1
|
Wolfe EC, Snorrason I, Laky ZE, Miyares P, Klare D, Fang A, Summers B, Phillips KA, Wilhelm S, Greenberg JL. Clinical characteristics among sexual minority and heterosexual women with body dysmorphic disorder. Body Image 2024; 49:101687. [PMID: 38471234 DOI: 10.1016/j.bodyim.2024.101687] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 02/19/2024] [Accepted: 02/21/2024] [Indexed: 03/14/2024]
Abstract
Body dysmorphic disorder (BDD) is a common disorder associated with substantial comorbidity, impairment, and poor quality of life. Research on subcultural variations of BDD is limited but may impact assessment and treatment of the disorder. The current study examined clinical features in a sample of sexual minority (SM; n = 43) and heterosexual (n = 155) women with diagnosed BDD. Participants completed self-report and clinician-administered measures of demographic and clinical characteristics. Results indicated largely similar clinical features across groups with some exceptions: compared to non-SM women, SM women were younger (M = 25.50 vs 31.96 years, p < .001), had better BDD-related insight (M = 14.51 vs 16.26, p = .01), endorsed a greater number of disliked body parts, and were more likely to express preoccupation with body build (OR = 4.6, 95% CI [2.0, 10.9]), chin/jaw (OR = 4.7, 95% CI [2.1, 10.3]), and shoulders (OR = 10.1, 95% CI [2.7, 37.9]), possibly reflecting nuanced beauty ideals within the SM community. There were no significant group differences in other body parts of concern, BDD severity, or depression. Future studies are needed in larger, more inclusive samples to explore the relationship between diverse identities on BDD and its associated features.
Collapse
Affiliation(s)
- Emma C Wolfe
- University of Virginia, 485 McCormick Road, Charlottesville, VA 22903, USA.
| | - Ivar Snorrason
- Massachusetts General Hospital and Harvard Medical School, 185 Cambridge Street, Suite 2000, Boston MA 02114, USA
| | - Zoë E Laky
- Massachusetts General Hospital and Harvard Medical School, 185 Cambridge Street, Suite 2000, Boston MA 02114, USA; American University, 4400 Massachusetts Avenue, NW, Washington, DC 20016, USA
| | - Peyton Miyares
- Massachusetts General Hospital and Harvard Medical School, 185 Cambridge Street, Suite 2000, Boston MA 02114, USA
| | - Dalton Klare
- Massachusetts General Hospital and Harvard Medical School, 185 Cambridge Street, Suite 2000, Boston MA 02114, USA
| | - Angela Fang
- University of Washington, 3751 West Stevens Way NE, Seattle WA 98195, USA
| | - Berta Summers
- Massachusetts General Hospital and Harvard Medical School, 185 Cambridge Street, Suite 2000, Boston MA 02114, USA
| | - Katharine A Phillips
- Rhode Island Hospital and Alpert Medical School of Brown University, 222 Richmond St, Providence, RI 02903, USA; New York-Presbyterian Hospital and Weill Cornell Medical College, 315 East 62nd Street, New York, NY 10065, USA
| | - Sabine Wilhelm
- Massachusetts General Hospital and Harvard Medical School, 185 Cambridge Street, Suite 2000, Boston MA 02114, USA
| | - Jennifer L Greenberg
- Massachusetts General Hospital and Harvard Medical School, 185 Cambridge Street, Suite 2000, Boston MA 02114, USA
| |
Collapse
|
2
|
Yang LJ, Knoll J, Kundu RV. Consumer attitudes toward aging skin during the COVID-19 pandemic. Int J Womens Dermatol 2023; 9:e095. [PMID: 37457381 PMCID: PMC10348726 DOI: 10.1097/jw9.0000000000000095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 06/06/2023] [Indexed: 07/18/2023] Open
Abstract
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.
Collapse
Affiliation(s)
- Lynna J. Yang
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Justin Knoll
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| | - Roopal V. Kundu
- Northwestern University Feinberg School of Medicine, Chicago, Illinois
| |
Collapse
|
3
|
Alam MM, Basak N, Shahjalal M, Nabi MH, Samad N, Mishu SM, Mazumder S, Basak S, Zaman S, Hawlader MDH. Body dysmorphic disorder (BDD) symptomatology among undergraduate university students of Bangladesh. J Affect Disord 2022; 314:333-340. [PMID: 35878832 DOI: 10.1016/j.jad.2022.07.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2021] [Revised: 06/29/2022] [Accepted: 07/17/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND Body Dysmorphic Disorder (BDD) is an obsessive-compulsive-related disorder causing clinically significant distress or impairment in functioning. The objective of this study was to assess the BDD symptoms and factors associated with BDD symptomatology among undergraduate students. METHODOLOGY A cross-sectional study was conducted from November 2019 to March 2020 in six different universities (3 private and 3 public) across Bangladesh. A total of 1204 undergraduate students were selected through the multistage sampling technique. The BDD-YBOCS tool was used to assess the BDD symptomatology. RESULTS Mild to moderate BDD symptoms was observed among 11.0 % participants, and 1.5 % had severe BDD symptoms. Around 58 % of participants had at least one body defect. Most embarrassments occurred due to acne (12.5 %), followed by thin hair (9.5 %) and scar marks (6.4 %). Males had significantly lower odds of having BDD symptomatology (OR = 0.394; 95%CI = 0.254-0.614) and Participants aged between 20 and 24 years had higher odds (OR = 4.639; 95%CI = 1.024-21.107). Studying in private universities had 1.7 times higher odds in comparison to the public universities (OR = 1.671, 95%CI = 1.052-2.656). Smokers were more prone to have BDD symptomatology than non-smokers (OR = 2.72; 95%CI = 1.571-4.709) and students who had body defects had higher odds (OR = 2.647; CI = 1.723-4.066) of BDD symptomatology. CONCLUSION The study has successfully revealed status and predictors of BDD symptomatology among university students. Further nationwide studies would be conducted to know the overall situation of Bangladesh.
Collapse
Affiliation(s)
- Mohammad Morshad Alam
- Department of Public Health, North South University, Dhaka 1229, Bangladesh; Health, Nutrition and Population (HNP) Global Practice, The World Bank, Dhaka 1207, Bangladesh.
| | - Nandita Basak
- Department of Public Health, North South University, Dhaka 1229, Bangladesh
| | - Md Shahjalal
- Department of Public Health, North South University, Dhaka 1229, Bangladesh
| | | | - Nandeeta Samad
- Department of Public Health, North South University, Dhaka 1229, Bangladesh
| | - Shah Mahmud Mishu
- Department of Public Health, North South University, Dhaka 1229, Bangladesh
| | - Saikot Mazumder
- Department of Chemistry, University of South Dakota, SD 57069, USA
| | - Supria Basak
- Department of Computer Science and Engineering, National Institute of Technology, Tiruchirappalli, Tamilnadu 620015, India
| | - Sanjana Zaman
- Department of Public Health, Daffodil International University, Dhaka 1205, Bangladesh
| | | |
Collapse
|
4
|
Moreno-Amador B, Cervin M, Falcó R, Marzo JC, Piqueras JA. Body-dysmorphic, hoarding, hair-pulling, and skin-picking symptoms in a large sample of adolescents. Curr Psychol 2022. [DOI: 10.1007/s12144-022-03477-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
AbstractFew 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.
Collapse
|
5
|
Longobardi C, Badenes-Ribera L, Fabris MA. Adverse childhood experiences and body dysmorphic symptoms: A meta-analysis. Body Image 2022; 40:267-284. [PMID: 35085863 DOI: 10.1016/j.bodyim.2022.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 12/26/2021] [Accepted: 01/10/2022] [Indexed: 12/29/2022]
Abstract
Adverse childhood experiences (ACEs) are considered a risk factor for the development of various forms of mental disorders, including body dysmorphic disorder (BDD). The aim of the present work was to examine the association between ACEs and BDD symptomatology and to identify features of studies that might moderate this association. We conducted a three-level meta-analysis of 27 articles that included 9167 participants. Results showed that the types of ACE examined (total ACE, abuse, neglect, teasing, and bullying) were positively associated with BDD symptomatology. Specifically, a low to moderate association was found for ACE overall, defined as abuse, neglect, bullying, or teasing (r = 0.289, 95% confidence interval (CI) [.240,.337), for bullying (r = 0.282, 95% CI [.206,.354]), and for abuse (r = 0.223, 95% CI [.169,.276]) were found; and a moderate to large association was found for experienced teasing (r = 0.423, 95% CI [.360,.482]). In addition, moderator analyses of the association between ACE and BDD symptomatology resulted in a predictive model in which the type of ACE, type of sample, and gender of participants moderated the magnitude of the association between ACEs and BDD symptomatology.
Collapse
|
6
|
Hakim RF, Alrahmani DA, Ahmed DM, Alharthi NA, Fida AR, Al-Raddadi RM. Association of body dysmorphic disorder with anxiety, depression, and stress among university students. J Taibah Univ Med Sci 2021; 16:689-94. [PMID: 34690648 DOI: 10.1016/j.jtumed.2021.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 04/28/2021] [Accepted: 05/01/2021] [Indexed: 11/21/2022] Open
Abstract
Objectives This study aims to estimate the prevalence of body dysmorphic disorder (BDD) and identify its association with depression, anxiety, and stress. Method We conducted a cross-sectional study in Jeddah, KSA. In 2019, a validated questionnaire with items on sociodemographic characteristics and body dysmorphic disorder, as well as the Depression, Anxiety, and Stress Scale – 21 items (DASS 21) was distributed to 1,112 students of King Abdulaziz University. SPSS version 23 was used for data analysis, which included descriptive statistics, chi-square tests, and binary logistic regression models. The association was presented as an odds ratio (OR) along with its 95% confidence Interval (CI). Results The overall prevalence of BDD was 13.9% (95% CI of 11.8–16.2.) with the highest reported sites being the skin (81.6%) and waist (68.8%). BDD was found to be a significant predictor of depression with an OR of 4.2 (95% CI 2.9–6.1), anxiety OR of 2.2 (95%1.6–3.2), and stress OR of 3.2 (2.2–4.7). Females were significantly associated with anxiety, OR of 1.4 (95% CI 1.1–1.9) and stress, OR of 1.5 (1.1–2). Affiliation to the administration, arts, humanities, and social colleges was also a significant predictor of anxiety as reflected by an OR of 1.4 (95% CI 1.1–1.8). Conclusions Our study shows that BDD is relatively common among university students in Jeddah and associated with depression, anxiety, and stress. BDD is common among university students. Skin and Waist circumference were the most reported sites among students. BDD is a significant predictor of depression, anxiety, and stress affecting both male and female university student.
Collapse
|
7
|
Malcolm A, Pikoos TD, Grace SA, Castle DJ, Rossell SL. Childhood maltreatment and trauma is common and severe in body dysmorphic disorder. Compr Psychiatry 2021; 109:152256. [PMID: 34147729 DOI: 10.1016/j.comppsych.2021.152256] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 04/19/2021] [Accepted: 05/20/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Childhood maltreatment and trauma may be risk factors for the development of body dysmorphic disorder (BDD). However, the limited research to date on these topics has been constrained by either the absence of a matched healthy control group or non-comprehensive assessments. METHODS This study assessed the prevalence and severity of childhood maltreatment and other traumatic events in 52 BDD participants (56% female) and 57 matched controls (51% female) with no history of mental illness, using the Childhood Trauma Questionnaire and a checklist assessing broader traumatic events. RESULTS In comparison with controls, participants with BDD showed a higher prevalence of emotional abuse (61.5% vs. 33.3%) and physical neglect (59.6% vs. 28.1%), as well as more severe overall maltreatment, emotional abuse, and emotional and physical neglect. BDD participants were also more likely to meet cut-offs for multiple types of maltreatment and reported an elevated number and variety of broader traumatic childhood events (e.g., life-threatening illness). In BDD, increasingly severe maltreatment was correlated with greater severity of BDD symptoms, anxiety and suicidal ideation. CONCLUSIONS These data suggest that childhood maltreatment and exposure to other traumatic events are common and severe in BDD and are cross-sectionally associated with the severity of clinical symptoms. Adversity linked to maladaptive family functioning during childhood may therefore be especially relevant to people with BDD and could relate to social and emotional processing problems in the disorder.
Collapse
Affiliation(s)
- Amy Malcolm
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Victoria, Australia.
| | - Toni D Pikoos
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - Sally A Grace
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Victoria, Australia
| | - David J Castle
- Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia; The University of Melbourne, Melbourne, Victoria, Australia; Centre for Addiction and Mental Health and the Department of Psychiatry, University of Toronto, Canada
| | - Susan L Rossell
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, Victoria, Australia; Department of Mental Health, St Vincent's Hospital, Melbourne, Victoria, Australia
| |
Collapse
|