Features Of Body Dysmorphic Disorder Research Articles

Quantifying body size estimation accuracy and body dissatisfaction in body dysmorphic disorder using a digital avatar

BackgroundA core feature of body dysmorphic disorder (BDD) is body image disturbance. Many with BDD misperceive and are dissatisfied with the sizes and shapes of body parts, but detailed quantification and analysis of this has not yet been performed. To address this gap, we applied Somatomap 3D, a digital avatar tool, to quantify body image disturbances by assessing body size estimation (BSE) accuracy and body dissatisfaction. MethodsSixty-one adults (31 with BDD, 30 healthy controls) created avatars to reflect their perceived current body and ideal body by altering 23 body part sizes and lengths using Somatomap 3D. Physical measurements of corresponding body parts were recorded for comparison. BSE accuracy (current minus actual) and body dissatisfaction (ideal minus current) were compared between groups and in relation to BDD symptom severity using generalized estimating equations. ResultsIndividuals with BDD significantly over- and under-estimated certain body parts compared to healthy controls. Individuals with BDD overall desired significantly thinner body parts compared to healthy controls. Moreover, those with worse BSE accuracy had greater body dissatisfaction and poorer insight. ConclusionIn sum, this digital avatar tool revealed disturbances in body image in individuals with BDD that may have perceptual and cognitive/affective components.

The Prevalence and Clinical Features of Body Dysmorphic Disorder Among Dermatology Patients in the Eastern Province of Saudi Arabia.

Background and objective Body dysmorphic disorder (BDD), which affects 1.7% to 2.4% of people worldwide, is usually encountered for the first time by nonpsychiatric physicians. Up to 37% of cases have been documented in dermatology clinics. This study aims to estimate the prevalence of BDD among Saudis attending dermatology clinics because the literature is lacking in this field, especially in the Eastern Province. Methods This is a cross-sectional study, conducted in 2023. A total of 412 Saudi Eastern Province residents, aged 18 years and older, were included in the study and given a self-administered web-based questionnaire. The study uses the Body Dysmorphic Disorder Questionnaire as one of its three primary measurements, together with sociodemographic data, and dermatological and previous psychological histories. Results A total of 412 participants were enrolled in this study. Of the total sample, 64.5% had more than one skin condition, with the rest having only one one. The most received cosmetic treatment in this study was topical agents. It was estimated that the prevalence of BDD is 9.5% among the studied population. However, it was found that there are no significantly associated factors with the prevalence of BDD. Conclusions This study reports a prevalence of 9.5% among people visiting dermatological clinics. The prevalence is alarming, which emphasizes the importance of enhancing the awareness of BDD among dermatologists and developing certain guidelines to identify and refer these patients to mental health professionals.

Narcissism and Selfitis Disorder Features among Young Adults: Body Dysmorphic Disorder as Mediator

Nowadays young generations are involved in such activities which abolish their life seriously. In today’s world everyone wants to look flawless and wants to be praised. Objective: To investigate the mediating effect of body dysmorphic disorder on narcissism and selfitis disorder among young adults. Methods: The sample size for the present study was 400 young adults. Convenient sampling technique was used for screening of young adults on Body Image Concern Inventory and further data were collected on Selfitis Behavior Scale and Narcissistic Personality Inventory from screened sample. Inclusion criteria included all the young adults aged between 20 to 35 and have body dysmorphic disorder. Results: Narcissism had significant positive correlation with features of both selfitis disorder and body dysmorphic disorder. Age of persons had significant negative correlation with narcissism, selfitis disorder and features of body dysmorphic disorder. Outcomes revealed that both selfitis disorder and narcissism are greater in males, while features of body dysmorphic disorder are greater in females as compared to males. Conclusions: This study will be beneficial for professionals (sociologists and social workers) for creating awareness in young generation about flaws or defects in the physical appearance should not be considered as life frightening conditions and they should appreciate themselves as they are.

"Motivations, demography, and clinical features of body dysmorphic disorder among people seeking cosmetic treatments: A study of 199 patients".

Motivations for getting aesthetic medicine treatments concern not only the improvement of the physical appearance but also internal aspects such as feeling more confident or happier. Body dysmorphic disorder (BDD)is a disorderthataffectsfrom 5 to 15% of aesthetic medicine clients and characterizes by an obsessive preoccupation with a non-visible or minimal defect in appearance. The aim of the study was to assess the main motivations, demography, and clinical features of body dysmorphic disorder among people seeking cosmetic treatments. A single-center study was performed using an anonymous questionnaire on 199 patients of the private aesthetic medicine clinic in Gdansk, Poland. A typical client of an aesthetic clinic is a woman aged 40 to 50, with higher education, who undergoes aesthetic treatments more than twice a year, mainly with botulinum toxin injections. The most common motivations are the desire to achieve a fresh look, the will to reduce the signs of aging, and to invest in oneself. Furthermore, over 38% of patients stated that they were having critical and recurring thoughts about their appearance, which affected their daily functioning and caused a decrease in their well-being. Almost 20% of them performed repetitive activities, such as frequently looking in the mirror or asking others for opinions about their appearance. 15.6% of patients presented at least two characteristic features of BDD. Patients seeking cosmetic treatments may suffer from body dysmorphic disorder, thus the need for aesthetic medicine practitioners to be aware of this disease.

The ugliest woman un the world

IntroductionThe main feature of body dysmorphic disorder (BDD) is impairing preoccupation with a physical defect that appears slight or non-existent to others.ObjectivesTo draw an overview of BDD through a clinical case of a patient with BDD and autolytic ideation, which improved after an adequate diagnosis and an early pharmacological and psychotherapeutic approach.MethodsBibliographic review of the treatment and diagnosis of BDD, from articles published in the last 5 years in Pubmed.Results18-year-old woman diagnosed with depression and obsessive ideation, which started at the age of 11, after a comment at school. The patient believes that she has intenseunder-eye bags or dark circles, this has caused her to abandon all activity and self-isolate at home. Symptoms included recurring obsessive and intruding thoughts related to the supposed defect, ritualized behaviors of hours of duration aiming toit through makeup, and autolytic ideation. Therapeutic approach combined psychopharmacological and psychotherapeutic treatments, obtaining gradual improvement of symptomatology and disappearance of the autolytic ideation.ConclusionsThe disorder is severe, which is reflected in high rates of suicide attempts. Differential diagnosis between obsessive and delirious dysmorphophobia is essential for improving outcomes; the egodystonic nature of the symptom, awareness of illness and obsessive personality traits facilitate the diagnosis. A multidisciplinary approach involving psychiatrists and clinical psychologists is necessary for a correct diagnosis and early treatment of this pathology, as well as recognition by dermatologists, surgeons and medical aesthetic professionals, where these patients go with the aim of finding solutions to their problem.DisclosureNo significant relationships.

Internalizing behavior problems and body dysmorphic disorder features among medical students who consume pharmaceutical drugs as coping motives

Internalizing behavior problems and body dysmorphic disorder features among medical students who consume pharmaceutical drugs as coping motives

A network perspective on body dysmorphic disorder and major depressive disorder

Background. Body dysmorphic disorder (BDD) is a highly debilitating mental disorder associated with notable psychosocial impairment and high rates of suicidality. This study investigated BDD from a network perspective, which conceptualizes mental disorders as systems of symptoms that cause and exacerbate one another (e.g., preoccupation with perceived appearance defect triggering compulsive checking in the mirror). Methods. In a sample of BDD patients (N = 148), we used cross-sectional network models to explore the network structure of 1) BDD symptoms and 2) BDD symptoms and major depressive disorder (MDD) symptoms, and tested which symptoms were most central (i.e., most strongly associated to other symptoms). Results. Interference in functioning due to appearance-related compulsions (BDD), feelings of worthlessness (MDD), and loss of pleasure (MDD) were most central. Conclusion. These symptoms were most strongly predictive of other BDD and MDD symptoms and may be features of BDD that warrant prioritization in theory development and treatment. A limitation of our study is that the precision of these findings may be limited due to a small sample size relative to the number of parameters. Replication studies in larger samples of BDD patients are needed.

Factor Analysis and Psychometric Validation of the Body Image Disturbance Questionnaire in an Australian Undergraduate Sample

ObjectiveBody image disturbance encompasses various cognitive and behavioural states originating from a distressing, negative evaluation of one's appearance. It is broader than negative body image, comprising not only dissatisfaction but also distress and dysfunction, and is a core feature of body dysmorphic disorder (BDD). This study had two broad aims: to establish normative values for body image disturbance within an Australian population and to examine the factor structure and psychometric properties of the Body Image Disturbance Questionnaire (BIDQ).MethodAustralian undergraduate students (N = 950, 744 female) from Western Sydney completed the BIDQ, along with measures of clinical psychopathology, self‐esteem, and functional impairment.ResultsThe BIDQ displayed good internal consistency and predictable concurrent relationships with measures of depression, anxiety, stress, self‐esteem, and functional impairment. It also yielded a single latent construct, while higher scores were noted among participants who screened positively for BDD.ConclusionsBIDQ scores for this sample differ to those originally reported, which may reflect sample differences or cultural variation. These values provide a more accurate and reliable guide for clinicians using the BIDQ in Australia than previously available. Overall, the BIDQ demonstrates good psychometric efficacy in an undergraduate sample, although future research should validate the measure among wider clinical and community populations.

Body dysmorphic disorder: Classification challenges and variants

IntroductionThe main feature of body dysmorphic disorder (BDD) is impairing preoccupation with a physical defect that appears slight to others. Previously, its delusional and nondelusional variants were sorted in two separate categories, but owing to new data suggesting that there are more similitudes than differences between them, DSM-5 now classifies both as levels of insight of the same disorder.ObjectivesTo enunciate the similarities and differences between the two variants of BDD.AimsTo better understand the features and comorbidity of BDD, so as to improve its management and treatment.MethodsTaking DSM-5 and DSM-IV-TR as a reference, we have made a bibliographic search in MEDLINE (PubMed), reviewing articles no older than 5 years that fit into the following keywords: body dysmorphic disorder, delusions, comorbidity, DSM-IV, DSM-5.ResultsBoth the delusional and nondelusional form presented many similarities in different validators, which include family and personal history, pathophysiology, core symptoms, comorbidity, course and response to pharmacotherapy.ConclusionsThe new classification of delusional and nondelusional forms of BDD as levels of insight of the same disorder, which places them closer to the obsessive-compulsive spectrum than to the psychotic one, not only improves treatment options, but also reinforces the theory that delusions are not exclusive of psychotic disorders, setting a precedent for the understanding and classification of other disorders with delusional/nondelusional symptoms.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Cosmetic Professionals' Awareness of Body Dysmorphic Disorder.

Preoccupation with a perceived appearance flaw is the main feature of body dysmorphic disorder. The majority of these patients seek and often receive some sort of cosmetic procedure, although this condition is considered to be a contraindication. This study evaluates cosmetic professionals' recognition of body dysmorphic disorder and the way they act on this. Members of Dutch professional associations for aesthetic plastic surgery, dermatology, and cosmetic medicine received an online survey by means of their association's digital mailing lists; the survey was completed by 173 respondents. Most participants indicated being more or less familiar with the diagnostic criteria and clinical picture of body dysmorphic disorder. Approximately two-thirds of the participants reported that they had encountered between one and five of these patients in their practice over the past year, a percentage that is significantly lower than the estimated prevalence of body dysmorphic disorder. The majority of professionals sometimes or often address body image problems during consultation, most of them collaborate with psychologists or psychiatrists when encountering a patient with body dysmorphic disorder, and approximately 70 percent had refused to perform a procedure in such a patient. Our results converge with those of previous studies, showing that most cosmetic professionals have some degree of awareness of body dysmorphic disorder, although the number they report encountering in clinical practice departs from prevalence figures. When a patient is identified as having body dysmorphic disorder, the professionals use this knowledge to guide their decision to perform a cosmetic procedure.

Commentary on: Muscle dysmorphia: Could it be classified as an addiction to body image?

BackgroundThe article titled ‘Muscle dysmorphia: Could it be classified as an addiction to body image?’ used Griffiths (2005) addiction components model as the framework in which to define muscle dysmorphia (MD) as an addiction. The authors (Foster, Shorter & Griffiths, 2014) proposed that MD could be re-classified as an addiction to body image.Method and aimIn response to the original article, the author of this commentary reflected on the ‘Addiction to body image’ model and the components of addiction as described in the context of MD. This invited commentary aimed to provide opposing viewpoints in order to give a balanced overview on the topic.ResultsIt appears as if the components of addictions can be used as a framework in which to define MD. However, systematic empirical evidence had not been provided for the withdrawal symptoms associated with this behavioral addiction. An opposing viewpoint is provided in response to Foster et al.’s (2014) statement that MD is different from other body dysmorphic disorders in regards to cognitive dysfunction, and therefore cannot be explained in the same way.ConclusionsBased on the little systematic empirical evidence to date, it may be a bit premature to re-classify MD as an addiction to body image.

Personal and appearance-based rejection sensitivity in body dysmorphic disorder

Although rejection sensitivity may be an important feature of body dysmorphic disorder (BDD), no studies have examined rejection sensitivity in a clinical sample and compared types of rejection sensitivity in individuals with BDD. Personal and appearance-based rejection sensitivity scores in forty-six patients diagnosed with BDD were compared with published norms. Associations between rejection sensitivity, BDD severity, and other clinical variables were examined. Personal and appearance-based rejection sensitivity scores were 0.6 and 1.1 standard deviation units above published norms, respectively. Greater personal rejection sensitivity was associated with more severe BDD and depressive symptoms, poorer mental health, general health, and physical and social functioning. Greater appearance-based rejection sensitivity was associated with more severe BDD and depressive symptoms, and poorer general health. Appearance-based rejection sensitivity contributed more unique variance to BDD severity than personal rejection sensitivity did; however, personal rejection sensitivity contributed more unique variance to general health than appearance-based rejection sensitivity did.

Delusional versus nondelusional body dysmorphic disorder: recommendations for DSM-5.

The core feature of body dysmorphic disorder (BDD) is distressing or impairing preoccupation with nonexistent or slight defects in one's physical appearance. BDD beliefs are characterized by varying degrees of insight, ranging from good (ie, recognition that one's BDD beliefs are not true) through "absent insight/delusional" beliefs (ie, complete conviction that one's BDD beliefs are true). The Diagnostic and Statistical Manual of Mental Disorders, 3rd ed., rev. (DSM-III-R) and The Diagnostic and Statistical Manual of Mental Disorders, 4th ed. (DSM-IV) classified BDD's nondelusional form in the somatoform section of the manual and its delusional form in the psychosis section, as a type of delusional disorder, somatic type (although DSM-IV allowed double-coding of delusional BDD as both a psychotic disorder and BDD). However, little or no evidence on this issue was available when these editions were published. In this article, we review the classification of BDD's delusional and nondelusional variants in earlier editions of DSM and the limitations of their approaches. We then review empirical evidence on this topic, which has become available since DSM-IV was developed. Available evidence indicates that across a range of validators, BDD's delusional and nondelusional variants have many more similarities than differences, including response to pharmacotherapy. Based on these data, we propose that BDD's delusional and nondelusional forms be classified as the same disorder and that BDD's diagnostic criteria include an insight specifier that spans a range of insight, including absent insight/delusional BDD beliefs. We hope that this recommendation will improve care for patients with this common and often-severe disorder. This increased understanding of BDD may also have implications for other disorders that have an "absent insight/delusional" form.

Patient Selection in Plastic Surgery: Recognizing Body Dysmorphic Disorder

Plastic surgery is a branch of medicine that provides significant improvements to the people with positive changes. But first of all, this branch has a characteristic which requires analysing patients’ psychological situation very carefully. Plastic surgeons are often confronted by patients with mental disorders seeking aesthetic surgery. It is imperative for surgeons to recognize possible underlying psychiatric illnesses. Common psychiatric conditions seen in cosmetic surgery patients include body dysmorphic disorder (BDD), narcissistic personality disorder and histrionic personality disorders. BDD is of particular importance to plastic surgeons. Because outrageous dissatisfaction with one’s appearance may conceal psychopathologic traits that are not always easily recognizable, and which, if neglected, may result in serious iatrogenic and medicolegal consequences, we hope that this paper will help plastic surgeons in ultimately preventing patient and surgeon dissatisfaction within the population of patients with psychiatric disorders, and should recognize the diagnostic features of body dysmorphic disorder and screen psychologically unstable patients who may never be satisfied with surgery.

BODY DYSMORPHIC DISORDER IN PATIENTS WITH OBSESSIVE-COMPULSIVE DISORDER: PREVALENCE AND CLINICAL CORRELATES

The prevalence, sociodemographic aspects, and clinical features of body dysmorphic disorder (BDD) in patients with obsessive-compulsive disorder (OCD) have been previously addressed in primarily relatively small samples. We performed a cross-sectional demographic and clinical assessment of 901 OCD patients participating in the Brazilian Research Consortium on Obsessive-Compulsive Spectrum Disorders. We used the Structured Clinical Interview for DSM-IV Axis I Disorders; Yale-Brown Obsessive-Compulsive Scale; Dimensional Yale-Brown Obsessive-Compulsive Scale (DY-BOCS); Brown Assessment of Beliefs Scale; Clinical Global Impression Scale; and Beck Depression and Anxiety Inventories. The lifetime prevalence of BDD was 12.1%. The individuals with comorbid BDD (OCD-BDD; n = 109) were younger than were those without it. In addition, the proportions of single and unemployed patients were greater in the OCD-BDD group. This group of patients also showed higher rates of suicidal behaviors; mood, anxiety, and eating disorders; hypochondriasis; skin picking; Tourette syndrome; and symptoms of the sexual/religious, aggressive, and miscellaneous dimensions. Furthermore, OCD-BDD patients had an earlier onset of OC symptoms; greater severity of OCD, depression, and anxiety symptoms; and poorer insight. After logistic regression, the following features were associated with OCD-BDD: current age; age at OCD onset; severity of the miscellaneous DY-BOCS dimension; severity of depressive symptoms; and comorbid social phobia, dysthymia, anorexia nervosa, bulimia nervosa, and skin picking. Because OCD patients might not inform clinicians about concerns regarding their appearance, it is essential to investigate symptoms of BDD, especially in young patients with early onset and comorbid social anxiety, chronic depression, skin picking, or eating disorders.

The relationship between body dysmorphic concerns and the effects of image suppression: Implications for models of body dysmorphic disorder

A key clinical feature of body dysmorphic disorder (BDD) is the use of avoidance behaviours to minimise discomfort associated with perceived defects in appearance. While overt avoidance, such as avoidance of social situations, has been well-documented (e.g., Phillips, 2005), covert avoidance, such as image suppression, has not been explored. This study investigated the role of suppression of negative self-imagery in the maintenance of dysmorphic concern. Undergraduate participants completed a thought suppression paradigm with an experimentally-constructed negative self-image as the target. Dysmorphic concern was associated with how distressing and vivid an appearance-related intrusion was, although it did not affect whether participants engaged in suppression of the intrusion. Instructions to suppress the image led to reduced intrusion frequency and discomfort but it did not affect the quality (e.g., vividness) of intrusions. In addition, participants high in dysmorphic concern were more likely to internalise distorted appearance-related information and be disgusted by that information. Implications for models of body dysmorphic disorder are discussed.

Body image, emotions and thought control strategies in body dysmorphic disorder compared to eating disorders and healthy controls

ObjectiveA disordered body image, emotions such as shame and disgust, and intrusive thoughts are described as important and interdependent features of body dysmorphic disorder (BDD). However, research in this field is scarce and knowledge is often based on clinical observation. MethodsThe present study examined body image dimensions, emotions, and thought control strategies in individuals with: BDD (n=31), anorexia nervosa (n=32), bulimia nervosa (n=34), and healthy controls (n=33). Assessment was based on structured diagnostic interviews and self-report questionnaires. ResultsIndividuals with BDD scored higher on psychosocial and appearance manipulation dimensions of body image compared to healthy controls. Furthermore, they reported higher psychosocial impairment due to appearance than both eating disorder groups. In terms of emotions, BDD subjects reported a higher degree of negative emotions compared to healthy controls, whereas no differences were found in comparison to eating-disordered patients. Individuals with BDD reported using maladaptive strategies such as worrying and confrontation more often than healthy controls, when encountering intrusive and unwanted thoughts. ConclusionThe results indicate that individuals with BDD experience substantial psychosocial impairment due to appearance, high levels of various negative emotions and frequently use maladaptive thought control strategies.

Body dysmorphic symptoms: Phenomenology and ethnicity

Differences in the presentation of clinical features of body dysmorphic disorder (BDD) across ethnic groups have received little investigation. The current study assessed BDD symptoms in an ethnically diverse sample of adults ( n = 401) using an online survey. Participants completed self-report measures assessing BDD symptoms, body parts of concern and BDD behaviors. Compared to Caucasian participants, no significant differences were found in body parts or behaviors reported by Latino or African American participants. Significant group differences did emerge between Asian and Caucasian participants. Specifically, Asians reported more concern with straight hair and dark skin and fewer body shape concerns than Caucasians. Asians also endorsed lower rates of grooming, touching body parts, and camouflaging and higher rates of exercise compared to Caucasians. Although most clinical features of BDD appear similar across ethnic groups, results showed some differences in body parts and behaviors between Caucasians and Asian Americans with BDD symptoms.

Clinical Features of Body Dysmorphic Disorder

Clinical Features of Body Dysmorphic Disorder

Comorbidade entre transtorno dismórfico corporal e transtornos alimentares: uma revisão sistemática

INTRODUÇÃO: A insatisfação com a imagem corporal é uma das características mais proeminentes do transtorno dismórfico corporal (TDC) e dos transtornos alimentares (TA). Esses dois grupos de transtornos apresentam semelhanças em suas características psicopatológicas e epidemiológicas e na resposta ao tratamento. Apesar de ambos serem considerados transtornos do espectro obsessivo-compulsivo, pouco se sabe em relação à comorbidade entre esses dois grupos de transtornos. OBJETIVO: Avaliar a produção bibliográfica atual sobre a comorbidade entre TDC e TA. MÉTODO: Foi realizada uma revisão sistemática nos bancos de dados PubMed e ISI Web of Science dos artigos referentes à comorbidade entre TDC e TA. RESULTADOS: Oito artigos foram selecionados. As amostras de portadores de TA apresentavam comorbidade com TDC em 6% a 39% dos casos. Dos pacientes com TDC, 10% a 32,5%, por sua vez, podem apresentar comorbidade com TA. O TDC frequentemente precedia o TA, e os pacientes com comorbidade apresentavam quadro clínico mais grave que os com apenas um dos transtornos. CONCLUSÃO: Estudos recentes demonstram que as taxas de comorbidade entre esses dois transtornos são elevadas. Apesar disso, o TDC raramente é diagnosticado em portadores de TA, mesmo quando é o transtorno que causa mais incômodo.