12.9, P&gt;0.05, 315/315). In the negative meta-emotions variable, the main effect of the three stages of pre-test, post-test and follow-up (P&lt;0.05, P&lt;0.05, F=13.5) was significant. It was also reported as significant in the variable of body dysmorphic symptoms (P&gt;0.05, P&gt;0.05, F=6.37). Conclusion: It can be concluded that solution-oriented therapy is effective in negative meta-emotions and body dysmorphic disorder symptoms. Therefore, they can be useful for cosmetic surgery applicants.

Body dysmorphic disorder: A critical appraisal of diagnostic, screening, and assessment tools.

Body dysmorphic disorder (BDD) is a psychiatric condition characterized by profound concern about a minor or imagined defect in the appearance of individuals and increased preoccupation with the imagined/perceived defect. Individuals with BDD often undergo cosmetic intervention for the perceived imperfection but rarely experience improvement in their signs and symptoms after such treatment. It is recommended that aesthetic providers evaluate individuals face-to-face and screen for BDD with approved scales preoperatively to determine the candidate's suitability for the procedure. This contribution focuses on diagnostic and screening tools and measures of disease severity and insight that providers working in nonpsychiatric settings can use. Several screening tools were explicitly developed for BDD; others were designed to evaluate body image/dysmorphic concern. The BDD Questionnaire (BDDQ)-Dermatology Version (BDDQ-DV), BDDQ-Aesthetic Surgery (BDDQ-AS), Cosmetic Procedure Screening Questionnaire (COPS), and Body Dysmorphic Symptom Scale (BDSS) have been developed explicitly for BDD and validated in cosmetic settings. The limitations of screening tools are discussed. Given the increasing use of social media, future revisions of BDD instruments should consider incorporating questions relevant to patients' behaviors on social media. Current screening tools can adequately test for BDD despite their limitations and a need for updates.

Prevalence of Body Dysmorphic Disorder and Dysmorphic Symptoms in Rhinoplasty Candidates: a Systematic Review and Meta-Analysis

Prevalence of Body Dysmorphic Disorder and Dysmorphic Symptoms in Rhinoplasty Candidates: a Systematic Review and Meta-Analysis

Reliability and Validity of the Self-Report Version of the Yale-Brown Obsessive-Compulsive Scale Modified for Body Dysmorphic Disorder.

Despite its frequent use in research studies, the self-report version of the Yale-Brown Obsessive-Compulsive Scale modified for Body Dysmorphic Disorder (BDD-YBOCS-SR) is yet to be formally validated. The present investigation sought to examine the psychometric properties of the BDD-YBOCS-SR across three different samples. In Study 1 (N = 847), we sought to explore the factor structure of the BDD-YBOCS-SR. In addition, we evaluated the convergent and divergent validity with similar self-report measures. In Study 2 (N = 187), the convergence of the BDD-YBOCS-SR with reactivity to an in vivo appearance-related task was observed. In Study 3, we compared scores on the BDD-YBOCS-SR between a clinical sample of individuals with BDD (n = 50) and a "healthy" control sample (n = 51). We further observed the BDD-YBOCS-SR's sensitivity to treatment and convergence with the rater-administered version in the clinical sample. The BDD-YBOCS-SR demonstrated strong psychometric properties across all three studies. Scores on the BDD-YBOCS-SR were found to be strongly associated with appearance anxiety, reactivity to the appearance task, and the rater-administered BDD-YBOCS. The present investigation provides support for the BDD-YBOCS-SR's utility in measuring body dysmorphic symptom severity for use in research and clinical settings.

Examining the relationship between dysmorphia symptoms and suicidality through the lens of the Interpersonal Theory of Suicide.

Using the Interpersonal Theory of Suicide (IPTS) as a framework, this two-study investigation tested whether burdensomeness and low belongingness explained the association between body and muscle dysmorphia symptoms and suicidal ideation (tested in Study 1 and Study 2), and if fearlessness about death and pain tolerance explained the association between dysmorphia symptoms and previous suicide attempt frequency (tested in Study 2). Study 1 used a community sample (n = 273) and Study 2 used an at-risk population sample (n = 261). Participants completed cross-sectional questionnaires online. In Study 1, both types of dysmorphic symptoms related to suicidal ideation through burdensomeness, but only body dysmorphic symptoms related to suicidal ideation through low belongingness. In Study 2, results were replicated as both types of dysmorphic symptoms related to suicidal ideation through burdensomeness. While both types of symptoms related to low belonging, low belonging did not relate to suicidal ideation. Neither dysmorphic symptoms nor capability for suicide related to frequency of suicide attempts. Results suggest that improving interpersonal needs, such as feeling more effective, may be important treatment targets for individuals with dysmorphic symptoms who also experience suicidal ideation. Future work should continue to identify mediators for suicide attempts among individuals with dysmorphia symptoms.

Longitudinal study of social anxiety symptoms and appearance rejection in predicting body dysmorphic symptoms: Appearance-based rejection sensitivity as a mediator

Previous findings from cross-sectional studies suggest that social anxiety symptoms and negative peers’ experiences regarding appearance were predictors of body dysmorphic symptoms through appearance-based rejection sensitivity. However, little is known about longitudinal relations and parental appearance rejection on body dysmorphic symptoms. Therefore, this study aims to examine the longitudinal mediation of appearance-based rejection sensitivity with social anxiety symptoms, remembered peers’, maternal, and paternal appearance-based rejection as predictors, and body dysmorphic symptoms as an outcome. The study included 277 university students who completed questionnaires in two-measurements points 5 months apart. The results indicated that social anxiety symptoms predicted changes in body dysmorphic symptoms through appearance-based rejection sensitivity. In addition, remembered childhood peers’ appearance-based rejection predicted both directly and indirectly changes in body dysmorphic symptoms over time. Maternal and paternal appearance-based rejection were not predictors of appearance-based rejection sensitivity or body dysmorphic symptoms. Findings support rejection sensitivity theory and the long-lasting impact of negative peers’ experiences for impaired body dysmorphic symptoms. However, further research regarding remembered parental negative experiences is needed.

Body-dysmorphic, hoarding, hair-pulling, and skin-picking symptoms in a large sample of adolescents

Few studies have investigated body-dysmorphic, hoarding, hair-pulling, and skin-picking symptoms in adolescents and how they relate to mental health, quality of life, suicide attempts, and non-suicidal self-harm. We used a quota sampling procedure and contacted 100 secondary centres in the Southeast of Spain, of which 34 participated in the study. A sample of 5,345 adolescents (12–18 years) completed dimensional measures of body-dysmorphic, hoarding, hair-pulling, and skin-picking symptoms. The proportion of adolescents with clinically significant symptoms within each symptom type was estimated and associations with other indicators of mental health examined. Clinically significant body-dysmorphic symptoms were reported by 3.7%, hoarding by 0.9%, hair-pulling by 0.7%, and skin-picking by 1.8%. Body-dysmorphic symptoms were more common in girls and in those over 14 years of age. Body-dysmorphic, hoarding, hair-pulling, and skin-picking symptoms were moderately to strongly associated with obsessive-compulsive symptoms, internalizing symptoms, externalizing symptoms, and poor quality of life. Those with significant body-dysmorphic, hoarding, hair-pulling, and skin-picking symptoms were much more likely to have attempted suicide and engaged in non-suicidal self-harm during the last twelve months than those without such symptoms. Body-dysmorphic symptoms showed the strongest associations with internalizing symptoms and poor quality of life. Limitations are the sole use of self-report and a sample from only two regions in Spain, but findings suggest that body-dysmorphic, hoarding, hair-pulling, and skin-picking symptoms are common and impairing during adolescence.

Adolescent Girls' Body Dysmorphic Symptoms: A Path Analysis of Body Dysmorphic Disorder Based on Obsessive-Compulsive Symptoms, Obsessive and Metacognitive Beliefs

Adolescent Girls' Body Dysmorphic Symptoms: A Path Analysis of Body Dysmorphic Disorder Based on Obsessive-Compulsive Symptoms, Obsessive and Metacognitive Beliefs

Body Dysmorphic Symptoms in Youth with Obsessive-compulsive Disorder: Prevalence, Clinical Correlates, and Cognitive Behavioral Therapy Outcome.

The aims of the study were to estimate the prevalence of body dysmorphic symptoms in a sample of children and adolescents with obsessive-compulsive disorder, possible clinical correlates and whether BDD symptoms predict poorer treatment outcomes after cognitive behavioral therapy. The study included 269 children and adolescents with OCD, aged 7-17 years, from Denmark, Sweden, and Norway, who were treated with 14 weekly sessions of manualized, exposure-based CBT. Twenty-one patients (7.8%) had BDD symptoms. BDD symptoms were associated with older age (p = 0.003) and a higher prevalence of comorbid anxiety disorders (p = 0.025). In addition, patients with BDD symptoms endorsed a greater number of OCD symptoms than did those without BDD symptoms. Having symptoms of BDD did not affect the CBT outcome on OCD. The results of the study suggest that CBT for OCD is equally effective for those with and without comorbid BDD symptoms.