Rising dysmorphia among adolescents : A cause for concern

Prevalence and Characteristics Associated with Positive Body Dysmorphic Disorder Screening Among Patients Presenting for Cosmetic Facial Plastic Surgery

Background: Many patients with body dysmorphic disorder (BDD) seek out cosmetic surgery to alleviate their symptoms of distress related to a perceived defect in their appearance; however, the prevalence and risk factors for BDD among patients with cosmetic concerns have not been well characterized. Methods: We screened adult patients presenting to the clinic from June 2021 through September 2022 for BDD using the BDD Questionnaire-Aesthetic Surgery (BDDQ-AS) who were seen in consultation for rhinoplasty, aging face, and injectables. Results: Among 488 patients, the prevalence of screening positive for BDD was 41.0%. The prevalence of a positive BDD screen was highest among patients who were younger (p = 0.02), and those who had a positive self-reported psychiatric history (p = 0.02). Among rhinoplasty patients, those with aesthetic/cosmetic motivations, and those seeking revision rhinoplasty had higher rates of positive BDD screen. Higher scores on the Standardized Cosmesis and Health Nasal Outcomes Survey-Nasal Obstruction Score (SCHNOS-O) (p = 0.01) and Standardized Cosmesis and Health Nasal Outcomes Survey-Nasal Obstruction Score-Nasal Cosmesis Score (SCHNOS-C) (p < 0.0001) were predictive of a positive BDD screen, while question 5 of the SCHNOS was highly predictive of positive BDD screening (p < 0.0001). Conclusions: Our study characterizes relationships between positive BDD screening and age, gender, self-reported psychiatric history, and motivations for consultation, among patients seen for cosmetic surgery evaluation in a facial plastic and reconstructive surgery setting.

Consumer attitudes toward aging skin during the COVID-19 pandemic

The impact of the novel coronavirus disease (COVID-19) pandemic on consumer attitudes toward their skin has not been well characterized.

Objective

This study investigated how consumers' attitudes toward their skin changed during the COVID-19 pandemic.

Methods

A cross-sectional survey was conducted using REDCap. A total of 1,434 participants were recruited and consented to participate online through ResearchMatch. The survey gathered demographic information and assessed participants' attitudes toward their skin using a Likert scale. An ordered logistic regression analysis was performed.

Results

Nearly one-third of participants felt unhappy with their skin. Forty four percent feel less happy about their skin compared with 5 years earlier. The top skin concerns were eye puffiness (86.5%), loose skin (85.1%), uneven tone (84.9%), uneven texture (83.5%), and dry skin (81.4%). Video conferencing (31%), wearing masks (23%), and increased stress (21%) during the COVID-19 pandemic affected how participants felt about their skin. Compared with men, women were 1.6 to 1.8 times (P < .01) more likely to "strongly agree" that all 3 pandemic-related factors-video conferencing, wearing masks, and increased stress-affected how they felt about their skin. Younger age groups were 1.5 to 2.8 times (P < .01) more likely to answer in the top category for all 3 pandemic-related factors compared with the oldest age group.

Limitations

Recruitment of participants was limited to English-speaking adults aged 18 years or older who were registered on ResearchMatch, which underrepresents minority populations. Further studies should be conducted to elucidate how the pandemic affected perceptions of skin.

Conclusion

Skin aging is a significant concern among adults of all ages. The COVID-19 pandemic has exacerbated skin concerns. Women and young adults are more likely to be affected by the COVID-19 pandemic in their attitudes toward their skin.

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

Introduction

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.

Method

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.

Results

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.

Discussion

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.

Zoom dysmorphia in e-teaching: shifting the value from attributes to appearance

The current study is motivated by Tory Higgins's self-discrepancy theory and the objectification theory. It aimed to investigate university staff members' perspectives towards zoom dysmorphia while involved in e-teaching during the Covid-19 Pandemic in terms of its popularity, causes, and instructors' experiences with the healing or eliminating mechanisms. Put simply, the researchers meant to identify the impact of the pandemic on body image and the long-term repercussions of e-teaching on instructors' quality. A descriptive online questionnaire was compiled to explore the way (630) university staff members having academic and academic/administrative positions evaluate, perceive, and handle zoom dysmorphia while teaching online. The study results showed several associations between the variables studied. Gender was significant because females proved to have more features of dysmorphia; faculty members who serve in scientific faculties also proved to expect more features of dysmorphia as they tended not to turn on their cameras. The study results also showed that sufferers of zoom dysmorphia warranted that their appearances occasionally made them feel insecure and occupationally unstable. Therefore, they tried different healing mechanisms to eliminate or, at least, reduce its traits. The study concluded that the prevalence of zoom dysmorphia may result in shifting the value from good, effective attributes (e.g., professionalism, adaptability, collaboration, empathy, and patience) of instructors to merely outside physical appearances. The researchers recommend that educators should elicit the presence of zoom dysmorphia at an early stage. They should prepare courses to improve instructors' self-confidence, and provide them with proper technical experience.

#TheUglyTruth? A Qualitative Evaluation of Outcomes Photography on Instagram: Introducing the SEPIA Scoring System

Photographs of cosmetic treatment outcomes on social media are prone to bias and misrepresentation from nonadherence to established photographic standards. However, there is currently insufficient information regarding which norms are most-commonly violated, precluding quality improvement efforts.

Methods

A qualitative study of cosmetic treatment photographs published on Instagram was undertaken in accordance with the Guidelines for Reporting Reliability and Agreement Studies using a newly proposed Standards for the Evaluation of Photographs In Aesthetics (SEPIA) nine-point photograph scoring system and grading scale.

Results

A total of 510 posts encompassing 2020 clinical photographs published by 102 practitioner accounts on Instagram were audited for photographic quality. The average score was 4 out of 9 (medium quality), with approximately 40% of posts scoring in the low-quality range. Zoom, lighting, timing, and presentation of multiple views were the standards most-commonly disregarded. Plastic and Reconstructive Surgery specialty and subspecialty (PRSS) practitioners scored higher (4.5/9 versus 3.1/9, P = 0.002) and had fewer low-quality posts (22% versus 54%, P = 0.001) than non-PRSS providers. Low-quality photographs were most often seen with rhinoplasty (30% versus 7%, P < 0.00001) and lip filler (60% versus 33%, P = 0.0001) compared with surgical and nonsurgical treatments, respectively, due to a higher incidence of immediate photographs and selfies.

Conclusions

Before and after photographs of surgical and nonsurgical cosmetic treatment outcomes on social media are frequently of substandard quality. This study outlines specific items frequently neglected in outcomes photography to assist practitioners in maximizing adherence to established standards of photography online.

Psychedelic therapy for body dysmorphic disorder

In this opinion piece we propose the investigation of psychedelic-assisted psychotherapy for the treatment of body dysmorphic disorder (BDD). BDD is a psychiatric disorder characterised by appearance-based preoccupations and accompanying compulsions. While safe and effective treatments for BDD exist, non-response and relapse rates remain high. Therefore, there is a need to investigate promising new treatment options for this highly debilitating condition. Preliminary evidence suggests safety, feasibility, and potential efficacy of psychedelic treatments in disorders that share similar psychopathological mechanisms with BDD. Drawing on this evidence, as well as on relevant qualitative reports and theoretical proposals, we argue that it would be worthwhile to conduct a phase 2a study aimed at assessing the safety and feasibility of psychedelic-assisted psychotherapy in BDD. We also offer some suggestions for how future research ought to proceed.

A complex conceptualization of beauty in Latinx women: A mixed methods study

Latinx women face a myriad of unique pressures to meet unrealistic standards of beauty that are not captured in the dominant, Eurocentric framework of beauty and body image in the U.S. The majority of the extant body image literature represents the experiences of White women and overlooks salient body areas that women of color may experience dissatisfaction with. The present researchers employed a convergent-parallel mixed methods design to examine demographic differences as well as the lived experiences of Latinx women's relationship with beauty and their bodies. Quantitative results from 118 participants revealed that Latinx women with an annual income< 60k (54.2%) reported a higher discrepancy between their actual and ideal buttock size compared to Latinx women with an annual income> 60k (45.8%). Furthermore, a thematic analysis revealed four emergent themes that reflected the unique perceptions and lived experiences of 98 Latinx women's experiences with body image. Findings may assist clinicians working with Latinx women, as they will be able to better understand and integrate relevant cultural aspects of body dissatisfaction when working with Latinx clients.

Body dysmorphic disorder in children and young people

The incidence of body dysmorphic disorder (BDD) in young people is increasing. Causes of BDD are related to the prevalence of social media and adolescent development, especially the role that brain neuroplasticity has on influencing perception. There are long-term impacts of BDD, including depression and suicide. Prevention and promotion of positive body image are part of the nurse's role; treatment can prevent unnecessary aesthetic surgical interventions.