[Body dysmorphic disorder].

Science.gov (United States)

Grau, Katharina; Fegert, Jörg Michael; Allroggen, Marc

2015-01-01

Body dysmorphic disorder (BDD) is a relatively common disorder with a point prevalence of 0.7-2.4 %. BDD is characterized by the patient's excessive concern with an imagined or slight defect in physical appearance. BDD usually begins in adolescence. Comorbidity rates and also suicidality rates are high. The course of BDD tends to be chronic. According to the present state of knowledge, cognitive-behavioral therapy and pharmacotherapy with selective serotonin reuptake inhibitors are valuable options in the therapy of BDD. The case report describes a recent case of BDD with typical clinical and therapy-related characteristics. The aim of this work is to strengthen the awareness of BDD in clinical practice of child and adolescent psychiatry, facilitating an adequate diagnosis and treatment of the affected individuals.

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

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Senín-Calderón, Cristina; Valdés-Díaz, María; Benítez-Hernández, Ma M; Núñez-Gaitán, Ma C; Perona-Garcelán, Salvador; Martínez-Cervantes, Rafael; Rodríguez-Testal, Juan F

2017-01-01

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, M age = 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.

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

Directory of Open Access Journals (Sweden)

Cristina Senín-Calderón

2017-06-01

Full Text Available 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.

Body Dysmorphic Disorder: Easing the Distress of Distortion.

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Fore, Cynthia M.

People who suffer from body dysmorphic disorder believe that their body is defected and that this defect makes them ugly. Their distorted body image can be precipitated by many internal and external factors and as a result of their imagined defect, these normal-appearing individuals exhibit self-defeating behaviors. The disorder can lead to the…

Potential link between body dysmorphic disorder symptoms and alexithymia in an eating-disordered treatment-seeking sample.

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Fenwick, Andrea Siân; Sullivan, Karen Anne

2011-09-30

This study aimed to explore the manifestation of body dysmorphic disorder symptoms in a sample of people with eating disorders and to investigate possible associations between body dysmorphia and alexithymia. Forty patients currently seeking treatment for an eating disorder completed a battery of six measures assessing alexithymia, mood, eating behaviours, weight-related body image, body dysmorphia and non-weight related body image. Significant moderate positive correlations (Pearson's r) between selected variables were found, suggesting that participants with high levels of dysmorphic concern (imagined ugliness) have more difficulty with the affective elements of alexithymia, that is, identifying and describing feelings. When depression, eating attitudes, and weight-related body image concerns were controlled for, significant moderate positive correlations between this alexithymia factor and dysmorphic concerns remained present. An independent-samples t-test between eating-disordered participants with and without symptoms of body dysmorphic disorder (BDD) revealed significant group differences in difficulties identifying feelings. This pattern of results was replicated when the groups were identified on the basis of dysmorphic concerns, as opposed to BDD symptoms. This study highlights the associations between alexithymia and body dysmorphia that have not previously been demonstrated. Copyright © 2011 Elsevier Ltd. All rights reserved.

Cognitive-Behavioral Body Image Therapy for Body Dysmorphic Disorder.

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Rosen, James C.; And Others

1995-01-01

Randomly assigned 54 body dysmorphic disorder (BDD) subjects to cognitive behavior therapy or no treatment. BDD symptoms were significantly decreased in therapy subjects and the disorder was eliminated in 82 percent of cases at posttreatment and 77 percent at follow-up. Subjects' overall psychological symptoms and self-esteem also improved. (RJM)

Body Dysmorphic Disorder: Contraindication or Ethical Justification for Female Genital Cosmetic Surgery in Adolescents.

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Spriggs, Merle; Gillam, Lynn

2016-11-01

Is Female Genital Cosmetic Surgery for an adolescent with Body Dysmorphic Disorder ever ethically justified? Cosmetic genital surgery (specifically labioplasty) for adolescent girls is one of the most ethically controversial forms of cosmetic surgery and Body Dysmorphic Disorder is typically seen as a contraindication for cosmetic surgery. Two key ethical concerns are (1) that Body Dysmorphic Disorder undermines whatever capacity for autonomy the adolescent has; and (2) even if there is valid parental consent, the presence of Body Dysmorphic Disorder means that cosmetic surgery will fail in its aims. In this article, we challenge, in an evidence-based way, the standard view that Body Dysmorphic Disorder is a contraindication for genital cosmetic surgery in adolescents. Our argument gathers together and unifies a substantial amount of disparate research in the context of an ethical argument. We focus on empirical questions about benefit and harm, because these are ethically significant. Answers to these questions affect the answer to the ethical question. We question the claim that there would be no benefit from surgery in this situation, and we consider possible harms that might be done if treatment is refused. For an adolescent with Body Dysmorphic Disorder, the most important thing may be to avoid harm. We find ourselves arguing for the ethical justifiability of cosmetic labioplasty for an adolescent with Body Dysmorphic Disorder, even though we recognize that it is a counter intuitive position. We explain how we reached our conclusion. © 2016 John Wiley & Sons Ltd.

Cognitive-behavioral therapy for body dysmorphic disorder: a review of its efficacy

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Prazeres, Angélica M; Nascimento, Antônio L; Fontenelle, Leonardo F

2013-01-01

The aim of this study was to review the efficacy of different methods of cognitive and/or behavioral therapies used to treat body dysmorphic disorder. We evaluated all case series, open studies, controlled trials, and meta-analyses of cognitive and/or behavioral treatment approaches to body dysmorphic disorder published up to July 2012, identified through a search in the PubMed/Medline, PsycINFO, ISI Web of Knowledge, and Scopus databases. Our findings indicate that individual and group cognitive behavioral therapies are superior to waiting list for the treatment of body dysmorphic disorder. While the efficacy of cognitive therapy is supported by one controlled trial, utility of behavioral therapy is suggested by one open study and one controlled relapse prevention follow-up study. There is a pressing need to conduct head-to-head studies, with appropriate, active, control treatment groups, in order to examine further the efficacy of cognitive and/or behavioral therapies for body dysmorphic disorder. PMID:23467711

Placebo-Controlled Study of Pimozide Augmentation of Fluoxetine in Body Dysmorphic Disorder

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Phillips, Katharine A.

2006-01-01

Objective Although body dysmorphic disorder often responds to serotonin reuptake inhibitors (SRIs), most patients do not respond or respond only partially. However, placebo-controlled studies of augmentation of SRIs have not been done. Furthermore, although 40%–50% of patients are delusional, studies of antipsychotic medications have not been done. Method Twenty-eight patients with body dysmorphic disorder or its delusional variant participated in an 8-week, placebo-controlled, double-blind, parallel-group study of pimozide augmentation of fluoxetine. Results Pimozide was not more effective than placebo: two (18.2%) of 11 subjects responded to pimozide and three (17.6%) of 17 subjects responded to placebo. There was no significant effect of baseline delusionality on endpoint severity of body dysmorphic disorder. Delusionality did not decrease significantly more with pimozide than placebo. Conclusions Pimozide augmentation of fluoxetine treatment for body dysmorphic disorder was not more effective than placebo, even in more delusional patients. Further studies of augmentation for SRIs are needed. PMID:15677604

Pharmacotherapy Relapse Prevention in Body Dysmorphic Disorder: A Double-Blind, Placebo-Controlled Trial.

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Phillips, Katharine A; Keshaviah, Aparna; Dougherty, Darin D; Stout, Robert L; Menard, William; Wilhelm, Sabine

2016-09-01

Body dysmorphic disorder is common, distressing, and often severely impairing. Serotonin reuptake inhibitors appear efficacious, but the few existing pharmacotherapy studies were short term (≤4 months), and no relapse prevention studies or continuation phase studies have been conducted to the authors' knowledge. The authors report results from the first relapse prevention study in body dysmorphic disorder. Adults (N=100) with DSM-IV body dysmorphic disorder received open-label escitalopram for 14 weeks (phase 1); 58 responders were then randomized to double-blind continuation treatment with escitalopram versus switch to placebo for 6 months (phase 2). Reliable and valid outcome measures were utilized. In phase 1, 67.0% of treated subjects and 81.1% of subjects who completed phase 1 responded to escitalopram. Body dysmorphic disorder severity (in both the intent-to-treat and the completer groups) and insight, depressive symptoms, psychosocial functioning, and quality of life significantly improved from baseline to end of phase 1. In phase 2, time to relapse was significantly longer with escitalopram than with placebo treatment (hazard ratio=2.72, 95% CI=1.01-8.57). Phase 2 relapse proportions were 18% for escitalopram and 40% for placebo. Among escitalopram-treated subjects, body dysmorphic disorder severity significantly decreased over time during the continuation phase, with 35.7% of subjects showing further improvement. There were no significant group differences in body dysmorphic disorder severity or insight, depressive symptoms, psychosocial functioning, or quality of life. Continuation-phase escitalopram delayed time to relapse, and fewer escitalopram-treated subjects relapsed than did placebo-treated subjects. Body dysmorphic disorder severity significantly improved during 6 additional months of escitalopram treatment following acute response; more than one-third of escitalopram-treated subjects experienced further improvement.

A Case of Treatment- resistant Depression and Body Dysmorphic Disorder: The Role of Electroconvulsive Therapy Revisited.

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Mahato, Ram S; San Gabriel, Maria Chona P; Longshore, Carrol T; Schnur, David B

2016-01-01

Body dysmorphic disorder is a common, often disabling condition, and is frequently comorbid with major depressive disorder. Selective serotonin reuptake inhibitors constitute first line set of somatic interventions but the management of refractory patients remains challenging. Electroconvulsive therapy, an often highly beneficial treatment for medication resistant-depression, is not considered an effective therapeutic alternative for treatment refractory body dysmorphic disorder. Here we present a 50-year-old woman with body dysmorphic disorder and comorbid major depressive disorder who remained incapacitated and suicidal despite several trials with selective serotonin reuptake inhibitors and antipsychotic medication. Depressive and dysmorphic symptoms appeared to resolve with electroconvulsive therapy, and remission was sustained for two months. Electroconvulsive therapy has an important place in the management of treatment- resistant depression associated with body dysmorphic disorder, and, in select cases, may be effective for dysmorphic symptoms as well.

Skin picking disorder with co-occurring body dysmorphic disorder

DEFF Research Database (Denmark)

Grant, Jon E; Redden, Sarah A; Leppink, Eric W

2015-01-01

There is clinical overlap between skin picking disorder (SPD) and body dysmorphic disorder (BDD), but little research has examined clinical and cognitive correlates of the two disorders when they co-occur. Of 55 participants with SPD recruited for a neurocognitive study and two pharmacological st...... unique clinical and cognitive aspects of SPD may be more pronounced. Future work should explore possible subgroups in SPD and whether these predict different treatment outcomes....

The relationship between perceived social support and severity of body dysmorphic disorder symptoms: the role of gender.

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Marques, Luana; Weingarden, Hilary M; LeBlanc, Nicole J; Siev, Jedidiah; Wilhelm, Sabine

2011-09-01

Whether social support is associated with severity of body dysmorphic symptoms is unknown. To address this gap in the literature, the present study aims to examine the association between three domains of perceived social support (i.e., family, friends, and significant others) and severity of body dysmorphic disorder symptoms. Participants (N = 400) with symptoms consistent with diagnosis of body dysmorphic disorder completed measures of symptomatology and social support via the internet. More perceived social support from friends and significant others was associated with less severe body dysmorphic disorder symptoms for males, and more perceived social support from family and friends was associated with less severe body dysmorphic disorder symptoms among females. Additionally, gender moderated the association between perceived social support from significant others and symptom severity, such that perceived social support from a significant other was significantly negatively associated with body dysmorphic symptom severity in males, but not females. The present study implicates social support as an important area of future body dysmorphic disorder research.

[Prevalence of depression and body dysmorphic disorder in patients before functional rhinosurgery].

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Bender, M; Rustige, L; Lindemann, J

2014-11-01

Psychiatric disorders are known to influence the result of many surgical procedures. Body dysmorphic disorder (BDD) is found in many patients undergoing plastic surgery. The prevalence before functional rhinosurgery has not been examined so far. The aim of this study was to determine the prevalence of depression and BDD before functional rhinosurgery. 201 patients were prospectively examined with a questionnaire before functional rhinosurgery. Beck-Depression-Index was used to rate depression, the PISA body dsymorphic symptom scale was used to evaluate the likelihood that a patient suffers from body dysmoprhic disorder. 186 patients returned a complete questionnaire. In 33.9% showed a mild or strong indication for a body dysmorphic disorder. Patients who were planned to undergo septorhinoplasty had a significantly higher scores in the PISA-scale compared to patients before septoplasty. 1.7% patients were depressive without a significant difference between the planned surgical procedure. Many patients before functional septorhinoplasty show signs of body dysmorphic disorder. Whether this influences the subjective clinical outcome needs to be evaluated in further studies. © Georg Thieme Verlag KG Stuttgart · New York.

Childhood Abuse and Neglect in Body Dysmorphic Disorder

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Didie, Elizabeth R.; Tortolani, Christina C.; Pope, Courtney G.; Menard, William; Fay, Christina; Phillips, Katharine A.

2006-01-01

Objective: No published studies have examined childhood abuse and neglect in body dysmorphic disorder (BDD). This study examined the prevalence and clinical correlates of abuse and neglect in individuals with this disorder. Methods: Seventy-five subjects (69.3% female, mean age = 35.4 +/- 12.0) with DSM-IV BDD completed the Childhood Trauma…

Prevalence of Body Dysmorphic Disorder and its Association With Body Features in Female Medical Students.

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Shaffi Ahamed, Shaik; Enani, Jawaher; Alfaraidi, Lama; Sannari, Lujain; Algain, Rihaf; Alsawah, Zainah; Al Hazmi, Ali

2016-06-01

Body dysmorphic disorder (BDD) is a distressing psychiatric disorder. So far there have not been any studies on BDD in Saudi Arabia. The aim of this study was to determine the prevalence of body dysmorphic disorder in female medical students and to investigate whether there is an association between BDD and body features of concern, social anxiety and symptoms of BDD. A cross sectional study was carried out on female medical students of the college of medicine, King Saud University, Riyadh, Saudi Arabia during January to April, 2015. Data were collected using the body image disturbance questionnaire, Body dysmorphic disorder symptomatology and social interaction anxiety scale. Descriptive statistics, bivariate and multivariate analysis were used to analyze the results. Out of 365 students who filled out the questionnaire, 4.4% (95% confidence intervals (CI): 2.54% to 7.04%) were positive for BDD with skin (75%) and fat (68.8%) as the most frequent body features of concern. Ten features (skin, fat, chest, hips, buttocks, arms, legs, lips, fingers, and shoulders) out of twenty-six were significantly associated with BDD. Arms and chest were independently associated with BDD. The odds of presence of body concern related to "arms" was 4.3 (95% C.I: 1.5, 12.1) times more in BDD subjects than non-BDD subjects, while concern about "chest" was 3.8 (1.3, 10.9) times more when compared to non-BDD subjects. No statistically significant association was observed between BDD and social anxiety (P = 0.13). This was the first study conducted in Kingdom of Saudi Arabia (KSA) on female medical students, which quantified the prevalence of BDD and identified the body features associated with it. Body dysmorphic disorder is prevalent in female medical students but it is relatively rare and an unnoticed disorder.

[Body dysmorphic disorder and aesthetic surgery: A systematic review].

Science.gov (United States)

Kerfant, N; Henry, A-S; Ta, P; Trimaille, A; Philandrianos, C; Hu, W

2015-12-01

Patients suffering from body dysmorphic disorder (BDD) are preoccupied with an imagined or minor defect in appearance that causes significant distress and impairment in social and occupational functioning. Despite a rate of up to 15% of BDD patients reported in cosmetic surgery settings, there is no consensus on the best management for these patients. The main purpose of this article was to conduct a literature review on BDD and cosmetic surgery. Properly trained healthcare professionals in recognizing and diagnosing this pathology is essential for the delivery of quality psychiatric care while taking into account the high prevalence of body dysmorphic disorder patients in cosmetic surgery and the poor outcome of these patients following cosmetic procedures. Copyright © 2015 Elsevier Masson SAS. All rights reserved.

Patient Selection in Plastic Surgery: Recognizing Body Dysmorphic Disorder

Directory of Open Access Journals (Sweden)

Cihan Sahin

2013-04-01

Full Text Available 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. [Arch Clin Exp Surg 2013; 2(2.000: 109-115

Cognitive-behavioral therapy for body dysmorphic disorder: a review of its efficacy

Directory of Open Access Journals (Sweden)

Prazeres AM

2013-02-01

Full Text Available Angélica M Prazeres,1 Antônio L Nascimento,1 Leonardo F Fontenelle1,21Anxiety and Depression Research Program, Institute of Psychiatry, Universidade Federal do Rio de Janeiro, Rio de Janeiro, 2Department of Psychiatry and Mental Health, Universidade Federal Fluminense, Hospital Universitário Antonio Pedro, Niterói, BrazilAbstract: The aim of this study was to review the efficacy of different methods of cognitive and/or behavioral therapies used to treat body dysmorphic disorder. We evaluated all case series, open studies, controlled trials, and meta-analyses of cognitive and/or behavioral treatment approaches to body dysmorphic disorder published up to July 2012, identified through a search in the PubMed/Medline, PsycINFO, ISI Web of Knowledge, and Scopus databases. Our findings indicate that individual and group cognitive behavioral therapies are superior to waiting list for the treatment of body dysmorphic disorder. While the efficacy of cognitive therapy is supported by one controlled trial, utility of behavioral therapy is suggested by one open study and one controlled relapse prevention follow-up study. There is a pressing need to conduct head-to-head studies, with appropriate, active, control treatment groups, in order to examine further the efficacy of cognitive and/or behavioral therapies for body dysmorphic disorder.Keywords: dysmorphophobia, behavioral therapy, cognitive therapy, literature review

Cognitive-Behavioral Therapy for Adolescent Body Dysmorphic Disorder

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Greenberg, Jennifer L.; Markowitz, Sarah; Petronko, Michael R.; Taylor, Caitlin E.; Wilhelm, Sabine; Wilson, G. Terence

2010-01-01

The onset of appearance-related concerns associated with body dysmorphic disorder (BDD) typically occurs in adolescence, and these concerns are often severe enough to interfere with normal development and psychosocial functioning. Cognitive behavioral therapy (CBT) is an effective treatment for adults with BDD. However, no treatment studies…

A Review of Body Dysmorphic Disorder and Its Presentation in Different Clinical Settings

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Mufaddel, Amir; Osman, Ossama T.; Almugaddam, Fadwa

2013-01-01

Objective: Body dysmorphic disorder (BDD) is a relatively common psychiatric disorder characterized by preoccupations with perceived defects in physical appearance. This review aimed to explore epidemiology, clinical features, comorbidities, and treatment options for BDD in different clinical settings. Data Source and Study Selection: A search of the literature from 1970 to 2011 was performed using the MEDLINE search engine. English-language articles, with no restriction regarding the type of articles, were identified using the search terms body dysmorphic disorder, body dysmorphic disorder clinical settings, body dysmorphic disorder treatment, and body dysmorphic disorder & psychodermatology. Results: BDD occurs in 0.7% to 2.4% of community samples and 13% of psychiatric inpatients. Etiology is multifactorial, with recent findings indicating deficits in visual information processing. There is considerable overlap between BDD and obsessive-compulsive disorder (OCD) in symptom etiology and response to treatment, which has led to suggestions that BDD can be classified with anxiety disorders and OCD. A recent finding indicated genetic overlap between BDD and OCD. Over 60% of patients with BDD had a lifetime anxiety disorder, and 38% had social phobia, which tends to predate the onset of BDD. Studies reported a high level of comorbidity with depression and social phobia occurring in > 70% of patients with BDD. Individuals with BDD present frequently to dermatologists (about 9%–14% of dermatologic patients have BDD). BDD co-occurs with pathological skin picking in 26%–45% of cases. BDD currently has 2 variants: delusional and nondelusional, and both variants respond similarly to serotonin reuptake inhibitors (SRIs), which may have effect on obsessive thoughts and rituals. Cognitive-behavioral therapy has the best established treatment results. Conclusions: A considerable overlap exists between BDD and other psychiatric disorders such as OCD, anxiety, and delusional

Preoperative symptoms of body dysmorphic disorder determine postoperative satisfaction and quality of life in aesthetic rhinoplasty.

Science.gov (United States)

Picavet, Valerie A; Gabriëls, Loes; Grietens, Jente; Jorissen, Mark; Prokopakis, Emmanuel P; Hellings, Peter W

2013-04-01

In patients seeking aesthetic rhinoplasty, a high prevalence of body dysmorphic disorder symptoms has recently been reported. However, the impact of these symptoms on the outcomes after rhinoplasty remains elusive. This large-scale study determines the influence of preoperative body dysmorphic disorder symptoms on patients' postoperative satisfaction and quality of life, using validated questionnaires. A 1-year prospective study of 166 adult patients undergoing cosmetic rhinoplasty in a tertiary referral center was performed. Severity of body dysmorphic disorder symptoms was assessed by the modified Yale-Brown Obsessive Compulsive Scale. Postoperative satisfaction was evaluated using a visual analog scale for patients' appraisal of nasal shape and the Rhinoplasty Outcome Evaluation. Generic quality of life was quantified by the Sheehan Disability Scale, whereas the appearance-related disruption of everyday life was measured by the Derriford Appearance Scale-59. Preoperative body dysmorphic disorder symptom scores inversely correlated with postoperative satisfaction at 3 months (visual analog scale nasal shape: rho = -0.43, p dysmorphic disorder symptom scores positively correlated with Sheehan Disability Scale scores and Derriford Appearance Scale-59 scores at 3 months (rho = 0.43, p dysmorphic disorder symptoms on subjective outcomes after rhinoplasty, hence unveiling a crucial factor in patient dissatisfaction after aesthetic rhinoplasty.

What Rhinoplasty Surgeons Should Know about Body Dysmorphic Disorder (BDD)

NARCIS (Netherlands)

Reichert, M.; Scheithauer, M.; Hoffmann, T. K.; Hellings, P.; Picavet, V.

2014-01-01

Body dysmorphic disorder (BDD) is a psychiatric disorder characterized by an excessive concern with a non-existing or slight defect in physical appearance. BDD patients frequently show impaired judgment regarding the psychiatric origin of their concerns and often seek aesthetic treatment to resolve

Body dysmorphic disorder: prevalence and outcomes in an oculofacial plastic surgery practice.

Science.gov (United States)

Woolley, Austin J; Perry, Julian D

2015-06-01

To determine the prevalence, associated factors, and surgical outcomes of patients with body dysmorphic disorder in an oculofacial surgery practice. Retrospective cross-sectional analysis of a consecutive case series. Participants consisted of a consecutive series of 728 patients who completed the Dysmorphic Concern Questionnaire in an oculofacial surgery practice at The Cole Eye Institute between November 2013 and June 2014. A questionnaire score ≥9 was used as a positive screen for body dysmorphic disorder. Three control patients scoring ≤8 in the same month were randomly selected for each positive-screening patient. Main outcome measures included number of reoperations, surgical complications, and follow-up visits; preoperative and postoperative pain scores; and the technician word count. Categorical variables were analyzed with Pearson χ(2) tests or Fisher exact tests, while continuous variables were analyzed with Wilcoxon rank sum tests or t tests. A total of 728 patients completed the questionnaire and 50 (6.9%) scored 9 or more. Using a confidence interval of 95%, patients in the positive questionnaire screen group were younger (P = .004), had more eyelid surgeries (P = .007), experienced higher rates of complications after surgery (P = .002), reported higher postoperative pain scores (P = .034), required more reoperations (P = .050), and had a higher technician word count compared to the control group (P = .003). The prevalence of body dysmorphic disorder in an oculofacial surgical setting matches reports from other surgical specialties, and is significantly higher than in the general population. Patients screening positively for body dysmorphic disorder tend to have higher postoperative pain scores and more postoperative complications. Copyright © 2015 Elsevier Inc. All rights reserved.

Modular Cognitive-Behavioral Therapy for Body Dysmorphic Disorder

Science.gov (United States)

Wilhelm, Sabine; Phillips, Katharine A.; Fama, Jeanne M.; Greenberg, Jennifer L.; Steketee, Gail

2011-01-01

This study pilot tested a newly developed modular cognitive-behavioral therapy (CBT) treatment manual for body dysmorphic disorder (BDD). We tested feasibility, acceptability, and treatment outcome in a sample of 12 adults with primary BDD. Treatment was delivered in weekly individual sessions over 18 or 22 weeks. Standardized clinician ratings…

Prevalence of Body Dysmorphic Disorder Symptoms and Associated Clinical Features among Australian University Students

Science.gov (United States)

Bartsch, Dianna

2007-01-01

The current study addressed the frequency of body dysmorphic disorder (BDD) symptoms among university students and investigated the predictors of dysmorphic concern. Six hundred and nineteen Australian university students completed measures assessing BDD, dysmorphic concern, self-esteem, depression, life satisfaction, self-oriented and socially…

[Body dysmorphic disorder in cosmetic surgery - prevalence, psychiatric comorbidity and outcome].

Science.gov (United States)

Hundscheid, T; van der Hulst, R R W J; Rutten, B P F; Leue, C

2014-01-01

Patients suffering from body dysmorphic disorder (bdd) are preoccupied with a slight or imagined defect in appearance. First of all, to review the literature on the prevalence of bdd in cosmetic surgery and thereafter to review the literature on psychiatric comorbidity and the outcome of surgical interventions. We based our search strategy on Embase, Medline and PubMed, using the search terms 'body dysmorphic disorder', 'cosmetic surgery', 'prevalence', 'comorbidity' and 'outcome'. Our search covered English and Dutch literature published after the introduction of bdd in dsm-iii-r and before 1 November, 2013. A study of the relevant articles enabled us to access additional articles mentioned in these texts. Our initial search strategy turned out to be too narrow. It was therefore broadened to include 'body dysmorphic disorder', 'cosmetic surgery', and 'prevalence'. Eventually we included 23 original articles. In 11 of these the prevalence of bdd varied from 3.2 to 53.6%. Twelve articles on psychiatric comorbidity revealed predominantly mood and anxiety disorders on axis I and cluster C personality disorders on axis II. Only two studies reported on the outcome of cosmetic surgery performed on bdd patients; surgical interventions, however, seemed to result in new preoccupations with the prolongation of psychiatric comorbidity. bdd is a common psychiatric disorder that can sometimes lead to cosmetic surgery. However, pre-operative screening of bdd patients is vital so that efficient psychiatric treatment can be initiated and patients are not subjected to surgical interventions which may be ineffective or even harmful.

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

Science.gov (United States)

Baykal, Bahadir; Erdim, Ibrahim; Ozbay, Isa; Oghan, Fatih; Oncu, Fatih; Erdogdu, Zeynep; Kayhan, Fatma Tulin

2015-11-01

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.

Demographic Characteristics, Phenomenology, Comorbidity, and Family History in 200 Individuals With Body Dysmorphic Disorder

Science.gov (United States)

Phillips, Katharine A.; Menard, William; Fay, Christina; Weisberg, Risa

2005-01-01

The authors examined characteristics of body dysmorphic disorder in the largest sample for which a wide range of clinical features has been reported. The authors also compared psychiatrically treated and untreated subjects. Body dysmorphic disorder usually began during adolescence, involved numerous body areas and behaviors, and was characterized by poor insight, high comorbidity rates, and high rates of functional impairment, suicidal ideation, and suicide attempts. There were far more similarities than differences between the currently treated and untreated subjects, although the treated subjects displayed better insight and had more comorbidity. PMID:16000674

A Cognitive-Behavioral Treatment Approach for Body Dysmorphic Disorder

Science.gov (United States)

Wilhelm, Sabine; Buhlmann, Ulrike; Hayward, Laura C.; Greenberg, Jennifer L.; Dimaite, Ruta

2010-01-01

Although body dysmorphic disorder (BDD) has been described in the literature for more than a century, there has been only a limited focus on the development of cognitive behavioral treatments for BDD. Our case report provides a detailed description of a course of cognitive behavioral treatment (CBT) for an individual with BDD. The patient was…

Case Conceptualization and Treatment of Comorbid Body Dysmorphic Disorder and Bulimia Nervosa

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Didie, Elizabeth R.; Reinecke, Mark A.; Phillips, Katharine A.

2010-01-01

Body dysmorphic disorder (BDD) and eating disorders often co-occur and share some clinical features. In addition, the co-occurrence of BDD and an eating disorder may be associated with greater impairment in functioning. Furthermore, clinical impressions suggest that this comorbidity may be more treatment resistant than either disorder alone. The…

Preoperative symptoms of body dysmorphic disorder determine postoperative satisfaction and quality of life in aesthetic rhinoplasty

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Picavet, Valerie A.; Gabriëls, Loes; Grietens, Jente; Jorissen, Mark; Prokopakis, Emmanuel P.; Hellings, Peter W.

2013-01-01

In patients seeking aesthetic rhinoplasty, a high prevalence of body dysmorphic disorder symptoms has recently been reported. However, the impact of these symptoms on the outcomes after rhinoplasty remains elusive. This large-scale study determines the influence of preoperative body dysmorphic

Suicidality in Body Dysmorphic Disorder

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Phillips, Katharine A.

2008-01-01

Suicidal ideation, suicide attempts, and completed suicide appear common in individuals with body dysmorphic disorder (BDD). Available evidence indicates that approximately 80% of individuals with BDD experience lifetime suicidal ideation and 24% to 28% have attempted suicide. Although data on completed suicide are limited and preliminary, the suicide rate appears markedly high. These findings underscore the importance of recognizing and effectively treating BDD. However, BDD is underrecognized in clinical settings even though it is relatively common and often presents to psychiatrists and other mental health practitioners, dermatologists, surgeons, and other physicians. This article reviews available evidence on suicidality in BDD and discusses how to recognize and diagnose this often secret disorder. Efficacious treatments for BDD, ie, serotonin reuptake inhibitors (SRIs) and cognitive-behavioral therapy, are also discussed. Although data are limited, it appears that SRIs often diminish suicidality in these patients. Additional research is greatly needed on suicidality rates, characteristics, correlates, risk factors, treatment, and prevention of suicidality in BDD. PMID:18449358

Personality traits as vulnerability factors in body dysmorphic disorder.

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Schieber, Katharina; Kollei, Ines; de Zwaan, Martina; Müller, Astrid; Martin, Alexandra

2013-11-30

Cognitive behavioural models consider certain personality traits to be risk factors for the development of Body Dysmorphic Disorder (BDD). Research on personality traits in BDD is scarce, therefore this study examined perfectionism, aesthetic sensitivity and the behavioural inhibition system (BIS) in BDD. Furthermore, the association between these personality traits and the extent of dysmorphic concerns was investigated. Individuals with BDD (n=58) and a population based control sample (n=2071), selected from a representative German population survey, completed self-report questionnaires assessing DSM-5 criteria of BDD, dysmorphic concerns, perfectionism, aesthetic sensitivity and BIS-reactivity. Individuals with BDD reported significantly higher degrees of perfectionism as well as of BIS-reactivity compared to the population based control sample, whereas the groups did not differ significantly regarding aesthetic sensitivity. However, for the total sample, each of the personality traits was related dimensionally to dysmorphic concerns. Current BDD models consider perfectionism and aesthetic sensitivity to be vulnerability factors. In addition to these concepts, the present study suggests that BIS-reactivity is related to BDD. Self-reported aesthetic sensitivity was not found to be specifically pronounced in BDD, but along with perfectionism and BIS-reactivity aesthetic sensitivity was generally associated with dysmorphic concerns. © 2013 Elsevier Ireland Ltd. All rights reserved.

Subthreshold body dysmorphic disorder in adolescents: Prevalence and impact.

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Schneider, Sophie C; Mond, Jonathan; Turner, Cynthia M; Hudson, Jennifer L

2017-05-01

The aim of the current study was to establish the prevalence of subthreshold body dysmorphic disorder (subthreshold-BDD) in a community sample of adolescents, and to compare disorder correlates in individuals with subthreshold-BDD to those with probable full-syndrome BDD (probable-BDD) and those without BDD (non-BDD). Self-report questionnaires assessing DSM-IV BDD criteria, past mental health service use, and symptoms of body dysmorphic disorder, anxiety, depression, obsessive-compulsive disorder and eating disorders, were completed by 3149 Australian high school students (mean age =14.6 years, 63.5% male). Male participants also completed measures assessing quality of life, muscularity concerns, emotional symptoms, conduct problems, hyperactivity, and peer problems. The prevalence of subthreshold-BDD was 3.4%, and probable-BDD was 1.7%. Compared to the non-BDD group, subthreshold-BDD was associated with elevated symptoms of comorbid psychopathology and greater past mental health service use, and in male-only measures, with poorer quality of life and elevated muscularity concerns. Subthreshold-BDD participants reported significantly lower mental health service use, and fewer symptoms of depression, eating disorders, and hyperactivity than probable-BDD participants, however, other comorbid symptoms did not differ significantly between these groups. These findings indicate that subthreshold-BDD is associated with substantial difficulties for adolescents in the general community. BDD screening should include subthreshold presentations, as these may be an important target for early intervention programs. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Neurocognitive Functioning in Young Adults with Subclinical Body Dysmorphic Disorder.

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Blum, Austin W; Redden, Sarah A; Grant, Jon E

2018-03-01

Despite reasonable knowledge of body dysmorphic disorder (BDD), little is known of its cognitive antecedents. In this study, we evaluated executive functioning and decision-making in people at risk of developing BDD using neuropsychological tests. Participants were non-treatment seeking volunteers (18-29 years) recruited from the general community, and split into two groups: those "at risk" of developing BDD (N = 5) and controls (N = 82). Participants undertook the One-Touch Stockings of Cambridge, Cambridge Gamble and Spatial Working Memory tasks and were assessed with the Body Dysmorphic Disorder Questionnaire. Results showed that the at-risk subjects performed significantly worse on a measure of executive function, whereas measures of risk-seeking behavior, quality of decision-making, and spatial working memory were largely intact. The findings suggest that selective cognitive dysfunction may already be present in terms of executive functioning in those at risk of developing BDD, even before psychopathology arises.

Anorexia nervosa and body dysmorphic disorder: A comparison of body image concerns and explicit and implicit attractiveness beliefs.

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Hartmann, A S; Thomas, J J; Greenberg, J L; Elliott, C M; Matheny, N L; Wilhelm, S

2015-06-01

Although body image is central to the etiological models of anorexia nervosa and body dysmorphic disorder, studies comparing body image and beliefs about attractiveness between the disorders are rare. Sixty-nine individuals (anorexia nervosa: n=24, body dysmorphic disorder: n=23, healthy controls: n=22) completed self-report measures (body image and general psychopathology), diagnostic interviews, and Go/No-Go Association tasks measuring implicit associations. Compared to controls, both clinical groups exhibited greater negative body image, a more negative attitude toward their physical selves, and more dysfunctional coping strategies (ps<.001). Also, both clinical groups shared greater explicit beliefs about the importance of attractiveness (ps<.001). In addition to supporting previous research with regard to comparable body image disturbance, this study also showed that beliefs regarding the importance of appearance (e.g., "one must be attractive to be successful") might be a fruitful target for therapy across both disorders. Copyright © 2015 Elsevier Ltd. All rights reserved.

Body Dysmorphic Disorder and Other Clinically Significant Body Image Concerns in Adolescent Psychiatric Inpatients: Prevalence and Clinical Characteristics

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Dyl, Jennifer; Kittler, Jennifer; Phillips, Katharine A.; Hunt, Jeffrey I.

2006-01-01

Background: This study assessed prevalence and clinical correlates of body dysmorphic disorder (BDD), eating disorders (ED), and other clinically significant body image concerns in 208 consecutively admitted adolescent inpatients. It was hypothesized that adolescents with BDD would have higher levels of depression, anxiety, and suicidality.…

Body dysmorphic disorder screening in maxillofacial outpatients presenting for orthognathic surgery

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Vulink, N. C. C.; Rosenberg, A.; Plooij, J. M.; Koole, R.; Bergé, S. J.; Denys, D.

2008-01-01

Body dysmorphic disorder (BDD) is a severe psychiatric disease with delusions about defects in appearance for which patients seek surgical help. This is the first European study to determine the half-year prevalence of BDD in a maxillofacial outpatient clinic. A total of 160 patients with

Prevalence of Body Dysmorphic Disorder Among Patients Seeking Breast Reconstruction.

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Metcalfe, Drew B; Duggal, Claire S; Gabriel, Allen; Nahabedian, Maurice Y; Carlson, Grant W; Losken, Albert

2014-07-01

Body dysmorphic disorder (BDD) is characterized by a preoccupation with a slight or imagined defect in physical appearance. It has significant implications for patients who desire breast reconstruction, because patient satisfaction with the aesthetic outcome is a substantial contributor to the success of the procedure. The authors estimated the prevalence of BDD among women seeking breast reconstruction by surveying patients with the previously validated Dysmorphic Concerns Questionnaire (DCQ). One hundred eighty-eight women who presented for immediate or delayed breast reconstruction completed the DCQ anonymously, during initial consultation with a plastic surgeon. Two groups of respondents were identified: those who desired immediate reconstruction and those who planned to undergo delayed reconstruction. The prevalence of BDD among breast reconstruction patients was compared between the 2 groups, and the overall prevalence was compared with published rates for the general public. Body dysmorphic disorder was significantly more prevalent in breast reconstruction patients than in the general population (17% vs 2%; P < .001). It also was much more common among patients who planned to undergo delayed (vs immediate) reconstruction (34% vs 13%; P = .004). Relative to the general public, significantly more women who sought breast reconstruction were diagnosed as having BDD. Awareness of the potential for BDD will enable clinicians to better understand their patients' perspectives and discuss realistic expectations at the initial consultation. Future studies are warranted to examine the implications of BDD on patient satisfaction with reconstructive surgery. 3. © 2014 The American Society for Aesthetic Plastic Surgery, Inc.

Prevalence of Body Dysmorphic Disorder in Plastic Surgery and Dermatology Patients: A Systematic Review with Meta-Analysis.

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Ribeiro, Rafael Vilela Eiras

2017-08-01

The aim of the present study was to evaluate the prevalence of body dysmorphic disorder in plastic surgery and dermatology patients, by performing a systematic review of the literature and meta-analysis. The most relevant studies published originally in any language were analyzed. The literature search was performed using the PubMed, Cochrane Central Register of Controlled Trials (CENTRAL), and Scielo databases. The final sample comprised 33 publications that were submitted to meta-analysis. The study verified that 15.04% of plastic surgery patients had body dysmorphic disorder (range 2.21-56.67%); patient mean age was 34.54 ± 12.41 years, and most were women (74.38%). Among dermatology patients, 12.65% (range 4.52-35.16%) had body dysmorphic disorder; patient mean age was 27.79 ± 9.03 years, and most were women (76.09%). Both plastic surgeons and dermatologists must adequately assess their patients to identify those with a higher likelihood of body dysmorphic disorder and should arrange multidisciplinary care for such individuals. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

A twin study of body dysmorphic concerns.

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Monzani, B; Rijsdijk, F; Anson, M; Iervolino, A C; Cherkas, L; Spector, T; Mataix-Cols, D

2012-09-01

Dysmorphic concern refers to an excessive preoccupation with a perceived or slight defect in physical appearance. It lies on a continuum of severity from no or minimal concerns to severe concerns over one's appearance. The present study examined the heritability of dysmorphic concerns in a large sample of twins. Twins from the St Thomas UK twin registry completed a valid and reliable self-report measure of dysmorphic concerns, which also includes questions about perceived body odour and malfunction. Twin modelling methods (female twins only, n=3544) were employed to decompose the variance in the liability to dysmorphic concerns into additive genetic, shared and non-shared environmental factors. Model-fitting analyses showed that genetic factors accounted for approximately 44% [95% confidence intervals (CI) 36-50%] of the variance in dysmorphic concerns, with non-shared environmental factors and measurement error accounting for the remaining variance (56%; 95% CI 50-63%). Shared environmental factors were negligible. The results remained unchanged when excluding individuals reporting an objective medical condition/injury accounting for their concern in physical appearance. Over-concern with a perceived or slight defect in physical appearance is a heritable trait, with non-shared environmental factors also playing an important role in its causation. The results are relevant for various psychiatric disorders characterized by excessive concerns in body appearance, odour or function, including but not limited to body dysmorphic disorder.

Body Dysmorphic Symptoms Scale for patients seeking esthetic surgery: cross-cultural validation study.

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Ramos, Tatiana Dalpasquale; Brito, Maria José Azevedo de; Piccolo, Mônica Sarto; Rosella, Maria Fernanda Normanha da Silva Martins; Sabino, Miguel; Ferreira, Lydia Masako

2016-01-01

Rhinoplasty is one of the most sought-after esthetic operations among individuals with body dysmorphic disorder. The aim of this study was to cross-culturally adapt and validate the Body Dysmorphic Symptoms Scale. Cross-cultural validation study conducted in a plastic surgery outpatient clinic of a public university hospital. Between February 2014 and March 2015, 80 consecutive patients of both sexes seeking rhinoplasty were selected. Thirty of them participated in the phase of cultural adaptation of the instrument. Reproducibility was tested on 20 patients and construct validity was assessed on 50 patients, with correlation against the Yale-Brown Obsessive Compulsive Scale for Body Dysmorphic Disorder. The Brazilian version of the instrument showed Cronbach's alpha of 0.805 and excellent inter-rater reproducibility (intraclass correlation coefficient, ICC = 0.873; P Dysmorphic Disorder and the Body Dysmorphic Symptoms Scale. The area under the receiver operating characteristic curve was 0.981, thus showing good accuracy for discriminating between presence and absence of symptoms of body dysmorphic disorder. Forty-six percent of the patients had body dysmorphic symptoms and 54% had moderate to severe appearance-related obsessive-compulsive symptoms. The Brazilian version of the Body Dysmorphic Symptoms Scale is a reproducible instrument that presents face, content and construct validity.

Dysfunctional Metacognitive Beliefs in Body Dysmorphic Disorder

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Zeinodini, Zahra; Sedighi, Sahar; Rahimi, Mandana Baghertork; Noorbakhsh, Simasadat; Esfahani, Sepideh Rajezi

2016-01-01

The present study aims to examine the correlation of body dysmorphic disorder, with metacognitive subscales, metaworry and thought-fusion. The study was conducted in a correlation framework. Sample included 155 high school students in Isfahan, Iran in 2013-2014, gathered through convenience sampling. To gather data about BDD, Yale-Brown Obsessive Compulsive Scale Modified for BDD was applied. Then, Meta Cognitive Questionnaire, Metaworry Questionnaire, and Thought-Fusion Inventory were used to assess metacognitive subscales, metaworry and thought-fusion. Data obtained from this study were analyzed using Pearson correlation and multiple regressions in SPSS 18. Result indicated YBOCS-BDD scores had a significant correlation with scores from MCQ (Pdysmorphic disorder was significantly related to metacognitive subscales, metaworry, and thought fusion in high school students in Isfahan, which is in line with previous studies. A deeper understanding of these processes can broaden theory and treatment of BDD, thereby improve the lives of sufferers and potentially protect others from developing this devastating disorder. PMID:26493420

Prevalence of Body Dysmorphic Disorder Symptoms and Body Weight Concerns in Patients Seeking Abdominoplasty.

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Brito, Maria José Azevedo de; Nahas, Fábio Xerfan; Cordás, Táki Athanássios; Gama, Maria Gabriela; Sucupira, Eduardo Rodrigues; Ramos, Tatiana Dalpasquale; Felix, Gabriel de Almeida Arruda; Ferreira, Lydia Masako

2016-03-01

Body dysmorphic disorder (BDD) is one of the most common psychiatric conditions found in patients seeking cosmetic surgery, and body contouring surgery is most frequently sought by patients with BDD. To estimate the prevalence and severity of BDD symptoms in patients seeking abdominoplasty. Ninety patients of both sexes were preoperatively divided into two groups: patients with BDD symptoms (n = 51) and those without BDD symptoms (n = 39) based both on the Body Dysmorphic Disorder Examination (BDDE) and clinical assessment. Patients in the BDD group were classified as having mild to moderate or severe symptoms, according to the BDDE. Body weight and shape concerns were assessed using the Body Shape Questionnaire (BSQ). The prevalence of BDD symptoms was 57%. There were significant associations between BDD symptoms and degree of body dissatisfaction, level of preoccupation with physical appearance, and avoidance behaviors. Mild to moderate and severe symptoms of BDD were present in 41% and 59% of patients, respectively, in the BDD group. It was found that the more severe the symptoms of BDD, the higher the level of concern with body weight and shape (P < .001). Patients having distorted self-perception of body shape, or distorted comparative perception of body image were respectively 3.67 or 5.93 times more likely to show more severe symptoms of BDD than those with a more accurate perception. Candidates for abdominoplasty had a high prevalence of BDD symptoms, and body weight and shape concerns were associated with increased symptom severity. © 2016 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

[An old "new" disease: body dysmorphic disorder (dysmorphophobia)].

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Szabó, Pál

2010-10-31

Body dysmorphic disorder causes significant suffering and serious impairment in psychosocial functions. However, this disease with dangerous risks is scarcely mentioned in the Hungarian medical literature. The objective of the author is to give a detailed review about this almost unknown, but relatively common disorder. The serious disorder of body perception is in the centre of symptoms, leading to social isolation, anxiety, depression and obsessive-compulsive phenomena. The disorder often remains unrecognized because of the lack of insight of disease. Comorbidity with affective disorders, anxiety disorders, personality disorders, eating disorders, alcoholism and substance use disorders is common. The life quality of affected patients is bad, the risk of suicide or violence is high. Biological, psychological and sociocultural factors play an important role in the etiopathogenesis of the disorder. Imaging techniques and neuropsychological measures revealed changes characteristic for the disease. Childhood abuse and neglect, appearance-related critical remarks, stressors and the impact of media are also supposed to have role in the development of the disorder. The point prevalence is 0.7-2.5% in the general population, however, in special groups such as in tertiary students, psychiatric, dermatological and cosmetic surgery patients the prevalence rates may be much higher. Typically, the disease begins in early adolescence, and it persists and deteriorates without treatment, showing a chronic course. By means of pharmacotherapy and/or psychotherapy long-during improvement or full recovery can be achieved within a relatively short period of time.

Body Dysmorphic Symptoms Scale for patients seeking esthetic surgery: cross-cultural validation study

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Tatiana Dalpasquale Ramos

Full Text Available ABSTRACT: CONTEXT AND OBJECTIVE: Rhinoplasty is one of the most sought-after esthetic operations among individuals with body dysmorphic disorder. The aim of this study was to cross-culturally adapt and validate the Body Dysmorphic Symptoms Scale. DESIGN AND SETTING: Cross-cultural validation study conducted in a plastic surgery outpatient clinic of a public university hospital. METHODS: Between February 2014 and March 2015, 80 consecutive patients of both sexes seeking rhinoplasty were selected. Thirty of them participated in the phase of cultural adaptation of the instrument. Reproducibility was tested on 20 patients and construct validity was assessed on 50 patients, with correlation against the Yale-Brown Obsessive Compulsive Scale for Body Dysmorphic Disorder. RESULTS: The Brazilian version of the instrument showed Cronbach's alpha of 0.805 and excellent inter-rater reproducibility (intraclass correlation coefficient, ICC = 0.873; P < 0.001 and intra-rater reproducibility (ICC = 0.939; P < 0.001. Significant differences in total scores were found between patients with and without symptoms (P < 0.001. A strong correlation (r = 0.841; P < 0.001 was observed between the Yale-Brown Obsessive Compulsive Scale for Body Dysmorphic Disorder and the Body Dysmorphic Symptoms Scale. The area under the receiver operating characteristic curve was 0.981, thus showing good accuracy for discriminating between presence and absence of symptoms of body dysmorphic disorder. Forty-six percent of the patients had body dysmorphic symptoms and 54% had moderate to severe appearance-related obsessive-compulsive symptoms. CONCLUSIONS: The Brazilian version of the Body Dysmorphic Symptoms Scale is a reproducible instrument that presents face, content and construct validity.

Clinical Application of a Behavioral Model for the Treatment of Body Dysmorphic Disorder

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Rabinowitz, Dena; Neziroglu, Fugen; Roberts, Marty

2007-01-01

Body dysmorphic disorder (BDD) is characterized by an obsessive concern over a perceived flaw in bodily appearance. If a minor flaw does exist, the patient displays unwarranted distress. This preoccupation typically leads to compulsive behaviors, such as mirror checking or mirror avoiding, camouflaging, and seeking reassurance from others…

The Relationship between Body Dysmorphic Disorder Behaviors and the Acquired Capability for Suicide

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Witte, Tracy K.; Didie, Elizabeth R.; Menard, William; Phillips, Katharine A.

2012-01-01

In a sample of 200 individuals diagnosed with body dysmorphic disorder (BDD), we utilized the interpersonal-psychological theory for suicide as a framework to examine BDD behaviors that might be associated with suicide risk, insofar as they might increase the acquired capability for suicide. We predicted that physically painful BDD behaviors…

Body Dysmorphic Symptoms, Functional Impairment, and Depression: The Role of Appearance-Based Teasing.

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Weingarden, Hilary; Renshaw, Keith D

2016-01-01

Body dysmorphic disorder is associated with elevated social and occupational impairment and comorbid depression, but research on risk factors for body dysmorphic symptoms and associated outcomes is limited. Appearance-based teasing may be a potential risk factor. To examine the specificity of this factor, the authors assessed self-reported appearance-based teasing, body dysmorphic, and obsessive-compulsive symptom severity, functional impairment (i.e., social, occupational, family impairment), and depression in a nonclinical sample of undergraduates. As hypothesized, appearance-based teasing was positively correlated with body dysmorphic symptoms. The correlation between teasing and body dysmorphic symptoms was stronger than that between teasing and obsessive-compulsive symptom severity. Last, body dysmorphic symptom severity and appearance-based teasing interacted in predicting functional impairment and depression. Specifically, appearance-based teasing was positively associated with depression and functional impairment only in those with elevated body dysmorphic symptoms. When a similar moderation was tested with obsessive-compulsive, in place of body dysmorphic, symptom severity, the interaction was nonsignificant. Findings support theory that appearance-based teasing is a specific risk factor for body dysmorphic symptoms and associated functional impairment.

Personality disorders and traits in patients with body dysmorphic disorder.

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Phillips, K A; McElroy, S L

2000-01-01

Individuals with body dysmorphic disorder (BDD) have been postulated to have schizoid, narcissistic, and obsessional personality traits and to be sensitive, introverted, perfectionistic, and insecure. However, data on personality traits and disorders in BDD are limited. This study assessed 148 subjects with BDD, 26 of whom participated in a fluvoxamine treatment study; 74 subjects were assessed for personality disorders with the Structured Clinical Interview for DSMIII-R Personality Disorders (SCID-II), 100 subjects completed the NEO-Five Factor Inventory (NEO-FFI), and 51 subjects completed the Rathus Assertiveness Scale. Forty-two subjects (57%) had one or more personality disorders, with avoidant personality disorder (43%) being most common, followed by dependent (15%), obsessive-compulsive (14%), and paranoid (14%) personality disorders. On the NEO-FFI, the mean scores were in the very high range for neuroticism, the low range for extraversion and conscientiousness, the low-average range for agreeableness, and the average range for openness to experience. On the Rathus Assertiveness Scale, the mean score was -17.1 +/- 32.0 for women and -17.0 +/- 32.3 for men. Among fluvoxamine responders, the number of personality disorders significantly decreased between the study baseline and endpoint. These findings suggest that the rate of personality disorders in BDD is relatively high, with avoidant personality disorder being most common. The high neuroticism scores and low extraversion scores are consistent with this finding.

Selfie use: The implications for psychopathology expression of body dysmorphic disorder

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Anisha Khanna

2017-01-01

Full Text Available Preoccupation with a body part can lead to indulgence in various forms of coping behavior. Users are frequently using technology as well as selfie to overcome their anxiety to relate to a body part as well as get approval from other online users. The present case highlights the excessive use of selfie to manage the distress-related body dysmorphic disorder (BDD. Psychiatric interview and assessment tools were used to elicit information about BDD, technology use, and affective states. Repeated use of selfie has been thought to manage the distress associated with appearance. It implies the need for screening excessive use of technology as comorbid condition and psychoeducation for promotion of healthy use of technology.

New perspectives in the treatment of body dysmorphic disorder

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Hong, Kevin; Nezgovorova, Vera; Hollander, Eric

2018-01-01

Body dysmorphic disorder (BDD) is a disabling illness with a high worldwide prevalence. Patients demonstrate a debilitating preoccupation with one or more perceived defects, often marked by poor insight or delusional convictions. Multiple studies have suggested that selective serotonin reuptake inhibitors and various cognitive behavioral therapy modalities are effective first-line treatments in decreasing BDD severity, relieving depressive symptoms, restoring insight, and increasing quality of life. Selective serotonin reuptake inhibitors have also recently been shown to be effective for relapse prevention. This review provides a comprehensive summary of the current understanding of BDD, including its clinical features, epidemiology, genetics, and current treatment modalities. Additional research is needed to fully elucidate the relationship between BDD and comorbid illnesses such as obsessive–compulsive-related disorders and depression and to develop therapies for refractory patients and those who have contraindications for pharmacological intervention. PMID:29636904

Can understanding the neurobiology of body dysmorphic disorder (BDD) inform treatment?

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Rossell, Susan L; Harrison, Ben J; Castle, David

2015-08-01

We aim to provide a clinically focused review of the neurobiological literature in body dysmorphic disorder (BDD), with a focus on structural and functional neuroimaging. There has been a recent influx of studies examining the underlying neurobiology of BDD using structural and functional neuroimaging methods. Despite obvious symptom similarities with obsessive-compulsive disorder (OCD), no study to date has directly compared the two groups using neuroimaging techniques. Studies have established that there are limbic and visual cortex abnormalities in BDD, in contrast to fronto-striatal differences in OCD. Such data suggests affect or visual training maybe useful in BDD. © The Royal Australian and New Zealand College of Psychiatrists 2015.

Clinical features of muscle dysmorphia among males with body dysmorphic disorder

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Pope, Courtney G.; Pope, Harrison G.; Menard, William; Fay, Christina; Olivardia, Roberto; Phillips, Katharine A.

2005-01-01

Muscle dysmorphia – a pathological preoccupation with muscularity – appears to be a form of body dysmorphic disorder (BDD) with a focus on muscularity. However, little is known about muscle dysmorphia in men with BDD, and no study has compared men with BDD who do and do not report muscle dysmorphia. To explore this issue, we reviewed the histories of 63 men with BDD; we compared those rated as having a history of muscle dysmorphia with those who had BDD but not muscle dysmorphia in several do...

抑郁症合并躯体变形障碍的临床特征%CLINICAL FEATURES OF DEPRESSION WITH BODY DYSMORPHIC DISORDER

Institute of Scientific and Technical Information of China (English)

程宇

2015-01-01

Objective To study the clinical features of depression with body dysmorphic disorder .Meth‐ods A comparative study on the clinical data of 138 patients who had depression with or without body dysmorphic disorder was conducted .Results Of the 17 patients (12 .32% ) with depression and body dysmor‐phic disorder ,the levels of anxiety ,despair ,psychomotor inhibition ,self‐accusation ,self‐guilty and sui‐cidal behavior were found much higher than those in the patients without body dysmorphic disorder .The attack time in patients with body dysmorphic disorder was earlier than that in patientd without body dys‐morphic disorder ,and the combined treatments were frequently used .There existed no significant differ‐ence in onset time and curative effect between the two groups .Conclusion Body dysmorphic disorder is common in patients with depression ,and measures for preventing suicide in patients with body dysmorphic disorder should be taken .%目的：探讨抑郁症合并躯体变形障碍的临床特征。方法对138例抑郁症患者按照合并躯体变形障碍和不合并躯体变形障碍分为两组，对比分析两组患者的临床资料。结果抑郁症合并躯体变形障碍者17例（12．32％），其焦虑、绝望、精神运动性抑制、自责自罪、自杀行为显著高于不合并躯体障碍者，其发病年龄较早，联合用药较多，而起效时间、疗效与不合并躯体变形障碍者无显著性差异。结论躯体变形障碍在抑郁症中并非少见，对伴有躯体变形障碍的抑郁症患者应谨防自杀行为的发生。

Comorbidity between obsessive-compulsive disorder and body dysmorphic disorder: prevalence, explanatory theories, and clinical characterization

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Frías Á

2015-08-01

Full Text Available Álvaro Frías,1,2 Carol Palma,1,2 Núria Farriols,1,2 Laura González2 1FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, 2Adult Outpatient Mental Health Center, Hospital de Mataró – CSdM, Mataró, Spain Background: With the advent of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders, body dysmorphic disorder (BDD has been subsumed into the obsessive-compulsive disorders and related disorders (OCDRD category. Objective: We aimed to determine the empirical evidence regarding the potential relationship between BDD and obsessive-compulsive disorder (OCD based on the prevalence data, etiopathogenic pathways, and clinical characterization of patients with both disorders. Method: A comprehensive search of databases (PubMed and PsycINFO was performed. Published manuscripts between 1985 and May 2015 were identified. Overall, 53 studies fulfilled inclusion criteria. Results: Lifetime comorbidity rates of BDD–OCD are almost three times higher in samples with a primary diagnosis of BDD than those with primary OCD (27.5% vs 10.4%. However, other mental disorders, such as social phobia or major mood depression, are more likely among both types of psychiatric samples. Empirical evidence regarding the etiopathogenic pathways for BDD–OCD comorbidity is still inconclusive, whether concerning common shared features or one disorder as a risk factor for the other. Specifically, current findings concerning third variables show more divergences than similarities when comparing both disorders. Preliminary data on the clinical characterization of the patients with BDD and OCD indicate that the deleterious clinical impact of BDD in OCD patients is greater than vice versa. Conclusion: Despite the recent inclusion of BDD within the OCDRD, data from comparative studies between BDD and OCD need further evidence for supporting this nosological approach. To better define this issue, comparative studies between BDD, OCD, and social phobia

Prevalence and clinical characteristics of body dysmorphic disorder in an adult inpatient setting†

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Conroy, Michelle; Menard, William; Fleming-Ives, Kathryn; Modha, Poonam; Cerullo, Hilary; Phillips, Katharine A.

2008-01-01

Objective Body dysmorphic disorder (BDD), a distressing or impairing preoccupation with an imagined or slight defect in appearance, is an often-severe, understudied disorder. We determined BDD’s prevalence and clinical features on a general adult psychiatric inpatient unit. To our knowledge, only one previous prevalence study has been done in this setting. Method One hundred patients completed 3 self-report measures: the Body Dysmorphic Disorder Questionnaire (BDD-Q), Beck Anxiety Inventory (BAI) and Center for Epidemiologic Studies Depression Scale (CES-D). Those who screened positive for BDD were interviewed to confirm DSM-IV BDD and its clinical features. Charts were reviewed for demographic and clinical information. Results BDD was diagnosed in 16.0% (95% CI=8.7–23.3%) (n=16) of patients. A high proportion of those with BDD reported that BDD symptoms contributed to suicidality. Patients revealed BDD symptoms to a mean of only 15.1%±33.7% lifetime mental health clinicians; only one (6.3%) reported symptoms to his current inpatient psychiatrist. Most did not disclose their symptoms due to embarrassment. Those with BDD were younger (P=.008) and had higher CES-D scores (P=.008). The two groups did not significantly differ on BAI score, demographic characteristics or discharge diagnoses. Conclusions BDD is relatively common but underdiagnosed in psychiatric inpatients and is associated with more severe depressive symptoms. PMID:18164943

Clinical features of muscle dysmorphia among males with body dysmorphic disorder.

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Pope, Courtney G; Pope, Harrison G; Menard, William; Fay, Christina; Olivardia, Roberto; Phillips, Katharine A

2005-12-01

Muscle dysmorphia - a pathological preoccupation with muscularity - appears to be a form of body dysmorphic disorder (BDD) with a focus on muscularity. However, little is known about muscle dysmorphia in men with BDD, and no study has compared men with BDD who do and do not report muscle dysmorphia. To explore this issue, we reviewed the histories of 63 men with BDD; we compared those rated as having a history of muscle dysmorphia with those who had BDD but not muscle dysmorphia in several domains. The 14 men with muscle dysmorphia resembled the 49 comparison men in demographic features, BDD severity, delusionality, and number of non-muscle-related body parts of concern. However, those with muscle dysmorphia were more likely to have attempted suicide, had poorer quality of life, and had a higher frequency of any substance use disorder and anabolic steroid abuse. Thus, muscle dysmorphia was associated with greater psychopathology.

Patients with mild to moderate body dysmorphic disorder may benefit from rhinoplasty.

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Felix, Gabriel Almeida Arruda; de Brito, Maria José Azevedo; Nahas, Fabio Xerfan; Tavares, Hermano; Cordás, Táki Athanássios; Dini, Gal Moreira; Ferreira, Lydia Masako

2014-05-01

Body dysmorphic disorder (BDD) is one of the most common psychiatric conditions found in patients seeking cosmetic surgery. BDD is also a challenge for plastic surgeons because it is still an underdiagnosed mental disorder. The aims of this study were to prospectively investigate whether patients with mild to moderate BDD are suitable for rhinoplasty, and to assess BDD severity and patient satisfaction with the surgical outcome 1 year after the intervention. All women (n = 116) seeking rhinoplasty at a university hospital between September 2009 and August 2010 were recruited for the study and assessed for BDD. The final sample consisted of 31 patients aged 32 (standard deviation (SD), 10) years with mild to moderate BDD who underwent rhinoplasty. The participants were assessed preoperatively (baseline) and 1 year postoperatively with the Body Dysmorphic Disorder Examination (BDDE). Most patients (22/31, 71%) were of African descent. Socio-demographic variables and the extent of the nasal deformities had no effect on the severity of BDD symptoms and patient satisfaction with surgery outcome. At the 1-year postoperative follow-up, there was a significant decrease from baseline in BDDE scores and time spent by patients worrying about their appearance; 25 (25/31, 81%) patients experienced complete remission from BDD and 28 (28/31, 90%) were satisfied with the results of surgery. Rhinoplasty may be indicated in the treatment of female patients with mild to moderate BDD. Copyright © 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Metacognitive therapy for body dysmorphic disorder patients in Iran: acceptability and proof of concept.

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Rabiei, Mehdi; Mulkens, Sandra; Kalantari, Mehrdad; Molavi, Hossein; Bahrami, Fatemeh

2012-06-01

The purpose of the present study was to determine the effect of metacognitive therapy (MCT) on symptoms of body dysmorphic disorder (BDD) and on symptoms of thought-fusion, by means of a wait-list controlled clinical trial. Participants were referred from dermatology and cosmetic surgery clinics in the city of Isfahan, Iran, and 20 patients were selected on the basis of DSM-IV-TR diagnostic criteria for BDD. They were randomly assigned to either the experimental or the wait-list control group. The Yale-Brown Obsessive Compulsive Scale Modified for Body Dysmorphic Disorder (BDD-YBOCS) and the Thought-Fusion Inventory (TFI) were used as the outcome measures. The experimental group received 8 weekly metacognitive intervention sessions. The control group was in the waiting-list until the end of the follow-up. Measures were taken at pre-test, post-test (after 2 months) and follow-up (after 6-months). The results of analysis of variance showed that MCT significantly reduced the symptoms of BDD and of thought-fusion, compared to the wait-list. Effects on both outcome measures were maintained at 6-months follow-up. Copyright © 2011 Elsevier Ltd. All rights reserved.

Prevalence of body dysmorphic disorder and associated features in German adolescents: A self-report survey.

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Möllmann, Anne; Dietel, Fanny A; Hunger, Antje; Buhlmann, Ulrike

2017-08-01

Prior research has not yet investigated the prevalence of body dysmorphic disorder (BDD) in adolescents and young adults based on criteria from the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5). In the current study, the point prevalence of BDD, comorbid symptoms, and associated features, such as appearance-related suicidality, level of insight or history of plastic surgeries, were examined in a non-clinical sample of German adolescents and young adults (n=308), between 15 and 21 years old, using self-report measures. Eleven participants (3.6%; 95% CI=[1.9, 5.8]) met DSM-5 criteria for BDD. Self-reported BDD (vs. no-BDD) was related to respondents showing significantly more obsessive-compulsive (OC) symptoms and lower degrees of insight regarding appearance concerns. Significantly more adolescents and young adults with vs. without self-reported BDD (36.4% vs. 8.8%) reported appearance-related suicidal ideation. In conclusion, body dysmorphic symptoms are common in adolescents and young adults and are associated with high rates of comorbid symptoms and suicidal ideation. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

Body Dysmorphic Disorder in Patients With Cosmetic Surgery

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Chung-Sheng Lai

2010-09-01

Full Text Available Body dysmorphic disorder (BDD refers to a preoccupation with an imagined or grossly exaggerated minor physical defect. Those with BDD might seek medical help (cosmetic surgery rather than attend a psychiatric clinic. Therefore, it is often underdiagnosed. To investigate the prevalence of BDD, we reviewed the medical records of 817 individuals who sought cosmetic surgery during a 3-year period. The outcome after surgery was described for those with BDD. Our results showed that 63 (7.7% patients had BDD, of which 54 (85.7% were diagnosed at preoperative evaluation. However, nine (14.3% patients went undiagnosed and all had a bad outcome after cosmetic surgery. BDD was not uncommon at the cosmetic surgery clinic. Our results support the idea that cosmetic surgery should be avoided for patients with BDD. The development of a more effective diagnostic procedure could help address this issue.

Body Dysmorphic Disorder: Some Key Issues for DSM-V

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Phillips, Katharine A.; Wilhelm, Sabine; Koran, Lorrin M.; Didie, Elizabeth R.; Fallon, Brian A.; Feusner, Jamie; Stein, Dan J.

2014-01-01

Body dysmorphic disorder (BDD), a distressing or impairing preoccupation with an imagined or slight defect in appearance, has been described for more than a century and increasingly studied over the past several decades. This paper provides a focused review of issues pertaining to BDD that are relevant to DSM-V. The review presents a number of options and preliminary recommendations to be considered for DSM-V: 1) Criterion A may benefit from some rewording, without changing its focus or meaning; 2) Potential disadvantages of adding a new criterion to reflect BDD compulsive behaviors seem to outweigh potential advantages, but adding such a criterion remains an option that can be considered; 3) A clinical significance criterion seems necessary for BDD to differentiate it from normal appearance concerns; 4) BDD and eating disorders have some overlapping features and need to be differentiated; some minor changes to DSM-IV’s criterion C are suggested; 5) BDD should not be broadened to include body integrity identity disorder (apotemnophilia) or olfactory reference syndrome; 6) There is no compelling evidence for including diagnostic features or subtypes that are specific to gender-related, age-related, or cultural manifestations of BDD; 7) Adding muscle dysmorphia as a specifier may have clinical utility; and 8) The ICD-10 criteria for hypochondriacal disorder are not suitable for BDD, and there is no empirical evidence that BDD and hypochondriasis are the same disorder. The issue of how BDD’s delusional variant should be classified in DSM-V is briefly discussed and will be addressed more extensively in a separate paper. PMID:20533368

Body dysmorphic disorder: some key issues for DSM-V.

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Phillips, Katharine A; Wilhelm, Sabine; Koran, Lorrin M; Didie, Elizabeth R; Fallon, Brian A; Feusner, Jamie; Stein, Dan J

2010-06-01

Body dysmorphic disorder (BDD), a distressing or impairing preoccupation with an imagined or slight defect in appearance, has been described for more than a century and increasingly studied over the past several decades. This article provides a focused review of issues pertaining to BDD that are relevant to DSM-V. The review presents a number of options and preliminary recommendations to be considered for DSM-V: (1) Criterion A may benefit from some rewording, without changing its focus or meaning; (2) There are both advantages and disadvantages to adding a new criterion to reflect compulsive BDD behaviors; this possible addition requires further consideration; (3) A clinical significance criterion seems necessary for BDD to differentiate it from normal appearance concerns; (4) BDD and eating disorders have some overlapping features and need to be differentiated; some minor changes to DSM-IV's criterion C are suggested; (5) BDD should not be broadened to include body integrity identity disorder (apotemnophilia) or olfactory reference syndrome; (6) There is no compelling evidence for including diagnostic features or subtypes that are specific to gender-related, age-related, or cultural manifestations of BDD; (7) Adding muscle dysmorphia as a specifier may have clinical utility; and (8) The ICD-10 criteria for hypochondriacal disorder are not suitable for BDD, and there is no empirical evidence that BDD and hypochondriasis are the same disorder. The issue of how BDD's delusional variant should be classified in DSM-V is briefly discussed and will be addressed more extensively in a separate article. (c) 2010 Wiley-Liss, Inc.

Body Dysmorphic Disorder: Neurobiological Features and an Updated Model

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Li, Wei; Arienzo, Donatello; Feusner, Jamie D.

2013-01-01

Body Dysmorphic Disorder (BDD) affects approximately 2% of the population and involves misperceived defects of appearance along with obsessive preoccupation and compulsive behaviors. There is evidence of neurobiological abnormalities associated with symptoms in BDD, although research to date is still limited. This review covers the latest neuropsychological, genetic, neurochemical, psychophysical, and neuroimaging studies and synthesizes these findings into an updated (yet still preliminary) neurobiological model of the pathophysiology of BDD. We propose a model in which visual perceptual abnormalities, along with frontostriatal and limbic system dysfunction, may combine to contribute to the symptoms of impaired insight and obsessive thoughts and compulsive behaviors expressed in BDD. Further research is necessary to gain a greater understanding of the etiological formation of BDD symptoms and their evolution over time. PMID:25419211

Therapist guided internet based cognitive behavioural therapy for body dysmorphic disorder: single blind randomised controlled trial.

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Enander, Jesper; Andersson, Erik; Mataix-Cols, David; Lichtenstein, Linn; Alström, Katarina; Andersson, Gerhard; Ljótsson, Brjánn; Rück, Christian

2016-02-02

To evaluate the efficacy of therapist guided internet based cognitive behavioural therapy (CBT) programme for body dysmorphic disorder (BDD-NET) compared with online supportive therapy. A 12 week single blind parallel group randomised controlled trial. Academic medical centre. 94 self referred adult outpatients with a diagnosis of body dysmorphic disorder and a modified Yale-Brown obsessive compulsive scale (BDD-YBOCS) score of ≥ 20. Concurrent psychotropic drug treatment was permitted if the dose had been stable for at least two months before enrolment and remained unchanged during the trial. Participants received either BDD-NET (n=47) or supportive therapy (n=47) delivered via the internet for 12 weeks. The primary outcome was the BDD-YBOCS score after treatment and follow-up (three and six months from baseline) as evaluated by a masked assessor. Responder status was defined as a ≥ 30% reduction in symptoms on the scale. Secondary outcomes were measures of depression (MADRS-S), global functioning (GAF), clinical global improvement (CGI-I), and quality of life (EQ5D). The six month follow-up time and all outcomes other than BDD-YBOCS and MADRS-S at 3 months were not pre-specified in the registration at clinicaltrials.gov because of an administrative error but were included in the original trial protocol approved by the regional ethics committee before the start of the trial. BDD-NET was superior to supportive therapy and was associated with significant improvements in severity of symptoms of body dysmorphic disorder (BDD-YBOCS group difference -7.1 points, 95% confidence interval -9.8 to -4.4), depression (MADRS-S group difference -4.5 points, -7.5 to -1.4), and other secondary measures. At follow-up, 56% of those receiving BDD-NET were classed as responders, compared with 13% receiving supportive therapy. The number needed to treat was 2.34 (1.71 to 4.35). Self reported satisfaction was high. CBT can be delivered safely via the internet to patients with body

Body dysmorphic disorder: Diagnosis, clinical aspects and treatment strategies

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Rajiv Ahluwalia

2017-01-01

Full Text Available Aim: With the increased demand to undertake dental aesthetic and reconstructive procedures, it is imperative for all dental clinicians to have an understanding of body dysmorphic disorder (BDD. Patient's preoccupations with perceived defect in appearance or excessive concern about minimal flaws are among diagnostic criteria of BDD. Such patients are difficult to please and often undergo cosmetic procedures such as orthodontic treatment. Methodology: Literature search in PubMed/MEDLINE was conducted from 1891 to 2015. A manual search of relevant articles and review was done and relevant data was collected and analysed. Results: One of the most common areas of preoccupation is the dento-facial region, with up to 20% of patients diagnosed with BDD expressing specific concern regarding their dental appearance. Conclusion: BDD patients often request multiple aesthetic procedures, but remain unsatisfied with their treatment results.

The Body Dysmorphic Disorder Symptom Scale: Development and preliminary validation of a self-report scale of symptom specific dysfunction.

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Wilhelm, Sabine; Greenberg, Jennifer L; Rosenfield, Elizabeth; Kasarskis, Irina; Blashill, Aaron J

2016-06-01

The Body Dysmorphic Disorder Symptom Scale (BDD-SS) is a new self-report measure used to examine the severity of a wide variety of symptoms associated with body dysmorphic disorder (BDD). The BDD-SS was designed to differentiate, for each group of symptoms, the number of symptoms endorsed and their severity. This report evaluates and compares the psychometric characteristics of the BDD-SS in relation to other measures of BDD, body image, and depression in 99 adult participants diagnosed with BDD. Total scores of the BDD-SS showed good reliability and convergent validity and moderate discriminant validity. Analyses of the individual BDD-SS symptom groups confirmed the reliability of the checking, grooming, weight/shape, and cognition groups. The current findings indicate that the BDD-SS can be quickly administered and used to examine the severity of heterogeneous BDD symptoms for research and clinical purposes. Copyright © 2016. Published by Elsevier Ltd.

Symptoms of muscle dysmorphia, body dysmorphic disorder, and eating disorders in a nonclinical population of adult male weightlifters in Australia.

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Nieuwoudt, Johanna E; Zhou, Shi; Coutts, Rosanne A; Booker, Ray

2015-05-01

The current study aimed to (a) determine the rates of symptoms of muscle dysmorphia (MD), body dysmorphic disorder (BDD), and eating disorder; (b) determine the relationships among symptoms of MD, BDD, and eating disorders; and (c) provide a comprehensive comparison of symptoms of MD, BDD, and eating disorders in a nonclinical population of adult male weightlifters in Australia. The participants (N = 648, mean age = 29.5 years, SD = 10.1) participated in an online survey, consisting of Muscle Appearance Satisfaction Scale, the Body Dysmorphic Disorder Questionnaire, and the Eating Attitude Test-26. Results indicated that 110 participants (17%) were at risk of having MD, 69 participants (10.6%) were at risk of having BDD, and 219 participants (33.8%) were at risk of having an eating disorder. Furthermore, 36 participants (5.6%) were found at risk of having both MD and BDD, and 60 participants (9.3%) were at risk of having both MD and an eating disorder. Significant correlations and associations were found between symptoms of MD and BDD, and symptoms of MD and eating disorders. Support was provided for the comorbidity of, and symptomatic similarities between, symptoms of MD and BDD, and symptoms of MD and eating disorders. This may reflect a shared pathogenesis between symptoms of MD, BDD, and eating disorders. Strength and conditioning professionals, exercise scientists, athletic trainers, and personal trainers should be aware that adult males who are working out with weights (i.e., free weights or machines) may be at increased risk of having MD, BDD, and eating disorders.

Appearance evaluation of others' faces and bodies in anorexia nervosa and body dysmorphic disorder.

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Moody, Teena D; Shen, Vivian W; Hutcheson, Nathan L; Henretty, Jennifer R; Sheen, Courtney L; Strober, Michael; Feusner, Jamie D

2017-02-01

Individuals with anorexia nervosa (AN) and body dysmorphic disorder (BDD) exhibit distorted perception and negative evaluations of their own appearance; however, little is known about how they perceive others' appearance, and whether or not the conditions share perceptual distortions. Thirty participants with BDD, 22 with AN, now weight-restored, and 39 healthy comparison participants (HC) rated photographs of others' faces and bodies on attractiveness, how overweight or underweight they were, and how much photographs triggered thoughts of their own appearance. We compared responses among groups by stimulus type and by level-of-detail (spatial frequency). Compared to HCs, AN and BDD had lower attractiveness ratings for others' bodies and faces for high-detail and low-detail images, rated bodies as more overweight, and were more triggered to think of their own appearance for faces and bodies. In AN, symptom severity was associated with greater triggering of thoughts of own appearance and higher endorsement of overweight ratings for bodies. In BDD, symptom severity was associated with greater triggering of thoughts of own appearance for bodies and higher overweight ratings for low-detail images. BDD was more triggered to think of own facial appearance than AN. AN and BDD show similar behavioral phenotypes of negative appearance evaluations for others' faces and bodies, and have thoughts of their own appearance triggered even for images outside of their primary appearance concerns, suggesting a more complex cross-disorder body-image phenotype than previously assumed. Future treatment strategies may benefit from addressing how these individuals evaluate others in addition to themselves. © 2016 Wiley Periodicals, Inc.(Int J Eat Disord 2017; 50:127-138). © 2016 Wiley Periodicals, Inc.

Brazilian version of the body dysmorphic disorder examination.

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Jorge, Renata Trajano Borges; Sabino Neto, Miguel; Natour, Jamil; Veiga, Daniela Francescato; Jones, Anamaria; Ferreira, Lydia Masako

2008-03-06

Body image improvement is considered to be the main reason for undergoing plastic surgery. The objective was to translate the Body Dysmorphic Disorder Examination (BDDE) into Brazilian Portuguese and to adapt and validate this questionnaire for use in Brazil. Cross-sectional survey, at the Department of Plastic Surgery of Universidade Federal de São Paulo. The BDDE was first translated into Portuguese and then back-translated into English. These translations were then discussed by healthcare professionals in order to establish the final Brazilian version. In a second stage, the validity and reliability of the BDDE were assessed. For this, patients were initially interviewed by two interviewers and subsequently, by only one of these interviewers. On the first occasion, in addition to the BDDE, the body shape questionnaire (BSQ) and the Rosenberg self-esteem scale were also applied. These questionnaires were applied to 90 patients. Six questions were modified during the assessment of cultural equivalence. Cronbach's alpha was 0.89 and the intraclass correlation coefficients for interobserver and test-retest reliability were 0.91 and 0.87, respectively. Pearson's coefficient showed no correlation between the BDDE and the Rosenberg self-esteem scale (0.22), whereas there was a moderate correlation between the BDDE and the BSQ (0.64). The BDDE was successfully translated and adapted, with good internal consistency, reliability and construct validity.

Body dysmorphic disorder and orthodontics--an overview for clinicians.

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Anthony, Marshneil Trista; Farella, Mauro

2014-11-01

Patients with body dysmorphic disorder (BDD) often seek aesthetic medical treatment including orthodontics to correct their perceived physical defects. When the disorder pertains to the dentofacial region, it is important for orthodontists to be familiar with this condition. The purpose of this article is to provide an overview of the current knowledge on BDD and its relationship to orthodontics. PubMed, Scopus, Science Direct, and Google Scholar databases were searched for publications relating to BDD and orthodontics. Further articles were sourced from the reference lists of the articles identified through the search. The literature recommends that orthodontic patients suspected of having BDD should be referred to a psychiatrist for a definitive diagnosis and subsequent management. However, this may be difficult to implement in clinical practice. Management by a psychiatrist could include pharmacotherapy and cognitive behavioural therapy. There is still debate as to whether orthodontic treatment should be provided for these patients. As health care workers providing aesthetic treatment to patients, orthodontists should be aware of BDD and its implications. Risks include repeated requests for unnecessary treatment, dissatisfaction with the result and thus potential for litigation. BDD still remains a challenge to diagnose, and further research is needed to determine the appropriate management of orthodontic patients suffering from the disorder.

Body Dysmorphic Disorder in aesthetic rhinoplasty: Validating a new screening tool.

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Lekakis, Garyfalia; Picavet, Valerie A; Gabriëls, Loes; Grietens, Jente; Hellings, Peter W

2016-08-01

To validate a new screening tool for body dysmorphic disorder (BDD) in patients seeking aesthetic rhinoplasty. We performed a prospective instrument validation study in an academic rhinology clinic. The Body Dysmorphic Disorder Questionnaire-Aesthetic Surgery (BDDQ-AS) is a seven-item short questionnaire validated in 116 patients undergoing aesthetic rhinoplasty. Screening was positive if the patient acknowledged on the BDDQ-AS that he/she was concerned about their appearance (question 1 = yes) AND preoccupied with these concerns (question 2 = yes) AND that these concerns caused at least moderate distress or impairment in different domains of daily life (question 3 or 4 or 5 or 6 ≥ 3 or question 7 = yes). Construct validity was assessed by comparing the BDDQ-AS to the Sheehan Disability Scale and the Derriford Appearance Scale-59. To determine concurrent validity, the BDDQ-AS was compared to the Yale-Brown Obsessive Compulsive Scale Modified for BDD. Finally, the predictive value of the BDDQ-AS on satisfaction 12 months after rhinoplasty was evaluated using a visual analogue scale and the Rhinoplasty Outcome Evaluation. Reliability of the BDDQ-AS was adequate, with Cronbach alpha = .83 for rhinoplasty patients and .84 for controls. Sensitivity was 89.6% and specificity 81.4%. BDDQ-AS-positive patients (n = 55) were more impaired in daily life and experienced more appearance-related distress and dysfunction compared to BDDQ-AS-negative patients. Moreover, they had more severe BDD symptoms. Finally, BDDQ-AS-positive patients were less satisfied after surgery compared to BDDQ-AS-negative patients. We hereby validated a new screening tool for BDD in an aesthetic rhinoplasty population. 3b. Laryngoscope, 126:1739-1745, 2016. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

Gender similarities and differences in 200 individuals with body dysmorphic disorder⋆

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Phillips, Katharine A.; Menard, William; Fay, Christina

2006-01-01

Background Gender is a critically important moderator of psychopathology. However, gender similarities and differences in body dysmorphic disorder (BDD) have received scant investigation. In this study, we examined gender similarities and differences in the broadest sample in which this topic has been examined. Methods Two hundred subjects with BDD recruited from diverse sources were assessed with a variety of standard measures. Results There were more similarities than differences between men and women, but many gender differences were found. The men were significantly older and more likely to be single and living alone. Men were more likely to obsess about their genitals, body build, and thinning hair/balding; excessively lift weights; and have a substance use disorder. In contrast, women were more likely to obsess about their skin, stomach, weight, breasts/chest, buttocks, thighs, legs, hips, toes, and excessive body/facial hair, and they were excessively concerned with more body areas. Women also performed more repetitive and safety behaviors, and were more likely to camouflage and use certain camouflaging techniques, check mirrors, change their clothes, pick their skin, and have an eating disorder. Women also had earlier onset of subclinical BDD symptoms and more severe BDD as assessed by the Body Dysmorphic Disorder Examination. However, men had more severe BDD as assessed by the Psychiatric Status Rating Scale for Body Dysmorphic Disorder, and they had poorer Global Assessment of Functioning Scale scores, were less likely to be working because of psychopathology, and were more likely to be receiving disability, including disability for BDD. Conclusions The clinical features of BDD in men and women have many similarities but also some interesting and important differences. These findings have implications for the detection and treatment of BDD. PMID:16490564

A comparison of self-esteem and perfectionism in anorexia nervosa and body dysmorphic disorder.

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Hartmann, Andrea S; Thomas, Jennifer J; Greenberg, Jennifer L; Matheny, Natalie L; Wilhelm, Sabine

2014-12-01

Previous studies have identified phenotypic similarities between anorexia nervosa (AN) and body dysmorphic disorder (BDD), which share the common feature of negative body image. Studies comparing endophenotypes that may cut across both disorders-as suggested by the National Institute of Mental Health's Research Domain Criteria-are limited. Sixty-nine individuals (AN, n = 24; BDD, n = 23; mentally healthy controls [MHCs], n = 22) completed diagnostic interviews and self-reports assessing self-esteem and perfectionism. Clinical groups showed greater perfectionism in almost all subdimensions as well as poorer self-esteem compared with MHCs, with no clinical group differences when controlling for level of depression. Depression was a mediator of the relationship between symptom severity and self-esteem in both clinical groups. Comparable low self-esteem and greater perfectionism in AN and BDD corroborated existing etiological models and previous studies. Depression was a significant contributor to negative self-esteem in both disorders.

The prevalence of body dysmorphic disorder among South African university students

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Antonia Dlagnikova

2015-08-01

Full Text Available Background. The prevalence of body dysmorphic disorder (BDD among South African students is explored in this article. BDD is regarded as an obsessive-compulsive-related disorder characterised by a preoccupation with one or more perceived defects or flaws in physical appearance and expressed in repetitive behaviours or mental acts as a response to the appearance concerns, causing clinically significant distress or impairment in functioning.  Objectives. To determine the prevalence of BDD among undergraduate students (N=395 at an inner-city university.  Methods. Proportionate stratified random cluster sampling was used to select the sample. The students completed a demographics survey and the Body Image Disturbance Questionnaire.  Results and conclusion. An overall prevalence rate of 5.1% was found in this study, which is similar to prevalence rates reported in existing literature among student populations. No clinically significant differences in the severity of the BDD were found on the demographic variables of gender, race or sexual orientation. However, students differed significantly in their experience of the severity of the disorder in terms of age, in that students over the age of 21 reported higher severity levels than students under the age of 21. Although the prevalence of the disorder compares with that in other countries, its severity seems to increase with age among South African students.

Brazilian version of the Body Dysmorphic Disorder Examination

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Renata Trajano Borges Jorge

Full Text Available CONTEXT AND OBJECTIVE: Body image improvement is considered to be the main reason for undergoing plastic surgery. The objective was to translate the Body Dysmorphic Disorder Examination (BDDE into Brazilian Portuguese and to adapt and validate this questionnaire for use in Brazil. DESIGN AND SETTING: Cross-sectional survey, at the Department of Plastic Surgery of Universidade Federal de São Paulo. METHODS: The BDDE was first translated into Portuguese and then back-translated into English. These translations were then discussed by healthcare professionals in order to establish the final Brazilian version. In a second stage, the validity and reliability of the BDDE were assessed. For this, patients were initially interviewed by two interviewers and subsequently, by only one of these interviewers. On the first occasion, in addition to the BDDE, the body shape questionnaire (BSQ and the Rosenberg self-esteem scale were also applied. These questionnaires were applied to 90 patients. RESULTS: Six questions were modified during the assessment of cultural equivalence. Cronbach's alpha was 0.89 and the intraclass correlation coefficients for interobserver and test-retest reliability were 0.91 and 0.87, respectively. Pearson's coefficient showed no correlation between the BDDE and the Rosenberg self-esteem scale (0.22, whereas there was a moderate correlation between the BDDE and the BSQ (0.64. CONCLUSIONS: The BDDE was successfully translated and adapted, with good internal consistency, reliability and construct validity.

The Presentation of Body Dysmorphic Disorder in Medical Settings

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Phillips, Katharine A.

2006-01-01

Body dysmorphic disorder (BDD) is a relatively common psychiatric illness that often presents to mental health professionals as well as nonpsychiatric physicians. However, BDD usually goes unrecognized and undiagnosed in clinical settings. It is important to recognize and accurately diagnose BDD because this often secret illness may be debilitating. Patients with BDD typically have markedly impaired functioning, notably poor quality of life, and a high rate of suicidal ideation and suicide attempts. Thus, it is important to screen patients for BDD and avoid misdiagnosing it as another illness. Nonpsychiatric treatments (eg, dermatologic, surgical), which most patients seek and receive, appear ineffective for BDD and can be risky for physicians to provide. This article provides a clinically focused overview of BDD, including its symptoms, morbidity, case examples, nonpsychiatric (ie, cosmetic) treatment, diagnostic “do’s” and “don’ts,” and suggestions for how to persuade patients to accept appropriate psychiatric care. PMID:17183412

Body dysmorphic concerns, social adaptation, and motivation for psychotherapeutic support in dermatological outpatients.

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Ritter, Viktoria; Fluhr, Joachim W; Schliemann-Willers, Sibylle; Elsner, Peter; Strauß, Bernhard; Stangier, Ulrich

2016-09-01

Dermatologists are increasingly confronted with patients affected by body dysmorphic disorder (BDD). BDD is characterized by excessive preoccupation with one or more perceived defect(s) or flaw(s) in physical appearance which are not observable or appear slight to others. So far, there have been only few studies examining the prevalence of BDD in dermatological outpatients. In addition, the need for psychotherapeutic support in dermatological outpatients with body dysmorphic concerns has not yet been systematically examined. The objective of the present study was therefore to investigate the frequency of body dysmorphic concerns as well as social adaptation and the need for psychotherapeutic support in the aforementioned patient group. A total of 252 dermatological outpatients seen at a German university hospital were consecutively enrolled, and examined using the Dysmorphic Concerns Questionnaire, the Social Adaptation Self-Evaluation Scale, and the German version of the University of Rhode Island Change Assessment Scale. 7.9 % of all outpatients (unselected sample) showed positive test results, suggesting clinically relevant body dysmorphic concerns. Patients with clinically relevant body dysmorphic concerns exhibited poor social adaptation. Contrary to expectations, these patients revealed a high motivation for change, indicating the necessity for psychotherapeutic support. Our findings confirm previous prevalence rates of BDD in dermatological outpatients, and highlight the need for providing psychotherapeutic support to dermatological patients. © 2016 Deutsche Dermatologische Gesellschaft (DDG). Published by John Wiley & Sons Ltd.

Facial discrimination in body dysmorphic, obsessive-compulsive and social anxiety disorders.

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Hübner, Claudia; Wiesendahl, Wiebke; Kleinstäuber, Maria; Stangier, Ulrich; Kathmann, Norbert; Buhlmann, Ulrike

2016-02-28

Body dysmorphic disorder (BDD) is characterized by preoccupation with perceived flaws in one's own appearance. Several risk factors such as aesthetic perceptual sensitivity have been proposed to explain BDD's unique symptomatology. Although research on facial discrimination is limited so far, the few existing studies have produced mixed results. Thus, the purpose of this study was to further examine facial discrimination in BDD. We administered a facial discrimination paradigm, which allows to assess the ability to identify slight to strong facial changes (e.g., hair loss, acne) when presented with an original (unmodified) facial image, relative to a changed (modified) facial image. The experiment was administered in individuals with BDD, social anxiety disorder, obsessive-compulsive disorder, and mentally healthy controls (32 per group, respectively). Overall, groups did not differ with respect to their ability to correctly identify facial aberrations when presented with other people's faces. Our findings do not support the hypothesis of enhanced general aesthetic perceptual sensitivity in individuals with (vs. without) BDD. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

How do people with body dysmorphic disorder view themselves? A thematic analysis.

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Silver, Joanna; Reavey, Paula; Anne Fineberg, Naomi

2010-09-01

Abstract Objectives. To examine the accounts of people with body dysmorphic disorder (BDD) and qualitatively explore self perceptions. Methods. Eleven people with BDD were interviewed using a semi-structured schedule. Participants brought photographs of themselves and drew a self-portrait. Transcribed interviews were analysed using a thematic analysis. Results. The most common theme was increased threat perception resulting in disordered interpersonal relationships. Other themes included the wish for regularity and symmetry in appearance, an idealised childhood self, the duty to look good, and a focus on specific "defective" features rather than general ugliness. Conclusions. Using thematic analysis and visual methods, we identified core themes that appear to characterise the way individuals with BDD perceive themselves and their interpersonal relationships. Thematic analysis offers promise as a tool to explore the overlap between BDD and other putatively related mental health problems.

Body dysmorphic disorder in patients undergoing septorhinoplasty surgery: should we be performing routine screening?

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Joseph, J; Randhawa, P; Hannan, S A; Long, J; Goh, S; O'Shea, N; Saleh, H; Hansen, E; Veale, D; Andrews, P

2017-06-01

Body dysmorphic disorder (BDD) is defined as having a preoccupation with a perceived flaw in one's appearance, which appears slight to others and significantly interferes with a person's functioning. When undetected in septorhinoplasty patients, it will often lead to poor outcomes. We performed a prospective cohort study to determine the prevalence of BDD in our patients and whether surgical correction could be considered. We recruited 34 patients being considered for septorhinoplasty in a tertiary referral rhinology clinic and a control group of 50 from the otology clinic giving a total of 84. Participants completed the Body Dysmorphic Disorder Questionnaire (BDDQ), the sino-nasal outcome test-23 (SNOT-23) and underwent nasal inspiratory peak flow (NIPF). Those found to be at high risk for BDD were referred to a clinical psychologist. Of the septorhinoplasty patients, 11 (32%) were high risk for BDD. Following psychological assessment, 7 (63%) patients were felt to be unsuitable for surgery and were offered psychological therapy. SNOT-23 scores were significantly higher in the BDD group indicating a negative impact on quality of life. NIPF readings were not significantly different in the BDD group compared to the control group. The BDDQ is a valid tool for identifying patients at risk of BDD. A close working relationship with clinical psychology has been advantageous to help the selection process of candidates for surgery when there is a high risk of BDD. © 2016 John Wiley & Sons Ltd.

Relative relationships of general shame and body shame with body dysmorphic phenomenology and psychosocial outcomes.

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Weingarden, Hilary; Renshaw, Keith D; Davidson, Eliza; Wilhelm, Sabine

2017-07-01

Body Dysmorphic Disorder (BDD) is characterized by a preoccupation with a perceived flaw in appearance and repetitive avoidance behaviors. BDD involves severe psychosocial outcomes (e.g., depression, suicidality, functional impairment). Identifying correlates of BDD symptoms and outcomes can inform treatment. Shame, a painful emotion felt in response to critical self-judgment, may be one key correlate. However, research on shame in BDD is scarce and previous studies have not distinguished general shame from body shame. This study examines the relative relationships between body shame and general shame with body dysmorphic phenomenology and psychosocial outcomes. Participants ( N = 184) were recruited online via BDD organizations and completed a survey. Path analysis was used to examine associations between body and general shame with 1) body dysmorphic phenomenology and 2) depression severity, suicide risk, and functional impairment. Both types of shame were differentially related to outcomes. Body shame was more strongly related to phenomenology, whereas general shame was more strongly related to psychosocial outcomes. Thus, it may be important for BDD treatment to focus on reducing both general and body shame. Further research should evaluate whether current treatments adequately address and reduce general and body shame, and whether addressing shame promotes better treatment outcomes.

Victimization, social anxiety, and body dysmorphic concerns: appearance-based rejection sensitivity as a mediator.

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Lavell, Cassie H; Zimmer-Gembeck, Melanie J; Farrell, Lara J; Webb, Haley

2014-09-01

Body dysmorphic disorder (BDD) is characterized by extreme preoccupation with perceived deficits in physical appearance, and sufferers experience severe impairment in functioning. Previous research has indicated that individuals with BDD are high in social anxiety, and often report being the victims of appearance-based teasing. However, there is little research into the possible mechanisms that might explain these relationships. The current study examined appearance-based rejection sensitivity as a mediator between perceived appearance-based victimization, social anxiety, and body dysmorphic symptoms in a sample of 237 Australian undergraduate psychology students. Appearance-based rejection sensitivity fully mediated the relationship between appearance-based victimization and body dysmorphic symptoms, and partially mediated the relationship between social anxiety and body dysmorphic symptoms. Findings suggest that individuals high in social anxiety or those who have a history of more appearance-based victimization may have a bias towards interpreting further appearance-based rejection, which may contribute to extreme appearance concerns such as BDD. Copyright © 2014 Elsevier Ltd. All rights reserved.

Set shifting and visuospatial organization deficits in body dysmorphic disorder.

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Greenberg, Jennifer L; Weingarden, Hilary; Reuman, Lillian; Abrams, Dylan; Mothi, Suraj S; Wilhelm, Sabine

2017-11-24

Individuals with body dysmorphic disorder (BDD) over-attend to perceived defect(s) in their physical appearance, often becoming "stuck" obsessing about perceived flaws and engaging in rituals to hide flaws. These symptoms suggest that individuals with BDD may experience deficits in underlying neurocognitive functions, such as set-shifting and visuospatial organization. These deficits have been implicated as risk and maintenance factors in disorders with similarities to BDD but have been minimally investigated in BDD. The present study examined differences in neurocognitive functions among BDD participants (n = 20) compared to healthy controls (HCs; n = 20). Participants completed neuropsychological assessments measuring set-shifting (Cambridge Neuropsychological Test Automated Battery Intra-Extra Dimensional Set Shift [IED] task) and visuospatial organization and memory (Rey-Osterrieth Complex Figure Test [ROCF]). Results revealed a set-shifting deficit among BDD participants compared to HCs on the IED. On the ROCF, BDD participants exhibited deficits in visuospatial organization compared to HCs, but they did not differ in visuospatial memory compared to HCs. Results did not change when accounting for depression severity. Findings highlight neurocognitive deficits as potential endophenotype markers of clinical features (i.e., delusionality). Understanding neuropsychological deficits may clarify similarities and differences between BDD and related disorders and may guide targets for BDD treatment. Copyright © 2017 Elsevier B.V. All rights reserved.

Perceptual and cognitive biases in individuals with body dysmorphic disorder symptoms.

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Clerkin, Elise M; Teachman, Bethany A

2008-01-01

Given the extreme focus on perceived physical defects in body dysmorphic disorder (BDD), we expected that perceptual and cognitive biases related to physical appearance would be associated with BDD symptomology. To examine these hypotheses, participants ( N = 70) high and low in BDD symptoms completed tasks assessing visual perception and cognition. As expected, there were significant group differences in self-, but not other-, relevant cognitive biases. Perceptual bias results were mixed, with some evidence indicating that individuals high (versus low) in BDD symptoms literally see themselves in a less positive light. Further, individuals high in BDD symptoms failed to demonstrate a normative self-enhancement bias. Overall, this research points to the importance of assessing both cognitive and perceptual biases associated with BDD symptoms, and suggests that visual perception may be influenced by non-visual factors.

Recent advances in understanding and managing body dysmorphic disorder

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Krebs, Georgina; Fernández de la Cruz, Lorena; Mataix-Cols, David

2017-01-01

Body dysmorphic disorder (BDD) is a relatively common and disabling psychiatric disorder characterised by excessive and persistent preoccupation with perceived defects or flaws in one's appearance, which are unnoticeable to others, and associated repetitive behaviours (eg, mirror checking). The disorder generally starts in adolescence, but often goes unnoticed and is severely underdiagnosed. Left untreated, BDD typically persists and causes marked functional impairment in multiple domains. This clinical review considers recent advances in the epidemiology and classification of BDD, including its reclassification in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders under the new ‘Obsessive–Compulsive and Related Disorders’ chapter. Key issues in assessment are outlined including the use of validated screening instruments to minimise misdiagnosis and the importance of risk assessment in this population given the high rates of suicidality and inappropriate use of cosmetic treatments. In addition, current knowledge regarding the causes and mechanisms underlying BDD are summarised. The recommended treatments for BDD are outlined, namely cognitive behavioural therapy (CBT) and antidepressants, such as selective serotonin reuptake inhibitors. Both CBT and pharmacotherapy have been shown to be efficacious treatments for BDD in adult populations, and evidence is emerging to support their use in young people. Although the majority of patients improve with existing evidence-based treatment, a large proportion are left with clinically significant residual symptoms. Priorities for future research are therefore discussed including the need to further refine and evaluate existing interventions with the goal of improving treatment outcomes and to increase their availability. PMID:28729345

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

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Phillips, Katharine A.; Hart, Ashley S.; Simpson, Helen Blair; Stein, Dan J.

2016-01-01

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. PMID:23659348

A critical review of cosmetic treatment outcomes in body dysmorphic disorder.

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Bowyer, Laura; Krebs, Georgina; Mataix-Cols, David; Veale, David; Monzani, Benedetta

2016-12-01

A high proportion of individuals with body dysmorphic disorder (BDD) undergo cosmetic treatments in an attempt to 'fix' perceived defect/s in their physical appearance. Despite the frequency with which such procedures are sought, few studies have prospectively examined the outcomes of cosmetic procedures in individuals with BDD. This article aims to critically review the literature and discuss the current debate that exists on outcomes of cosmetic treatment for individuals with BDD. An emerging literature suggests the majority of individuals with BDD have poor outcomes after cosmetic interventions; however, based on the current literature, it cannot be fully ruled out that certain individuals with mild BDD and localised appearance concerns may benefit from these interventions. Gaps in the current literature are highlighted, alongside recommendations for future research. Carefully conducted longitudinal studies with well-characterised patient populations are needed. Copyright © 2016 Elsevier Ltd. All rights reserved.

Evidence for a genetic overlap between body dysmorphic concerns and obsessive-compulsive symptoms in an adult female community twin sample.

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Monzani, Benedetta; Rijsdijk, Fruhling; Iervolino, Alessandra C; Anson, Martin; Cherkas, Lynn; Mataix-Cols, David

2012-06-01

Body dysmorphic disorder (BDD) is thought to be etiologically related to obsessive-compulsive disorder (OCD) but the available evidence is incomplete. The current study examined the genetic and environmental sources of covariance between body dysmorphic and obsessive-compulsive symptoms in a community sample of adult twins. A total of 2,148 female twins (1,074 pairs) completed valid and reliable measures of body dysmorphic concerns and obsessive-compulsive symptoms. The data were analyzed using bivariate twin modeling methods and the statistical programme Mx. In the best-fitting model, the covariation between body dysmorphic and obsessive-compulsive traits was largely accounted for by genetic influences common to both phenotypes (64%; 95% CI: 0.50-0.80). This genetic overlap was even higher when specific obsessive-compulsive symptom dimensions were considered, with up to 82% of the phenotypic correlation between the obsessing and symmetry/ordering symptom dimensions and dysmorphic concerns being attributable to common genetic factors. Unique environmental factors, although influencing these traits individually, did not substantially contribute to their covariation. The results remained unchanged when excluding individuals reporting an objective medical condition/injury accounting for their concern in physical appearance. The association between body dysmorphic concerns and obsessive-compulsive symptoms is largely explained by shared genetic factors. Environmental risk factors were largely unique to each phenotype. These results support current recommendations to group BDD together with OCD in the same DSM-5 chapter, although comparison with other phenotypes such as somatoform disorders and social phobia is needed. Copyright © 2012 Wiley Periodicals, Inc.

Prevalence of Body Dysmorphic Disorder and Surgeon Diagnostic Accuracy in Facial Plastic and Oculoplastic Surgery Clinics.

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Joseph, Andrew W; Ishii, Lisa; Joseph, Shannon S; Smith, Jane I; Su, Peiyi; Bater, Kristin; Byrne, Patrick; Boahene, Kofi; Papel, Ira; Kontis, Theda; Douglas, Raymond; Nelson, Christine C; Ishii, Masaru

2017-07-01

Body dysmorphic disorder (BDD) is a relative contraindication for facial plastic surgery, but formal screening is not common in practice. The prevalence of BDD in patients seeking facial plastic surgery is not well documented. To establish the prevalence of BDD across facial plastic and oculoplastic surgery practice settings, and estimate the ability of surgeons to screen for BDD. This multicenter prospective study recruited a cohort of 597 patients who presented to academic and private facial plastic and oculoplastic surgery practices from March 2015 to February 2016. All patients were screened for BDD using the Body Dysmorphic Disorder Questionnaire (BDDQ). After each clinical encounter, surgeons independently evaluated the likelihood that a participating patient had BDD. Validated instruments were used to assess satisfaction with facial appearance including the FACE-Q, Blepharoplasty Outcomes Evaluation (BOE), Facelift Outcomes Evaluation (FOE), Rhinoplasty Outcomes Evaluation (ROE), and Skin Rejuvenation Outcomes Evaluation (SROE). Across participating practices (9 surgeons, 3 sites), a total of 597 patients were screened for BDD: 342 patients from site 1 (mean [SD] age, 44.2 [16.5] years); 158 patients, site 2 (mean [SD] age, 46.0 [16.2] years), site 3, 97 patients (mean [SD] age, 56.3 [15.5] years). Overall, 58 patients [9.7%] screened positive for BDD by the BDDQ instrument, while only 16 of 402 patients [4.0%] were clinically suspected of BDD by surgeons. A higher percentage of patients presenting for cosmetic surgery (37 of 283 patients [13.1%]) compared with those presenting for reconstructive surgery (21 of 314 patients [6.7%]) screened positive on the BDDQ (odds ratio, 2.10; 95% CI, 1.20-3.68; P = .01). Surgeons were only able to correctly identify 2 of 43 patients (4.7%) who screened positive for BDD on the BDDQ, and the positive likelihood ratio was only 1.19 (95% CI, 0.28-5.07). Patients screening positive for BDD by the BDDQ had lower

Body dysmorphic disorder and cosmetic dermatology: more than skin deep

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Castle, David J; Phillips, Katharine A; Dufresne, Raymond G

2006-01-01

Summary Body dysmorphic disorder (BDD) is relatively common in cosmetic practise, yet it remains under-recognized. BDD patients are unnaturally concerned with minimal or non-existent flaws, most commonly in the skin (e.g. facial acne or scarring) and hair (e.g. hair loss). Many patients develop social avoidance and suffer occupational or academic impairment. More severely ill patients may become housebound or even attempt suicide. Despite the minimal or non-existent nature of the perceived appearance flaws, patients with BDD may request dermatological treatments such as isotretinoin or dermabrasion. Although treatment outcome has received little investigation, it appears that most patients are dissatisfied with dermatological treatment and, even if the outcome is objectively acceptable, they do not worry any the less about their appearance afterwards. In contrast, a majority of patients respond to serotonin reuptake inhibitors or cognitive behavioural therapy. Treatment of these patients is best given by an experienced health professional. This may be a mental health professional or a dermatologist with an interest in psychological medicine. PMID:17147563

New perspectives in the treatment of body dysmorphic disorder [version 1; referees: 2 approved

Directory of Open Access Journals (Sweden)

Kevin Hong

2018-03-01

Full Text Available Body dysmorphic disorder (BDD is a disabling illness with a high worldwide prevalence. Patients demonstrate a debilitating preoccupation with one or more perceived defects, often marked by poor insight or delusional convictions. Multiple studies have suggested that selective serotonin reuptake inhibitors and various cognitive behavioral therapy modalities are effective first-line treatments in decreasing BDD severity, relieving depressive symptoms, restoring insight, and increasing quality of life. Selective serotonin reuptake inhibitors have also recently been shown to be effective for relapse prevention. This review provides a comprehensive summary of the current understanding of BDD, including its clinical features, epidemiology, genetics, and current treatment modalities. Additional research is needed to fully elucidate the relationship between BDD and comorbid illnesses such as obsessive–compulsive-related disorders and depression and to develop therapies for refractory patients and those who have contraindications for pharmacological intervention.

The classification of body dysmorphic disorder symptoms in male and female adolescents.

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Schneider, Sophie C; Baillie, Andrew J; Mond, Jonathan; Turner, Cynthia M; Hudson, Jennifer L

2018-01-01

Body dysmorphic disorder (BDD) was categorised in DSM-5 within the newly created 'obsessive-compulsive and related disorders' chapter, however this classification remains subject to debate. Confirmatory factor analysis was used to test competing models of the co-occurrence of symptoms of BDD, obsessive-compulsive disorder, unipolar depression, anxiety, and eating disorders in a community sample of adolescents, and to explore potential sex differences in these models. Self-report questionnaires assessing disorder symptoms were completed by 3149 Australian adolescents. The fit of correlated factor models was calculated separately in males and females, and measurement invariance testing compared parameters of the best-fitting model between males and females. All theoretical models of the classification of BDD had poor fit to the data. Good fit was found for a novel model where BDD symptoms formed a distinct latent factor, correlated with affective disorder and eating disorder latent factors. Metric non-invariance was found between males and females, and the majority of factor loadings differed between males and females. Correlations between some latent factors also differed by sex. Only cross-sectional data were collected, and the study did not assess a broad range of DSM-5 defined eating disorder symptoms or other disorders in the DSM-5 obsessive-compulsive and related disorders chapter. This study is the first to statistically evaluate competing models of BDD classification. The findings highlight the unique features of BDD and its associations with affective and eating disorders. Future studies examining the classification of BDD should consider developmental and sex differences in their models. Copyright © 2017. Published by Elsevier B.V.

Reduced striatal dopamine D2/3 receptor availability in Body Dysmorphic Disorder.

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Vulink, Nienke C; Planting, Robin S; Figee, Martijn; Booij, Jan; Denys, Damiaan

2016-02-01

Though the dopaminergic system is implicated in Obsessive Compulsive and Related Disorders (OCRD), the dopaminergic system has never been investigated in-vivo in Body Dysmorphic Disorder (BDD). In line with consistent findings of reduced striatal dopamine D2/3 receptor availability in Obsessive Compulsive Disorder (OCD), we hypothesized that the dopamine D2/3 receptor availability in the striatum will be lower in patients with BDD in comparison to healthy subjects. Striatal dopamine D2/3 receptor Binding Potential (BPND) was examined in 12 drug-free BDD patients and 12 control subjects pairwise matched by age, sex, and handedness using [(123)I]iodobenzamide Single Photon Emission Computed Tomography (SPECT; bolus/constant infusion technique). Regions of interest were the caudate nucleus and the putamen. BPND was calculated as the ratio of specific striatal to binding in the occipital cortex (representing nonspecific binding). Compared to controls, dopamine D2/3 receptor BPND was significantly lower in BDD, both in the putamen (p=0.017) and caudate nucleus (p=0.022). This study provides the first evidence of a disturbed dopaminergic system in BDD patients. Although previously BDD was classified as a separate disorder (somatoform disorder), our findings give pathophysiological support for the recent reclassification of BDD to the OCRD in DSM-5. Copyright © 2015 Elsevier B.V. and ECNP. All rights reserved.

Patient-identified events implicated in the development of body dysmorphic disorder.

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Weingarden, Hilary; Curley, Erin E; Renshaw, Keith D; Wilhelm, Sabine

2017-06-01

Little is known about the causes of body dysmorphic disorder (BDD), but researchers have proposed a diathesis-stress model. This study uses a patient-centered approach to identify stressful events to which patients attribute the development of their BDD symptoms. An Internet-recruited sample of 165 adults with BDD participated. A large minority of participants attributed the development of their BDD to a triggering event. Bullying experiences were the most commonly described type of event. Additionally, most events were interpersonal and occurred during grade school or middle school. There were no differences in severity of psychosocial outcomes between participants who did or did not attribute their BDD to a specific triggering event. However, participants who specifically attributed their BDD development to a bullying experience had poorer psychosocial outcomes (i.e., perceived social support, depression severity, functional impairment, quality of life) compared to those who attributed their BDD development to another type of triggering event. Copyright © 2017 Elsevier Ltd. All rights reserved.

Comorbidity between obsessive-compulsive disorder and body dysmorphic disorder: prevalence, explanatory theories, and clinical characterization

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Frías, Álvaro; Palma, Carol; Farriols, Núria; González, Laura

2015-01-01

Background With the advent of the fifth edition of Diagnostic and Statistical Manual of Mental Disorders, body dysmorphic disorder (BDD) has been subsumed into the obsessive-compulsive disorders and related disorders (OCDRD) category. Objective We aimed to determine the empirical evidence regarding the potential relationship between BDD and obsessive-compulsive disorder (OCD) based on the prevalence data, etiopathogenic pathways, and clinical characterization of patients with both disorders. Method A comprehensive search of databases (PubMed and PsycINFO) was performed. Published manuscripts between 1985 and May 2015 were identified. Overall, 53 studies fulfilled inclusion criteria. Results Lifetime comorbidity rates of BDD–OCD are almost three times higher in samples with a primary diagnosis of BDD than those with primary OCD (27.5% vs 10.4%). However, other mental disorders, such as social phobia or major mood depression, are more likely among both types of psychiatric samples. Empirical evidence regarding the etiopathogenic pathways for BDD–OCD comorbidity is still inconclusive, whether concerning common shared features or one disorder as a risk factor for the other. Specifically, current findings concerning third variables show more divergences than similarities when comparing both disorders. Preliminary data on the clinical characterization of the patients with BDD and OCD indicate that the deleterious clinical impact of BDD in OCD patients is greater than vice versa. Conclusion Despite the recent inclusion of BDD within the OCDRD, data from comparative studies between BDD and OCD need further evidence for supporting this nosological approach. To better define this issue, comparative studies between BDD, OCD, and social phobia should be carried out. PMID:26345330

Cognitive-Behavioral Therapy for Body Dysmorphic Disorder by Proxy.

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Greenberg, Jennifer L; Mothi, Suraj Sarvode; Wilhelm, Sabine

2016-07-01

Body dysmorphic disorder (BDD) is a distressing or impairing preoccupation with a perceived defect in physical appearance. BDD by proxy (BDDBP) is a significant but understudied variant of BDD in which the primary preoccupation involves perceived imperfections of another person. Like BDD, individuals with BDDBP engage in time-consuming rituals to "fix" the other person's appearance or alleviate distress. Avoidance is common and the impact of BDDBP on social functioning is profound. Cognitive-behavioral therapy (CBT) is the best-studied and most promising psychological treatment for BDD, but no studies have examined its generalizability to the BDDBP variant. We tested feasibility, acceptability, and treatment outcome of CBT modified for BDDBP in a sample of 6 adults with primary BDDBP. Treatment was delivered in weekly individual sessions over 12-20weeks. Mean symptom severity (BDDBP-YBOCS) dropped from the moderately severe range at pretreatment to the subclinical range at posttreatment, t(6)=10.7, p<.001, d=3.3. One hundred percent of treatment completers were responders (≥30% reduction in BDDBP-YBOCS). Insight also improved. Treatment gains were maintained at 3-month follow-up. To our knowledge, this represents the first treatment study for BDDBP. Copyright © 2016. Published by Elsevier Ltd.

Body Dysmorphic, Obsessive-Compulsive, and Social Anxiety Disorder Beliefs as Predictors of In Vivo Stressor Responding.

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Parsons, E Marie; Straub, Kelsey T; Smith, April R; Clerkin, Elise M

2017-06-01

This study tested the potential transdiagnostic nature of body dysmorphic disorder (BDD), obsessive-compulsive disorder (OCD), and social anxiety disorder (SAD) beliefs, in addition to testing the specificity of those beliefs, in predicting how individuals responded to symptom-specific stressors. Participants included 127 adults (75% women) with a broad range of symptom severity. Path analysis was used to evaluate whether specific maladaptive beliefs predicted distress in response to symptom-relevant stressors over and above other beliefs and baseline distress. SAD beliefs emerged as a significant predictor of distress in response to a mirror gazing (BDD-relevant), a thought (OCD-relevant), and a public speaking (SAD-relevant) task, controlling for other disorder beliefs and baseline distress. BDD beliefs were also a robust predictor of BDD stressor responding. Results suggest that social anxiety-relevant beliefs may function as a transdiagnostic risk factor that predicts in vivo symptoms across a range of problem areas.

Prevalence of body dysmorphic disorder in patients referred to Razi hospital cosmetic clinic with complaints of cosmetic disorders

Directory of Open Access Journals (Sweden)

Amirhooshang Ehsani

2013-06-01

Full Text Available Background: Body dysmorphic disorder (BDD is characterized by a preoccupation with an imagined defect in ones appearance or an exaggeration of a slight physical anomaly. Any part of the appearance may be the focuse of BDD patients. Thus preoccupation with appearance leads to significant damages of social and job functioning. The aim of this study is to determine the prevalence of BDD in patients referred to cosmetic clinic of Razi hospital.Methods: Patients visiting cosmetic clinic of Razi hospital were selected if they agreed to participate in the study. They were evaluated by Yale brown obsessive compulsive scale modified for body dysmorphic disorder (YBOCS-BDD as well as questionnaires containing demographic characteristics of patients including gender, educational status, marital status, history of reference to psychiatrist or psychologist, other medication, history of cosmetic surgery and rate of satisfaction of cosmetic surgery. YBOCS-BDD questionnaires then processed by educated specialist to determine BDD score of patie-nts. Demographic questionnaires, also analysed to evaluate epidemiologic properties of patients visiting cosmetic clinic of Razi hospital.Results: The prevalence of BDD in current sample was 33.3%. 70.7% of BDD patients were female while 29.3% were male. The commonest age range was 21-50 years (82.8%. 65.5% were educated to level of diploma or lower, while 34.5% had academic degrees. 51.7% were married. 20.7% had history of reference to psychiatrist or psycholo-gist. 17/2% had history of cosmetic surgery with satisfaction ranging from unsatisfied (20% to relative satisfaction (80%. None were fully satisfied.Conclusion: BDD had high prevalence in patients visiting cosmetic clinic of Razi skin hospital. This high rate of prevalence show the necessity of diagnosis of BDD in skin patients and it is critical for them to refer to psychiatrists or psychologists.

Prevalence, demographic and clinical characteristics of body dysmorphic disorder among psychiatric outpatients with mood, anxiety or somatoform disorders.

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van der Meer, Job; van Rood, Yanda R; van der Wee, Nic J; den Hollander-Gijsman, Margien; van Noorden, Martijn S; Giltay, Erik J; Zitman, Frans G

2012-09-01

To describe the prevalence, demographic and clinical characteristics of body dysmorphic disorder (BDD) compared with other psychiatric outpatients with a mood, anxiety or somatoform disorder. Outpatients referred for treatment of a mood, anxiety or somatoform disorder were routinely assessed at intake. A structured interview (MINI-Plus), observer-based and self-rating instruments were administered by an independent assessor. Among our sample of 3798 referred patients, 2947 patients were diagnosed with at least one DSM-IV mood, anxiety or somatoform disorder. Of these patients 1.8% (n = 54) met the diagnostic criteria for BDD. In comparison with other outpatients, patients with BDD were on average younger, less often married and were more often living alone. Highly prevalent comorbid diagnoses were major depression (in 46.3% of cases), social anxiety disorder (in 35.2% of cases) and obsessive-compulsive disorder (OCD) (in 16.7% of cases). Furthermore, patients with BDD had higher scores on the Clinical Global Impression of Severity (CGI-S) as well as lower scores on the Short Form 36 social role functioning. BDD is frequently associated with depression, social phobia and OCD. Patients with BDD have more distress and more impaired interpersonal functioning.

Selective attention to imagined facial ugliness is specific to body dysmorphic disorder.

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Grocholewski, Anja; Kliem, Sören; Heinrichs, Nina

2012-03-01

Cognitive-behavioral models postulate that biases in selective attention are key factors contributing to susceptibility to and maintenance of body dysmorphic disorder (BDD). Visual attention in particular toward the imagined defect in appearance may be a crucial element. The present study therefore examined whether individuals with BDD showed increased visual attention to flaws in their own and in unfamiliar faces. Twenty individuals with BDD, 20 individuals with social phobia, and 20 mentally healthy individuals participated in an eye-tracking experiment. Participants were instructed to gaze at the photographs of 15 pictures of themselves and several unfamiliar faces. Only patients with BDD showed heightened selective visual attention to the imagined defect in their own face, as well to corresponding regions in other, unfamiliar faces. The results support the assumption that there is a specific attentional bias in BDD. Copyright © 2012 Elsevier Ltd. All rights reserved.

Prevalence of and associations between body dysmorphic concerns, obsessive beliefs and social anxiety.

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Barahmand, Usha; Shahbazi, Zeynab

2015-03-01

Physical attractiveness has been of concern in different cultures and at different times. Physical attractiveness can influence one's thoughts and actions, and concerns regarding body image can be destructive, giving rise to psychological problems. The purpose of the present study was to determine the prevalence of body dysmorphic concerns, related sex differences and comorbidity with social anxiety and obsessive beliefs. Using a stratified and cluster sampling procedure, 1,200 males and females were randomly selected. Self-report measures on body image, social anxiety and obsessive beliefs were distributed of which 843 completed questionnaires (54.9% males and 45.1% females) were returned (return rate of 70.25%). Therefore, data pertaining to 463 males and 380 females ranging in age from 17 to 20 years with a mean age of 18.12 years (SD = 1.06) were analyzed. Findings suggest a prevalence rate of 19.1% for body dysmorphic disorder, 23.6% for social anxiety and 8.8% for obsessive beliefs. Both social anxiety and obsessive beliefs were found to be comorbid with body dysmorphic concerns. The percentage of individuals reporting comorbid social anxiety (12.9%) was greater than that of those reporting comorbid obsessive beliefs (6.4%). Males with body dysmorphic concerns reported more obsessive beliefs (8.2% versus 4.1%), while their female counterparts reported more social anxiety (23.4% versus 4.2%). In males, body image concerns appear to be more cognitive in quality, while in females, body image concerns seem more emotional in tone. As the measures used do not yield formal diagnoses, findings should be viewed with caution. Copyright © 2013 Wiley Publishing Asia Pty Ltd.

Brain connectome modularity in weight-restored anorexia nervosa and body dysmorphic disorder

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Zhang, A; Leow, A; Zhan, L; GadElkarim, J; Moody, T; Khalsa, S; Strober, M; Feusner, JD

2017-01-01

Background Anorexia nervosa (AN) and body dysmorphic disorder (BDD) frequently co-occur, and have several overlapping phenomenological features. Little is known about their shared neurobiology. Aims To compare modular organization of brain structural connectivity. Methods We acquired diffusion-weighted magnetic resonance imaging data on unmedicated individuals with BDD (n=29), weight-restored AN (n=24), and healthy controls (HC) (n=31). We constructed connectivity matrices using whole-brain white matter tractography, and compared modular structures across groups. Results AN showed abnormal modularity involving frontal, basal ganglia, and posterior cingulate nodes. There was a trend in BDD for similar abnormalities, but no significant differences compared with AN. In AN, poor insight correlated with longer path length in right caudal anterior cingulate and right posterior cingulate. Conclusions Abnormal network organization patterns in AN, partially shared with BDD, may have implications for understanding integration between reward and habit/ritual formation, as well as conflict monitoring/error detection. PMID:27429183

Body dysmorphic disorder symptoms and risk for suicide: The role of depression.

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Shaw, A M; Arditte Hall, K A; Rosenfield, E; Timpano, K R

2016-12-01

Body dysmorphic disorder (BDD) is associated with elevated suicidality. Little is known about why BDD patients are at increased risk. The interpersonal-psychological theory of suicide (IPTS) could clarify suicidality in BDD, and theorizes that perceived burdensomeness and thwarted belongingness lead to suicidal desire, while an acquired capability for suicide is necessary to attempt suicide. No study has investigated how BDD symptoms relate to IPTS constructs or mediators of the relationship between BDD and suicidality. Individuals (N=235) enrolled in Amazon.com's Mechanical Turk (MTurk), who had appearance concerns, completed questionnaires about BDD, depression, eating pathology, and suicide risk. MTurk is an online data collection platform in which participants complete surveys for payment. BDD symptoms predicted suicidal desire, but not acquired capability for suicide. Depression mediated the relationship between BDD and suicidal desire. Research should examine how fluctuations in BDD affect suicide risk. Replication in a clinical sample may inform treatments for BDD. Copyright © 2016 Elsevier Ltd. All rights reserved.

Anxiety and Shame as Risk Factors for Depression, Suicidality, and Functional Impairment in Body Dysmorphic Disorder and Obsessive Compulsive Disorder.

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Weingarden, Hilary; Renshaw, Keith D; Wilhelm, Sabine; Tangney, June P; DiMauro, Jennifer

2016-11-01

Body dysmorphic disorder (BDD) and obsessive compulsive disorder (OCD) are associated with elevated depression, suicidality, functional impairment, and days housebound, yet little research has identified risk factors for these outcomes. Using path analysis, the present study examined anxiety and shame as risk factors for these outcomes across Internet-recruited self-report groups (BDD [n = 114], OCD [n = 114], and healthy control [HC; n = 133]). Paths from anxiety and shame to outcomes were similar and mostly significant across BDD and OCD, compared to non-significant paths for HCs, with one exception: the path from shame to depression was significant in the BDD group (b = 0.32) but non-significant in the OCD group (b = 0.07). Findings underscore similarities in BDD and OCD, supporting their reclassification into the same Obsessive Compulsive Related Disorders category. Results emphasize the importance of targeting shame, in addition to anxiety, in treatments for BDD and OCD.

A Review of Body Dysmorphic Disorder in Aesthetic Surgery Patients and the Legal Implications.

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Sweis, Iliana E; Spitz, Jamie; Barry, David R; Cohen, Mimis

2017-08-01

Body dysmorphic disorder (BDD) is an often under-recognized yet severe psychiatric illness. There is limited guidance for plastic surgeons in the USA in how to recognize and manage patients with BDD and protect themselves from potential litigation and harm. Therefore, in collaboration with legal counsel, we remind our profession of the serious nature of patients with BDD, provide warning signs for recognizing BDD, and critically evaluate the validity of informed consent and the legal ramifications of operating on such patients in the USA. A literature review was performed to clearly define the psychopathology of BDD and identify cases of patients with BDD who underwent cosmetic surgery resulting in potential threats to the surgeon. An additional search of the legal literature was performed in collaboration with legal counsel to identify key cases of patients with BDD attempting litigation following cosmetic surgery procedures. The diagnostic criteria and psychopathology of BDD are presented. Warning signs are highlighted to alert the plastic surgeon to patients at high risk for BDD. Strategies for legal protection include a pre-procedure checklist for patients that are suspected of having a BDD diagnosis. Body dysmorphic disorder is prevalent in the cosmetic surgery population. Patients with BDD often have a poor outcome following aesthetic surgery, which can result in a dangerous or even deadly situation for the surgeon. We aim to remind aesthetic plastic surgeons of the psychopathology, severity, and specific risks associated with operating on patients with BDD while suggesting specific protective strategies. This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please

High-Dose Glycine Treatment of Refractory Obsessive-Compulsive Disorder and Body Dysmorphic Disorder in a 5-Year Period

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W. Louis Cleveland

2009-01-01

Full Text Available This paper describes an individual who was diagnosed with obsessive-compulsive disorder (OCD and body dysmorphic disorder (BDD at age 17 when education was discontinued. By age 19, he was housebound without social contacts except for parents. Adequate trials of three selective serotonin reuptake inhibitors, two with atypical neuroleptics, were ineffective. Major exacerbations following ear infections involving Group A -hemolytic streptococcus at ages 19 and 20 led to intravenous immune globulin therapy, which was also ineffective. At age 22, another severe exacerbation followed antibiotic treatment for H. pylori. This led to a hypothesis that postulates deficient signal transduction by the N-methyl-D-aspartate receptor (NMDAR. Treatment with glycine, an NMDAR coagonist, over 5 years led to robust reduction of OCD/BDD signs and symptoms except for partial relapses during treatment cessation. Education and social life were resumed and evidence suggests improved cognition. Our findings motivate further study of glycine treatment of OCD and BDD.

Cognitive-Behavioral Therapy for Adolescent Body Dysmorphic Disorder: A Pilot Study.

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Greenberg, Jennifer L; Mothi, Suraj Sarvode; Wilhelm, Sabine

2016-03-01

Body dysmorphic disorder (BDD) is a relatively common and severe disorder that typically onsets in adolescence, but often goes unrecognized. Despite BDD's severity and early onset, treatment outcome research on adolescent BDD is scarce. Cognitive-behavioral therapy is the gold-standard psychosocial treatment for BDD in adults and has shown promise in adolescents. The current study examined the development and testing of a new CBT for adolescents with BDD. We tested feasibility, acceptability, and treatment outcome in a sample of 13 adolescents (mean age 15.23years, range: 13-17) with primary BDD. Treatment was delivered in 12-22 weekly individual sessions. Standardized clinician ratings and self-report measures were used to assess BDD and related symptoms pre- and posttreatment and at 3- and 6-months follow-up. At posttreatment, BDD and related symptoms (e.g., insight, mood) were significantly improved. Scores on the Yale-Brown Obsessive Compulsive Scale for BDD indicated a 50% (intent-to-treat) and 68% (completer) improvement in BDD symptoms. Seventy-five percent of adolescents who started treatment and 100% of completers were considered treatment responders. Treatment gains were maintained at follow-up. High patient satisfaction ratings and patient feedback indicated that treatment was acceptable. This represents the largest study of a psychosocial treatment for adolescent BDD. Copyright © 2015. Published by Elsevier Ltd.

Body dysmorphic disorder in different settings: A systematic review and estimated weighted prevalence.

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Veale, David; Gledhill, Lucinda J; Christodoulou, Polyxeni; Hodsoll, John

2016-09-01

Our aim was to systematically review the prevalence of body dysmorphic disorder (BDD) in a variety of settings. Weighted prevalence estimate and 95% confidence intervals in each study were calculated. The weighted prevalence of BDD in adults in the community was estimated to be 1.9%; in adolescents 2.2%; in student populations 3.3%; in adult psychiatric inpatients 7.4%; in adolescent psychiatric inpatients 7.4%; in adult psychiatric outpatients 5.8%; in general cosmetic surgery 13.2%; in rhinoplasty surgery 20.1%; in orthognathic surgery 11.2%; in orthodontics/cosmetic dentistry settings 5.2%; in dermatology outpatients 11.3%; in cosmetic dermatology outpatients 9.2%; and in acne dermatology clinics 11.1%. Women outnumbered men in the majority of settings but not in cosmetic or dermatological settings. BDD is common in some psychiatric and cosmetic settings but is poorly identified. Copyright © 2016 Elsevier Ltd. All rights reserved.

Classification of body dysmorphic disorder - what is the advantage of the new DSM-5 criteria?

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Schieber, Katharina; Kollei, Ines; de Zwaan, Martina; Martin, Alexandra

2015-03-01

In DSM-5 the diagnosis of body dysmorphic disorder (BDD) has been subjected to two important changes: Firstly, BDD has been assigned to the category of obsessive-compulsive and related disorders. Secondly, a new criterion has been defined requiring the presence of repetitive behaviors or mental acts in response to appearance concerns. The aims of this study were to report the prevalence rates of BDD based on a DSM-5 diagnosis, and to evaluate the impact of the recently introduced DSM-5 criteria for BDD by comparing the prevalence rates (DSM-5 vs. BDD-criteria (DSM-IV/DSM-5), dysmorphic concerns, and depressive symptoms, were assessed in a representative sample of the German general population (N=2129, aged 18-65years). The association between BDD case identification based on DSM-IV and DSM-5 was strong (Phi=.95, p<.001), although point prevalence of BDD according to DSM-5 was slightly lower (2.9%, n=62 vs. 3.2%, n=68). Approximately one third of the identified BDD (DSM-5) cases reported time-consuming behavioral acts in response to appearance concerns. In detail, 0.8% of the German general population fulfilled the BDD criteria and reported repetitive acts of at least one hour/day. The revised criteria of BDD in DSM-5 do not seem to have an impact on prevalence rates. However, the recently added B-criterion reflects more precisely the clinical symptoms of BDD, and may be useful for distinguishing between various severity levels related to repetitive behaviors/mental acts. Copyright © 2015 Elsevier Inc. All rights reserved.

Rejection Sensitivity Mediates the Relationship between Social Anxiety and Body Dysmorphic Concerns

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Fang, Angela; Asnaani, Anu; Gutner, Cassidy; Cook, Courtney; Wilhelm, Sabine; Hofmann, Stefan G.

2011-01-01

The goal of this study was to examine the role of rejection sensitivity in the relationship between social anxiety and body dysmorphic concerns. To test our hypothesis that rejection sensitivity mediates the link between social anxiety and body dysmorphic concerns, we administered self-report questionnaires to 209 student volunteers. Consistent with our prediction, rejection sensitivity partially mediated the relationship between social anxiety symptoms and body dysmorphic concerns. The implications of the overlap between these constructs are discussed. PMID:21741203

Body Dysmorphic Disorder: Gender differences and prevalence in a Pakistani medical student population

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Vaqar Talha

2008-04-01

Full Text Available Abstract Background Body dysmorphic disorder (BDD is a psychiatric disorder characterized by a preoccupation with an imagined or slight defect which causes significant distress or impairment in functioning. Few studies have assessed gender differences in BDD in a non clinical population. Also no study assessed BDD in medical students. This study was designed to determine the point prevalence of BDD in Pakistani medical students and the gender differences in prevalence of BDD, body foci of concern and symptoms of BDD. Methods The medical students enrolled in a medical university in Karachi, Pakistan filled out a self-report questionnaire which assessed clinical features of BDD. BDD was diagnosed according to the DSM-IV criteria. Results Out of the 156 students, 57.1% were female. A total of 78.8% of the students reported dissatisfaction with some aspect of their appearance and 5.8% met the DSM-IV criteria for BDD. The male to female ratio for BDD was 1.7. Regarding gender differences in body foci of concern, the top three reported foci of concern in male students were head hair (34.3%, being fat (32.8%, skin (14.9% and nose(14.9%, whereas in females they were being fat (40.4%, skin (24.7% and teeth (18%. Females were significantly more concerned about being fat (p = 0.005. Male students were significantly more concerned about being thin (p = 0.01 and about head hair (p = 0.012. Conclusion BDD is fairly common in our medical student population, with a higher prevalence in males. Important gender differences in BDD symptomatology and reported body foci of concern were identified which reflected the influence of media on body image perception. The impact of cultural factors on the prevalence as well as gender differences in BDD symptomatology was also established.

Body dysmorphic disorder: Latest neuroanatomical and neuropsychological findings.

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Tasios, K; Michopoulos, I

2017-01-01

Body dysmorphic disorder (BDD) is characterized by a preoccupation with a perceived defect or flaw in physical appearance that is not observable or appears slight to others. It leads to severe distress and functional impairment. Cognitive-behavioural and neurobiological similarities to obsessive compulsive disorder (OCD) have led to its newly conceived classification as an obsessive compulsive related disorder (OCRD). In the process of investigating the neurobiology of BDD, neuroimaging and neuropsychological studies have been conducted. This review presents the most recent research findings and their connection with BDD clinical features. Imaging studies have shown increased total white matter volume and caudate volume asymmetry in BDD patients. These findings are consistent with the striatal topography model of OCRDs. Other studies have showed perfusion deficits in bilateral anterior-medial temporal and occipital regions and asymmetric perfusion in parietal lobes. In addition, correlation between symptom severity and left inferior frontal gyrus volume reflects the degree of detailed, analytic encoding that occurs on day-to-day basis when viewing others and themselves, and that likely underlies their symptoms. Finally, positive correlation between right amygdala volume and symptom severity signifies pathological fear circuitry engagement, hypervigilance and heightened sensitivity to social situations. Neuropsychological studies of BDD reveal deficits in strategic organization, learning and free recall after short and long delays. Executive function deficits are related to spatial working memory and subsequent thinking speed as well as impaired higher level planning ability. BDD patients' organizational strategies tend to focus on detail rather than on larger, global clustering features. They are characterized by abnormal visual processing of both details and global elements, inaccurate processing of global elements and reduced flexibility in switching visual

A Pilot Randomized Controlled Trial of Cognitive-Behavioral Therapy for Adolescents With Body Dysmorphic Disorder.

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Mataix-Cols, David; Fernández de la Cruz, Lorena; Isomura, Kayoko; Anson, Martin; Turner, Cynthia; Monzani, Benedetta; Cadman, Jacinda; Bowyer, Laura; Heyman, Isobel; Veale, David; Krebs, Georgina

2015-11-01

Body dysmorphic disorder (BDD) typically starts in adolescence, but evidence-based treatments are yet to be developed and formally evaluated in this age group. We designed an age-appropriate cognitive-behavioral therapy (CBT) protocol for adolescents with BDD and evaluated its acceptability and efficacy in a pilot randomized controlled trial. Thirty adolescents aged 12 to 18 years (mean = 16.0, SD = 1.7) with a primary diagnosis of BDD, together with their families, were randomly assigned to 14 sessions of CBT delivered over 4 months or a control condition of equivalent duration, consisting of written psycho-education materials and weekly telephone monitoring. Blinded evaluators assessed participants at baseline, midtreatment, posttreatment, and at 2-month follow-up. The primary outcome measure was the Yale-Brown Obsessive-Compulsive Scale Modified for BDD, Adolescent Version (mean baseline score = 37.13, SD = 4.98, range = 24-43). The CBT group showed a significantly greater improvement than the control group, both at posttreatment (time × group interaction coefficient [95% CI] = -11.26 [-17.22 to -5.31]; p = .000) and at 2-month follow-up (time × group interaction coefficient [95% CI] = -9.62 [-15.74 to -3.51]; p = .002). Six participants (40%) in the CBT group and 1 participant (6.7%) in the control condition were classified as responders at both time points (χ(2) = 4.658, p = .031). Improvements were also seen on secondary measures, including insight, depression, and quality of life at posttreatment. Both patients and their families deemed the treatment as highly acceptable. Developmentally tailored CBT is a promising intervention for young people with BDD, although there is significant room for improvement. Further clinical trials incorporating lessons learned in this pilot study and comparing CBT and pharmacological therapies, as well as their combination, are warranted. Cognitive-Behaviour Therapy for Adolescents With Body Dysmorphic Disorder; http

The presence, predictive utility, and clinical significance of body dysmorphic symptoms in women with eating disorders

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2013-01-01

Background Both eating disorders (EDs) and body dysmorphic disorder (BDD) are disorders of body image. This study aimed to assess the presence, predictive utility, and impact of clinical features commonly associated with BDD in women with EDs. Methods Participants recruited from two non-clinical cohorts of women, symptomatic and asymptomatic of EDs, completed a survey on ED (EDE-Q) and BDD (BDDE-SR) psychopathology, psychological distress (K-10), and quality of life (SF-12). Results A strong correlation was observed between the total BDDE-SR and the global EDE-Q scores (r = 0.79, p 0.05) measured appearance checking, reassurance-seeking, camouflaging, comparison-making, and social avoidance. In addition to these behaviors, inspection of sensitivity (Se) and specificity (Sp) revealed that BDDE-SR items measuring preoccupation and dissatisfaction with appearance were most predictive of ED cases (Se and Sp > 0.60). Higher total BDDE-SR scores were associated with greater distress on the K-10 and poorer quality of life on the SF-12 (all p < 0.01). Conclusions Clinical features central to the model of BDD are common in, predictive of, and associated with impairment in women with EDs. Practice implications are that these features be included in the assessment and treatment of EDs. PMID:24999401

Is Body Dysmorphic Disorder Associated with Abnormal Bodily Self-Awareness? A Study Using the Rubber Hand Illusion

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Kaplan, Ryan A.; Enticott, Peter G.; Hohwy, Jakob; Castle, David J.; Rossell, Susan L.

2014-01-01

Evidence from past research suggests that behaviours and characteristics related to body dissatisfaction may be associated with greater instability of perceptual body image, possibly due to problems in the integration of body-related multisensory information. We investigated whether people with body dysmorphic disorder (BDD), a condition characterised by body image disturbances, demonstrated enhanced susceptibility to the rubber hand illusion (RHI), which arises as a result of multisensory integration processes when a rubber hand and the participant's hidden real hand are stimulated in synchrony. Overall, differences in RHI experience between the BDD group and healthy and schizophrenia control groups (n = 17 in each) were not significant. RHI strength, however, was positively associated with body dissatisfaction and related tendencies. For the healthy control group, proprioceptive drift towards the rubber hand was observed following synchronous but not asynchronous stimulation, a typical pattern when inducing the RHI. Similar drifts in proprioceptive awareness occurred for the BDD group irrespective of whether stimulation was synchronous or not. These results are discussed in terms of possible abnormalities in visual processing and multisensory integration among people with BDD. PMID:24925079

Is body dysmorphic disorder associated with abnormal bodily self-awareness? A study using the rubber hand illusion.

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Kaplan, Ryan A; Enticott, Peter G; Hohwy, Jakob; Castle, David J; Rossell, Susan L

2014-01-01

Evidence from past research suggests that behaviours and characteristics related to body dissatisfaction may be associated with greater instability of perceptual body image, possibly due to problems in the integration of body-related multisensory information. We investigated whether people with body dysmorphic disorder (BDD), a condition characterised by body image disturbances, demonstrated enhanced susceptibility to the rubber hand illusion (RHI), which arises as a result of multisensory integration processes when a rubber hand and the participant's hidden real hand are stimulated in synchrony. Overall, differences in RHI experience between the BDD group and healthy and schizophrenia control groups (n = 17 in each) were not significant. RHI strength, however, was positively associated with body dissatisfaction and related tendencies. For the healthy control group, proprioceptive drift towards the rubber hand was observed following synchronous but not asynchronous stimulation, a typical pattern when inducing the RHI. Similar drifts in proprioceptive awareness occurred for the BDD group irrespective of whether stimulation was synchronous or not. These results are discussed in terms of possible abnormalities in visual processing and multisensory integration among people with BDD.

Penile Dysmorphic Disorder: Development of a Screening Scale.

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Veale, David; Miles, Sarah; Read, Julie; Troglia, Andrea; Carmona, Lina; Fiorito, Chiara; Wells, Hannah; Wylie, Kevan; Muir, Gordon

2015-11-01

Penile dysmorphic disorder (PDD) is shorthand for men diagnosed with body dysmorphic disorder, in whom the size or shape of the penis is their main, if not their exclusive, preoccupation causing significant shame or handicap. There are no specific measures for identifying men with PDD compared to men who are anxious about the size of their penis but do not have PDD. Such a measure might be helpful for treatment planning, reducing unrealistic expectations, and measuring outcome after any psychological or physical intervention. Our aim was, therefore, to validate a specific measure, termed the Cosmetic Procedure Screening Scale for PDD (COPS-P). Eighty-one male participants were divided into three groups: a PDD group (n = 21), a small penis anxiety group (n = 37), and a control group (n = 23). All participants completed the COPS-P as well as standardized measures of depression, anxiety, social phobia, body image, quality of life, and erectile function. Penis size was also measured. The final COPS-P was based on nine items. The scale had good internal reliability and significant convergent validity with measures of related constructs. It discriminated between the PDD group, the small penis anxiety group, and the control group. This is the first study to develop a scale able to discriminate between those with PDD and men anxious about their size who did not have PDD. Clinicians and researchers may use the scale as part of an assessment for men presenting with anxiety about penis size and as an audit or outcome measure after any intervention for this population.

Aberrant Dynamic Connectivity for Fear Processing in Anorexia Nervosa and Body Dysmorphic Disorder

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D. Rangaprakash

2018-06-01

Full Text Available Anorexia nervosa (AN and body dysmorphic disorder (BDD share distorted perceptions of appearance with extreme negative emotion, yet the neural phenotypes of emotion processing remain underexplored in them, and they have never been directly compared. We sought to determine if shared and disorder-specific fronto-limbic connectivity patterns characterize these disorders. FMRI data was obtained from three unmedicated groups: BDD (n = 32, weight-restored AN (n = 25, and healthy controls (HC; n = 37, while they viewed fearful faces and rated their own degree of fearfulness in response. We performed dynamic effective connectivity modeling with medial prefrontal cortex (mPFC, rostral anterior cingulate cortex (rACC, and amygdala as regions-of-interest (ROI, and assessed associations between connectivity and clinical variables. HCs exhibited significant within-group bidirectional mPFC-amygdala connectivity, which increased across the blocks, whereas BDD participants exhibited only significant mPFC-to-amygdala connectivity (P < 0.05, family-wise error corrected. In contrast, participants with AN lacked significant prefrontal-amygdala connectivity in either direction. AN showed significantly weaker mPFC-to-amygdala connectivity compared to HCs (P = 0.0015 and BDD (P = 0.0050. The mPFC-to-amygdala connectivity was associated with greater subjective fear ratings (R2 = 0.11, P = 0.0016, eating disorder symptoms (R2 = 0.33, P = 0.0029, and anxiety (R2 = 0.29, P = 0.0055 intensity scores. Our findings, which suggest a complex nosological relationship, have implications for understanding emotion regulation circuitry in these related psychiatric disorders, and may have relevance for current and novel therapeutic approaches.

Visual processing in anorexia nervosa and body dysmorphic disorder: similarities, differences, and future research directions

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Madsen, Sarah K.; Bohon, Cara; Feusner, Jamie D.

2013-01-01

Anorexia nervosa (AN) and body dysmorphic disorder (BDD) are psychiatric disorders that involve distortion of the experience of one’s physical appearance. In AN, individuals believe that they are overweight, perceive their body as “fat,” and are preoccupied with maintaining a low body weight. In BDD, individuals are preoccupied with misperceived defects in physical appearance, most often of the face. Distorted visual perception may contribute to these cardinal symptoms, and may be a common underlying phenotype. This review surveys the current literature on visual processing in AN and BDD, addressing lower- to higher-order stages of visual information processing and perception. We focus on peer-reviewed studies of AN and BDD that address ophthalmologic abnormalities, basic neural processing of visual input, integration of visual input with other systems, neuropsychological tests of visual processing, and representations of whole percepts (such as images of faces, bodies, and other objects). The literature suggests a pattern in both groups of over-attention to detail, reduced processing of global features, and a tendency to focus on symptom-specific details in their own images (body parts in AN, facial features in BDD), with cognitive strategy at least partially mediating the abnormalities. Visuospatial abnormalities were also evident when viewing images of others and for non-appearance related stimuli. Unfortunately no study has directly compared AN and BDD, and most studies were not designed to disentangle disease-related emotional responses from lower-order visual processing. We make recommendations for future studies to improve the understanding of visual processing abnormalities in AN and BDD. PMID:23810196

Emotion recognition in body dysmorphic disorder: application of the Reading the Mind in the Eyes Task.

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Buhlmann, Ulrike; Winter, Anna; Kathmann, Norbert

2013-03-01

Body dysmorphic disorder (BDD) is characterized by perceived appearance-related defects, often tied to aspects of the face or head (e.g., acne). Deficits in decoding emotional expressions have been examined in several psychological disorders including BDD. Previous research indicates that BDD is associated with impaired facial emotion recognition, particularly in situations that involve the BDD sufferer him/herself. The purpose of this study was to further evaluate the ability to read other people's emotions among 31 individuals with BDD, and 31 mentally healthy controls. We applied the Reading the Mind in the Eyes task, in which participants are presented with a series of pairs of eyes, one at a time, and are asked to identify the emotion that describes the stimulus best. The groups did not differ with respect to decoding other people's emotions by looking into their eyes. Findings are discussed in light of previous research examining emotion recognition in BDD. Copyright © 2013. Published by Elsevier Ltd.

Associations in the longitudinal course of body dysmorphic disorder with major depression, obsessive-compulsive disorder, and social phobia.

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Phillips, Katharine A; Stout, Robert L

2006-06-01

Body dysmorphic disorder (BDD) is an impairing and relatively common disorder that has high comorbidity with certain Axis I disorders. However, the longitudinal associations between BDD and comorbid disorders have not previously been examined. Such information may shed light on the nature of BDD's relationship to putative "near-neighbor" disorders, such as major depression, obsessive-compulsive disorder (OCD), and social phobia. This study examined time-varying associations between BDD and these comorbid disorders in 161 participants over 1-3 years of follow-up in the first prospective longitudinal study of the course of BDD. We found that BDD had significant longitudinal associations with major depression--that is, change in the status of BDD and major depression was closely linked in time, with improvement in major depression predicting BDD remission, and, conversely, improvement in BDD predicting depression remission. We also found that improvement in OCD predicted BDD remission, but that BDD improvement did not predict OCD remission. No significant longitudinal associations were found for BDD and social phobia (although the results for analyses of OCD and social phobia were less numerically stable). These findings suggest (but do not prove) that BDD may be etiologically linked to major depression and OCD, i.e., that BDD may be a member of both the putative OCD spectrum and the affective spectrum. However, BDD does not appear to simply be a symptom of these comorbid disorders, as BDD symptoms persisted in a sizable proportion of subjects who remitted from these comorbid disorders. Additional studies are needed to elucidate the nature of BDD's relationship to commonly co-occurring disorders, as this issue has important theoretical and clinical implications.

Randomised controlled trials of psychological & pharmacological treatments for body dysmorphic disorder: A systematic review.

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Phillipou, Andrea; Rossell, Susan L; Wilding, Helen E; Castle, David J

2016-11-30

Treatment for body dysmorphic disorder (BDD) often involves a combination of psychological and pharmacological interventions. However, only a small number of randomised controlled trials (RCTs) have been undertaken examining the efficacy of different therapeutic interventions. The aim of this study was to systematically review the RCTs involving psychological and pharmacological interventions for the treatment of BDD. The literature was searched to June 2015, and studies were included if they were written in English, empirical research papers published in peer-review journals, specifically assessed BDD patients, and involved a RCT assessing BDD symptoms pre- and post-intervention. Nine studies were identified: six involving psychological and three involving pharmacological interventions. Cognitive behaviour therapy, metacognitive therapy and selective serotonin reuptake inhibitors were identified as treatments with potential benefit. The small number of RCTs and the heterogeneity of findings emphasises the need for more high quality RCTs assessing both psychological and pharmacological interventions for BDD. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Cognitive-Behavioral Therapy for Youth with Body Dysmorphic Disorder: Current Status and Future Directions

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Phillips, Katharine A.; Rogers, Jamison

2011-01-01

SYNOPSIS Body dysmorphic disorder (BDD), a distressing or impairing preoccupation with nonexistent or slight defect(s) in appearance, usually begins during early adolescence and appears to be common in youth. BDD is characterized by substantial impairment in psychosocial functioning and markedly high rates of suicidality. Cognitive-behavioral therapy (CBT) tailored to BDD’s unique features is the best tested and most promising psychosocial treatment for adults with BDD. CBT has been used for youth with BDD, but it has not been systematically developed for or tested in this age group, and there is a pressing need for this work to be done. This article focuses on CBT for BDD in adults and youth, possible adaptations for youth, and the need for treatment research in youth. We also discuss BDD’s prevalence, clinical features, how to diagnose BDD in youth, recommended pharmacotherapy for BDD (serotonin-reuptake inhibitors), and treatments that are not recommended (surgery and other cosmetic treatments). PMID:21440856

Prevalence of Body Dysmorphic Disorder and Muscle Dysmorphia Among Entry-Level Military Personnel.

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Campagna, John D A; Bowsher, Barbara

2016-05-01

To determine the prevalence of body dysmorphic disorder (BDD) and muscle dysmorphia (MD) in enlisted U.S. military personnel; and secondarily, to determine supplement use and relationship with BDD and MD. A survey of advanced individual training of tri-service personnel at Fort Sam Houston, Texas, was performed combining the dysmorphia concern questionnaire, the MD symptom questionnaire, a supplement questionnaire, and demographic factors. Of the 1,320 service members approached, 1,150 (87.1%) completed the survey. The majority of participants were male, 62.8% (n = 722) and Army soldiers 59.0% (n = 679). The prevalence rate of BDD was 13.0% in males and 21.7% in females. The prevalence of MD was 12.7% in males and 4.2% in females. There was a strong correlation between having BDD and using supplements to get thinner (odds ratio 5.1; 95% confidence interval 3.4-7.8; p dysmorphias in mental health providers, primary care providers, and commanders and justifies further military specific BDD and MD research. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Is body dysmorphic disorder associated with abnormal bodily self-awareness? A study using the rubber hand illusion.

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Ryan A Kaplan

Full Text Available Evidence from past research suggests that behaviours and characteristics related to body dissatisfaction may be associated with greater instability of perceptual body image, possibly due to problems in the integration of body-related multisensory information. We investigated whether people with body dysmorphic disorder (BDD, a condition characterised by body image disturbances, demonstrated enhanced susceptibility to the rubber hand illusion (RHI, which arises as a result of multisensory integration processes when a rubber hand and the participant's hidden real hand are stimulated in synchrony. Overall, differences in RHI experience between the BDD group and healthy and schizophrenia control groups (n = 17 in each were not significant. RHI strength, however, was positively associated with body dissatisfaction and related tendencies. For the healthy control group, proprioceptive drift towards the rubber hand was observed following synchronous but not asynchronous stimulation, a typical pattern when inducing the RHI. Similar drifts in proprioceptive awareness occurred for the BDD group irrespective of whether stimulation was synchronous or not. These results are discussed in terms of possible abnormalities in visual processing and multisensory integration among people with BDD.

Degree connectivity in body dysmorphic disorder and relationships with obsessive and compulsive symptoms.

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Beucke, Jan C; Sepulcre, Jorge; Buhlmann, Ulrike; Kathmann, Norbert; Moody, Teena; Feusner, Jamie D

2016-10-01

Individuals with body dysmorphic disorder (BDD) and obsessive-compulsive disorder (OCD) are categorized within the same major diagnostic group and both show regional brain hyperactivity in the orbitofrontal cortex (OFC) and the basal ganglia during symptom provocation. While recent studies revealed that degree connectivity of these areas is abnormally high in OCD and positively correlates with symptom severity, no study has investigated degree connectivity in BDD. We used functional magnetic resonance imaging (fMRI) to compare the local and distant degree of functional connectivity in all brain areas between 28 unmedicated BDD participants and 28 demographically matched healthy controls during a face-processing task. Correlational analyses tested for associations between degree connectivity and symptom severity assessed by the BDD version of the Yale-Brown obsessive-compulsive scale (BDD-Y-BOCS). Reduced local amygdalar connectivity was found in participants with BDD. No differences in distant connectivity were found. BDD-Y-BOCS scores significantly correlated with the local connectivity of the posterior-lateral OFC, and distant connectivity of the posterior-lateral and post-central OFC, respectively. These findings represent preliminary evidence that individuals with BDD exhibit brain-behavioral associations related to obsessive thoughts and compulsive behaviors that are highly similar to correlations previously found in OCD, further underscoring their related pathophysiology. This relationship could be further elucidated through investigation of resting-state functional connectivity in BDD, ideally in direct comparison with OCD and other obsessive-compulsive and related disorders. Copyright © 2016 Elsevier B.V. and ECNP. All rights reserved.

Anorexia nervosa and body dysmorphic disorder are associated with abnormalities in processing visual information.

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Li, W; Lai, T M; Bohon, C; Loo, S K; McCurdy, D; Strober, M; Bookheimer, S; Feusner, J

2015-07-01

Anorexia nervosa (AN) and body dysmorphic disorder (BDD) are characterized by distorted body image and are frequently co-morbid with each other, although their relationship remains little studied. While there is evidence of abnormalities in visual and visuospatial processing in both disorders, no study has directly compared the two. We used two complementary modalities--event-related potentials (ERPs) and functional magnetic resonance imaging (fMRI)--to test for abnormal activity associated with early visual signaling. We acquired fMRI and ERP data in separate sessions from 15 unmedicated individuals in each of three groups (weight-restored AN, BDD, and healthy controls) while they viewed images of faces and houses of different spatial frequencies. We used joint independent component analyses to compare activity in visual systems. AN and BDD groups demonstrated similar hypoactivity in early secondary visual processing regions and the dorsal visual stream when viewing low spatial frequency faces, linked to the N170 component, as well as in early secondary visual processing regions when viewing low spatial frequency houses, linked to the P100 component. Additionally, the BDD group exhibited hyperactivity in fusiform cortex when viewing high spatial frequency houses, linked to the N170 component. Greater activity in this component was associated with lower attractiveness ratings of faces. Results provide preliminary evidence of similar abnormal spatiotemporal activation in AN and BDD for configural/holistic information for appearance- and non-appearance-related stimuli. This suggests a common phenotype of abnormal early visual system functioning, which may contribute to perceptual distortions.

Relationship between self-discrepancy and worries about penis size in men with body dysmorphic disorder.

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Veale, David; Miles, Sarah; Read, Julie; Bramley, Sally; Troglia, Andrea; Carmona, Lina; Fiorito, Chiara; Wells, Hannah; Wylie, Kevan; Muir, Gordon

2016-06-01

We explored self-discrepancy in men with body dysmorphic disorder (BDD) concerned about penis size, men without BDD but anxious about penis size, and controls. Men with BDD (n=26) were compared to those with small penis anxiety (SPA; n=31) and controls (n=33), objectively (by measuring) and investigating self-discrepancy: actual size, ideal size, and size they felt they should be according to self and other. Most men under-estimated their penis size, with the BDD group showing the greatest discrepancy between perceived and ideal size. The SPA group showed a larger discrepancy than controls. This was replicated for the perceptions of others, suggesting the BDD group internalised the belief that they should have a larger penis size. There was a significant correlation between symptoms of BDD and this discrepancy. This self-actual and self-ideal/self-should discrepancy and the role of comparing could be targeted in therapy. Copyright © 2016. Published by Elsevier Ltd.

Imagery Rescripting for Body Dysmorphic Disorder: A Multiple-Baseline Single-Case Experimental Design.

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Willson, Rob; Veale, David; Freeston, Mark

2016-03-01

Individuals with body dysmorphic disorder (BDD) often experience negative distorted images of their appearance, and research suggests these may be linked to memories of adverse events such as bullying or teasing. This study evaluates imagery rescripting (ImR) as an intervention for BDD. In this article, we present a multiple-baseline single-case experimental design testing imagery rescripting as a brief, stand-alone intervention, with six individuals with BDD that related to aversive memories. The impact of the intervention was assessed by self-reported daily measures of symptom severity (preoccupation with appearance, appearance-related checking behaviors, appearance-related distress, and strength of belief that their main problem is their appearance) and standardized clinician ratings of BDD severity (Yale-Brown Obsessive Compulsive Scale modified for BDD). Four out of six of the participants responded positively to the intervention, with clinically meaningful improvement in symptomatology. Overall response was rapid; improvements began within the first week post-ImR intervention. From a small sample it is cautiously concluded that imagery rescripting may show promise as a module in cognitive-behavioral therapy for BDD, and is worthy of further investigation. Copyright © 2015. Published by Elsevier Ltd.

Seeing in the Mind's eye: Imagery rescripting for patients with body dysmorphic disorder. A single case series.

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Ritter, Viktoria; Stangier, Ulrich

2016-03-01

Intrusive images of appearance play an important role in the maintenance of body dysmorphic disorder (BDD) and are often linked to negative autobiographical experiences. However, to date there is no study examining the use and efficacy of imagery rescripting in BDD. This study investigated imagery rescripting in six patients with BDD, using a single case series A-B design. The intervention consisted of two treatment sessions (T1, T2). BDD and depressive symptoms were evaluated prior to (T1), post (T2) and two weeks after intervention (FU), using the Yale -Brown Obsessive Compulsive Scale for BDD (BDD-YBOCS), the Body Dysmorphic Symptoms Inventory, and the Beck Depression Inventory. At post-treatment, significant reductions in negative affect, distress, vividness and encapsulated beliefs associated with images and memories as well as an increased control were observed for five of six patients. These were maintained or decreased at two weeks follow-up. Scores on the BDD-YBOCS indicated a significant 26% improvement in BDD severity at follow-up for the whole group. Considering response as a ≥ 30% reduction in BDD-YBOCS score, four of six patients were classified as treatment responders. At follow-up, significant improvements in BDD and depressive symptoms were observed for the whole group. The small sample size and the lack of a control group limit the generalizability of our results. The findings indicate the potential efficacy of imagery rescripting, and highlight the need for further controlled trials. Imagery rescripting should be considered as a treatment technique within the cognitive framework of BDD. Copyright © 2015 Elsevier Ltd. All rights reserved.

Emotion recognition bias for contempt and anger in body dysmorphic disorder.

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Buhlmann, Ulrike; Etcoff, Nancy L; Wilhelm, Sabine

2006-03-01

Body dysmorphic disorder (BDD) patients are preoccupied with imagined defects or flaws in appearance (e.g., size or shape of nose). They are afraid of negative evaluations by others and often suffer significant morbidity including hospitalization and suicide attempts. Many patients experience ideas of reference, e.g., they often believe others take special notice of their "flaw". Facial expressions play an important role in conveying negative or positive feelings, and sympathy or rejection. In this study, we investigated emotion recognition deficits in 18 BDD patients and 18 healthy controls. Participants were presented with two questionnaires accompanying facial photographs. One questionnaire included self-referent scenarios ("Imagine that the bank teller is looking at you. What is his facial expression like?"), whereas the other one included other-referent scenarios ("Imagine that the bank teller is looking at a friend of yours," etc.), and participants were asked to identify the corresponding emotion (e.g., anger, contempt, neutral, or surprise). Overall, BDD patients, relative to controls, had difficulty identifying emotional expressions in self-referent scenarios. They misinterpreted more expressions as contemptuous and angry in self-referent scenarios than did controls. However, they did not have significantly more difficulties identifying emotional expressions in other-referent scenarios than controls. Thus, poor insight and ideas of reference, common in BDD, might be related to a bias for misinterpreting other people's emotional expressions as negative. Perceiving others as rejecting might reinforce concerns about one's personal perceived ugliness and social desirability.

Body dysmorphic factors and mental health problems in people seeking rhinoplastic surgery.

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Javanbakht, M; Nazari, A; Javanbakht, A; Moghaddam, L

2012-02-01

There has been increasing number of requests for cosmetic rhinoplastic surgery among Iranian people in different age groups in recent years. One risk for people who undergo such plastic operations is the presence of body dysmorphic disorder (BDD), which can complicate the result and decrease the rate of satisfaction from surgery. This study aimed to investigate mental health problems in people seeking rhinoplastic surgery. In this case-control study, the scores of General Health Questionnaire (GHQ) and DCQ (Dysmorphic Concerns Questionnaire) were obtained from 50 individuals who were candidates for rhinoplasty, and the results were compared with a normal control group. The total GHQ score and scores in anxiety, depression, and social dysfunction sub-scales were higher among the study group. This was the same for the DCQ score. However, the scores of somatization sub-scale of GHQ were not significantly different between the two groups. Psychiatric evaluation of candidates for rhinoplasty seems necessary for prevention of unnecessary and repetitive surgical operations.

Attentional biases in body dysmorphic disorder (BDD): Eye-tracking using the emotional Stroop task.

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Toh, Wei Lin; Castle, David J; Rossell, Susan L

2017-04-01

Body dysmorphic disorder (BDD) is characterised by repetitive behaviours and/or mental acts occurring in response to preoccupations with perceived defects or flaws in physical appearance. This study aimed to examine attentional biases in BDD via the emotional Stroop task with two modifications: i) incorporating an eye-tracking paradigm, and ii) employing an obsessive-compulsive disorder (OCD) control group. Twenty-one BDD, 19 OCD and 21 HC participants, who were age-, sex-, and IQ-matched, were included. A card version of the emotional Stroop task was employed based on seven 10-word lists: (i) BDD-positive, (ii) BDD-negative, (iii) OCD-checking, (iv) OCD-washing, (v) general positive, (vi) general threat, and (vii) neutral (as baseline). Participants were asked to read aloud words and word colours consecutively, thereby yielding accuracy and latency scores. Eye-tracking parameters were also measured. Participants with BDD exhibited significant Stroop interference for BDD-negative words relative to HC participants, as shown by extended colour-naming latencies. In contrast, the OCD group did not exhibit Stroop interference for OCD-related nor general threat words. Only mild eye-tracking anomalies were uncovered in clinical groups. Inspection of individual scanning styles and fixation heat maps however revealed that viewing strategies adopted by clinical groups were generally disorganised, with avoidance of certain disorder-relevant words and considerable visual attention devoted to non-salient card regions. The operation of attentional biases to negative disorder-specific words was corroborated in BDD. Future replication studies using other paradigms are vital, given potential ambiguities inherent in emotional Stroop task interpretation. Copyright © 2017 Elsevier Inc. All rights reserved.

The relationship between perceived social support and severity of body dysmorphic disorder symptoms: the role of gender O efeito do gênero sobre a relação entre suporte social apreendido e gravidade dos sintomas do transtorno dismórfico corporal

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Luana Marques

2011-09-01

Full Text Available OBJECTIVE: Whether social support is associated with severity of body dysmorphic symptoms is unknown. To address this gap in the literature, the present study aims to examine the association between three domains of perceived social support (i.e., family, friends, and significant others and severity of body dysmorphic disorder symptoms. METHOD: Participants (N = 400 with symptoms consistent with diagnosis of body dysmorphic disorder completed measures of symptomatology and social support via the internet. RESULTS: More perceived social support from friends and significant others was associated with less severe body dysmorphic disorder symptoms for males, and more perceived social support from family and friends was associated with less severe body dysmorphic disorder symptoms among females. Additionally, gender moderated the association between perceived social support from significant others and symptom severity, such that perceived social support from a significant other was significantly negatively associated with body dysmorphic symptom severity in males, but not females. CONCLUSION: The present study implicates social support as an important area of future body dysmorphic disorder research.OBJETIVO: Não há informação sobre o impacto do suporte social apreendido sobre a gravidade dos sintomas do transtorno dismórfico corporal. A fim de investigar essa relação, este estudo visa avaliar a associação entre três domínios do suporte social apreendido (familiares, amigos, e relacionamentos amorosos significativos e a gravidade dos sintomas do transtorno dismórfico corporal. MÉTODO: Os participantes (N = 400 com sintomas compatíveis com o diagnóstico de transtorno dismórfico corporal preencheram questionários sobre seus sintomas e suporte social via internet. RESULTADOS: Foi encontrada correlação inversa estatisticamente significativa entre a apreensão do suporte social por parte de amigos e relacionamentos amorosos e a

The relationship between perceived social support and severity of body dysmorphic disorder symptoms: the role of gender O efeito do gênero sobre a relação entre suporte social apreendido e gravidade dos sintomas do transtorno dismórfico corporal

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Luana Marques

2011-01-01

Full Text Available OBJECTIVE: Whether social support is associated with severity of body dysmorphic symptoms is unknown. To address this gap in the literature, the present study aims to examine the association between three domains of perceived social support (i.e., family, friends, and significant others and severity of body dysmorphic disorder symptoms. METHOD: Participants (N = 400 with symptoms consistent with diagnosis of body dysmorphic disorder completed measures of symptomatology and social support via the internet. RESULTS: More perceived social support from friends and significant others was associated with less severe body dysmorphic disorder symptoms for males, and more perceived social support from family and friends was associated with less severe body dysmorphic disorder symptoms among females. Additionally, gender moderated the association between perceived social support from significant others and symptom severity, such that perceived social support from a significant other was significantly negatively associated with body dysmorphic symptom severity in males, but not females. CONCLUSION: The present study implicates social support as an important area of future body dysmorphic disorder research.OBJETIVO: Não há informação sobre o impacto do suporte social apreendido sobre a gravidade dos sintomas do transtorno dismórfico corporal. A fim de investigar essa relação, este estudo visa avaliar a associação entre três domínios do suporte social apreendido (familiares, amigos, e relacionamentos amorosos significativos e a gravidade dos sintomas do transtorno dismórfico corporal. MÉTODO: Os participantes (N = 400 com sintomas compatíveis com o diagnóstico de transtorno dismórfico corporal preencheram questionários sobre seus sintomas e suporte social via internet. RESULTADOS: Foi encontrada correlação inversa estatisticamente significativa entre a apreensão do suporte social por parte de amigos e relacionamentos amorosos e a

Automatic and strategic measures as predictors of mirror gazing among individuals with body dysmorphic disorder symptoms.

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Clerkin, Elise M; Teachman, Bethany A

2009-08-01

The current study tests cognitive-behavioral models of body dysmorphic disorder (BDD) by examining the relationship between cognitive biases and correlates of mirror gazing. To provide a more comprehensive picture, we investigated both relatively strategic (i.e., available for conscious introspection) and automatic (i.e., outside conscious control) measures of cognitive biases in a sample with either high (n = 32) or low (n = 31) BDD symptoms. Specifically, we examined the extent that (1) explicit interpretations tied to appearance, as well as (2) automatic associations and (3) strategic evaluations of the importance of attractiveness predict anxiety and avoidance associated with mirror gazing. Results indicated that interpretations tied to appearance uniquely predicted self-reported desire to avoid, whereas strategic evaluations of appearance uniquely predicted peak anxiety associated with mirror gazing, and automatic appearance associations uniquely predicted behavioral avoidance. These results offer considerable support for cognitive models of BDD, and suggest a dissociation between automatic and strategic measures.

Automatic and Strategic Measures as Predictors of Mirror Gazing Among Individuals with Body Dysmorphic Disorder Symptoms

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Clerkin, Elise M.; Teachman, Bethany A.

2011-01-01

The current study tests cognitive-behavioral models of body dysmorphic disorder (BDD) by examining the relationship between cognitive biases and correlates of mirror gazing. To provide a more comprehensive picture, we investigated both relatively strategic (i.e., available for conscious introspection) and automatic (i.e., outside conscious control) measures of cognitive biases in a sample with either high (n=32) or low (n=31) BDD symptoms. Specifically, we examined the extent that 1) explicit interpretations tied to appearance, as well as 2) automatic associations and 3) strategic evaluations of the importance of attractiveness predict anxiety and avoidance associated with mirror gazing. Results indicated that interpretations tied to appearance uniquely predicted self-reported desire to avoid, while strategic evaluations of appearance uniquely predicted peak anxiety associated with mirror gazing, and automatic appearance associations uniquely predicted behavioral avoidance. These results offer considerable support for cognitive models of BDD, and suggest a dissociation between automatic and strategic measures. PMID:19684496

The impact of comorbid body dysmorphic disorder on the response to sequential pharmacological trials for obsessive-compulsive disorder.

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Diniz, Juliana B; Costa, Daniel Lc; Cassab, Raony Cc; Pereira, Carlos Ab; Miguel, Euripedes C; Shavitt, Roseli G

2014-06-01

Our aim was to investigate the impact of comorbid body dysmorphic disorder (BDD) on the response to sequential pharmacological trials in adult obsessive-compulsive disorder (OCD) patients. The sequential trial initially involved fluoxetine monotherapy followed by one of three randomized, add-on strategies: placebo, clomipramine or quetiapine. We included 138 patients in the initial phase of fluoxetine, up to 80 mg or the maximum tolerated dosage, for 12 weeks. We invited 70 non-responders to participate in the add-on trial; as 54 accepted, we allocated 18 to each treatment group and followed them for an additional 12 weeks. To evaluate the combined effects of sex, age, age at onset, initial severity, type of augmentation and BDD on the response to sequential treatments, we constructed a model using generalized estimating equations (GEE). Of the 39 patients who completed the study (OCD-BDD, n = 13; OCD-non-BDD, n = 26), the OCD-BDD patients were less likely to be classified as responders than the OCD-non-BDD patients (Pearson Chi-Square = 4.4; p = 0.036). In the GEE model, BDD was not significantly associated with a worse response to sequential treatments (z-robust = 1.77; p = 0.07). The predictive potential of BDD regarding sequential treatment strategies for OCD did not survive when the analyses were controlled for other clinical characteristics. © The Author(s) 2013.

A systematic review of visual processing and associated treatments in body dysmorphic disorder.

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Beilharz, F; Castle, D J; Grace, S; Rossell, S L

2017-07-01

Recent advances in body dysmorphic disorder (BDD) have explored abnormal visual processing, yet it is unclear how this relates to treatment. The aim of this study was to summarize our current understanding of visual processing in BDD and review associated treatments. The literature was collected through PsycInfo and PubMed. Visual processing articles were included if written in English after 1970, had a specific BDD group compared to healthy controls and were not case studies. Due to the lack of research regarding treatments associated with visual processing, case studies were included. A number of visual processing abnormalities are present in BDD, including face recognition, emotion identification, aesthetics, object recognition and gestalt processing. Differences to healthy controls include a dominance of detailed local processing over global processing and associated changes in brain activation in visual regions. Perceptual mirror retraining and some forms of self-exposure have demonstrated improved treatment outcomes, but have not been examined in isolation from broader treatments. Despite these abnormalities in perception, particularly concerning face and emotion recognition, few BDD treatments attempt to specifically remediate this. The development of a novel visual training programme which addresses these widespread abnormalities may provide an effective treatment modality. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Prevalence of body dysmorphic disorder on a psychiatric inpatient ward and the value of a screening question.

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Veale, David; Akyüz, Elvan U; Hodsoll, John

2015-12-15

The aim of this study was to estimate the prevalence of body dysmorphic disorder (BDD) on an inpatient ward in the UK with a larger sample than previously studied and to investigate the value of a simple screening question during an assessment interview. Four hundred and thirty two consecutive admissions were screened for BDD on an adult psychiatric ward over a period of 13 months. Those who screened positive had a structured diagnostic interview for BDD. The prevalence of BDD was estimated to be 5.8% (C.I. 3.6-8.1%). Our screening question had a slightly low specificity (76.6%) for detecting BDD. The strength of this study was a larger sample size and narrower confidence interval than previous studies. The study adds to previous observations that BDD is poorly identified in psychiatric inpatients. BDD was identified predominantly in those presenting with depression, substance misuse or an anxiety disorder. The screening question could be improved by excluding those with weight or shape concerns. Missing the diagnosis is likely to lead to inappropriate treatment. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Screening for Body Dysmorphic Disorder in a Dermatology Outpatient Setting at a Tertiary Care Centre

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Thanveer, Fibin; Khunger, Niti

2016-01-01

Context: A distressing pre-occupation with an imagined or slight defect in appearance with a marked negative effect on the patient's life is the core symptom of body dysmorphic disorder (BDD). Aim: To screen the patients attending a dermatology clinic at a tertiary care centre for BDD using the BDD-dermatology version (DV) questionnaire. Settings and Design: This cross-sectional study enrolled 245 consecutive patients from the dermatology outpatients clinic. Methods: The demographic details were collected and the DV of BDD screening questionnaire was administered. A 5-point Likert scale was used for objective scoring of the stated concern and patients who scored ≥3 were excluded from the study. Statistical Analysis Used: The results were statistically analysed. Differences between the groups were investigated by Chi-square analysis for categorical variables, and Fisher exact test wherever required. Results: A total of 177 patients completed the study, and of these, eight patients screened positive for BDD. The rate of BDD in patients presenting with cosmetic complaints was 7.5% and in those with general dermatology, complaints were 2.1%, with no significant difference between the two groups (P = 0.156). Facial flaws (62.5%) were the most common concern followed by body asymmetry (25%). Conclusion: The rates of BDD found in this study are comparable but at a lower rate than that reported in literature data. PMID:27761090

Screening for body dysmorphic disorder in a dermatology outpatient setting at a tertiary care centre

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Fibin Thanveer

2016-01-01

Full Text Available Context: A distressing pre-occupation with an imagined or slight defect in appearance with a marked negative effect on the patient's life is the core symptom of body dysmorphic disorder (BDD. Aim: To screen the patients attending a dermatology clinic at a tertiary care centre for BDD using the BDD-dermatology version (DV questionnaire. Settings and Design: This cross-sectional study enrolled 245 consecutive patients from the dermatology outpatients clinic. Methods: The demographic details were collected and the DV of BDD screening questionnaire was administered. A 5-point Likert scale was used for objective scoring of the stated concern and patients who scored ≥3 were excluded from the study. Statistical Analysis Used: The results were statistically analysed. Differences between the groups were investigated by Chi-square analysis for categorical variables, and Fisher exact test wherever required. Results: A total of 177 patients completed the study, and of these, eight patients screened positive for BDD. The rate of BDD in patients presenting with cosmetic complaints was 7.5% and in those with general dermatology, complaints were 2.1%, with no significant difference between the two groups (P = 0.156. Facial flaws (62.5% were the most common concern followed by body asymmetry (25%. Conclusion: The rates of BDD found in this study are comparable but at a lower rate than that reported in literature data.

Modifying interpretation biases in body dysmorphic disorder: Evaluation of a brief computerized treatment.

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Summers, Berta J; Cougle, Jesse R

2016-12-01

Individuals meeting diagnostic criteria for body dysmorphic disorder (BDD; N = 40) were enrolled in a randomized, four-session trial comparing interpretation bias modification (IBM) training designed to target social evaluation- and appearance-related interpretation biases with a placebo control training condition (PC). Sessions took place over the course of two weeks (two sessions per week). Analyses indicated that, relative to the PC condition, IBM led to a significant increase in benign biases and reduction in threat biases at post-treatment. IBM also led to greater reductions in BDD symptoms compared to PC, though this effect was present at high but not low levels of pre-treatment BDD symptoms. Additionally, compared to PC, IBM led to lower urge to check and lower fear in response to an in vivo appearance-related stressor (having their picture taken from different angles), though the latter effect was present only among those reporting elevated fear at pre-treatment. The effects of treatment on interpretation biases and BDD symptoms were largely maintained at a one-month follow-up assessment. Moderated-mediation analyses showed that change in threat bias mediated the effect of condition on post-treatment symptoms for individuals high in pre-treatment BDD symptoms. The current study provides preliminary support for the efficacy of IBM for BDD. Copyright © 2016 Elsevier Ltd. All rights reserved.

Long-Term Outcomes of Cognitive-Behavioral Therapy for Adolescent Body Dysmorphic Disorder.

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Krebs, Georgina; de la Cruz, Lorena Fernández; Monzani, Benedetta; Bowyer, Laura; Anson, Martin; Cadman, Jacinda; Heyman, Isobel; Turner, Cynthia; Veale, David; Mataix-Cols, David

2017-07-01

Emerging evidence suggests that cognitive-behavioral therapy (CBT) is an efficacious treatment for adolescent body dysmorphic disorder (BDD) in the short term, but longer-term outcomes remain unknown. The current study aimed to follow up a group of adolescents who had originally participated in a randomized controlled trial of CBT for BDD to determine whether treatment gains were maintained. Twenty-six adolescents (mean age = 16.2, SD = 1.6) with a primary diagnosis of BDD received a course of developmentally tailored CBT and were followed up over 12 months. Participants were assessed at baseline, midtreatment, posttreatment, 2-, 6-, and 12-month follow-up. The primary outcome measure was the clinician-rated Yale-Brown Obsessive-Compulsive Scale Modified for BDD. Secondary outcomes included measures of insight, depression, quality of life, and global functioning. BDD symptoms decreased significantly from pre- to posttreatment and remained stable over the 12-month follow-up. At this time point, 50% of participants were classified as responders and 23% as remitters. Participants remained significantly improved on all secondary outcomes at 12-month follow-up. Neither baseline insight nor baseline depression predicted long-term outcomes. The positive effects of CBT appear to be durable up to 12-month follow-up. However, the majority of patients remained symptomatic and vulnerable to a range of risks at 12-month follow-up, indicating that longer-term monitoring is advisable in this population. Future research should focus on enhancing the efficacy of CBT in order to improve long-term outcomes. Copyright © 2017. Published by Elsevier Ltd.

Visual selective attention in body dysmorphic disorder, bulimia nervosa and healthy controls.

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Kollei, Ines; Horndasch, Stefanie; Erim, Yesim; Martin, Alexandra

2017-01-01

Cognitive behavioral models postulate that selective attention plays an important role in the maintenance of body dysmorphic disorder (BDD). It is suggested that individuals with BDD overfocus on perceived defects in their appearance, which may contribute to the excessive preoccupation with their appearance. The present study used eye tracking to examine visual selective attention in individuals with BDD (n=19), as compared to individuals with bulimia nervosa (BN) (n=21) and healthy controls (HCs) (n=21). Participants completed interviews, questionnaires, rating scales and an eye tracking task: Eye movements were recorded while participants viewed photographs of their own face and attractive as well as unattractive other faces. Eye tracking data showed that BDD and BN participants focused less on their self-rated most attractive facial part than HCs. Scanning patterns in own and other faces showed that BDD and BN participants paid as much attention to attractive as to unattractive features in their own face, whereas they focused more on attractive features in attractive other faces. HCs paid more attention to attractive features in their own face and did the same in attractive other faces. Results indicate an attentional bias in BDD and BN participants manifesting itself in a neglect of positive features compared to HCs. Perceptual retraining may be an important aspect to focus on in therapy in order to overcome the neglect of positive facial aspects. Future research should aim to disentangle attentional processes in BDD by examining the time course of attentional processing. Copyright © 2016 Elsevier Inc. All rights reserved.

Adjunctive antipsychotic in the treatment of body dysmorphic disorder - A retrospective naturalistic case note study.

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Rashid, Haroon; Khan, Akif A; Fineberg, Naomi A

2015-06-01

A retrospective naturalistic case note study to determine the frequency, co-morbidity and treatment-response of body dysmorphic disorder (BDD). Records from 280 patients attending a highly specialised obsessive-compulsive disorder (OCD)/BDD service were analysed. The clinical outcome was measured either through scoring of the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) for OCD/BDD, or textual analysis of case notes for evidence of symptomatic improvement, treatment tolerability, and premature disengagement. A total of 32 patients (11.43%) were diagnosed with BDD. Of these, 28 (87.5%) had at least one co-morbidity. All patients were offered cognitive behavioural therapy (CBT) and selective serotonin reuptake inhibitor (SSRI). Adjunctive low-dose antipsychotic was prescribed for 21 (66%) patients. Overall, 18/32 (56%) responded, and 7/32 (22%) disengaged prematurely. Patients offered antipsychotic, SSRI and CBT (n = 21) were compared with those offered SSRI and CBT only (n = 11). The treatment was well-tolerated. Whereas there was no significant inter-group difference in the clinical response rate, premature disengagement occurred less frequently in the antipsychotic-treated patients (9.5% versus 45%; Fisher's Exact Test P = 0.0318). BDD frequently presents with co-morbidity, treatment-resistance and premature disengagement. Adjunctive antipsychotic was associated with significantly better treatment adherence, but responder rates did not differ significantly, possibly related to the small sample-size. A well-powered randomised controlled study is warranted, to determine clinical outcomes with adjunctive antipsychotic in BDD.

Correlates of dysmorphic concern in people seeking cosmetic enhancement

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Castle, David J.; Molton, Michael; Hoffman, Keturah; Preston, Neil J.; Phillips, Katharine A.

2006-01-01

Objective To determine the clinical correlates of dysmorphic concern in persons seeking cosmetic enhancement from cosmetic physicians. Method A questionnaire survey of 137 patients attending the practices of two cosmetic physicians. Results Four subjects (2.9%; 95% CI = 0.8%–7.3%) had a diagnosis of body dysmorphic disorder (BDD), but many more expressed overconcern with physical appearance (‘dysmorphic concern’). Dysmorphic concern accounted for a substantial amount of the variance for mood, social anxiety, and impairment in work and social functioning, while concerns related to how self or others perceive the putative flaw in appearance, impacted significantly on work and leisure activities, but did not apparently influence mood and social anxiety to any significant degree. Conclusions Dysmorphic concern is a broad dimensional construct that is related to both inter- and intrapsychic distress and disablement associated with people seeking cosmetic enhancement PMID:15209836

Sexual Functioning and Behavior of Men with Body Dysmorphic Disorder Concerning Penis Size Compared with Men Anxious about Penis Size and with Controls: A Cohort Study

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David Veale, MD, FRCPsych

2015-09-01

Conclusion: Men with BDD are more likely to have erectile dysfunction and less satisfaction with intercourse than controls but maintain their libido. Further research is required to develop and evaluate a psychological intervention for such men with adequate outcome measures. Veale D, Miles S, Read J, Troglia A, Wylie K, and Muir G. Sexual functioning and behavior of men with body dysmorphic disorder concerning penis size compared with men anxious about penis size and with controls: A cohort study. Sex Med 2015;3:147–155.

Sexual Functioning and Behavior of Men with Body Dysmorphic Disorder Concerning Penis Size Compared with Men Anxious about Penis Size and with Controls: A Cohort Study

OpenAIRE

Veale, David; Miles, Sarah; Read, Julie; Troglia, Andrea; Wylie, Kevan; Muir, Gordon

2015-01-01

Introduction: Little is known about the sexual functioning and behavior of men anxious about the size of their penis and the means that they might use to try to alter the size of their penis. Aim: To compare sexual functioning and behavior in men with body dysmorphic disorder (BDD) concerning penis size and in men with small penis anxiety (SPA without BDD) and in a control group of men who do not have any concerns. Methods: An opportunistic sample of 90 men from the community were recru...

Impairment in local and global processing and set-shifting in body dysmorphic disorder

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Kerwin, Lauren; Hovav, Sarit; Helleman, Gerhard; Feusner, Jamie D.

2014-01-01

Body dysmorphic disorder (BDD) is characterized by distressing and often debilitating preoccupations with misperceived defects in appearance. Research suggests that aberrant visual processing may contribute to these misperceptions. This study used two tasks to probe global and local visual processing as well as set shifting in individuals with BDD. Eighteen unmedicated individuals with BDD and 17 non-clinical controls completed two global-local tasks. The embedded figures task requires participants to determine which of three complex figures contained a simpler figure embedded within it. The Navon task utilizes incongruent stimuli comprised of a large letter (global level) made up of smaller letters (local level). The outcome measures were response time and accuracy rate. On the embedded figures task, BDD individuals were slower and less accurate than controls. On the Navon task, BDD individuals processed both global and local stimuli slower and less accurately than controls, and there was a further decrement in performance when shifting attention between the different levels of stimuli. Worse insight correlated with poorer performance on both tasks. Taken together, these results suggest abnormal global and local processing for non-appearance related stimuli among BDD individuals, in addition to evidence of poor set-shifting abilities. Moreover, these abnormalities appear to relate to the important clinical variable of poor insight. Further research is needed to explore these abnormalities and elucidate their possible role in the development and/or persistence of BDD symptoms. PMID:24972487

Somatic Symptom and Related Disorders

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... A headache may mean a brain tumor. Body dysmorphic disorder occurs when a person becomes obsessed with ... body. Common concerns for people who have body dysmorphic disorder include: wrinkles hair loss weight gain size ...

Modular cognitive-behavioral therapy for body dysmorphic disorder: a randomized controlled trial.

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Wilhelm, Sabine; Phillips, Katharine A; Didie, Elizabeth; Buhlmann, Ulrike; Greenberg, Jennifer L; Fama, Jeanne M; Keshaviah, Aparna; Steketee, Gail

2014-05-01

There are few effective treatments for body dysmorphic disorder (BDD) and a pressing need to develop such treatments. We examined the feasibility, acceptability, and efficacy of a manualized modular cognitive-behavioral therapy for BDD (CBT-BDD). CBT-BDD utilizes core elements relevant to all BDD patients (e.g., exposure, response prevention, perceptual retraining) and optional modules to address specific symptoms (e.g., surgery seeking). Thirty-six adults with BDD were randomized to 22 sessions of immediate individual CBT-BDD over 24 weeks (n=17) or to a 12-week waitlist (n=19). The Yale-Brown Obsessive-Compulsive Scale Modified for BDD (BDD-YBOCS), Brown Assessment of Beliefs Scale, and Beck Depression Inventory-II were completed pretreatment, monthly, posttreatment, and at 3- and 6-month follow-up. The Sheehan Disability Scale and Client Satisfaction Inventory (CSI) were also administered. Response to treatment was defined as ≥30% reduction in BDD-YBOCS total from baseline. By week 12, 50% of participants receiving immediate CBT-BDD achieved response versus 12% of waitlisted participants (p=0.026). By posttreatment, 81% of all participants (immediate CBT-BDD plus waitlisted patients subsequently treated with CBT-BDD) met responder criteria. While no significant group differences in BDD symptom reduction emerged by Week 12, by posttreatment CBT-BDD resulted in significant decreases in BDD-YBOCS total over time (d=2.1, p<0.0001), with gains maintained during follow-up. Depression, insight, and disability also significantly improved. Patient satisfaction was high, with a mean CSI score of 87.3% (SD=12.8%) at posttreatment. CBT-BDD appears to be a feasible, acceptable, and efficacious treatment that warrants more rigorous investigation. Copyright © 2014. Published by Elsevier Ltd.

Accept, distract, or reframe? An exploratory experimental comparison of strategies for coping with intrusive body image thoughts in anorexia nervosa and body dysmorphic disorder.

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Hartmann, Andrea S; Thomas, Jennifer J; Greenberg, Jennifer L; Rosenfield, Elizabeth H; Wilhelm, Sabine

2015-02-28

Negative body image is the hallmark of anorexia nervosa (AN) and body dysmorphic disorder (BDD). One aspect of body image, appearance-related thoughts, have shown to be a major contributor to relapse, thus further investigation of successful treatment strategies targeting these maladaptive thoughts are warranted. The present study tested an acceptance/mindfulness (AC), a cognitive restructuring (CR), and a distraction strategy with regard to their short-term effectiveness of reducing the frequency of thought occurrence and associated outcomes in participants with AN (n=20), BDD (n=21), and healthy controls (HC; n=22). Although all strategies led to a significant reduction of thought frequency, there was no group × strategy interaction effect in their reduction. Positive affect increased in the BDD group through the AC strategy, but decreased in healthy controls. Acceptance of the thought increased in the CR strategy in AN, whereas that strategy seemed to work least for BDD. Healthy controls showed most acceptance when using distraction. Taken together, the study suggests that all strategies might have their benefits and that it might be worthwhile further investigating differential indication of the strategies with regard to diagnosis and individual factors. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

Shadows of Beauty - Prevalence of Body Dysmorphic Concerns in Germany is Increasing: Data from Two Representative Samples from 2002 and 2013.

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Gieler, Tanja; Schmutzer, Gabriele; Braehler, Elmar; Schut, Christina; Peters, Eva; Kupfer, Jörg

2016-08-23

Body dysmorphic disorder (BDD) is a psychosomatic disease associated with reduced quality of life and suicidal ideations. Increasing attention to beauty and the development of beauty industries lead to the hypothesis that BDD is increasing. The aim of this study was to test this hypothesis in two representative samples of Germans, assessed in 2002 and 2013. In 2002, n = 2,066 and in 2013, n = 2,508 Germans were asked to fill in the Dysmorphic Concern Questionnaire (DCQ), which assesses dysmorphic concerns. Subclinical and clinical dysmorphic concerns increased from 2002 to 2013 (subclinical from 0.5% to 2.6%, OR = 5.16 (CI95% = 2.64; 10.06); clinical from 0.5% to 1.0%, OR = 2.20 (CI95% = 1.03; 4.73). Women reported more dysmorphic concerns than men, with rates of 0.7% subclinical and 0.8 clinical BDD in women and 0.3% subclinical and 0.1% clinical BDD in men in 2002. In 2013, 2.8% subclinical and 1.2% clinical BDD were found in women and 2.4% subclinical and 0.8% clinical BDD in men. Further studies should assess predictors for developing a BDD and evaluate factors determining the efficacy of disease-specific psychotherapeutic and psychotropic drug treatments.

Inferring other people's states of mind: Comparison across social anxiety, body dysmorphic, and obsessive-compulsive disorders.

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Buhlmann, Ulrike; Wacker, Renata; Dziobek, Isabel

2015-08-01

Social anxiety disorder (SAD) and body dysmorphic disorder (BDD) are characterized by fears of negative evaluation by others (related to one's own incompetence or flawed appearance, respectively). Previous research has shown that individuals with SAD and BDD exhibit difficulty identifying facial expressions and interpretive biases for threat in social situations. The current study aimed at further investigating social cognition in SAD, BDD, and mentally healthy controls (35 individuals per group, respectively). Further, 35 individuals with obsessive-compulsive disorder (OCD) as a clinical control group not characterized by evaluation fears were included. The Movie for the Assessment of Social Cognition (MASC) was applied. It consists of 45 video sequences depicting interactions among four people at a dinner party. Participants are instructed to evaluate each scenario with respect to the characters' emotions, thoughts, and intentions from a bystander perspective (i.e. other-referent context). Only the socially anxious groups (SAD and BDD) were overall less accurate than the other groups in correctly interpreting the social situations, whereas no difference was obtained between the OCD and the control group. Further analyses indicated that the SAD and BDD groups were less accurate in identifying other people's thoughts and intentions, whereas, again, no difference was observed between the OCD and control groups. In addition, the SAD group was less accurate in inferring thoughts and intentions than the OCD group. Interestingly, the groups did not differ with respect to identifying other people's emotions. These results mostly confirm existing cognitive-behavioral models of SAD and BDD emphasizing that biased interpretation of what others think or intend is one of the key factors maintaining social anxiety and appearance-related concerns. Our study shows that this bias generalizes to social situations in which individuals take a third-person observer perspective

The frequency of body dysmorphic disorder in dermatology and cosmetic dermatology clinics: a study from Turkey.

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Dogruk Kacar, S; Ozuguz, P; Bagcioglu, E; Coskun, K S; Uzel Tas, H; Polat, S; Karaca, S

2014-06-01

Body dysmorphic disorder (BDD) is a distressing and impairing preoccupation with a slight or imagined defect in appearance. There are few reports on the prevalence of BDD in the Turkish population. To investigate the frequency of BDD in dermatology settings, and to compare the results from cosmetic dermatology with those from general dermatology settings. This cross-sectional study recruited 400 patients from cosmetic dermatology (CD) (n = 200) and general dermatology (GD) clinics (n = 200). A mini-survey was used to collect demographic and clinical characteristics, and the dermatology version of a brief self-report BDD screening questionnaire was administered. A five-point Likert scale was used for objective scoring of the stated concern, which was performed by dermatologists, and patients who scored ≥ 3 were excluded from the study. In total, 318 patients (151 in the CD group and 167 in the GD group) completed the study, and of these, 20 were diagnosed with BDD. The CD group had a higher rate of BDD (8.6%) than the GD group (4.2%) but this was not significant (P = 0.082). The major concern focused on body and weight (40.0%), followed by acne (25.0%). The number of cosmetic procedures in dermatology practices is increasing Therefore, it is becoming more important to recognize patients with BDD. Although the rates of BDD found in the present study are in agreement with the literature data, population-based differences still exist between this study and previous studies. © 2014 British Association of Dermatologists.

Transtorno dismórfico corporal em dermatologia: diagnóstico, epidemiologia e aspectos clínicos Body dysmorphic disorder in dermatology: diagnosis, epidemiology and clinical aspects

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Luciana Archetti Conrado

2009-12-01

Full Text Available São cada vez mais frequentes as queixas cosméticas, uma vez que objetivam a perfeição das formas do corpo e da pele. Os dermatologistas são consultados para avaliar e tratar essas queixas. Sendo assim, é importante conhecer o Transtorno Dismórfico Corporal, inicialmente chamado de "dismorfofobia", pouco estudado até recentemente. Esse transtorno é relativamente comum, por vezes, incapacitante, e envolve uma percepção distorcida da imagem corporal, caracterizada pela preocupação exagerada com um defeito imaginário na aparência ou com um mínimo defeito corporal presente. A maioria dos pacientes apresenta algum grau de prejuízo no funcionamento social e ocupacional, e como resultado de suas queixas obsessivas com a aparência, podem desenvolver comportamentos compulsivos, e, em casos mais graves, há risco de suicídio. O nível de crença é prejudicado, visto que não reconhecem o seu defeito como mínimo ou inexistente e, frequentemente, procuram tratamentos cosméticos para um transtorno psíquico. A prevalência do transtorno, na população geral, é de 1 a 2% e, em pacientes dermatológicos e de cirurgia cosmética, de 2,9 a 16%. Considerando a alta prevalência do Transtorno Dismórfico Corporal, em pacientes dermatológicos, e que os tratamentos cosméticos raramente melhoram seus sintomas, o treinamento dos profissionais para a investigação sistemática, diagnóstico e encaminhamento para tratamento psiquiátrico é fundamental.Cosmetic concerns are becoming increasingly common in view of the obsession with the perfect body and skin. Dermatologists are often seen to evaluate and treat these conditions. Therefore, it is important to acknowledge the existence of Body Dysmorphic Disorder, also known as dysmorphophobia. Despite being relatively common, this disorder has not been well researched. Sometimes causing impairment, the disease involves a distorted body image perception characterized by excessive preoccupation with

Dysmorphic disorders: clinical and nosological heterogeneity

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V. E. Medvedev

2016-01-01

Full Text Available The clinical picture of dysmorphophobia (DMP (dysmorphia, DM has been inadequately investigated; its descriptions are contradictory.Objective: to study the clinical structure of DMP (DM on a sample of plastic or cosmetic surgery patients.Patients and methods. An examination was made in of 103 patients, including 81 (78.6% women (mean age, 35.8±4.9 years and 22 (21.4% men (mean age, 30.9±5.7 years, who had gone to a clinic of cosmetic or plastic surgery with complaints of objectively unverified appearance defects and DM signs and given consent to take part in the investigation. All the patients underwent clinical and psychopathological examination; in so doing the follow-up data in the past 1-3 tears were borne in mind. Their somatic condition was analyzed on the basis of the data available in the medical documents and the results of laboratory, clinical, and instrumental studies.Results. The dysmorphic syndrome has been found to have overvalued, hypochondriacal, obsessive-compulsive, depressive, and delusional forms. It has been established that DM can manifest within schizophrenia, personality disorders, affective disorders, and organic mental diseases. Differential diagnostic criteria for different types of DM in heterogeneous psychopathological disorders are given.

Prevalence and heritability of body dysmorphic symptoms in adolescents and young adults: a population-based nationwide twin study.

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Enander, Jesper; Ivanov, Volen Z; Mataix-Cols, David; Kuja-Halkola, Ralf; Ljótsson, Brjánn; Lundström, Sebastian; Pérez-Vigil, Ana; Monzani, Benedetta; Lichtenstein, Paul; Rück, Christian

2018-02-28

Body dysmorphic disorder (BDD) usually begins during adolescence but little is known about the prevalence, etiology, and patterns of comorbidity in this age group. We investigated the prevalence of BDD symptoms in adolescents and young adults. We also report on the relative importance of genetic and environmental influences on BDD symptoms, and the risk for co-existing psychopathology. Prevalence of BDD symptoms was determined by a validated cut-off on the Dysmorphic Concerns Questionnaire (DCQ) in three population-based twin cohorts at ages 15 (n = 6968), 18 (n = 3738), and 20-28 (n = 4671). Heritability analysis was performed using univariate model-fitting for the DCQ. The risk for co-existing psychopathology was expressed as odds ratios (OR). The prevalence of clinically significant BDD symptoms was estimated to be between 1 and 2% in the different cohorts, with a significantly higher prevalence in females (1.3-3.3%) than in males (0.2-0.6%). The heritability of body dysmorphic concerns was estimated to be 49% (95% CI 38-54%) at age 15, 39% (95% CI 30-46) at age 18, and 37% (95% CI 29-42) at ages 20-28, with the remaining variance being due to non-shared environment. ORs for co-existing neuropsychiatric and alcohol-related problems ranged from 2.3 to 13.2. Clinically significant BDD symptoms are relatively common in adolescence and young adulthood, particularly in females. The low occurrence of BDD symptoms in adolescent boys may indicate sex differences in age of onset and/or etiological mechanisms. BDD symptoms are moderately heritable in young people and associated with an increased risk for co-existing neuropsychiatric and alcohol-related problems.

Cognitive-behavioral therapy for body dysmorphic disorder: A systematic review and meta-analysis of randomized controlled trials.

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Harrison, Amy; Fernández de la Cruz, Lorena; Enander, Jesper; Radua, Joaquim; Mataix-Cols, David

2016-08-01

Body dysmorphic disorder (BDD) is a chronic and disabling psychiatric disorder unlikely to remit without treatment. A systematic review and meta-analysis of randomized controlled trials (RCTs) of cognitive-behavioral therapy (CBT) for BDD was conducted, including published and unpublished trials to 26th November 2015. Primary outcomes were validated BDD measures; secondary outcomes included depression and insight. Meta-regressions were conducted to examine potential effects of variables on the primary outcome, including socio-demographic variables, comorbidity, symptom severity/duration, concomitant medication, treatment duration, and methodological quality of the RCTs. Seven RCTs (N=299) met inclusion criteria. CBT was superior to waitlist or credible psychological placebo in reducing BDD (7 studies; delta=-1.22, 95% CI=-1.66 to -0.79) and depression symptoms (5 studies; delta=-0.49, 95% CI=-0.76 to -0.22). CBT was associated with improvements in insight/delusionality (4 studies; delta=-0.56, 95% CI=-0.93 to -0.19). Improvement in BDD was maintained after 2-4months follow-up (3 studies; delta=-0.89, 95% CI=-1.24 to -0.54). Meta-regression analyses did not reveal any significant predictors of outcome. CBT is an efficacious treatment for BDD but there is substantial room for improvement. The specificity and long-term effects of CBT for BDD require further evaluation using credible control conditions. Additional trials comparing CBT with pharmacological therapies, as well as their combination, are warranted. Tele-care options, such as Internet-based CBT, hold great promise to increase access to evidence-based treatment for a majority of patients who need it and should be evaluated further. Copyright © 2016 Elsevier Ltd. All rights reserved.

Therapist-guided, Internet-based cognitive–behavioural therapy for body dysmorphic disorder (BDD-NET): a feasibility study

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Enander, Jesper; Ivanov, Volen Z; Andersson, Erik; Mataix-Cols, David; Ljótsson, Brjánn; Rück, Christian

2014-01-01

Objectives Cognitive–behavioural therapy (CBT) is an effective treatment for body dysmorphic disorder (BDD). However, most sufferers do not have access to this treatment. One way to increase access to CBT is to administer treatment remotely via the Internet. This study piloted a novel therapist-supported, Internet-based CBT program for BDD (BDD-NET). Design Uncontrolled clinical trial. Participants Patients (N=23) were recruited through self-referral and assessed face to face at a clinic specialising in obsessive–compulsive and related disorders. Suitable patients were offered secure access to BDD-NET. Intervention BDD-NET is a 12-week treatment program based on current psychological models of BDD that includes psychoeducation, functional analysis, cognitive restructuring, exposure and response prevention, and relapse prevention modules. A dedicated therapist provides active guidance and feedback throughout the entire process. Main outcome measure The clinician-administered Yale-Brown Obsessive Compulsive Scale for BDD (BDD-YBOCS). Symptom severity was assessed pretreatment, post-treatment and at the 3-month follow-up. Results BDD-NET was deemed highly acceptable by patients and led to significant improvements on the BDD-YBOCS (p=<0.001) with a large within-group effect size (Cohen's d=2.01, 95% CI 1.05 to 2.97). At post-treatment, 82% of the patients were classified as responders (defined as≥30% improvement on the BDD-YBOCS). These gains were maintained at the 3-month follow-up. Secondary outcome measures of depression, global functioning and quality of life also showed significant improvements with moderate to large effect sizes. On average, therapists spent 10 min per patient per week providing support. Conclusions The results suggest that BDD-NET has the potential to greatly increase access to CBT, at least for low-risk individuals with moderately severe BDD symptoms and reasonably good insight. A randomised controlled trial of BDD-NET is warranted

Patterns of Dysmorphic Features in Schizophrenia

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Scutt, L.E.; Chow, E.W.C.; Weksberg, R.; Honer, W.G.; Bassett, Anne S.

2011-01-01

Congenital dysmorphic features are prevalent in schizophrenia and may reflect underlying neurodevelopmental abnormalities. A cluster analysis approach delineating patterns of dysmorphic features has been used in genetics to classify individuals into more etiologically homogeneous subgroups. In the present study, this approach was applied to schizophrenia, using a sample with a suspected genetic syndrome as a testable model. Subjects (n = 159) with schizophrenia or schizoaffective disorder were ascertained from chronic patient populations (random, n=123) or referred with possible 22q11 deletion syndrome (referred, n = 36). All subjects were evaluated for presence or absence of 70 reliably assessed dysmorphic features, which were used in a three-step cluster analysis. The analysis produced four major clusters with different patterns of dysmorphic features. Significant between-cluster differences were found for rates of 37 dysmorphic features (P dysmorphic features (P = 0.0001), and validating features not used in the cluster analysis: mild mental retardation (P = 0.001) and congenital heart defects (P = 0.002). Two clusters (1 and 4) appeared to represent more developmental subgroups of schizophrenia with elevated rates of dysmorphic features and validating features. Cluster 1 (n = 27) comprised mostly referred subjects. Cluster 4 (n= 18) had a different pattern of dysmorphic features; one subject had a mosaic Turner syndrome variant. Two other clusters had lower rates and patterns of features consistent with those found in previous studies of schizophrenia. Delineating patterns of dysmorphic features may help identify subgroups that could represent neurodevelopmental forms of schizophrenia with more homogeneous origins. PMID:11803519

Population differences in dysmorphic features among children with fetal alcohol spectrum disorders.

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May, Philip A; Gossage, J Phillip; Smith, Matthew; Tabachnick, Barbara G; Robinson, Luther K; Manning, Melanie; Cecanti, Mauro; Jones, Kenneth Lyons; Khaole, Nathaniel; Buckley, David; Kalberg, Wendy O; Trujillo, Phyllis M; Hoyme, H Eugene

2010-05-01

To examine the variation in significant dysmorphic features in children from 3 different populations with the most dysmorphic forms of fetal alcohol spectrum disorders, fetal alcohol syndrome (FAS), and partial fetal alcohol syndrome (PFAS). Advanced multiple regression techniques are used to determine the discriminating physical features in the diagnosis of FAS and PFAS among children from Northern Plains Indian communities, South Africa, and Italy. Within the range of physical features used to identify children with fetal alcohol spectrum disorders, specifically FAS and PFAS, there is some significant variation in salient diagnostic features from one population to the next. Intraclass correlations in diagnostic features between these 3 populations is 0.20, indicating that about 20% of the variability in dysmorphology core features is associated with location and, therefore, specific racial/ethnic population. The highly significant diagnostic indicators present in each population are identified for the full samples of FAS, PFAS, and normals and also among children with FAS only. A multilevel model for these populations combined indicates that these variables predict dysmorphology unambiguously: small palpebral fissures, narrow vermillion, smooth philtrum, flat nasal bridge, and fifth finger clinodactyly. Long philtrum varies substantially as a predictor in the 3 populations. Predictors not significantly related to fetal alcohol spectrum disorders dysmorphology across the 3 populations are centile of height (except in Italy) strabismus, interpupilary distance, intercanthal distance, and heart murmurs. The dysmorphology associated with FAS and PFAS vary across populations, yet a particular array of common features occurs in each population, which permits a consistent diagnosis across populations.

Adolescence and Body Image.

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Weinshenker, Naomi

2002-01-01

Discusses body image among adolescents, explaining that today's adolescents are more prone to body image distortions and dissatisfaction than ever and examining the historical context; how self-image develops; normative discontent; body image distortions; body dysmorphic disorder (BDD); vulnerability of boys (muscle dysmorphia); who is at risk;…

Delusional disorder-somatic type (or body dysmorphic disorder) and ...

African Journals Online (AJOL)

to distinguish cases of delusional disorder of somatic subtype from severe somatization .... features suggestive of a paranoid schizophrenia. Paranoid schizophrenia ... Of note is that the patient's personality and psychosocial functioning were ...

Phenomenology of men with body dysmorphic disorder concerning penis size compared to men anxious about their penis size and to men without concerns: a cohort study.

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Veale, David; Miles, Sarah; Read, Julie; Troglia, Andrea; Carmona, Lina; Fiorito, Chiara; Wells, Hannah; Wylie, Kevan; Muir, Gordon

2015-03-01

Men with body dysmorphic disorder (BDD) may be preoccupied with the size or shape of the penis, which may be causing significant shame or impairment. Little is known about the characteristics and phenomenology of such men and whether they can be differentiated from men with small penis anxiety (SPA) (who do not have BDD), and men with no penile concerns. Twenty-six men with BDD, 31 men with SPA, and 33 men without penile concerns were compared on psychopathology, experiences of recurrent imagery, avoidance and safety-seeking behaviours. Men with BDD had significantly higher scores than both the SPA group and no penile concern group for measures of imagery, avoidance, safety seeking and general psychopathology. The groups differed on the phenomenology of BDD specific to penile size preoccupation clearly from the worries of SPA, which in turn were different to those of the men without concerns. The common avoidance and safety seeking behaviours were identified in such men that may be used clinically. Copyright © 2014 Elsevier Ltd. All rights reserved.

Body dysmorphia and plastic surgery.

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Kyle, Allison

2012-01-01

Body dysmorphic disorder is a mental disorder characterized by a preoccupation with some aspect of one's appearance. In cosmetic surgery, this preoccupation can be overlooked by practitioners resulting in a discrepancy between expected and realistic outcome. Identifying the characteristics of this disorder may be crucial to the practitioner-patient relationship in the plastic surgery setting.

Long-Term Outcome of Cognitive Behavior Therapy for Body Dysmorphic Disorder: A Naturalistic Case Series of 1 to 4 Years After a Controlled Trial.

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Veale, David; Miles, Sarah; Anson, Martin

2015-11-01

There is some evidence for the efficacy of cognitive behavior therapy (CBT) for body dysmorphic disorder (BDD) after 1 to 6months but none in the long term. The aim of this study was to follow up the participants in a randomized controlled trial of CBT versus anxiety management to determine whether or not the treatment gains were maintained over time. Thirty of the original 39 participants who had CBT were followed up over 1 to 4years and assessed using a number of clinician and self-report measures, which included the primary outcome measure of the Yale-Brown Obsessive Compulsive Scale modified for BDD. Outcome scores generally maintained over time from end of treatment to long-term follow-up. There was a slight deterioration from n=20 (51.3%) to n=18 (46.2%) who met improvement criteria at long-term follow-up. Eleven (28.2%) were in full remission and 22 (56.4%) were in partial remission. The gains made were generally maintained at long-term follow-up. However, there were a significant number of participants who maintained chronic symptoms after treatment and may need a longer-term or more complex intervention and active medication management. Copyright © 2015. Published by Elsevier Ltd.

Disease: H01447 [KEGG MEDICUS

Lifescience Database Archive (English)

Full Text Available H01447 Body Dysmorphic Disorder Body dysmorphic disorder (BDD) is a psychiatric di... of Mental Disorders (DSM-5), body dysmorphic disorder (BDD) has been subsumed into the obsessive-compulsive...ompulsive disorder and body dysmorphic disorder: prevalence, explanatory theories, and clinical characteriza

Dysmorphic concern is related to delusional proneness and negative affect in a community sample.

Science.gov (United States)

Keating, Charlotte; Thomas, Neil; Stephens, Jessie; Castle, David J; Rossell, Susan L

2016-06-30

Body image concerns are common in the general population and in some mental illnesses reach pathological levels. We investigated whether dysmorphic concern with appearance (a preoccupation with minor or imagined defects in appearance) is explained by psychotic processes in a community sample. In a cross-sectional design, two hundred and twenty six participants completed an online survey battery including: The Dysmorphic Concern Questionnaire; the Peters Delusional inventory; the Aberrant Salience Inventory; and the Depression, Anxiety, Stress Scale. Participants were native English speakers residing in Australia. Dysmorphic concern was positively correlated with delusional proneness, aberrant salience and negative emotion. Regression established that negative emotion and delusional proneness predicted dysmorphic concern, whereas, aberrant salience did not. Although delusional proneness was related to body dysmorphia, there was no evidence that it was related to aberrant salience. Understanding the contribution of other psychosis processes, and other health related variables to the severity of dysmorphic concern will be a focus of future research. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Stress exposure and generation: A conjoint longitudinal model of body dysmorphic symptoms, peer acceptance, popularity, and victimization.

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Webb, Haley J; Zimmer-Gembeck, Melanie J; Mastro, Shawna

2016-09-01

This study examined the bidirectional (conjoint) longitudinal pathways linking adolescents' body dysmorphic disorder (BDD) symptoms with self- and peer-reported social functioning. Participants were 367 Australian students (45.5% boys, mean age=12.01 years) who participated in two waves of a longitudinal study with a 12-month lag between assessments. Participants self-reported their symptoms characteristic of BDD, and perception of peer acceptance. Classmates reported who was popular and victimized in their grade, and rated their liking (acceptance) of their classmates. In support of both stress exposure and stress generation models, T1 victimization was significantly associated with more symptoms characteristic of BDD at T2 relative to T1, and higher symptom level at T1 was associated with lower perceptions of peer acceptance at T2 relative to T1. These results support the hypothesized bidirectional model, whereby adverse social experiences negatively impact symptoms characteristic of BDD over time, and symptoms also exacerbate low perceptions of peer-acceptance. Copyright © 2016 Elsevier Ltd. All rights reserved.

Sexual Functioning and Behavior of Men with Body Dysmorphic Disorder Concerning Penis Size Compared with Men Anxious about Penis Size and with Controls: A Cohort Study.

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Veale, David; Miles, Sarah; Read, Julie; Troglia, Andrea; Wylie, Kevan; Muir, Gordon

2015-09-01

Little is known about the sexual functioning and behavior of men anxious about the size of their penis and the means that they might use to try to alter the size of their penis. To compare sexual functioning and behavior in men with body dysmorphic disorder (BDD) concerning penis size and in men with small penis anxiety (SPA without BDD) and in a control group of men who do not have any concerns. An opportunistic sample of 90 men from the community were recruited and divided into three groups: BDD (n = 26); SPA (n = 31) and controls (n = 33). The Index of Erectile Function (IEF), sexual identity and history; and interventions to alter the size of their penis. Men with BDD compared with controls had reduced erectile dysfunction, orgasmic function, intercourse satisfaction and overall satisfaction on the IEF. Men with SPA compared with controls had reduced intercourse satisfaction. There were no differences in sexual desire, the frequency of intercourse or masturbation across any of the three groups. Men with BDD and SPA were more likely than the controls to attempt to alter the shape or size of their penis (for example jelqing, vacuum pumps or stretching devices) with poor reported success. Men with BDD are more likely to have erectile dysfunction and less satisfaction with intercourse than controls but maintain their libido. Further research is required to develop and evaluate a psychological intervention for such men with adequate outcome measures.

Loose anagen hair syndrome associated with colobomas and dysmorphic features

DEFF Research Database (Denmark)

Hansen, Lars Kjaersgård; Brandrup, Flemming; Clemmensen, Ole

2004-01-01

Loose anagen hair syndrome is an uncommon congenital disorder. It may occur in association with other syndromes and dysmorphic features. We report a girl who fulfilled the diagnostic criteria for this syndrome as proposed by Tosti (Arch Dermatol 2002, 138: 521-522). She also had several other...

[Body Integrity Identity Disorder (BIID): interrogation of patients and theories for explanation].

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Kasten, E

2009-01-01

Apotemnophilia, Amputee Identity Disorder or Body Integrity Identity Disorder (BIID) is the intensive feeling that the body will be "more complete" after amputation of a limb. The article disputes the question of matching personality characteristics of these subjects and asks for motives. Based on reports of nine individuals, triggering experiences are referred. In contrast to other children, often these subjects were fascinated by the sight of a handicapped person. In the article is investigated, whether the concerned limb showed more affections. Described is typical pretending behavior. Parallels to body dysmorphic disorder (BDD), fetishism, or delusions are investigated. These were minor, in most cases the wish was fixated on a specific limb, the subjects were aware of the abnormity of their desire and quarreled with the pros and cons. Sexual motives were found in one third. Some of the interviewed persons were in medical or psychological therapy; this did not let the desire disappear. In several BIID sufferers the wish for amputation changed, e. g. from the left to the right leg. This finding is not in accordance with the brain-dysfunction-theory. These people rather have an ideal of a "perfect" body minus one arm or leg. Most admire the beauty of a stump, and see amputees as "heroes" who still master their life in spite of their handicap. BIID is not a homogenous disturbance, one should separate three axes: 1. Strength of neuronal dysfunction, 2. Psychic components (e. g. secondary morbid gain) and 3. Intensity of sexual interests.

Sexual Functioning and Behavior of Men with Body Dysmorphic Disorder Concerning Penis Size Compared with Men Anxious about Penis Size and with Controls: A Cohort Study

Science.gov (United States)

Veale, David; Miles, Sarah; Read, Julie; Troglia, Andrea; Wylie, Kevan; Muir, Gordon

2015-01-01

Introduction Little is known about the sexual functioning and behavior of men anxious about the size of their penis and the means that they might use to try to alter the size of their penis. Aim To compare sexual functioning and behavior in men with body dysmorphic disorder (BDD) concerning penis size and in men with small penis anxiety (SPA without BDD) and in a control group of men who do not have any concerns. Methods An opportunistic sample of 90 men from the community were recruited and divided into three groups: BDD (n = 26); SPA (n = 31) and controls (n = 33). Main Outcome Measures The Index of Erectile Function (IEF), sexual identity and history; and interventions to alter the size of their penis. Results Men with BDD compared with controls had reduced erectile dysfunction, orgasmic function, intercourse satisfaction and overall satisfaction on the IEF. Men with SPA compared with controls had reduced intercourse satisfaction. There were no differences in sexual desire, the frequency of intercourse or masturbation across any of the three groups. Men with BDD and SPA were more likely than the controls to attempt to alter the shape or size of their penis (for example jelqing, vacuum pumps or stretching devices) with poor reported success. Conclusion Men with BDD are more likely to have erectile dysfunction and less satisfaction with intercourse than controls but maintain their libido. Further research is required to develop and evaluate a psychological intervention for such men with adequate outcome measures. PMID:26468378

Dysmorphic Facial Features and Other Clinical Characteristics in Two Patients with PEX1 Gene Mutations

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Gunduz, Mehmet

2016-01-01

Peroxisomal disorders are a group of genetically heterogeneous metabolic diseases related to dysfunction of peroxisomes. Dysmorphic features, neurological abnormalities, and hepatic dysfunction can be presenting signs of peroxisomal disorders. Here we presented dysmorphic facial features and other clinical characteristics in two patients with PEX1 gene mutation. Follow-up periods were 3.5 years and 1 year in the patients. Case I was one-year-old girl that presented with neurodevelopmental delay, hepatomegaly, bilateral hearing loss, and visual problems. Ophthalmologic examination suggested septooptic dysplasia. Cranial magnetic resonance imaging (MRI) showed nonspecific gliosis at subcortical and periventricular deep white matter. Case II was 2.5-year-old girl referred for investigation of global developmental delay and elevated liver enzymes. Ophthalmologic examination findings were consistent with bilateral nystagmus and retinitis pigmentosa. Cranial MRI was normal. Dysmorphic facial features including broad nasal root, low set ears, downward slanting eyes, downward slanting eyebrows, and epichantal folds were common findings in two patients. Molecular genetic analysis indicated homozygous novel IVS1-2A>G mutation in Case I and homozygous p.G843D (c.2528G>A) mutation in Case II in the PEX1 gene. Clinical findings and developmental prognosis vary in PEX1 gene mutation. Kabuki-like phenotype associated with liver pathology may indicate Zellweger spectrum disorders (ZSD). PMID:27882258

Opitz C syndrome: Trigonocephaly, mental retardation and craniofacial dysmorphism

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J.A. Avina Fierro

2016-01-01

Full Text Available We describe a 4-year-old female child with a dysmorphic and neurological syndrome of trigonocephaly, mental and psychomotor retardation and dysmorphic facial features. The anomalies of the face were the following: slight upward palpebral fissures, ocular hypertelorism, depressed nasal bridge, hypoplastic nasal root, short nose with anteverted nares; small low set ears, smooth broad philtrum and thin upper lip. The patient had important cerebral anomalies with diffuse alterations in white matter that caused developmental delay with verbal and nonverbal disabilities and severe learning difficulties. This clinical presentation is compatible with the diagnosis of the Opitz C syndrome, a heterogeneous disease of multiple neurological and craniofacial abnormalities. The physical sign more detectable and notorious is the trigonocephaly that is manifested by a prominent metopic suture, but also can be distinguished the other minor facial anomalies that are found in the eyes, nose, mouth and ears that constitute the phenotype of the disorder. The neurological development was altered by the compression of the cerebral frontal lobes with narrowing of this cerebral area, producing hypotonia with muscle weakness, epileptic episodes manifested by seizures, and neurobehavioral and neurocognitive disorders. This syndrome is a very rare genetic disorder with autosomal recessive inheritance trait; our patient had no chromosomal abnormality in the usual karyotype but the fluorescence in situ hybridization (FISH technique showed a balanced translocation between the chromosomes two and eleven: t(2:11 (q32.2/q24.

Morphometric study of the true S1 and S2 of the normal and dysmorphic sacralized sacra.

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Firat, Ayşegül; Alemdaroğlu, Kadir Bahadır; Özmeriç, Ahmet; Yücens, Mehmet; Göksülük, Dinçer

2017-06-12

This study aimed to generate data for the S1 and S2 alar pedicle and body and the alar orientations for both dysmorphic and normal sacra. The study comprised two groups: Group N consisted of 53 normal sacra and Group D included 10 dysmorphic sacra. Various features such as alar pedicle circumference; anterior, middle, and posterior axis of the sacral ala; sacral body height and width; and sagittal thickness were measured. In group N, the median anterior axis of the alae was observed to be 30° on the right and 25° on the left, the median midline axis was found to be 20° on the right and 15° on the left, and the median posterior alar axis was -15° on the right and -20° on the left. The true S1 and S2 alar pedicle circumferences were observed to be significantly smaller in group D, which demonstrated a shorter S1 alar pedicle mean circumference, significantly narrower S1 body mean width, and considerably tapered sagittal thickness. Our analysis indicated that dysmorphic sacra have a lower sagittal thickness and width of bodies and smaller alar pedicles, which explains the difficulties in their percutaneous fixation.

Body image concern and selective attention to disgusting and non-self appearance-related stimuli.

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Onden-Lim, Melissa; Wu, Ray; Grisham, Jessica R

2012-09-01

Although selective attention to one's own appearance has been widely documented in studies of body dysmorphic disorder (BDD), little is known about attentional bias toward non-self appearance-related stimuli in BDD. Furthermore, despite reports of heightened experience of disgust in BDD, it is unknown whether these individuals differentially attend to disgusting stimuli and whether disgust is important in processing of unattractive stimuli. We used a dot probe procedure to investigate the relationship between dysmorphic concern, a defining feature of BDD, and selective attention to faces, attractive, unattractive and disgusting images in a female heterosexual student population (N=92). At the long stimulus presentation (1000 ms), dysmorphic concern was positively associated with attention to faces in general and attractive appearance-related images. In contrast, at the short stimulus presentation (200 ms), there was a positive association between dysmorphic concern and disgusting images. Implications for theoretical models of BDD are discussed. Copyright © 2012. Published by Elsevier Ltd.

Perception, experience and body identity.

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López-Ibor, Juan J; Ortiz, Tomás; López-Ibor, María I

2011-12-01

there is a confrontation between the body object and the body subject that has made it possible to investigate how the perception of the own body is and how the brain generates the schema and the body image. The study of the body experience, from the phenomenology and the anthropological psychiatry perspective, has made it possible to go greater in-depth into the knowledge of the alterations of the experience of the own body in different mental diseases, especially in those in which a confrontation between the body and the personal identity arises makes it necessary to consider the process of individual identification and a category of personal identity disorders that would include body dysmorphic disorder, erythrophobia, anorexia nervosa, body integrity identity as well as the gender-type disorders (transsexualism, nonfetishistic transvestism, gender identity disorder during childhood). Key words: Dualism, Monism, Agnosia, Phantom limb, Cenesthesia, Body schema, Body image, Body experience, Personal identity disorders, Body dysmorphic disorder, Anorexia nervosa, Personal integrity identity disorder.

Pornography use in sexual minority males: Associations with body dissatisfaction, eating disorder symptoms, thoughts about using anabolic steroids and quality of life.

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Griffiths, Scott; Mitchison, Deborah; Murray, Stuart B; Mond, Jonathan M

2018-04-01

We examined two hypotheses regarding the potential association of pornography use with body image-related and eating disorder-related psychopathology among sexual minority males (i.e. non-heterosexual males). Our primary hypothesis was that pornography use would be associated with males' body dissatisfaction, eating disorder symptoms, thoughts about using anabolic steroids and quality of life impairment; our secondary hypothesis was that the type of pornography, namely, professional versus amateur pornography, which contains idealised and non-idealised (i.e. regular) bodies, respectively, would moderate these associations. A sample of 2733 sexual minority males living in Australia and New Zealand completed an online survey that contained measures of pornography use, body dissatisfaction, eating disorder symptoms, thoughts about using anabolic steroids and quality of life. Almost all (98.2%) participants reported pornography use with a median use of 5.33 hours per month. Multivariate analyses revealed that increased pornography use was associated with greater dissatisfaction with muscularity, body fat and height; greater eating disorder symptoms; more frequent thoughts about using anabolic steroids; and lower quality of life. Effect sizes for these associations were uniformly small. Neither relationship status nor genital dissatisfaction was associated with pornography use. The association between pornography use and thoughts about using anabolic steroids was stronger for viewers of professional pornography than viewers of amateur pornography. The findings suggest that the use of pornography is weakly associated with body dissatisfaction and related variables and that the type of pornography (amateur vs professional) viewed may be a moderating factor in some cases. Within the limits of a cross-sectional study design, these findings may have implications for clinicians who treat individuals with eating disorders, body dysmorphic disorder, anabolic-androgenic steroid

The dysmorphic lung: imaging findings

International Nuclear Information System (INIS)

Mata, J.M.; Caceres, J.

1996-01-01

Congenital lung malformations are not infrequent and can be discovered in adults. It is, therefore, necessary to know their radiological manifestations in order to avoid diagnostic errors. We classify the congenital lung malformations in two main groups: dysmorphic lung and focal pulmonary malformations. We review the radiological spectrum of dysmorphic lung, based on a classification that emphasises the pulmonary abnormality, adding variants when diaphragmatic or venous abnormalities are present. In our opinion this approach allows for a rational use of advanced imaging techniques (CT, MRI). (orig.). With 13 figs

The dysmorphic lung: imaging findings

Energy Technology Data Exchange (ETDEWEB)

Mata, J.M. [SDI-UDIAT, Consorci Hospitalari del Parc Tauli, Parc Tauli s/n, E-08208 Barcelona (Spain)]|[Universitat Autonoma de Barcelona, Barcelona (Spain); Caceres, J. [Universitat Autonoma de Barcelona, Barcelona (Spain)]|[Hospital de la Santa Creu i Sant Pau, Barcelona (Spain)

1996-08-01

Congenital lung malformations are not infrequent and can be discovered in adults. It is, therefore, necessary to know their radiological manifestations in order to avoid diagnostic errors. We classify the congenital lung malformations in two main groups: dysmorphic lung and focal pulmonary malformations. We review the radiological spectrum of dysmorphic lung, based on a classification that emphasises the pulmonary abnormality, adding variants when diaphragmatic or venous abnormalities are present. In our opinion this approach allows for a rational use of advanced imaging techniques (CT, MRI). (orig.). With 13 figs.

A comparison of body image concern in candidates for rhinoplasty and therapeutic surgery.

Science.gov (United States)

Hashemi, Seyed Amirhosein Ghazizadeh; Edalatnoor, Behnoosh; Edalatnoor, Behnaz; Niksun, Omid

2017-09-01

Body dysmorphic disorder among patients referring for cosmetic surgeries is a disorder that if not diagnosed by a physician, can cause irreparable damage to the doctor and the patient. The aim of this study was to compare body image concern in candidates for rhinoplasty and therapeutic surgery. This was a cross-sectional study conducted on 212 patients referring to Loghman Hospital of Tehran for rhinoplasty and therapeutic surgery during the period from 2014 through 2016. For each person in a cosmetic surgery group, a person of the same sex and age in a therapeutic surgery group was matched, and the study was conducted on 60 subjects in the rhinoplasty group and 62 patients in the therapeutic surgery group. Then, the Body Image Concern Inventory and demographic data were filled by all patients and the level of body image concern in both groups was compared. Statistical analysis was conducted using SPSS 16, Chi-square test as well as paired-samples t-test. P-value of less than 0.05 was considered statistically significant. In this study, 122 patients (49 males and 73 females) with mean age of 27.1±7.3 between 18 and 55 years of age were investigated. Sixty subjects were candidates for rhinoplasty and 62 subjects for therapeutic surgery. Candidates for rhinoplasty were mostly male (60%) and single (63.3%). Results of the t-test demonstrated that body image concern and body dysmorphic disorder were higher in the rhinoplasty group compared to the therapeutic group (pconcern was higher in rhinoplasty candidates compared to candidates for other surgeries. Visiting and correct interviewing of people who referred for rhinoplasty is very important to measure their level of body image concern to diagnose any disorders available and to consider required treatments.

Fluvoxamine in the treatment of anxiety disorders.

Science.gov (United States)

Irons, Jane

2005-12-01

Fluvoxamine is a selective-serotonin reuptake inhibitor (SSRI) that has proved effective in large double-blind, randomized, controlled trials involving patients with social anxiety disorder (SAD), obsessive-compulsive disorder (OCD), and panic disorder. Improvements have also been demonstrated in patients with post-traumatic stress disorder, as well as those with a range of obsessive-compulsive spectrum disorders including binge eating disorder, bulimia nervosa, pathological gambling, and body dysmorphic disorder. Several well controlled studies have confirmed the efficacy of fluvoxamine in children and adolescents with OCD, SAD, and other anxiety disorders, and it was the first SSRI to be registered for the treatment of OCD in children. Fluvoxamine is well tolerated. In common with other SSRIs, the most frequently reported adverse event is nausea. Fluvoxamine does not cause sedation or cognitive impairment and is associated with a low risk of sexual dysfunction, suicidality, and withdrawal reactions. It is safe in overdose and has no significant effect on body weight or cardiovascular parameters.

Development and Validation of the Body-Focused Shame and Guilt Scale

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Weingarden, Hilary; Renshaw, Keith D.; Tangney, June P.; Wilhelm, Sabine

2015-01-01

Body shame is described as central in clinical literature on body dysmorphic disorder (BDD). However, empirical investigations of body shame within BDD are rare. One potential reason for the scarcity of such research may be that existing measures of body shame focus on eating and weight-based content. Within BDD, however, body shame likely focuses more broadly on shame felt in response to perceived appearance flaws in one’s body parts. We describe the development and validation of the Body-Focused Shame and Guilt Scale (BF-SGS), a measure of BDD-relevant body shame, across two studies: a two time-point study of undergraduates, and a follow-up study in two Internet-recruited clinical samples (BDD, obsessive compulsive disorder) and healthy controls. Across both studies, the BF-SGS shame subscale demonstrated strong reliability and construct validity, with Study 2 providing initial clinical norms. PMID:26640760

Co-Morbidity of Obsessive-Compulsive Disorder with Motor Tics in an Eight Year–Old Boy

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Mina Zarei

2013-02-01

Full Text Available Obsessive-Compulsive Disease (OCD incidence rate in children and adolescents is about 1-2 percent; males develop the disease more than females and it clearly is associated with attentiondeficithyperactivity disorder (ADHD, depression and body dysmorphic disorder. Regarding the fact that initial diagnosis and treatment of disorders with OCD in children can protect them from further problems in their life, in this study, the premature OCD with motor tic disorder in an 8-year-old boy is reported.

Phenotype in girls and women with Turner syndrome: Association between dysmorphic features, karyotype and cardio-aortic malformations.

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Noordman, Iris; Duijnhouwer, Anthonie; Kapusta, Livia; Kempers, Marlies; Roeleveld, Nel; Schokking, Michiel; Smeets, Dominique; Freriks, Kim; Timmers, Henri; van Alfen-van der Velden, Janiëlle

2018-06-01

Turner syndrome (TS) is a genetic disorder characterized by the (partial) absence or a structural aberration of the second sex chromosome and is associated with a variety of phenotypes with specific physical features and cardio-aortic malformations. The objective of this study was to gain a better insight into the differences in dysmorphic features between girls and women with TS and to explore the association between these features, karyotype and cardio-aortic malformations. This prospective study investigated 14 dysmorphic features of TS girls and women using a checklist. Three major phenotypic patterns were recognized (severe phenotype, lymphatic phenotype and skeletal phenotype). Patient data including karyotype and cardio-aortic malformations (bicuspid aortic valve (BAV) and aortic coarctation (COA)) were collected. Associations between the prevalence of dysmorphic features, karyotype and cardio-aortic malformations were analysed using chi 2 -test and odds ratios. A total of 202 patients (84 girls and 118 women) were analysed prospectively. Differences in prevalence of dysmorphic features were found between girls and women. A strong association was found between monosomy 45,X and the phenotypic patterns. Furthermore, an association was found between COA and lymphatic phenotype, but no association was found between karyotype and cardio-aortic malformations. This study uncovered a difference in dysmorphic features between girls and women. Monosomy 45,X is associated with a more severe phenotype, lymphatic phenotype and skeletal phenotype. All patients with TS should be screened for cardio-aortic malformations, because in contrast to previous reports, karyotype and cardio-aortic malformations showed no significant association. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

Use of Dysmorphology for Subgroup Classification on Autism Spectrum Disorder in Chinese Children

Science.gov (United States)

Wong, Virginia C. N.; Fung, Cecilia K. Y.; Wong, Polly T. Y.

2014-01-01

Data from 1,261 Chinese Autistic Spectrum Disorder (ASD) patients were evaluated and categorized into dysmorphic (10.79%) and non-dysmorphic groups (89.21%) upon physical examination by the presence of dysmorphic features. Abnormal MRI/CT result, IQ scores and epilepsy were significantly associated with the dysmorphic group of ASD children.…

Disorders of body temperature.

Science.gov (United States)

Gomez, Camilo R

2014-01-01

The human body generates heat capable of raising body temperature by approximately 1°C per hour. Normally, this heat is dissipated by means of a thermoregulatory system. Disorders resulting from abnormally high or low body temperature result in neurologic dysfunction and pose a threat to life. In response to thermal stress, maintenance of normal body temperature is primarily maintained by convection and evaporation. Hyperthermia results from abnormal temperature regulation, leading to extremely elevated body temperature while fever results from a normal thermoregulatory mechanism operating at a higher set point. The former leads to specific clinical syndromes with inability of the thermoregulatory mechanism to maintain a constant body temperature. Heat related illness encompasses heat rash, heat cramps, heat exhaustion and heat stroke, in order of severity. In addition, drugs can induce hyperthermia and produce one of several specific clinical syndromes. Hypothermia is the reduction of body temperature to levels below 35°C from environmental exposure, metabolic disorders, or therapeutic intervention. Management of disorders of body temperature should be carried out decisively and expeditiously, in order to avoid secondary neurologic injury. © 2014 Elsevier B.V. All rights reserved.

The psychosomatic disorders pertaining to dental practice with revised working type classification.

Science.gov (United States)

Shamim, Thorakkal

2014-01-01

Psychosomatic disorders are defined as disorders characterized by physiological changes that originate partially from emotional factors. This article aims to discuss the psychosomatic disorders of the oral cavity with a revised working type classification. The author has added one more subset to the existing classification, i.e., disorders caused by altered perception of dentofacial form and function, which include body dysmorphic disorder. The author has also inserted delusional halitosis under the miscellaneous disorders classification of psychosomatic disorders and revised the already existing classification proposed for the psychosomatic disorders pertaining to dental practice. After the inclusion of the subset (disorders caused by altered perception of dentofacial form and function), the terminology "psychosomatic disorders of the oral cavity" is modified to "psychosomatic disorders pertaining to dental practice".

Development of a Body Image Concern Scale using both exploratory and confirmatory factor analyses in Chinese university students

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He W

2017-05-01

Full Text Available Wenxin He, Qiming Zheng, Yutian Ji, Chanchan Shen, Qisha Zhu, Wei Wang Department of Clinical Psychology and Psychiatry, School of Public Health, Zhejiang University College of Medicine, Hangzhou, People’s Republic of China Background: The body dysmorphic disorder is prevalent in general population and in psychiatric, dermatological, and plastic-surgery patients, but there lacks a structure-validated, comprehensive self-report measure of body image concerns, which is established through both exploratory and confirmatory factor analyses. Methods: We have composed a 34-item matrix targeting the body image concerns and trialed it in 328 male and 365 female Chinese university students. Answers to the matrix dealt with treatments including exploratory factor analyses, reserve of qualified items, and confirmatory factor analyses of latent structures. Results: Six latent factors, namely the Social Avoidance, Appearance Dissatisfaction, Preoccupation with Reassurance, Perceived Distress/Discrimination, Defect Hiding, and Embarrassment in Public, were identified. The factors and their respective items have composed a 24-item questionnaire named as the Body Image Concern Scale. Each factor earned a satisfactory internal reliability, and the intercorrelations between these factors were in a median level. Women scored significantly higher than men did on the Appearance Dissatisfaction, Preoccupation with Reassurance, and Defect Hiding. Conclusion: The Body Image Concern Scale has displayed its structure validation and gender preponderance in Chinese university students. Keywords: body dysmorphic disorder, body image, factor analysis, questionnaire development

Dysmorphic features and developmental outcome of 2-year-old children.

Science.gov (United States)

Seggers, Jorien; Haadsma, Maaike L; Bos, Arend F; Heineman, Maas Jan; Middelburg, Karin J; van den Heuvel, Edwin R; Hadders-Algra, Mijna

2014-11-01

The aim of this study was to assess the associations between dysmorphic features and neurological, mental, psychomotor, and behavioural development in order to improve our understanding of aetiological pathways leading to minor developmental problems. In our cross-sectional study, 272 generally healthy 2-year-olds (143 males, 129 females; median gestational age 39 weeks, [range 30-43wks]), born after a parental history of subfertility either with or without fertility treatment, were examined. Dysmorphic features were classified as abnormalities (clinically relevant or not), minor anomalies, or common variants according to Merks' classification system. Hempel's neurological assessment resulted in a neurological optimality score (NOS) and fluency score. Mental and psychomotor development were assessed with the Dutch version of the Bayley Scales of Infant Development and behavioural development with the Achenbach Child Behaviour Checklist. Of the different types of dysmorphic feature, clinically relevant abnormalities were most strongly associated with a lower NOS (difference -2.53, 95% confidence interval [CI] -4.23 to -0.83) and fluency score (difference -0.62, 95% CI -1.1 to -0.15). The presence of one or more abnormalities (clinically relevant or not) or one or more common variants was significantly associated with a lower NOS, and the presence of three or more minor anomalies was associated with lower fluency scores. Dysmorphic features were not associated with mental, psychomotor, or behavioural development. As dysmorphic features originate during the first trimester of pregnancy, the association between dysmorphic features and minor alterations in neurodevelopment may suggest an early ontogenetic origin of subtle neurological deviations. © 2014 Mac Keith Press.

Accurate Detection of Dysmorphic Nuclei Using Dynamic Programming and Supervised Classification.

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Verschuuren, Marlies; De Vylder, Jonas; Catrysse, Hannes; Robijns, Joke; Philips, Wilfried; De Vos, Winnok H

2017-01-01

A vast array of pathologies is typified by the presence of nuclei with an abnormal morphology. Dysmorphic nuclear phenotypes feature dramatic size changes or foldings, but also entail much subtler deviations such as nuclear protrusions called blebs. Due to their unpredictable size, shape and intensity, dysmorphic nuclei are often not accurately detected in standard image analysis routines. To enable accurate detection of dysmorphic nuclei in confocal and widefield fluorescence microscopy images, we have developed an automated segmentation algorithm, called Blebbed Nuclei Detector (BleND), which relies on two-pass thresholding for initial nuclear contour detection, and an optimal path finding algorithm, based on dynamic programming, for refining these contours. Using a robust error metric, we show that our method matches manual segmentation in terms of precision and outperforms state-of-the-art nuclear segmentation methods. Its high performance allowed for building and integrating a robust classifier that recognizes dysmorphic nuclei with an accuracy above 95%. The combined segmentation-classification routine is bound to facilitate nucleus-based diagnostics and enable real-time recognition of dysmorphic nuclei in intelligent microscopy workflows.

Accurate Detection of Dysmorphic Nuclei Using Dynamic Programming and Supervised Classification.

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Marlies Verschuuren

Full Text Available A vast array of pathologies is typified by the presence of nuclei with an abnormal morphology. Dysmorphic nuclear phenotypes feature dramatic size changes or foldings, but also entail much subtler deviations such as nuclear protrusions called blebs. Due to their unpredictable size, shape and intensity, dysmorphic nuclei are often not accurately detected in standard image analysis routines. To enable accurate detection of dysmorphic nuclei in confocal and widefield fluorescence microscopy images, we have developed an automated segmentation algorithm, called Blebbed Nuclei Detector (BleND, which relies on two-pass thresholding for initial nuclear contour detection, and an optimal path finding algorithm, based on dynamic programming, for refining these contours. Using a robust error metric, we show that our method matches manual segmentation in terms of precision and outperforms state-of-the-art nuclear segmentation methods. Its high performance allowed for building and integrating a robust classifier that recognizes dysmorphic nuclei with an accuracy above 95%. The combined segmentation-classification routine is bound to facilitate nucleus-based diagnostics and enable real-time recognition of dysmorphic nuclei in intelligent microscopy workflows.

Case Report: Congenital Erythroleukemia in a Premature Infant with Dysmorphic Features.

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Helin, Heidi; van der Walt, Jon; Holder, Muriel; George, Simi

2016-01-01

We present a case of pure erythroleukemia, diagnosed at autopsy, in a dysmorphic premature infant who died of multiorgan failure within 24 hours of birth. Dysmorphic features included facial and limb abnormalities with long philtrum, microagnathia, downturned mouth, short neck as well as abnormal and missing nails, missing distal phalanx from the second toe, and overlapping toes. Internal findings included gross hepatomegaly and patchy hemorrhages in the liver, splenomegaly, and cardiomegaly; and subdural, intracerebral, and intraventricular hemorrhages. Histology revealed infiltration of bone marrow, kidney, heart, liver, adrenal, lung, spleen, pancreas, thyroid, testis, thymus, and placenta by pure erythroleukemia. Only 6 cases of congenital erythroleukemia have been previously reported with autopsy findings similar to those of this case. The dysmorphic features, although not fitting any specific syndrome, make this case unique. Congenital erythroleukemia and possible syndromes suggested by the dysmorphic features are discussed.

Clinical spectrum of immunodeficiency, centromeric instability and facial dysmorphism (ICF syndrome).

NARCIS (Netherlands)

Hagleitner, M.M.; Lankester, A.; Maraschio, P.; Hulten, M.; Fryns, J.P.; Schuetz, C.; Gimelli, G.; Davies, E.G.; Gennery, A.R.; Belohradsky, B.H.; Groot, R. de; Gerritsen, E.J.; Mattina, T.; Howard, P.J.; Fasth, A.; Reisli, I.; Furthner, D.; Slatter, M.A.; Cant, A.J.; Cazzola, G.; Dijken, P.J. van; Deuren, M. van; Greef, J.C. de; Maarel, S.M. van der; Weemaes, C.M.R.

2008-01-01

BACKGROUND: Immunodeficiency, centromeric instability and facial dysmorphism (ICF syndrome) is a rare autosomal recessive disease characterised by facial dysmorphism, immunoglobulin deficiency and branching of chromosomes 1, 9 and 16 after PHA stimulation of lymphocytes. Hypomethylation of DNA of a

Body Integrity Identity Disorder

NARCIS (Netherlands)

Blom, Rianne M.; Hennekam, Raoul C.; Denys, Damiaan

2012-01-01

Introduction: Body Integrity Identity Disorder (BIID) is a rare, infrequently studied and highly secretive condition in which there is a mismatch between the mental body image and the physical body. Subjects suffering from BIID have an intense desire to amputate a major limb or severe the spinal

Presence of muscle dysmorphia symptomology among male weightlifters.

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Hildebrandt, Tom; Schlundt, David; Langenbucher, James; Chung, Tammy

2006-01-01

Limited research exists on muscle dysmorphia (MD) in men and in nonclinical populations. The current study evaluated types of body image disturbance among 237 male weightlifters. Latent class analysis of 8 measures of body image disturbance revealed 5 independent types of respondents: Dysmorphic, Muscle Concerned, Fat Concerned, Normal Behavioral, and Normal. One-way analysis of variance of independent measures of body image disturbance and associated psychopathology confirmed significant differences between groups. The Dysmorphic group reported a pattern of body image disturbance consistent with MD by displaying a high overall level of body image disturbance, symptoms of associated psychopathology, steroid use, and appearance-controlling behavior. Findings generally supported classifying MD as a subtype of body dysmorphic disorder and an obsessive-compulsive spectrum disorder. Implications for studying body image disturbance in male weightlifters, and further evaluation of the MD diagnostic criteria are discussed.

Obsession with perfection: Body dysmorphia.

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Vashi, Neelam A

The deeply rooted fascination with beauty penetrates society worldwide. The indulgence to look and feel beautiful pervades all ages, genders, and nationalities, with research conferring a remarkable tendency to agree on measures of attractiveness among these disparate groups. Research has found that beautiful people do, in fact, receive more desirable outcomes in life and job satisfaction, family formation, and overall happiness. Humans have a tendency to respond to attractive persons more favorably, driving many patients to our clinics. Although some dissatisfaction with one's appearance is common and normal, excessive concern with certain facial or body attributes can be sign of an underlying disorder. Body dysmorphic disorder (BDD) is a disorder of self-perception. It is the obsession with perfection. Defined as the impairing preoccupation with a nonexistent or minimal flaw in appearance, BDD affects 0.7-2.4% of the general population and a much larger percentage of those attempting to receive aesthetic treatments. Clinicians should be aware of this disorder and remain vigilant because such patients will not be satisfied with corrective procedures. Although not involving cosmetic intervention, the treatment of BDD does involve psychiatric referral and psychopharmacologic therapy, with patients receiving these having a much better prognosis. Copyright © 2016 Elsevier Inc. All rights reserved.

Body Part Concerns Questionnaire (BPCQ in an Iranian Population with Special Needs

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Katayoun Khademi

2012-10-01

Full Text Available Objectives: During the past decades, cosmetic surgery has become increasingly popular. The purpose of this study is to make questionnaire for screening patients with negative body image in cosmetic clinics for special need people. Methods: In the present study, 150 special need people in cosmetic clinics were randomly assigned to fill questionnaires for assessing body area concerns. Results: Results of reliability analysis and validity have shown the effectiveness of this questionnaire for recognizing individuals with having negative body image. These preliminary results suggest that body dysmorphic disorder may be relatively common among patients seeking cosmetic surgery. Discussion: A high proportion of participants in cosmetic clinics have demonstrated significant body image concerns. These relatively common body image concerns deserve more study in adolescents and people with special needs.

The drive for muscle leanness: a complex case with features of muscle dysmorphia and eating disorder not otherwise specified.

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Cafri, G; Blevins, N; Thompson, J K

2006-12-01

Muscle dysmorphia has been described as a subtype of body dysmorphic disorder in which an individual experiences severe body image disturbance related to muscularity. The current case is of a 20-year-old man who describes a history of muscle dysmorphia in which the nature of the body image concern is related to leanness (i.e., muscularity in the absence of body fat), as opposed to increasing muscle mass, which is how muscle dysmorphia has typically been characterized in the literature. The case illustrates the need to consider this additional facet of body image when diagnosing muscle dysmorphia.

[Body experience and self-esteem after minimally invasive skin rejuvenation : Study of female patients using botulinum toxin A and/or dermal fillers].

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Scharschmidt, D; Preiß, S; Brähler, E; Fischer, T; Borkenhagen, A

2017-12-01

More and more people worldwide and also in Germany are using botulinum toxin type A (BoNT-A) and hyaluronic acid injections for skin rejuvenation. Study on body image and self-esteem of women with BoNT-A and/or hyaluronic acid filler treatment. A total of 145 women who requested BoNT-A and/or hyaluronic acid injections completed a survey comprised of the body dysmorphic disorder questionnaire, the Rosenberg self-esteem scale and questionnaires on the attitudes and motives on measures for optimization of the body and demographic features. Using this instrument data on the body image and self-esteem as well as attitudes and motives for utilization of minimally invasive skin rejuvenation were collated. Female users of minimally invasive skin rejuvenation showed an overall higher socioeconomic status and an above average high monthly income. They lived in a partnership more often in comparison to women of equal age living in Berlin. The users of BoNT-A and/or hyaluronic acid fillers showed no conspicuous differences in body image and self-esteem. They showed a moderately positive attitude to body optimization procedures and 91% achieved their standard weight with a body mass index (BMI) of ≤25 kg/m 2 in comparison to 56% of German women in the same age range (25 to ≥75 years old). In the first study of body image and self-esteem in users of BoNT‑A and/or dermal fillers in German women, the users showed no signs of body dysmorphic patterns or disorders of self-esteem.

Safe Zone Quantification of the Third Sacral Segment in Normal and Dysmorphic Sacra.

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Hwang, John S; Reilly, Mark C; Shaath, Mohammad K; Changoor, Stuart; Eastman, Jonathan; Routt, Milton Lee Chip; Sirkin, Michael S; Adams, Mark R

2018-04-01

To quantify the osseous anatomy of the dysmorphic third sacral segment and assess its ability to accommodate internal fixation. Retrospective chart review of a trauma database. University Level 1 Trauma Center. Fifty-nine patients over the age of 18 with computed tomography scans of the pelvis separated into 2 groups: a group with normal pelvic anatomy and a group with sacral dysmorphism. The sacral osseous area was measured on computed tomography scans in the axial, coronal, and sagittal planes in normal and dysmorphic pelves. These measurements were used to determine the possibility of accommodating a transiliac transsacral screw in the third sacral segment. In the normal group, the S3 coronal transverse width averaged 7.71 mm and the S3 axial transverse width averaged 7.12 mm. The mean S3 cross-sectional area of the normal group was 55.8 mm. The dysmorphic group was found to have a mean S3 coronal transverse width of 9.49 mm, an average S3 axial transverse width of 9.14 mm, and an S3 cross-sectional area of 77.9 mm. The third sacral segment of dysmorphic sacra has a larger osseous pathway available to safely accommodate a transiliac transsacral screw when compared with normal sacra. The S3 segment of dysmorphic sacra can serve as an additional site for screw placement when treating unstable posterior pelvic ring fractures.

Delusional disorders in dermatology: a brief review.

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Robles, David T; Romm, Sharon; Combs, Heidi; Olson, Jonathan; Kirby, Phil

2008-06-15

There are several unique psychiatric disorders that are likely to present to a dermatologist because of their accompanying skin complaints. Delusions of parasitosis (DP) is a fixed, false belief of parasitic infestation that may lead patients to compulsively self-mutilate while attempting to remove the non-existent parasites. Morgellons disease is a controversial condition characterized by a fixed belief that fibers that are imbedded or extruding from the skin; this condition is likely in the spectrum of DP. Body dysmorphic disorder (BDD) is a preoccupation with an imagined defect in appearance that causes significant distress and is associated with time consuming rituals, isolation, depression, and increased risk of suicide. Olfactory reference syndrome (ORS) is a preoccupation with body odor leading to the stigmata of shame, embarrassment, and social isolation. This brief review examines each of these conditions and their management because any one of them may present to a dermatologist.

Amputatiewens bij 'body integrity identity disorder'

NARCIS (Netherlands)

Blom, Rianne M.; Hennekam, Raoul C. M.

2014-01-01

Body integrity identity disorder (BIID) is a rare neuropsychiatric disorder in which patients experience a mismatch between the real and experienced body from childhood. BIID results in a strong desire to amputate or paralyse one or more limbs. We describe two BIID patients. A 40-year-old healthy

Body Image, Media, and Eating Disorders

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Derenne, Jennifer L.; Beresin, Eugene V.

2006-01-01

Objective: Eating disorders, including obesity, are a major public health problem today. Throughout history, body image has been determined by various factors, including politics and media. Exposure to mass media (television, movies, magazines, Internet) is correlated with obesity and negative body image, which may lead to disordered eating. The…

Muscle dysmorphia: could it be classified as an addiction to body image?

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Foster, Andrew C; Shorter, Gillian W; Griffiths, Mark D

2015-03-01

Muscle dysmorphia (MD) describes a condition characterised by a misconstrued body image in which individuals who interpret their body size as both small or weak even though they may look normal or highly muscular.MD has been conceptualized as a type of body dysmorphic disorder, an eating disorder, and obsessive–compulsive disorder symptomatology. METHOD AND AIM: Through a review of the most salient literature on MD, this paper proposes an alternative classification of MD--the ‘Addiction to Body Image’ (ABI) model--using Griffiths (2005)addiction components model as the framework in which to define MD as an addiction. It is argued the addictive activity in MD is the maintaining of body image via a number of different activities such as bodybuilding, exercise,eating certain foods, taking specific drugs (e.g., anabolic steroids), shopping for certain foods, food supplements,and the use or purchase of physical exercise accessories). In the ABI model, the perception of the positive effects on the self-body image is accounted for as a critical aspect of the MD condition (rather than addiction to exercise or certain types of eating disorder). Based on empirical evidence to date, it is proposed that MD could be re-classified as an addiction due to the individual continuing to engage in maintenance behaviours that may cause long-term harm.

Outcomes of Cognitive Behavioral Therapy (CBT) Interventions Provided by Unlicensed Professionals

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2018-05-04

Obsessive Compulsive Disorder; Body Dysmorphic Disorder; Tourette Syndrome; Trichotillomania; Panic Disorder; Social Phobia; Generalized Anxiety Disorder; Depression; Post-Traumatic Stress Disorder; Attention Deficit Hyperactivity Disorder; Eating Disorder; Specific Phobia; General Medical Condition

A recognizable systemic connective tissue disorder with polyvalvular heart dystrophy and dysmorphism associated with TAB2 mutations.

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Ritelli, M; Morlino, S; Giacopuzzi, E; Bernardini, L; Torres, B; Santoro, G; Ravasio, V; Chiarelli, N; D'Angelantonio, D; Novelli, A; Grammatico, P; Colombi, M; Castori, M

2018-01-01

Deletions encompassing TAK1-binding protein 2 (TAB2) associated with isolated and syndromic congenital heart defects. Rare missense variants are found in patients with a similar phenotype as well as in a single individual with frontometaphyseal dysplasia. We describe a family and an additional sporadic patient with polyvalvular heart disease, generalized joint hypermobility and related musculoskeletal complications, soft, velvety and hyperextensible skin, short limbs, hearing impairment, and facial dysmorphism. In the first family, whole-exome sequencing (WES) disclosed the novel TAB2 c.1398dup (p.Thr467Tyrfs*6) variant that eliminates the C-terminal zinc finger domain essential for activation of TAK1 (TGFβ-activated kinase 1)-dependent signaling pathways. The sporadic case carryed a ~2 Mb de novo deletion including 28 genes also comprising TAB2. This study reveal an association between TAB2 mutations and a phenotype resembling Ehlers-Danlos syndrome with severe polyvalvular heart disease and subtle facial dysmorphism. Our findings support the existence of a wider spectrum of clinical phenotypes associated with TAB2 perturbations and emphasize the role of TAK1 signaling network in human development. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Body Image and Eating Disorders

Directory of Open Access Journals (Sweden)

Janete Maximiano

2014-10-01

Full Text Available Eating disorders should be understood in a multidimensional perspective, emphasizing a biopsicossocial context. In these pathologies it`s the body, in the first instance, that reveals the disease, being in this way the target of the conflict, revealing a disturbed body experience and as a consequence a weak conception of their personal body image. The body image is conceptualised as a subjective image that the individuals form in their own mind, about their body, in relation with differ- ent contexts of life. The intent of the studies is to comprehend the level of body image disturbance, which have concluded that in the majority of the cases, significant changes on perceptive capacity of the patients do not exist. In this way it`s important to study in a more effective and qualitative way the affective and personal factors. The authors pretend with this bibliographic revision, make a research of body image assessment to the Eating Disorders (Anorexia Nervosa and Bulimia Nervosa, and to reflect which are the best ones to adapt for Portuguese reality.

Obsessive-compulsive disorder: an overview.

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Simpson, H B; Fallon, B A

2000-01-01

In this article, which is the first in a three-part series, the authors provide an overview of the current state of our knowledge of the phenomenology, etiology, and diagnosis of OCD. The DSM-IV criteria for OCD are presented and explicated. Disorders that are commonly comorbid with OCD (e.g., major depressive disorder, other anxiety dis-orders, Tourette's disorder) are described. The authors also discuss disorders such as body dysmorphic disorder that may be related to OCD and are often termed OCD spectrum disorders. OCD is likely to have multiple causes and the authors discuss behavioral, neuroanatomical, and neurochemical theories of OCD. Two treatments have demonstrated efficacy in OCD, cognitive-behavioral therapy and pharmacotherapy with serotonergic reuptake inhibitors, and the authors discuss how these treatments may work in light of what is known about the etiology of the disorder. The different subtypes of OCD that have been proposed are described along with their implications for treatment. The article concludes with a discussion of diagnosis that provides specific guidance for the clinician on how to assess a patient for possible OCD. The next two articles in this series will cover cognitive-behavioral and medication treatment in detail.

Excoriation (skin picking) disorder in Israeli University students

DEFF Research Database (Denmark)

Leibovici, Vera; Murad, Sari; Cooper-Kazaz, Rena

2014-01-01

, depression, obsessive-compulsive disorder, body dysmorphic disorder and disruptive, impulse control and conduct disorders. A total of 2176 participants (43.6%) responded and were included in the analysis. Mean age was 25.1 ± 4.8 (range 17-60) years, and 64.3% were female. RESULTS: The proportion of students...... who were screened positive for SPD was 3.03%, with a nearly equal gender distribution (3.0% in females and 3.1% in males). There was a trend toward significantly higher rates of psychiatric problems such as generalized anxiety, compulsive sexual behavior and eating disorders in these students. Within...... the group of students screening positive for SPD, alcohol intake was higher in male students, while female students perceived themselves as less attractive. No association was found between depression and SPD. A high prevalence rate of skin picking was found within first-degree family members...

Body Type, Self-Esteem and Assertiveness among High School Students in Ghana

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Daniel Bruce

2016-08-01

Full Text Available The aim of this study was to examine the relationship between body type, self-esteem and assertiveness among adolescents of ages between 13 and 19 years. To achieve this aim, the study sampled 56 male and 94 female adolescents of the Senior High School in Accra, Ghana. Results showed that, higher self-esteem leads to assertiveness. Results also showed that body type perception affects self-esteem. It is, therefore, recommended that Guidance and Counselling officers in our schools should educate adolescent students on the three body types and the advantages associated with being one of these body types. This may help prevent developing body dysmorphic disorder, low self-esteem and non-assertiveness among students with negative perceptions of their body types and the possible effects on their personal relationships with peers, general academic performance and in- school and out-of- school life.

Excoriation (skin-picking) disorder in adults: a cross-cultural survey of Israeli Jewish and Arab samples.

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Leibovici, Vera; Koran, Lorrin M; Murad, Sari; Siam, Ihab; Odlaug, Brian L; Mandelkorn, Uri; Feldman-Weisz, Vera; Keuthen, Nancy J

2015-04-01

We sought to estimate the lifetime prevalence of Excoriation (Skin-Picking) Disorder (SPD) in the Israeli adult population as a whole and compare SPD prevalence in the Jewish and Arab communities. We also explored demographic, medical and psychological correlates of SPD diagnosis. Questionnaires and scales screening for SPD, and assessing the severity of perceived stress, depression, obsessive-compulsive disorder (OCD), body dysmorphic disorder (BDD), alcohol use, illicit drug use, and medical disorders were completed in a sample of 2145 adults attending medical settings. The lifetime prevalence of SPD was 5.4% in the total sample; it did not differ between genders or within Jewish and Arab subsamples. Severity of depression (pcross-cultural variation in the correlates of this disorder. Copyright © 2014 Elsevier Inc. All rights reserved.

Generation of urine iPS cell line from a patient with obsessive-compulsive disorder using a non-integrative method

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Jaroslaw Sochacki

2016-07-01

Full Text Available Urine sample was collected from a 29-year-old male patient with an early onset form of DSM-5 obsessive-compulsive disorder (OCD, comorbid body dysmorphic and excoriation (skin-picking disorders, and a positive family history for OCD. Urine cell line was established and expanded for the reprogramming procedure. Induced pluripotent stem (iPS cells were derived using the integration-free CytoTune®-iPS 2.0 Sendai Reprogramming Kit, which includes Sendai virus particles of the four Yamanaka factors Oct3/4, Sox2, Klf4 and c-Myc.

Menstruation disorders in adolescents with eating disorders-target body mass index percentiles for their resolution.

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Vale, Beatriz; Brito, Sara; Paulos, Lígia; Moleiro, Pascoal

2014-04-01

To analyse the progression of body mass index in eating disorders and to determine the percentile for establishment and resolution of the disease. A retrospective descriptive cross-sectional study. Review of clinical files of adolescents with eating disorders. Of the 62 female adolescents studied with eating disorders, 51 presented with eating disorder not otherwise specified, 10 anorexia nervosa, and 1 bulimia nervosa. Twenty-one of these adolescents had menstrual disorders; in that, 14 secondary amenorrhea and 7 menstrual irregularities (6 eating disorder not otherwise specified, and 1 bulimia nervosa). In average, in anorectic adolescents, the initial body mass index was in 75th percentile; secondary amenorrhea was established 1 month after onset of the disease; minimum weight was 76.6% of ideal body mass index (at 4th percentile) at 10.2 months of disease; and resolution of amenorrhea occurred at 24 months, with average weight recovery of 93.4% of the ideal. In eating disorder not otherwise specified with menstrual disorder (n=10), the mean initial body mass index was at 85th percentile; minimal weight was in average 97.7% of the ideal value (minimum body mass index was in 52nd percentile) at 14.9 months of disease; body mass index stabilization occurred at 1.6 year of disease; and mean body mass index was in 73rd percentile. Considering eating disorder not otherwise specified with secondary amenorrhea (n=4); secondary amenorrhea occurred at 4 months, with resolution at 12 months of disease (mean 65th percentile body mass index). One-third of the eating disorder group had menstrual disorder - two-thirds presented with amenorrhea. This study indicated that for the resolution of their menstrual disturbance the body mass index percentiles to be achieved by female adolescents with eating disorders was 25-50 in anorexia nervosa, and 50-75, in eating disorder not otherwise specified.

Body-focused repetitive behavior disorders in ICD-11

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Jon E. Grant

2014-01-01

Full Text Available This article addresses the question of how body-focused repetitive behavior disorders (e.g., trichotillomania and skin-picking disorder should be characterized in ICD-11. The article reviews the historical nosology of the two disorders and the current approaches in DSM-5 and ICD-10. Although data are limited and mixed regarding the optimal relationship between body-focused repetitive behavior disorders and nosological categories, these conditions should be included within the obsessive-compulsive and related disorders category, as this is how most clinicians see these behaviors, and as this may optimize clinical utility. The descriptions of these disorders should largely mirror those in DSM-5, given the evidence from recent field surveys. The recommendations regarding ICD-11 and body-focused repetitive behavior disorders should promote the global identification and treatment of these conditions in primary care settings.

Hysteroscopic outpatient metroplasty to expand dysmorphic uteri (HOME-DU technique): a pilot study.

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Di Spiezio Sardo, A; Florio, P; Nazzaro, G; Spinelli, M; Paladini, D; Di Carlo, C; Nappi, C

2015-02-01

The new classification system of uterine anomalies from the European Society of Human Reproduction and Embryology and the European Society for Gynaecological Endoscopy defines T-shaped and tubular-shaped infantilis uteri as 'dysmorphic'. Such malformations have been proven to be associated with poor reproductive performance. A prospective observational study was conducted with 30 infertile women with dysmorphic uterus who underwent the novel Hysteroscopic Outpatient Metroplasty to Expand Dysmorphic Uteri (HOME-DU ) technique. Incisions are made on the uterine walls with a 5 Fr bipolar electrode. The procedure was conducted in outpatients under conscious sedation, using a 5-mm office hysteroscope. The technique was successful in all cases without complications. A net increase of uterine volume was found, as measured at hysteroscopy and three-dimensional transvaginal ultrasound (P dysmorphic uteri. Although the cohort was small, pregnancy and live births outcomes were favourable in this poor-prognosis group, implying desirable benefits, which should be compared with other techniques. Copyright © 2014 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

An autosomal recessive leucoencephalopathy with ischemic stroke, dysmorphic syndrome and retinitis pigmentosa maps to chromosome 17q24.2-25.3

OpenAIRE

Bouhouche Ahmed; Benomar Ali; Errguig Leila; Lachhab Lamiae; Bouslam Naima; Aasfara Jehanne; Sefiani Sanaa; Chabraoui Layachi; El Fahime Elmostafa; El Quessar Abdeljalil; Jiddane Mohamed; Yahyaoui Mohamed

2012-01-01

Abstract Background Single-gene disorders related to ischemic stroke seem to be an important cause of stroke in young patients without known risk factors. To identify new genes responsible of such diseases, we studied a consanguineous Moroccan family with three affected individuals displaying hereditary leucoencephalopathy with ischemic stroke, dysmorphic syndrome and retinitis pigmentosa that appears to segregate in autosomal recessive pattern. Methods All family members underwent neurologic...

Disordered eating behaviors and body image in male athletes

Directory of Open Access Journals (Sweden)

Fernanda Reistenbach Goltz

2013-09-01

Full Text Available Objective: To identify disordered eating behaviors and body image dissatisfaction, as well as their relationship to body fat (BF, among male athletes in high risk sports for eating disorders. Methods: One hundred and fifty-six male athletes were divided into the following categories: weight-class sports, sports where leanness improves performance, and sports with aesthetic ideals. BF was assessed and three questionnaires were used: the Eating Attitudes Test; the Bulimic Investigatory Test, Edinburgh; the Body Shape Questionnaire. Results: Disordered eating behaviors and body image dissatisfaction were found in 43 (27.6% and 23 athletes (14.7%, respectively, and an association was detected between the two variables (p < 0.001. Athletes with and without disordered eating behaviors did not differ in %BF (11.0±5.2% and 9.8±4.0%, respectively; p = 0.106. However, athletes with body image dissatisfaction had higher %BF than those who were satisfied (12.6±5.9% and 9.7±3.9%, respectively; p = 0.034. There were no differences in BF, frequency of disordered eating behaviors, and body image dissatisfaction between sports categories. Conclusion: Nearly one-quarter of athletes showed disordered eating behaviors, which was associated with body image dissatisfaction. Athletes with higher %BF were more likely to be dissatisfied with body image. There was no difference in eating behavior and body image between athletes from different sports categories.

Seizures and EEG features in 74 patients with genetic-dysmorphic syndromes.

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Alfei, Enrico; Raviglione, Federico; Franceschetti, Silvana; D'Arrigo, Stefano; Milani, Donatella; Selicorni, Angelo; Riva, Daria; Zuffardi, Orsetta; Pantaleoni, Chiara; Binelli, Simona

2014-12-01

Epilepsy is one of the most common findings in chromosome aberrations. Types of seizures and severity may significantly vary both between different conditions and within the same aberration. Hitherto specific seizures and EEG patterns are identified for only few syndromes. We studied 74 patients with defined genetic-dysmorphic syndromes with and without epilepsy in order to assess clinical and electroencephalographic features, to compare our observation with already described electro-clinical phenotypes, and to identify putative electroencephalographic and/or seizure characteristics useful to address the diagnosis. In our population, 10 patients had chromosomal disorders, 19 microdeletion or microduplication syndromes, and 32 monogenic syndromes. In the remaining 13, syndrome diagnosis was assessed on clinical grounds. Our study confirmed the high incidence of epilepsy in genetic-dysmorphic syndromes. Moreover, febrile seizures and neonatal seizures had a higher incidence compared to general population. In addition, more than one third of epileptic patients had drug-resistant epilepsy. EEG study revealed poor background organization in 42 patients, an excess of diffuse rhythmic activities in beta, alpha or theta frequency bands in 34, and epileptiform patterns in 36. EEG was completely normal only in 20 patients. No specific electro-clinical pattern was identified, except for inv-dup15, Angelman, and Rett syndromes. Nevertheless some specific conditions are described in detail, because of notable differences from what previously reported. Regarding the diagnostic role of EEG, we found that--even without any epileptiform pattern--the generation of excessive rhythmic activities in different frequency bandwidths might support the diagnosis of a genetic syndrome. © 2014 Wiley Periodicals, Inc.

Double trisomy 48,XXX,+18 with multiple dysmorphic features.

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Jiang, Zi-Yan; Wu, Xiao-Hui; Zou, Chao-Chun

2015-02-01

Chromosomal abnormality is a common cause of congenital anomalies, psychiatric disorders, and mental retardation. However, the double trisomy 48,XXX,+18 is a rare chromosome abnormality. Case report and literature review. A 7-hour-old girl presented to our unit because of poor response after birth. She presented with multiple dysmorphic features, including small for gestational age infant, flat nasal bridge, widely-spaced eyes, the left thumb deformities, flat facial profile, raised sternum, ventricular septal defect, the third lateral brain ventricle enlargement, and small liver. This case expands the spectrum of malformations reported in association with the double trisomy 48,XXX,+18. The literature on 16 fetuses or infants with the 48,XXX,+18 were also reviewed. These data suggested that in patients with clinical features similar to trisomy 18, especially with anomalies of the ears and/or reproductive malformations, double trisomy (48,XXX,+18) should be considered and karyotyping should be performed although it is a rare disease.

Feminist identity, body image, and disordered eating

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Borowsky, Hannah M.; Eisenberg, Marla E.; Bucchianeri, Michaela M.; Piran, Niva; Neumark-Sztainer, Dianne

2016-01-01

Using data from a community-based sample (Project EAT-III), this study (N = 1241; mean age = 25.2) examined the relationship of feminist identity with body image and disordered eating. Feminist-identified women reported significantly higher body satisfaction than non-feminist women and women who did not identify as feminists but held feminist beliefs. However, feminist-identified women did not differ from non-feminist women in disordered eating. Women holding feminist beliefs and non-feminist women did not differ in body satisfaction. Our findings suggest that self-identification as a feminist may promote positive body image in young adult women, but may be insufficient to change behaviors. PMID:26694553

Feminist identity, body image, and disordered eating.

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Borowsky, Hannah M; Eisenberg, Marla E; Bucchianeri, Michaela M; Piran, Niva; Neumark-Sztainer, Dianne

2016-01-01

Using data from a community-based sample (Project EAT-III), this study (N = 1241; mean age = 25.2) examined the relationship of feminist identity with body image and disordered eating. Feminist-identified women reported significantly higher body satisfaction than non-feminist women and women who did not identify as feminists but held feminist beliefs. However, feminist-identified women did not differ from non-feminist women in disordered eating. Women holding feminist beliefs and non-feminist women did not differ in body satisfaction. Our findings suggest that self-identification as a feminist may promote positive body image in young adult women, but may be insufficient to change behaviors.

Obsessive-compulsive skin disorders: a novel classification based on degree of insight.

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Zhu, Tian Hao; Nakamura, Mio; Farahnik, Benjamin; Abrouk, Michael; Reichenberg, Jason; Bhutani, Tina; Koo, John

2017-06-01

Individuals with obsessive-compulsive features frequently visit dermatologists for complaints of the skin, hair or nails, and often progress towards a chronic relapsing course due to the challenge associated with accurate diagnosis and management of their psychiatric symptoms. The current DSM-5 formally recognizes body dysmorphic disorder, trichotillomania, neurotic excoriation and body focused repetitive behavior disorder as psychodermatological disorders belonging to the category of Obsessive-Compulsive and Related Disorders. However there is evidence that other relevant skin diseases such as delusions of parasitosis, dermatitis artefacta, contamination dermatitis, AIDS phobia, trichotemnomania and even lichen simplex chronicus possess prominent obsessive-compulsive characteristics that do not necessarily fit the full diagnostic criteria of the DSM-5. Therefore, to increase dermatologists' awareness of this unique group of skin disorders with OCD features, we propose a novel classification system called Obsessive-Compulsive Insight Continuum. Under this new classification system, obsessive-compulsive skin manifestations are categorized along a continuum based on degree of insight, from minimal insight with delusional obsessions to good insight with minimal obsessions. Understanding the level of insight is thus an important first step for clinicians who routinely interact with these patients.

Eating Disorders and Body Image of Undergraduate Men

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Ousley, Louise; Cordero, Elizabeth Diane; White, Sabina

2008-01-01

Eating disorders and body dissatisfaction among undergraduate men are less documented and researched than are eating disorders and body dissatisfaction among undergraduate women. Objective and Participants: In this study, the authors examined these issues in undergraduate men to identify similarities and differences between this population and…

Body integrity identity disorder: deranged body processing, right fronto-parietal dysfunction, and phenomenological experience of body incongruity.

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Giummarra, Melita J; Bradshaw, John L; Nicholls, Michael E R; Hilti, Leonie M; Brugger, Peter

2011-12-01

Body integrity identity disorder (BIID) is characterised by profound experience of incongruity between the biological and desired body structure. The condition manifests in "non-belonging" of body parts, and the subsequent desire to amputate, paralyse or disable a limb. Little is known about BIID; however, a neuropsychological model implicating right fronto-parietal and insular networks is emerging, with potential disruption to body representation. We argue that, as there is scant systematic research on BIID published to date and much of the research is methodologically weak, it is premature to assume that the only process underlying bodily experience that is compromised is body representation. The present review systematically investigates which aspects of neurological processing of the body, and sense of self, may be compromised in BIID. We argue that the disorder most likely reflects dysregulation in multiple levels of body processing. That is, the disunity between self and the body could arguably come about through congenital and/or developmental disruption of body representations, which, together with altered multisensory integration, may preclude the experience of self-attribution and embodiment of affected body parts. Ulimately, there is a need for official diagnostic criteria to facilitate epidemiological characterisation of BIID, and for further research to systematically investigate which aspects of body representation and processing are truly compromised in the disorder.

Photoanthropometric study of dysmorphic features of the face in children with autism and asperger syndrome.

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Gorczyca, Piotr; Kapinos-Gorczyca, Agnieszka; Ziora, Katarzyna; Oświęcimska, Joanna

2012-01-01

Childhood autism is a neurodevelopmental disorder characterized by impairments in social interactions, verbal and non-verbal communication and by a pattern of stereotypical behaviors and interests. The aim of this study was to estimate the dysmorphic facial features of children with autism and children with Asperger syndrome. The examination was conducted on 60 children (30 with childhood autism and 30 with Asperger syndrome). The photo anthropometric method used in this study followed the protocol established by Stengel-Rutkowski et al. The performed statistical analysis showed that in patients with childhood autism, the anteriorly rotated ears and the long back of the nose appeared more often. In the group of children with autism, there was a connection between the amount of dysmorphies and the presence of some somatic diseases in the first-degree relatives. There was also a connection between the motor coordination and the age the child began to walk. In patients with childhood autism, there were certain dysmorphies (like the anterior rotated ears and the long back of the nose) which appeared more often. Although the connection was not statistically significant, it seemed to concur with data from the literature. Formulation of the other conclusions would require broader studies e.g. dealing with a familial analysis of dysmorphic features.

Body composition, disordered eating and menstrual regularity in a ...

African Journals Online (AJOL)

Body composition, disordered eating and menstrual regularity in a group of South African ... e between body composition and disordered eating in irregular vs normal menstruating athletes. ... measured by air displacement plethysmography.

Body integrity identity disorder.

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Blom, Rianne M; Hennekam, Raoul C; Denys, Damiaan

2012-01-01

Body Integrity Identity Disorder (BIID) is a rare, infrequently studied and highly secretive condition in which there is a mismatch between the mental body image and the physical body. Subjects suffering from BIID have an intense desire to amputate a major limb or severe the spinal cord in order to become paralyzed. Aim of the study is to broaden the knowledge of BIID amongst medical professionals, by describing all who deal with BIID. Somatic, psychiatric and BIID characteristic data were collected from 54 BIID individuals using a detailed questionnaire. Subsequently, data of different subtypes of BIID (i.e. wish for amputation or paralyzation) were evaluated. Finally, disruption in work, social and family life due to BIID in subjects with and without amputation were compared. Based on the subjects' reports we found that BIID has an onset in early childhood. The main rationale given for their desire for body modification is to feel complete or to feel satisfied inside. Somatic and severe psychiatric co-morbidity is unusual, but depressive symptoms and mood disorders can be present, possibly secondary to the enormous distress BIID puts upon a person. Amputation and paralyzation variant do not differ in any clinical variable. Surgery is found helpful in all subjects who underwent amputation and those subjects score significantly lower on a disability scale than BIID subjects without body modification. The amputation variant and paralyzation variant of BIID are to be considered as one of the same condition. Amputation of the healthy body part appears to result in remission of BIID and an impressive improvement of quality of life. Knowledge of and respect for the desires of BIID individuals are the first steps in providing care and may decrease the huge burden they experience.

Body integrity identity disorder.

Directory of Open Access Journals (Sweden)

Rianne M Blom

Full Text Available INTRODUCTION: Body Integrity Identity Disorder (BIID is a rare, infrequently studied and highly secretive condition in which there is a mismatch between the mental body image and the physical body. Subjects suffering from BIID have an intense desire to amputate a major limb or severe the spinal cord in order to become paralyzed. Aim of the study is to broaden the knowledge of BIID amongst medical professionals, by describing all who deal with BIID. METHODS: Somatic, psychiatric and BIID characteristic data were collected from 54 BIID individuals using a detailed questionnaire. Subsequently, data of different subtypes of BIID (i.e. wish for amputation or paralyzation were evaluated. Finally, disruption in work, social and family life due to BIID in subjects with and without amputation were compared. RESULTS: Based on the subjects' reports we found that BIID has an onset in early childhood. The main rationale given for their desire for body modification is to feel complete or to feel satisfied inside. Somatic and severe psychiatric co-morbidity is unusual, but depressive symptoms and mood disorders can be present, possibly secondary to the enormous distress BIID puts upon a person. Amputation and paralyzation variant do not differ in any clinical variable. Surgery is found helpful in all subjects who underwent amputation and those subjects score significantly lower on a disability scale than BIID subjects without body modification. CONCLUSIONS: The amputation variant and paralyzation variant of BIID are to be considered as one of the same condition. Amputation of the healthy body part appears to result in remission of BIID and an impressive improvement of quality of life. Knowledge of and respect for the desires of BIID individuals are the first steps in providing care and may decrease the huge burden they experience.

Body image, eating disorders, and the media.

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Hogan, Marjorie J; Strasburger, Victor C

2008-12-01

Adolescence is a time of tremendous change in physical appearance. Many adolescents report dissatisfaction with their body shape and size. Forming one's body image is a complex process, influenced by family, peers, and media messages. Increasing evidence shows that the combination of ubiquitous ads for foods and emphasis on female beauty and thinness in both advertising and programming leads to confusion and dissatisfaction for many young people. Sociocultural factors, specifically media exposure, play an important role in the development of disordered body image. Of significant concern, studies have revealed a link between media exposure and the likelihood of having symptoms of disordered eating or a frank eating disorder. Pediatricians and other adults must work to promote media education and make media healthier for young people. More research is needed to identify the most vulnerable children and adolescents.

Inner body and outward appearance: the relationships between appearance orientation, eating disorder symptoms, and internal body awareness.

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Spoor, Sonja T P; Bekker, Marrie H J; Van Heck, Guus L; Croon, Marcel A; Van Strien, Tatjana

2005-01-01

This study investigated the associations of appearance orientation and eating disorder symptoms with internal body awareness in an eating-disordered group of women and a general sample of women. In the eating-disordered group, appearance orientation was positively associated with internal body awareness. Eating disorders symptoms were negatively related to the awareness of bodily signals. No significant associations were found in the general sample of women. The results indicate that in eating-disordered individuals preoccupation with the body and eating-disordered behaviors are not only negatively associated with hunger, but with awareness of other bodily signals as well.

Brain imaging findings of patients with congenital cataracts, facial dysmorphism neuropathy syndrome

International Nuclear Information System (INIS)

Zlatareva, D.; Penev, L.; Hadjidekov, V.; Chamova, T.; Guergeltcheva, V.; Tournev, I.; Tournev, I.; Bojinova, V.; Kaprelian, A.; Tzoneva, D.

2012-01-01

Congenital cataracts, facial dysmorphism neuropathy (CCFDN) syndrome is a rare genetic disorder of autosomal recessive inheritance, observed in patients of Gypsy ancestry. All patients are homozygous for the same mutation in the CTDP1 gene mapping to 18qter. The clinical manifestations of the disease include congenital cataracts, facial dysmorphism, peripheral neuropathy due to primary hypomyelination, intellectual impairment and involvement of central nervous system.The aim of this study is to analyze CNS magnetic resonance imaging findings of patients with CCFDN syndrome and to apply severity score system. MRI of 20 patients (10 children - 4 girls and 6 boys and 10 adults - 6 women and 4 men with CCFDN was performed on 1,5T unit. We apply severity score system (previously used for metachromatic leukodystrophy) to evaluate patients with CCFDN which was adapted to the changes observed in CCFDN patients. This score system assessed WM involvement, as well as the presence of cerebral and cerebellar atrophy. We have found pathologic findings in 19 patients (95%). White matter hyperintensities were found in 18 and cerebral atrophy in 18 patients. The severity score have varied from 0 to 18 points. In contrast to previous studies we have found higher frequency of white matter hyperintensities. The findings are more prominent with patients' age. The most common MRI findings are cerebral atrophy and periventricular hyperintensities. This study gives the first detailed description of MRI findings in CCFDN syndrome patients where severity score system was applied. The score system could be applied in follow-up studies to evaluate progression of CNS findings. (authors)

Thought–shape fusion and body image in eating disorders

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Jáuregui-Lobera I

2012-10-01

Full Text Available Ignacio Jáuregui-Lobera,1 Patricia Bolaños-Ríos,2 Inmaculada Ruiz-Prieto21Department of Nutrition and Bromatology, Pablo de Olavide University, Seville, Spain; 2Behavioral Sciences Institute, Seville, SpainPurpose: The aim of this study was to analyze the relationships among thought–shape fusion (TSF, specific instruments to assess body image disturbances, and body image quality of life in eating disorder patients in order to improve the understanding of the links between body image concerns and a specific bias consisting of beliefs about the consequences of thinking about forbidden foods.Patients and methods: The final sample included 76 eating disorder patients (mean age 20.13 ± 2.28 years; 59 women and seven men. After having obtained informed consent, the following questionnaires were administered: Body Appreciation Scale (BAS, Body Image Quality of Life Inventory (BIQLI-SP, Body Shape Questionnaire (BSQ, Eating Disorders Inventory-2 (EDI-2, State-Trait Anxiety Inventory (STAI, Symptom Checklist-90-Revised (SCL-90-R and Thought-Shape Fusion Questionnaire (TSF-Q.Results: Significant correlations were found between TSF-Q and body image-related variables. Those with higher scores in TSF showed higher scores in the BSQ (P < 0.0001, Eating Disorder Inventory – Drive for Thinness (EDI-DT (P < 0.0001, and Eating Disorder Inventory – Body Dissatisfaction (EDI-BD (P < 0.0001. The same patients showed lower scores in the BAS (P < 0.0001. With respect to the psychopathological variables, patients with high TSF obtained higher scores in all SCL-90-R subscales as well as in the STAI.Conclusion: The current study shows the interrelations among different body image-related variables, TSF, and body image quality of life.Keywords: cognitive distortions, quality of life, body appreciation, psychopathology, anorexia nervosa, bulimia nervosa

Potential role of anticonvulsants in the treatment of obsessive-compulsive and related disorders.

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Wang, Hee Ryung; Woo, Young Sup; Bahk, Won-Myong

2014-10-01

We reviewed the extant literature to evaluate the current evidence regarding the efficacy and safety of anticonvulsants in the treatment of obsessive-compulsive and related disorders. Relevant literature was accessed using the Cochrane database, embase and PubMed on 29 October 2013. Prospective studies examining the efficacy of anticonvulsants in obsessive-compulsive and related disorders were included. Case reports, case series, and retrospective studies were excluded. A total of 10 studies were included in this review. The studies of obsessive-compulsive disorder, except for two negative studies, showed favorable efficacy results of anticonvulsants. In one study on body dysmorphic disorder, levetiracetam showed favorable efficacy. In two lamotrigine studies for pathologic skin-picking, the efficacy findings were inconsistent. In one trichotillomania study, topiramate had reduced hair-pulling symptoms. Despite limited evidence, our review suggests that anticonvulsants have a potential role in the treatment of obsessive-compulsive and related disorders. © 2014 The Authors. Psychiatry and Clinical Neurosciences © 2014 Japanese Society of Psychiatry and Neurology.

Age of heart disease presentation and dysmorphic nuclei in patients with LMNA mutations.

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Core, Jason Q; Mehrabi, Mehrsa; Robinson, Zachery R; Ochs, Alexander R; McCarthy, Linda A; Zaragoza, Michael V; Grosberg, Anna

2017-01-01

Nuclear shape defects are a distinguishing characteristic in laminopathies, cancers, and other pathologies. Correlating these defects to the symptoms, mechanisms, and progression of disease requires unbiased, quantitative, and high-throughput means of quantifying nuclear morphology. To accomplish this, we developed a method of automatically segmenting fluorescently stained nuclei in 2D microscopy images and then classifying them as normal or dysmorphic based on three geometric features of the nucleus using a package of Matlab codes. As a test case, cultured skin-fibroblast nuclei of individuals possessing LMNA splice-site mutation (c.357-2A>G), LMNA nonsense mutation (c.736 C>T, pQ246X) in exon 4, LMNA missense mutation (c.1003C>T, pR335W) in exon 6, Hutchinson-Gilford Progeria Syndrome, and no LMNA mutations were analyzed. For each cell type, the percentage of dysmorphic nuclei, and other morphological features such as average nuclear area and average eccentricity were obtained. Compared to blind observers, our procedure implemented in Matlab codes possessed similar accuracy to manual counting of dysmorphic nuclei while being significantly more consistent. The automatic quantification of nuclear defects revealed a correlation between in vitro results and age of patients for initial symptom onset. Our results demonstrate the method's utility in experimental studies of diseases affecting nuclear shape through automated, unbiased, and accurate identification of dysmorphic nuclei.

Polish normalization of the Body Esteem Scale

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Małgorzata Lipowska

2014-02-01

Full Text Available Background Physical attractiveness plays an important part in one’s social functioning. The interest in one’s own appearance have been documented as widespread among the female population, but over the recent years it is more and more often emphasized that concentrating on body appearance concerns men as well. Franzoi and Shields (1984 created the Body Esteem Scale which allows to qualify the subject’s attitude towards his or her own body. The aim of the study was to create a Polish version of the Body Esteem Scale along with the norms for age and sex clusters. Participants and procedure The normalization sample consisted of 4298 participants: 1865 women aged 16 to 80 (M = 29.92; SD = 12.85 and 2433 men aged 16 to 78 (M = 28.74; SD = 11.50. Education levels among the participants were also controlled for. In order to create a Polish version of the Body Esteem Scale, translation was adopted as the adaptation strategy. Like the original one, the Polish scale comprises 35 items grouped into three gender specific subscales. The subscales for women include Sexual Attractiveness, Weight Concern, and Physical Condition, whereas the body esteem of is examined with regards to Physical Attractiveness, Upper Body Strength, and Physical Condition. Results Reliability of subscales was high both for females (Cronbach’s alpha from 0.80 to 0.89 and males (Cronbach’s alpha from 0.85 to 0.88. The given coefficients of reliability cover the original division into subscales adopted by the authors of BES. Conclusions We confirmed high reliability of the Polish version of the Body Esteem Scale, thus we recommend it as a diagnostic tool. Created norms allowed to refer results obtained in the course of research carried out on people with various disorders (e.g. eating disorders or body dysmorphic disorder with population data for corresponding age brackets.

I-Metaiodobenzylguanidine Myocardial Scintigraphy in Lewy Body-Related Disorders: A Literature Review

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Eun Joo Chung

2015-05-01

Full Text Available Lewy body-related disorders are characterized by the presence of Lewy bodies and Lewy neurites, which have abnormal aggregations of α-synuclein in the nigral and extranigral areas, including in the heart. 123I-metaiodobenzylguanidine (MIBG scintigraphy is a well-known tool to evaluate cardiac sympathetic denervation in the Lewy body-related disorders. MIBG scintigraphy showed low uptake of MIBG in the Lewy body-related disorders, including Parkinson’s disease, dementia with Lewy bodies, pure autonomic failure and rapid eye movement sleep behavior disorder. This review summarizes previous results on the diagnostic applications of MIBG scintigraphy in Lewy body-related disorders.

Similar PDK1-AKT-mTOR pathway activation in balloon cells and dysmorphic neurons of type II focal cortical dysplasia with refractory epilepsy.

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Lin, Yuan-xiang; Lin, Kun; Kang, De-zhi; Liu, Xin-xiu; Wang, Xing-fu; Zheng, Shu-fa; Yu, Liang-hong; Lin, Zhang-ya

2015-05-01

Dysmorphic neurons and balloon cells constitute the neuropathological hallmarks of type II focal cortical dysplasias (FCDs) with refractory epilepsy. The genesis of these cells may be critical to the histological findings in type II FCD. Recent work has shown enhanced activation of the mTOR cascade in both balloon cells and dysmorphic neurons, suggesting a common pathogenesis for these two neuropathological hallmarks. A direct comparative analysis of balloon cells and dysmorphic neurons might identify a molecular link between balloon cells and dysmorphic neurons. Here, we addressed whether PDK1-AKT-mTOR activation differentiates balloon cells from dysmorphic neurons. We used immunohistochemistry with antibodies against phosphorylated (p)-PDK1 (Ser241), p-AKT (Thr308), p-AKT (Ser473), p-mTOR (Ser2448), p-P70S6K (Thr229), and p-p70S6 kinase (Thr389) in balloon cells compared with dysmorphic neurons. Strong or moderate staining for components of the PDK1-AKT-mTOR signaling pathway was observed in both balloon cells and dysmorphic neurons. However, only a few pyramidal neurons displayed weak staining in control group (perilesional neocortex and histologically normal neocortex). Additionally, p-PDK1 (Ser241) and p-AKT (Thr308) staining in balloon cells were stronger than in dysmorphic neurons, whereas p-P70S6K (Thr229) and p-p70S6 kinase (Thr389) staining in balloon cells was weaker than in dysmorphic neurons. In balloon cells, p-AKT (Ser473) and p-mTOR (Ser2448) staining was comparable with the staining in dysmorphic neurons. Our data support the previously suggested pathogenic relationship between balloon cells and dysmorphic neurons concerning activation of the PDK1-AKT-mTOR, which may play important roles in the pathogenesis of type II FCD. Differential expression of some components of the PDK1-AKT-mTOR pathway between balloon cells and dysmorphic neurons may result from cell-specific gene expression. Copyright © 2015 Elsevier B.V. All rights reserved.

Body image, media, and eating disorders.

Science.gov (United States)

Derenne, Jennifer L; Beresin, Eugene V

2006-01-01

Eating disorders, including obesity, are a major public health problem today. Throughout history, body image has been determined by various factors, including politics and media. Exposure to mass media (television, movies, magazines, Internet) is correlated with obesity and negative body image, which may lead to disordered eating. The authors attempt to explain the historical context of the problem and explore potential avenues for change. The authors review changes in ideal female body type throughout history, comment on current attitudes toward shape and weight in both men and women, and outline interventions aimed at increasing healthy habits and fostering self-esteem in youth. Throughout history, the ideal of beauty has been difficult to achieve and has been shaped by social context. Current mass media is ubiquitous and powerful, leading to increased body dissatisfaction among both men and women. Parents need to limit children's exposure to media, promote healthy eating and moderate physical activity, and encourage participation in activities that increase mastery and self-esteem. Funding for high-quality, visible advertising campaigns promoting healthy life styles may increase awareness.

Inner body and outward appearance: The relationships among appearance orientation, eating disorder symptoms, and internal body awareness

NARCIS (Netherlands)

Spoor, S.T.P.; Bekker, M.H.J.; Heck, G.L. van; Croon, M.A.; Strien, T. van

2005-01-01

This study investigated the associations of appearance orientation and eating disorder symptoms with internal body awareness in an eating-disordered group of women and a general sample of women. In the eating-disordered group, appearance orientation was positively associated with internal body

Photoanthropometric Study of Dysmorphic Features of the Face in Children with Autism and Asperger Syndrome

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Katarzyna Ziora

2012-04-01

Full Text Available Objective: Childhood autism is a neurodevelopmental disorder characterized by impairments in social interactions, verbal and non-verbal communication and by a pattern of stereotypical behaviors and interests. The aim of this study was to estimate the dysmorphic facial features of children with autism and children with Asperger syndrome . Methods: The examination was conducted on 60 children (30 with childhood autism and 30 with Asperger syndrome. The photo anthropometric method used in this study followed the protocol established by Stengel-Rutkowski et al . Results: The performed statistical analysis showed that in patients with childhood autism, the anteriorly rotated ears and the long back of the nose appeared more often. In the group of children with autism, there was a connection between the amount of dysmorphies and the presence of some somatic diseases in the first-degree relatives. There was also a connection between the motor coordination and the age the child began to walk. Discussion: In patients with childhood autism, there were certain dysmorphies (like the anterior rotated ears and the long back of the nose which appeared more often. Although the connection was not statistically significant, it seemed to concur with data from the literature . Conclusion: Formulation of the other conclusions would require broader studies e.g. dealing with a familial analysis of dysmorphic features.

Male body image in Taiwan versus the West: Yanggang Zhiqi meets the Adonis complex.

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Yang, Chi-Fu Jeffrey; Gray, Peter; Pope, Harrison G

2005-02-01

Body image disorders appear to be more prevalent in Western than non-Western men. Previous studies by the authors have shown that young Western men display unrealistic body ideals and that Western advertising seems to place an increasing value on the male body. The authors hypothesized that Taiwanese men would exhibit less dissatisfaction with their bodies than Western men and that Taiwanese advertising would place less value on the male body than Western media. The authors administered a computerized test of body image to 55 heterosexual men in Taiwan and compared the results to those previously obtained in an identical study in the United States and Europe. Second, they counted the number of undressed male and female models in American versus Taiwanese women's magazine advertisements. In the body image study, the Taiwanese men exhibited significantly less body dissatisfaction than their Western counterparts. In the magazine study, American magazine advertisements portrayed undressed Western men frequently, but Taiwanese magazines portrayed undressed Asian men rarely. Taiwan appears less preoccupied with male body image than Western societies. This difference may reflect 1) Western traditions emphasizing muscularity and fitness as a measure of masculinity, 2) increasing exposure of Western men to muscular male bodies in media images, and 3) greater decline in traditional male roles in the West, leading to greater emphasis on the body as a measure of masculinity. These factors may explain why body dysmorphic disorder and anabolic steroid abuse are more serious problems in the West than in Taiwan.

Overestimation of body size in eating disorders and its association to body-related avoidance behavior.

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Vossbeck-Elsebusch, Anna N; Waldorf, Manuel; Legenbauer, Tanja; Bauer, Anika; Cordes, Martin; Vocks, Silja

2015-06-01

Body-related avoidance behavior, e.g., not looking in the mirror, is a common feature of eating disorders. It is assumed that it leads to insufficient feedback concerning one's own real body form and might thus contribute to distorted mental representation of one's own body. However, this assumption still lacks empirical foundation. Therefore, the aim of the present study was to examine the relationship between misperception of one's own body and body-related avoidance behavior in N = 78 female patients with Bulimia nervosa and eating disorder not otherwise specified. Body-size misperception was assessed using a digital photo distortion technique based on an individual picture of each participant which was taken in a standardized suit. In a regression analysis with body-related avoidance behavior, body mass index and weight and shape concerns as predictors, only body-related avoidance behavior significantly contributed to the explanation of body-size overestimation. This result supports the theoretical assumption that body-related avoidance behavior makes body-size overestimation more likely.

Phantom Sensations, Supernumerary Phantom Limbs and Apotemnophilia: Three Body Representation Disorders.

Science.gov (United States)

Tatu, Laurent; Bogousslavsky, Julien

2018-01-01

Body representation disorders continue to be mysterious and involve the anatomical substrate that underlies the mental representation of the body. These disorders sit on the boundaries of neurological and psychiatric diseases. We present the main characteristics of 3 examples of body representation disorders: phantom sensations, supernumerary phantom limb, and apotemnophilia. The dysfunction of anatomical circuits that regulate body representation can sometimes have paradoxical features. In the case of phantom sensations, the patient feels the painful subjective sensation of the existence of the lost part of the body after amputation, surgery or trauma. In case of apotemnophilia, now named body integrity identity disorder, the subject wishes for the disappearance of the existing and normal limb, which can occasionally lead to self-amputation. More rarely, a brain-damaged patient with 4 existing limbs can report the existence of a supernumerary phantom limb. © 2018 S. Karger AG, Basel.

The bizarre request for amputation.

Science.gov (United States)

Barnes, Rachel

2011-12-01

Apotemnophilia is a condition where sufferers wish to be an amputee. Currently, belief in the medical profession is that it is part of the spectrum of body dysmorphic disorder and as such patients are denied surgical correction. This can lead sufferers to extreme lengths. Proponents seek to have the disorder reclassified to a body identity integrity disorder such as gender identity disorder. In this way treatment modalities could be reassessed.

Dysmorphic features and developmental outcome of 2-year-old children

NARCIS (Netherlands)

Seggers, Jorien; Haadsma, Maaike L.; Bos, Arend F.; Heineman, Maas Jan; Middelburg, Karin J.; van den Heuvel, Edwin R.; Hadders-Algra, Mijna

2014-01-01

The aim of this study was to assess the associations between dysmorphic features and neurological, mental, psychomotor, and behavioural development in order to improve our understanding of aetiological pathways leading to minor developmental problems. In our cross-sectional study, 272 generally

The prevalence of body dysmorphic disorder among South African ...

African Journals Online (AJOL)

14 items ... The prevalence of BDD among student populations ranges from. 2.3% in Australia ... since students tend to have a younger mean age than participants ... Proportionate stratified random cluster sampling was used to select the sample. ... In order to ensure optimal ... variables was determined by calculating Pearson.

Dysmorphic features and developmental outcome of 2-year-old children

NARCIS (Netherlands)

Seggers, Jorien; Haadsma, Maaike L.; Bos, Arend F.; Heineman, Maas Jan; Middelburg, Karin J.; Van den Heuvel, Edwin R.; Hadders-Algra, Mijna

2014-01-01

AimThe aim of this study was to assess the associations between dysmorphic features and neurological, mental, psychomotor, and behavioural development in order to improve our understanding of aetiological pathways leading to minor developmental problems. MethodIn our cross-sectional study, 272

Breast Hypertrophy, Reduction Mammaplasty, and Body Image.

Science.gov (United States)

Fonseca, Cristiane Costa; Veiga, Daniela Francescato; Garcia, Edgard da Silva; Cabral, Isaías Vieira; de Carvalho, Monique Maçais; de Brito, Maria José Azevedo; Ferreira, Lydia Masako

2018-02-07

Body image dissatisfaction is one of the major factors that motivate patients to undergo plastic surgery. However, few studies have associated body satisfaction with reduction mammaplasty. The aim of this study was to evaluate the impact of breast hypertrophy and reduction mammaplasty on body image. Breast hypertrophy patients, with reduction mammaplasty already scheduled between June 2013 and December 2015 (mammaplasty group, MG), were prospectively evaluated through the body dysmorphic disorder examination (BDDE), body investment scale (BIS), and breast evaluation questionnaire (BEQ55) tools. Women with normal-sized breasts were also evaluated as study controls (normal-sized breast group, NSBG). All the participants were interviewed at the initial assessment and after six months. Data were analyzed before and after six months. Each group consisted of 103 women. The MG group had a significant improvement in BDDE, BIS, and BEQ55 scores six months postoperatively (P ≤ 0.001 for the three instruments), whereas the NSBG group showed no alteration in results over time (P = 0.876; P = 0.442; and P = 0.184, respectively). In the intergroup comparison it was observed that the MG group began to invest more in the body, similarly to the NSBG group, and surpassed the level of satisfaction and body image that the women of the NSBG group had after the surgery. Reduction mammaplasty promoted improvement in body image of women with breast hypertrophy. © 2018 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com

Body-to-Body-Communication and Somatoform Disorder in China: A Case Study Regarding Culture and Gender

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Ulrich Sollmann

2017-08-01

Full Text Available Somatoform disorder and somatic symptom disorder (SSD are resistant to traditional medical support. Patients experience a vicious cycle of focused awareness/attention towards distressing bodily sensations. A negative interpretation of these phenomena leads to “worrying, cognitive styles” concerning the body (body-image, which enhances further self-awareness/self-observation towards unpleasant bodily sensations and hyper-arousal. Body-psychotherapy may be one approach appropriate in dealing with these disorders and syndromes. This article addresses the concept of creative body-work, defines its basic guidelines and aims, and demonstrates a practical approach to support patient familiarization with body-self-experience and how to establish a basic contact (relationship and control the vicious negative cycle. A positive working definition of somatoform disorder would include the following: illness perception and illness attribution; illness behaviour; health-related anxiety; emotional distress; disability; quality of life; doctor-patient-interaction and health care utilisation. This article relates to specific cultural aspects working with patients in China within a one-day professional workshop including clinical observations and analysis. It also refers to the gender perspective. Psychotherapy and psychosomatics more and more also have to consider these perspectives.

Binge Eating Disorder and Body Uneasiness

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Massimo Cuzzolaro

2008-12-01

Full Text Available Debate continues regarding the nosological status of binge eating disorder (BED and the specific diagnostic criteria, including whether, like anorexia nervosa and bulimia nervosa, it should be characterized by body image disturbances in addition to abnormal eating behaviour. The aims of this article are: a to concisely review the main points of the literature that has developed on diagnosis and treatment (especially pharmacological of BED and b to present the results of an original research on body image in obese patients with BED. The study was aimed to verify the following hypothesis: in persons with obesity, BED is associated with greater body uneasiness independently of some possible modulating factors. We studied a clinical sample of 159 (89 females and 70 males adult obese patients who fulfilled DSM-IV-TR diagnostic criteria for BED matched to 159 non-BED obese patients for gender, ethnicity, BMI class, age, weight, stature, onset age of obesity, education level, and marital status. We used the Body Uneasiness Test (BUT, a valuable multidimensional tool for the clinical assessment of body uneasiness in subjects suffering from eating disorders and/or obesity. Obese patients with BED reported higher scores than non-BED patients in the General Severity Index (BUT-A GSI and in every BUT-A subscale. All differences were statistically significant in both sexes. As expected women obtained higher scores than men. According to some other studies, our findings suggest that a negative body image should be included among diagnostic criteria for BED. Consequently, treatment should be focused not simply on eating behaviour and outcome studies should evaluate changes of body image as well.

Body image and nonsuicidal self-injury: Validation of the Body Investment Scale in participants with eating disorders.

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Marco, J H; Cañabate, M; García-Alandete, J; Llorca, G; Real-López, M; Beltrán, M; Pérez, S

2018-01-01

The Body Investment Scale (BIS) assesses body image feelings, body care, protection of the body, and comfort in touch, in order to identify and distinguish participants with self-harming and self-destructive tendencies. However, the psychometric properties of the BIS were not analysed in participants diagnosed with eating disorders. The main objective of the present study is to confirm the factor structure of the Spanish version of the BIS and analyse its psychometric properties in a sample composed of women diagnosed with eating disorders. Participants were 250 Spanish women between 12 and 60 years old (M = 26.05, SD = 11.97) diagnosed with eating disorders. A confirmatory factor analysis showed a poor fit of the original BIS. The final model showed an acceptable 4-factor structure (Body Feelings, α = .88; Body Touch, α = .82; Body Protection, α = .77; Body Care, α = .68), with a good fit to the data (SBχ 2 (246)  = 393.21, CFI = .906, IFI = .908, RMSEA = .049). The relationships between the BIS and both the Purpose-In-Life Test-10 Items and Beck Hopelessness Scale were analysed, as well as differences in the BIS score according to nonsuicidal self-injuries and suicidal ideation in the past year. The BIS is an appropriate instrument to assess the body investment dimension of body image in women with eating disorders. Copyright © 2017 John Wiley & Sons, Ltd.

Classifying dysmorphic syndromes by using artificial neural network based hierarchical decision tree.

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Özdemir, Merve Erkınay; Telatar, Ziya; Eroğul, Osman; Tunca, Yusuf

2018-05-01

Dysmorphic syndromes have different facial malformations. These malformations are significant to an early diagnosis of dysmorphic syndromes and contain distinctive information for face recognition. In this study we define the certain features of each syndrome by considering facial malformations and classify Fragile X, Hurler, Prader Willi, Down, Wolf Hirschhorn syndromes and healthy groups automatically. The reference points are marked on the face images and ratios between the points' distances are taken into consideration as features. We suggest a neural network based hierarchical decision tree structure in order to classify the syndrome types. We also implement k-nearest neighbor (k-NN) and artificial neural network (ANN) classifiers to compare classification accuracy with our hierarchical decision tree. The classification accuracy is 50, 73 and 86.7% with k-NN, ANN and hierarchical decision tree methods, respectively. Then, the same images are shown to a clinical expert who achieve a recognition rate of 46.7%. We develop an efficient system to recognize different syndrome types automatically in a simple, non-invasive imaging data, which is independent from the patient's age, sex and race at high accuracy. The promising results indicate that our method can be used for pre-diagnosis of the dysmorphic syndromes by clinical experts.

[Body image disorder in 100 Tunisian female breast cancer patients].

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Faten, Ellouze; Nader, Marrakchi; Raies, Hend; Sana, Masmoudi; Amel, Mezlini; Fadhel, M'rad Mohamed

2018-04-01

This study aimed at tracking the prevalence of body image disorder in a population of Tunisian women followed for breast cancer and the factors associated with it. The cross-sectional study was conducted at Salah-Azaiez Institute in Tunis, over a period of four months. One hundred outpatients followed for confirmed breast cancer were recruited. The questionnaire targeted the women's sexuality and their couple relationships, along with their socio-demographic, clinical, and therapeutic characteristics. The scales used were BIS, HADS, and FSFI. The prevalence of body image disorder according to BIS was 45% with an average of 11.5±11.2 among the interrogated patients, 24.7% of which reported an alteration in their couple relationships and 47% in their sexual relations. In univariate analysis, body image disorder was associated with family support, change in couple relationship, depression and anxiety. Body image disorder and sexual dysfunction were interrelated: each of them fostered the prevalence of the other. Multivariate analysis showed that occupational activity was an independent predictor and the absence of anxiety an independent protective factor. Body image disorder was an independent predictive factor of depression and anxiety. The quality of couple relation and sexuality, along with the impact of the patient's surrounding are decisive for the protection or alteration of her body image. Copyright © 2018 Société Française du Cancer. Published by Elsevier Masson SAS. All rights reserved.

Body Awareness in Preschool Children with Psychiatric Disorder

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Simons, J.; Leitschuh, C.; Raymaekers, A.; Vandenbussche, I.

2011-01-01

The purpose of this study was to investigate the body awareness of preschool children with a psychiatric disorder as measured by the test imitation of gestures (Berges & Lezine, 1978), using the subsections for pointing to body parts (passive vocabulary) and naming body parts (active vocabulary). Seventy-seven children from 37 to 72 months of age…

Body checking and body avoidance in eating disorders: Systematic review and meta-analysis.

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Nikodijevic, Alexandra; Buck, Kimberly; Fuller-Tyszkiewicz, Matthew; de Paoli, Tara; Krug, Isabel

2018-05-01

This review sought to systematically review and quantify the evidence related to body checking and body avoidance in eating disorders (EDs) to gauge the size of effects, as well as examine potential differences between clinical and nonclinical populations, and between different ED subtypes. PsycINFO, PsycARTICLES, PsycEXTRA, Cochrane Library, and MEDLINE databases were searched for academic literature published until October 2017. A grey literature search was also conducted. Fifty-two studies were identified for the systematic review, of which 34 were eligible for meta-analysis. Only female samples were included in the meta-analysis. ED cases experienced significantly higher body checking (d = 1.26, p < .001) and body avoidance (d = 1.88, p < .001) overall relative to healthy controls, but neither behaviour varied by ED subtype. In nonclinical samples, body checking (r = .60) and body avoidance (r = .56) were significantly correlated with ED pathology (p < .001). These findings support transdiagnostic theoretical models and approaches to ED treatment and early intervention programmes. Copyright © 2018 John Wiley & Sons, Ltd and Eating Disorders Association.

Ring 2 chromosome associated with failure to thrive, microcephaly and dysmorphic facial features.

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López-Uriarte, Arelí; Quintero-Rivera, Fabiola; de la Fuente Cortez, Beatriz; Puente, Viviana Gómez; Campos, María Del Roble Velazco; de Villarreal, Laura E Martínez

2013-10-15

We report here a child with a ring chromosome 2 [r(2)] associated with failure to thrive, microcephaly and dysmorphic features. The chromosomal aberration was defined by chromosome microarray analysis, revealing two small deletions of 2p25.3 (139 kb) and 2q37.3 (147 kb). We show the clinical phenotype of the patient, using a conventional approach and the molecular cytogenetics of a male with a history of prenatal intrauterine growth restriction (IUGR), failure to thrive, microcephaly and dysmorphic facial features. The phenotype is very similar to that reported in other clinical cases with ring chromosome 2. © 2013 Elsevier B.V. All rights reserved.

Enhancing the Detection of Dysmorphic Red Blood Cells and Renal Tubular Epithelial Cells with a Modified Urinalysis Protocol.

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Chu-Su, Yu; Shukuya, Kenichi; Yokoyama, Takashi; Lin, Wei-Chou; Chiang, Chih-Kang; Lin, Chii-Wann

2017-01-11

Urinary sediment is used to evaluate patients with possible urinary tract diseases. Currently, numerous protocols are applied to detect dysmorphic red blood cells (RBCs) and renal tubular epithelial cells (RTECs) in urinary sediment. However, distinct protocols are used by nephrologists and medical technologists for specimen concentration and observation, which leads to major discrepancies in the differential counts of formed elements such as dysmorphic RBCs and RTECs and might interfere with an accurate clinical diagnosis. To resolve these problems, we first tested a modified urinalysis protocol with an increased relative centrifuge force and concentration factor in 20 biopsy-confirmed glomerulonephritis patients with haematuria. We successfully improved the recovery ratio of dysmorphic RBCs in clinical specimens from 34.7% to 42.0% (P dysmorphic RBCs were detected using a bright field microscope, with results comparable to those using a standard phase contrast microscope. Finally, we applied Sternheimer stain to enhance the contrast of RTECs in the urinary sediments. We concluded that this modified urinalysis protocol significantly enhanced the quality of urinalysis.

Dissatisfaction with own body makes patients with eating disorders more sensitive to pain

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Yamamotova, Anna; Bulant, Josef; Bocek, Vaclav; Papezova, Hana

2017-01-01

Body image represents a multidimensional concept including body image evaluation and perception of body appearance. Disturbances of body image perception are considered to be one of the central aspects of anorexia nervosa and bulimia nervosa. There is growing evidence that body image distortion can be associated with changes in pain perception. The aim of our study was to examine the associations between body image perception, body dissatisfaction, and nociception in women with eating disorders and age-matched healthy control women. We measured body dissatisfaction and pain sensitivity in 61 patients with Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition diagnoses of eating disorders (31 anorexia nervosa and 30 bulimia nervosa) and in 30 healthy women. Thermal pain threshold latencies were evaluated using an analgesia meter and body image perception and body dissatisfaction were assessed using Anamorphic Micro software (digital pictures of their own body distorted into larger-body and thinner-body images). Patients with eating disorders overestimated their body size in comparison with healthy controls, but the two groups did not differ in body dissatisfaction. In anorexia and bulimia patient groups, body dissatisfaction (calculated in pixels as desired size/true image size) correlated with pain threshold latencies (r=0.55, p=0.001), while between body image perception (determined as estimation size/true image size) and pain threshold, no correlation was found. Thus, we demonstrated that in patients with eating disorders, pain perception is significantly associated with emotional contrary to sensory (visual) processing of one’s own body image. The more the patients desired to be thin, the more pain-sensitive they were. Our findings based on some shared mechanisms of body dissatisfaction and pain perception support the significance of negative emotions specific for eating disorders and contribute to better understanding of the psychosomatic

Body image disturbance in binge eating disorder: a comparison of obese patients with and without binge eating disorder regarding the cognitive, behavioral and perceptual component of body image.

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Lewer, Merle; Nasrawi, Nadia; Schroeder, Dorothea; Vocks, Silja

2016-03-01

Whereas the manifestation of body image disturbance in binge eating disorder (BED) has been intensively investigated concerning the cognitive-affective component, with regard to the behavioral and the perceptual components of body image disturbance in BED, research is limited and results are inconsistent. Therefore, the present study assessed body image disturbance in BED with respect to the different components of body image in a sample of obese females (n = 31) with BED compared to obese females without an eating disorder (n = 28). The Eating Disorder Inventory-2, the Eating Disorder Examination-Questionnaire, the Body Image Avoidance Questionnaire and the Body Checking Questionnaire as well as a Digital Photo Distortion Technique based on a picture of each participant taken under standardized conditions were employed. Using two-sample t tests, we found that the participants with BED displayed significantly greater impairments concerning the cognitive-affective component of body image than the control group. Concerning the behavioral component, participants with BED reported more body checking and avoidance behavior than the controls, but group differences failed to reach significance after the Bonferroni corrections. Regarding the perceptual component, a significant group difference was found for the perceived "ideal" figure, with the individuals suffering from BED displaying a greater wish for a slimmer ideal figure than the control group. These results support the assumption that body image disturbance is a relevant factor in BED, similar to other eating disorders.

Body image quality of life in eating disorders

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Ignacio Jáuregui Lobera

2011-03-01

Full Text Available Ignacio Jáuregui Lobera1, Patricia Bolaños Ríos21Department of Nutrition and Bromatology, Pablo de Olavide University, Seville, Spain; 2Behavior Sciences Institute, Seville, SpainPurpose: The objective was to examine how body image affects quality of life in an eating-disorder (ED clinical sample, a non-ED clinical sample, and a nonclinical sample. We hypothesized that ED patients would show the worst body image quality of life. We also hypothesized that body image quality of life would have a stronger negative association with specific ED-related variables than with other psychological and psychopathological variables, mainly among ED patients. On the basis of previous studies, the influence of gender on the results was explored, too.Patients and methods: The final sample comprised 70 ED patients (mean age 22.65 ± 7.76 years; 59 women and 11 men; 106 were patients with other psychiatric disorders (mean age 28.20 ± 6.52; 67 women and 39 men, and 135 were university students (mean age 21.57 ± 2.58; 81 women and 54 men, with no psychiatric history. After having obtained informed consent, the following questionnaires were administered: Body Image Quality of Life Inventory-Spanish version (BIQLI-SP, Eating Disorders Inventory-2 (EDI-2, Perceived Stress Questionnaire (PSQ, Self-Esteem Scale (SES, and Symptom Checklist-90-Revised (SCL-90-R.Results: The ED patients' ratings on the BIQLI-SP were the lowest and negatively scored (BIQLI-SP means: +20.18, +5.14, and —6.18, in the student group, the non-ED patient group, and the ED group, respectively. The effect of body image on quality of life was more negative in the ED group in all items of the BIQLI-SP. Body image quality of life was negatively associated with specific ED-related variables, more than with other psychological and psychopathological variables, but not especially among ED patients.Conclusion: Body image quality of life was affected not only by specific pathologies related to body

Out of my real body. Cognitive Neuroscience meets Eating Disorders

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Giuseppe eRiva

2014-05-01

Full Text Available Clinical psychology is starting to explain eating disorders (ED as the outcome of the interaction among cognitive, socio-emotional and interpersonal elements. In particular two influential models - the revised cognitive-interpersonal maintenance model and the transdiagnostic cognitive behavioral theory – identified possible key predisposing and maintaining factors. These models, even if very influential and able to provide clear suggestions for therapy, still are not able to provide answers to several critical questions: Why do not all the individuals with obsessive compulsive features, anxious avoidance or with a dysfunctional scheme for self-evaluation develop an eating disorder? What is the role of the body experience in the etiology of these disorders?In this paper we suggest that a meaningful answer requires the integration of these models with the recent outcomes of cognitive neuroscience. First, our bodily representations are not just a way to map an external space but the main tool we use to generate meaning, organize our experience, and shape our social identity. In particular, we will argue that our bodily experience evolves over time by integrating six different representations of the body characterized by specific pathologies – body schema (phantom limb, spatial body (unilateral hemi-neglect, active body (alien hand syndrome, personal body (autoscopic phenomena, objectified body (xenomelia and body image (body dysmorphia. Second, these representations include either schematic (allocentric or perceptual (egocentric contents that interact within the working memory of the individual through the alignment between the retrieved contents from long-term memory and the ongoing egocentric contents from perception. In this view eating disorders may be the outcome of an impairment in the ability of updating a negative body representation stored in autobiographical memory (allocentric with real-time sensorimotor and proprioceptive data

Body Covering and Body Image: A Comparison of Veiled and Unveiled Muslim Women, Christian Women, and Atheist Women Regarding Body Checking, Body Dissatisfaction, and Eating Disorder Symptoms.

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Wilhelm, Leonie; Hartmann, Andrea S; Becker, Julia C; Kişi, Melahat; Waldorf, Manuel; Vocks, Silja

2018-02-21

Although Islam is the fastest growing religion worldwide, only few studies have investigated body image in Muslim women, and no study has investigated body checking. Therefore, the present study examined whether body image, body checking, and disordered eating differ between veiled and unveiled Muslim women, Christian women, and atheist women. While the groups did not differ regarding body dissatisfaction, unveiled Muslim women reported more checking than veiled Muslim and Christian women, and higher bulimia scores than Christian. Thus, prevention against eating disorders should integrate all women, irrespective of religious affiliation or veiling, with a particular focus on unveiled Muslim women.

The sporting body: body image and eating disorder symptomatology among female athletes from leanness focused and nonleanness focused sports.

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Kong, Peiling; Harris, Lynne M

2015-01-01

Female athletes experience pressure to conform to social and sporting norms concerning body weight. This study compared general and sporting body dissatisfaction and disordered eating symptomatology among 320 elite, recreational, and noncompetitive female athletes aged 17 to 30 years competing in leanness focused sports and nonleanness focused sports. Participants completed an online questionnaire including demographic questions, the Eating Attitudes Test, and the Figure Rating Scale. Athletes from leanness focused sports reported higher levels of body dissatisfaction and greater disordered eating symptomatology regardless of participation level. Elite athletes reported higher levels of body dissatisfaction and greater disordered eating symptomatology regardless of sport type, and differences between recreational and noncompetitive athletes were not found. More than 60% of elite athletes from leanness focused and nonleanness focused sports reported pressure from coaches concerning body shape. The findings have important implications for identifying risk factors for eating disorders among female athletes, where athletes who compete at elite level and those who compete in leanness focused sports at any level may be at higher risk for developing eating disorders.

The moderating effect of gender on ideal-weight goals and exercise dependence symptoms.

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Cook, Brian; Hausenblas, Heather; Rossi, James

2013-03-01

Background and aims Exercise dependence is implicated in the development of eating disorders and muscle dysmorphic disorder. Although conceptually these disorders represent similar pathologies they largely affect different genders and result in opposite body composition, appearance, and ideal-weight goals (i.e., to gain or lose/maintain weight). Therefore, understanding individuals' ideal-weight goals related to engaging in exercise while simultaneously examining gender differences in exercise dependence symptoms may help to identify those whom may be most at-risk for eating disorders and muscle dysmorphic disorder. The purpose of our study was to examine the moderating effect of gender for exercise dependence symptoms in relation to weight gain, loss, or maintenance goals. Methods Self-reported exercise behavior and exercise dependence symptoms (i.e., Exercise Dependence Scale) were assessed in 513 undergraduate students. Results Our analysis revealed a moderating effect for gender on ideal-weight goals and a gender difference in exercise dependence symptoms. Specifically, men who were dissatisfied with their current weight reported more exercise dependence symptoms than women. Conclusions These results support a growing body of research and extend our understanding of the relationships among exercise dependence and gender specific body-focused psychiatric disorders.

The Study of Eating Disorders and Body Image Among Elite Martial Arts Athletes

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Morteza Taheri

2017-11-01

Full Text Available Study objective: The competitive sports environment can enhance social and cultural pressure towards having ideal body weight in weight-sensitive sports. The close relationship between body image and performance makes the elite athletes vulnerable to eating disorders. Thus, the purpose of this research was to study eating disorders and body image among weight-class elite athletes. Methods: A cross-sectional study was carried out with elite martial arts athletes (Karate, Taekwondo, and Judo who were considered to be of higher risk for eating disorders. 63 elite martial arts male athletes (18.59 ± 5.29 yrs, and 63 non-athlete persons (17.3 ± 3.4 yrs were recruited. Body Mass Index (BMI, Waist Hip Ratio (WHR, and Percent Body Fat (PBF were measured using caliper and meter. Eating Disorder Diagnosis Scale (EDDS and Body Image Rating Scale (BIRS were used to study eating disorders and body image among elite martial arts athletes. Results: no sign of clinical EDDS were found among the investigated athletes, and non-athletes. There were significant differences in total score of EDDS (p=0.001, eating disorder and weight concern subscales (respectively p=0.012, p=0.001 in athletes and non-athletes. Furthermore, compared with the non-athlete group, elite athlete group with middle, good, and great body images scored higher on total score and all subscales of EDDS (p ≤ 0.05. Conclusion: The results from our study show the presence of worriment about eating disorder especially body weight and eating concern in elite athletes and the early detection of it may prevent progression to severe eating disorders.

Body integrity identity disorder: from a psychological to a neurological syndrome.

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Sedda, Anna

2011-12-01

Body Integrity Identity Disorder (BIID) is a condition in which individuals experience an intense desire for amputation of an healthy limb. Recently, McGeoch and colleagues provided the first direct evidence that this syndrome may be neurological rather than psychological in its origin. However, before including BIID in body ownership disorders, several concerns should be clarified, exploring other components of body representation and not only somatosensory perception.

The body as a simulacrum of identity: the subjective experience in the eating disorders

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Patrizia Brogna

2010-12-01

Full Text Available This study aims at better understanding the subjective experience, the so-called Erlebnis, in individuals diagnosed with Eating Disorders (ED. We shall highlight the particular way in which people with such disorders perceive their own bodies and specifically how they perceive their bodies in the presence of other people. To this end we shall analyze the subjective experience by means of two concepts as described by French philosopher Jean-Paul Sartre: "body-self" and "body-forothers". Our hypothesis is that some people suffering from eating disorders, especially those with a diagnosis of Eating Disorders Not Otherwise Specified (EDNOS, experience their body mainly as body-for-others. Rather than a diagnostic category, EDNOS could be conceived as an anthropological configuration vulnerable to ED. Eating disorders appear as an "identity disorder" characterized by a suspension of the experiential polarity between self and other-than-self.

Self-compassion moderates the relationship between body mass index and both eating disorder pathology and body image flexibility.

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Kelly, Allison C; Vimalakanthan, Kiruthiha; Miller, Kathryn E

2014-09-01

The current study examined whether self-compassion, the tendency to treat oneself kindly during distress and disappointments, would attenuate the positive relationship between body mass index (BMI) and eating disorder pathology, and the negative relationship between BMI and body image flexibility. One-hundred and fifty-three female undergraduate students completed measures of self-compassion, self-esteem, eating disorder pathology, and body image flexibility, which refers to one's acceptance of negative body image experiences. Controlling for self-esteem, hierarchical regressions revealed that self-compassion moderated the relationships between BMI and the criteria. Specifically, the positive relationship between BMI and eating disorder pathology and the negative relationship between BMI and body image flexibility were weaker the higher women's levels of self-compassion. Among young women, self-compassion may help to protect against the greater eating disturbances that coincide with a higher BMI, and may facilitate the positive body image experiences that tend to be lower the higher one's BMI. Copyright © 2014 Elsevier Ltd. All rights reserved.

Dominant ELOVL1 mutation causes neurological disorder with ichthyotic keratoderma, spasticity, hypomyelination and dysmorphic features.

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Kutkowska-Kaźmierczak, Anna; Rydzanicz, Małgorzata; Chlebowski, Aleksander; Kłosowska-Kosicka, Kamila; Mika, Adriana; Gruchota, Jakub; Jurkiewicz, Elżbieta; Kowalewski, Cezary; Pollak, Agnieszka; Stradomska, Teresa Joanna; Kmieć, Tomasz; Jakubowski, Rafał; Gasperowicz, Piotr; Walczak, Anna; Śladowski, Dariusz; Jankowska-Steifer, Ewa; Korniszewski, Lech; Kosińska, Joanna; Obersztyn, Ewa; Nowak, Wieslaw; Śledziński, Tomasz; Dziembowski, Andrzej; Płoski, Rafał

2018-06-01

Ichthyosis and neurological involvement occur in relatively few known Mendelian disorders caused by mutations in genes relevant both for epidermis and neural function. To identify the cause of a similar phenotype of ichthyotic keratoderma, spasticity, mild hypomyelination (on MRI) and dysmorphic features (IKSHD) observed in two unrelated paediatric probands without family history of disease. Whole exome sequencing was performed in both patients. The functional effect of prioritised variant in ELOVL1 (very-long-chain fatty acids (VLCFAs) elongase) was analysed by VLCFA profiling by gas chromatography-mass spectrometry in stably transfected HEK2932 cells and in cultured patient's fibroblasts. Probands shared novel heterozygous ELOVL1 p.Ser165Phe mutation (de novo in one family, while in the other family, father could not be tested). In transfected cells p.Ser165Phe: (1) reduced levels of FAs C24:0-C28:0 and C26:1 with the most pronounced effect for C26:0 (P=7.8×10 -6  vs HEK293 cells with wild type (wt) construct, no difference vs naïve HEK293) and (2) increased levels of C20:0 and C22:0 (P=6.3×10 -7 , P=1.2×10 -5 , for C20:0 and C22:0, respectively, comparison vs HEK293 cells with wt construct; P=2.2×10 -7 , P=1.9×10 -4 , respectively, comparison vs naïve HEK293). In skin fibroblasts, there was decrease of C26:1 (P=0.014), C28:0 (P=0.001) and increase of C20:0 (P=0.033) in the patient versus controls. There was a strong correlation (r=0.92, P=0.008) between the FAs profile of patient's fibroblasts and that of p.Ser165Phe transfected HEK293 cells. Serum levels of C20:0-C26:0 FAs were normal, but the C24:0/C22:0 ratio was decreased. The ELOVL1 p.Ser165Phe mutation is a likely cause of IKSHD. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

[Desire for amputation in body integrity identity disorder].

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Blom, Rianne M; Hennekam, Raoul C M

2014-01-01

Body integrity identity disorder (BIID) is a rare neuropsychiatric disorder in which patients experience a mismatch between the real and experienced body from childhood. BIID results in a strong desire to amputate or paralyse one or more limbs. We describe two BIID patients. A 40-year-old healthy male suffered daily from his desire for amputation, and therefore made a request for amputation at our academic medical centre. A 61-year-old male proceeded to self-amputation to create the body he had wished for, thereby curing himself from BIID. To date, no treatment has been found for BIID. Therefore patients often proceed to self-amputation, which could lead to serious and even dangerous complications. These case histories suggest that elective amputation may be a treatment for BIID. Many doctors, however, will question the admissibility of amputation of a healthy limb.

78 FR 73696 - Extension of Expiration Date for Mental Disorders Body System Listings; Correction

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2013-12-09

... of Expiration Date for Mental Disorders Body System Listings; Correction AGENCY: Social Security... published a final rule document extending the expiration date of the Mental Disorders body system in the...) extending the expiration date of the Mental Disorders body system in the Listing of Impairments (listings...

Empowerment, feminism, and self-efficacy: relationships to body image and disordered eating.

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Kinsaul, Jessica A E; Curtin, Lisa; Bazzini, Doris; Martz, Denise

2014-01-01

Sociocultural norms pertaining to an ideal of thinness for women likely play a role in the development and maintenance of disturbance in body image, and by extension, disordered eating. However, competing norms associated with feminism may buffer women from pressures associated with achieving the thin ideal. The present study explored the relationship between feminist ideology, empowerment, and self-efficacy relative to body image and eating behavior with a sample of U.S. undergraduate women (N=318) attending a southeastern U.S. mid-sized university. In planned hierarchical multiple regression analyses, endorsement of feminist ideology predicted perceptions of positive body image, but did not appear to predict disordered eating. Self-efficacy emerged as a robust predictor of positive body image and lower disordered eating even after controlling for perceptions of personal empowerment and feminism. Results, although limited by correlational data, suggest that self-efficacy may protect college-aged women from disordered eating and negative body image. Copyright © 2013 Elsevier Ltd. All rights reserved.

Biases in attention and memory for body shape images in eating disorders.

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Pona, Ashleigh A; Jones, Angela C; Masterson, Tracy L; Ben-Porath, Denise D

2017-12-28

To investigate attentional and memorial biases towards body shape pictures among female patients with clinical eating disorders and healthy female controls. A visual dot-probe task was used to assess attention towards pictures reflecting either a thin, normal, or obese female body shape. Pictures were presented in pairs; each pair depicted two different body shapes and were presented twice. Participant responses were compared across time and population. Overall, the eating disorder patients responded more slowly than controls, F(1,63) = 20.32, p attentional bias towards the larger of two body shapes, F(1,63) = 4.30, p = .04, and responded more quickly the second time they viewed the picture pairs, F(1,63) = 33.80, p picture pairs, the eating disorder patients had a larger decrease in reaction time (86 ms) than the control sample (33 ms) only when both pictures included extreme body shapes (thin and obese); the decrease in reaction time when one of the pictures included a normal body shape was the same across groups upon second viewing (eating disorder: 37 ms; control: 32 ms), F(1,63) = 9.32, p = .003. These findings suggest that individuals with eating disorders may be biased towards recall of dichotomous and/or extreme body shape images. While it remains unclear whether attentional and/or memorial bias is a risk, maintenance, or causal factor in eating disorders, future studies should employ longitudinal, prospective research designs to address these questions. Level II, comparative study.

78 FR 72571 - Extension of Expiration Date for Mental Disorders Body System Listings

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2013-12-03

... of Expiration Date for Mental Disorders Body System Listings AGENCY: Social Security Administration. ACTION: Final rule. SUMMARY: We are extending the expiration date of the Mental Disorders body system in... need to evaluate mental disorders at step three of the sequential evaluation processes for initial...

Gender differences dominate sleep disorder patients' body problem complaints

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Ted L. Rosenthal

1994-12-01

Full Text Available We studied it age, gender, diagnostic status, and psychiatric features affected 291 consecutive sleep disorder patient's body complaints on a brief checklist. Gender had a strong impact on all four (tested dependent measures, with women reporting more distress than men. Age produced significant regressions on two measures, with younger patients complaining more than older. Presence of psychiatric features was associated with more complaints on one dependent measure - previously found to reflect internal medicine patients' emotional distress. The results of regression analyses were largely supported by follow-up ANOVAs. However, contrasting insomniac versus hypersomniac versus all other sleep disorder diagnoses did not affect body complaints on any dependent measure. The results caution against combining males and females to compare self-reported distress between sleep disorders.

Bleachorexia-an addictive behavior to tooth bleaching: a case report.

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Lee, Denzel Kun-Tsung; Kastl, Cameron; Chan, Daniel C N

2018-05-01

Bleachorexia, addiction to tooth bleaching, is a behavioral disorder similar to anorexia. The patient feels that their teeth are always not white enough and continues to use whiteners to obtain a "perfect" smile. Such behavior falls under the category of a body dysmorphic disorder and may need medical counseling.

Body Image and Eating Disorders Among Lesbian, Gay, Bisexual, and Transgender Youth.

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McClain, Zachary; Peebles, Rebecka

2016-12-01

Adolescence is a crucial period for emerging sexual orientation and gender identity and also body image disturbance and disordered eating. Body image distortion and disordered eating are important pediatric problems affecting individuals along the sexual orientation and gender identity spectrum. Lesbian, gay, bisexual, transgender (LGBT) youth are at risk for eating disorders and body dissatisfaction. Disordered eating in LGBT and gender variant youth may be associated with poorer quality of life and mental health outcomes. Pediatricians should know that these problems occur more frequently in LGBT youth. There is evidence that newer treatment paradigms involving family support are more effective than individual models of care. Copyright © 2016 Elsevier Inc. All rights reserved.

A de novo 11q23 deletion in a patient presenting with severe ophthalmologic findings, psychomotor retardation and facial dysmorphism.

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Şimşek-Kiper, Pelin Özlem; Bayram, Yavuz; Ütine, Gülen Eda; Alanay, Yasemin; Boduroğlu, Koray

2014-01-01

Distal 11q deletion, previously known as Jacobsen syndrome, is caused by segmental aneusomy for the distal end of the long arm of chromosome 11. Typical clinical features include facial dysmorphism, mild-to-moderate psychomotor retardation, trigonocephaly, cardiac defects, and thrombocytopenia. There is a significant variability in the range of clinical features. We report herein a five-year-old girl with severe ophthalmological findings, facial dysmorphism, and psychomotor retardation with normal platelet function, in whom a de novo 11q23 deletion was detected, suggesting that distal 11q monosomy should be kept in mind in patients presenting with dysmorphic facial features and psychomotor retardation even in the absence of hematological findings.

Dysmorphology and mental retardation: molecular cytogenetic studies in dysmorphic mentally retarded patients.

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Buggenhout, G.J.C.M. van; Ravenswaaij-Arts, C.M.A. van; Mieloo, H.; Syrrou, M.; Hamel, B.C.J.; Brunner, H.G.; Fryns, J.P.

2001-01-01

In an institutionalised population of 471 mentally retarded adult residents (436 males and 35 females), 18 patients (16 males and 2 females) with dysmorphic features were selected to perform FISH studies by using subtelomeric probes to discover cryptic terminal deletions or duplications,

Antenatal Diagnosis of Jeune Syndrome (Asphyxiating Thoracic Dysplasia) with Micromelia and Facial Dysmorphism on Second-Trimester Ultrasound

International Nuclear Information System (INIS)

Mistry, Kewal A.; Suthar, Pokhraj P.; Bhesania, Siddharth R.; Patel, Ankitkumar

2015-01-01

Jeune syndrome is a rare congenital malformation with a reported incidence of 1 in 100,000–130,000 live births. Thoracic hypoplasia is the most striking abnormality of this disorder. Here we report a case of Jeune syndrome with marked thoracic hypoplasia, micromelia and facial dysmorphism, which was diagnosed on a second-trimester antenatal real-time three-dimensional ultrasound. A 24-year-old primigravida came for routine anomaly scan at 19 weeks of gestation. Transabdominal grey scale and real time 3D ultrasound (US) was done with GE Logiq P5 with curvilinear array transducers (4C and 4D3C-L). US findings were consistent with the diagnosis of Jeune syndrome (Asphyxiating thoracic dysplasia). Jeune syndrome is an extremely rare congenital disorder with a spectrum of abnormalities of which thoracic hypoplasia is the most striking. It can be diagnosed on early antenatal US by its characteristic skeletal and morphological features which can guide further management of pregnancy in form of termination or preparation for surgical correction of the deformity

[Body integrity identity disorder, relief after amputation].

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Blom, R M; Braam, A W; de Boer-Kreeft, N; Sonnen, M P A M

2014-01-01

Body integrity identity disorder (BIID) is a rare condition in which a person, for no apparent physical reason, is tormented by the experience that a body-part, such as a limb, does not really belong to the body. Patients experience an intense desire for the limb to be amputated (a 'desire' formerly referred to as 'apotemnophilia'). We report on a 58-year-old male patient with BIID who froze one of his legs so that he could amputate it himself. A surgeon ultimately intervened and amputated the leg professionally. The patient was extremely relieved and was still experiencing relief at a follow-up three years later.

[Body schema, multisensory integration and developmental disorders].

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Reinersmann, Annika; Lücke, Thomas

2018-04-01

Our body is both, the object experiencing the world and the subject of our self- experience. As an object, the body provides sensory information via the bodily surface, which is processed and integrated into a coherent representation of the body, the body schema. This representation is considered to form a crucial structure underlying bodily self-identification. The process of integrating multimodal information into a coherent body representation has received extensive research interest with the aim to further clarify its neuronal correlates and functioning in health and disease. However, little is known about the ontogenetic functioning of body schema or multisensory integration processing and their role in the development of socio-emotional in children. This narrative overview discusses implication of a dysfunctional body schematic functioning for socio-emotional competencies. A general introduction on body schematic processes is followed by a narrative review of current findings on the maturation of the body schema and multisensory integration. We finally outline implications for the self- and socio-emotional development in children and discuss possible implications for a role of disrupted body schema functions in developmental disorders. © Georg Thieme Verlag KG Stuttgart · New York.

Eumorphic Plastic Surgery: Expectation Versus Satisfaction in Body Dysmorphic Disorder.

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Morselli, Paolo Giovanni; Micai, Alessandro; Boriani, Filippo

2016-08-01

Eumorphic Plastic Surgery aims at improving the severe psychosocial pain caused by a deformity. Dysmorphopathology is an increasingly relevant problem facing the plastic surgeon. The aim of this study is to describe the perioperative questionnaires created by the senior author and to present a cohort of plastic surgery patients suffering from dysmorphopathies. These patients were prospectively followed and evaluated with the proposed questionnaires through their surgical pathway to explore the degree of satisfaction or disappointment compared to expectations. All candidates for plastic surgery procedures between April 2011 and June 2013 were included in the study. Preoperatively, all patients completed the Patient Expectation Questionnaire (E-pgm). Twelve months postoperatively, they completed the Patient Satisfaction Questionnaire (S-pgm). The E-pgm and S-pgm were compared to evaluate the consistency between the patient's preoperative expectations and postoperative evaluations. A total of 158 patients were included in the study. Out of them, 79 % experienced an improvement or no variation between preoperative expectations and postoperative satisfaction. With regard to the motivation for undergoing surgery, 91 % showed that the surgical procedure met the motivation. An overall positive perioperative change in life was experienced by 93 % of patients. The E-pgm questionnaire proved to be a valid and reliable tool for the selection of suitable candidates for surgery and for identification of dysmorphophobic patients. Enhancing the doctor-patient relationship and communication can reduce ambiguity and avoid troublesome misunderstandings, litigation and other legal implications. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Training interpretation biases among individuals with body dysmorphic disorder symptoms.

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Premo, Julie E; Sarfan, Laurel D; Clerkin, Elise M

2016-03-01

The current study provided an initial test of a Cognitive Bias Modification for Interpretations (CBM-I) training paradigm among a sample with elevated BDD symptoms (N=86). As expected, BDD-relevant interpretations were reduced among participants who completed a positive (vs. comparison) training program. Results also pointed to the intriguing possibility that modifying biased appearance-relevant interpretations is causally related to changes in biased, socially relevant interpretations. Further, providing support for cognitive behavioral models, residual change in interpretations was associated with some aspects of in vivo stressor responding. However, contrary to expectations there were no significant effects of condition on emotional vulnerability to a BDD stressor, potentially because participants in both training conditions experienced reductions in biased socially-threatening interpretations following training (suggesting that the "comparison" condition was not inert). These findings have meaningful theoretical and clinical implications, and fit with transdiagnostic conceptualizations of psychopathology. Copyright © 2015 Elsevier Ltd. All rights reserved.

Structural relationships among attachment insecurity, alexithymia, and body esteem in women with eating disorders.

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Keating, Leah; Tasca, Giorgio A; Hill, Robert

2013-08-01

Patients with eating disorders tend to experience low levels of body esteem. To assess the psychosocial processes that may predict low body esteem in these individuals, we assessed the structural interrelations among attachment anxiety, attachment avoidance, alexithymia, and body esteem in a cross-sectional sample of patients with eating disorders. We tested a model in which alexithymia mediates the relationship between attachment insecurity and body esteem. Participants were 300 women with anorexia nervosa (n = 109), bulimia nervosa (n = 130), and eating disorders not otherwise specified (n = 61) who completed pretreatment self-report questionnaires at intake for a day hospital treatment program. We found a direct and negative relationship between attachment anxiety and body esteem. Additionally, attachment avoidance had an indirect negative relationship to body esteem through alexithymia. These results indicate that therapists may attend to attachment insecurity and affective regulation strategies when addressing body image issues in patients with eating disorders. © 2013 Elsevier Ltd. All rights reserved.

Disordered eating attitudes and body shame among athletes, exercisers and sedentary female college students.

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Jankauskiene, R; Pajaujiene, S

2012-02-01

The aim of the present study was to examine the disordered eating attitudes and sociocultural body ideals internalization among university athletes (N.=98), exercisers (N.=125) and sedentary (N.=81) undergraduate female students. The mean age (SD) of the sample was 20.17 (2.00). The students completed Eating Attitude Test - 26, Body Areas Satisfaction subscale of the Multidimensional Body-Self Relations Questionnaire, Body Shame subscale from the Objectified Body Consciousness Scale, Rosenberg Self- Esteem Scale, Appearance subscale from the Motives for Physical Activity Measure--Revised, reported their physical activity and fluid manipulation-related behaviour. We observed no significant differences in disordered eating, body dissatisfaction, self-esteem and fluid manipulation-related behaviour among athletes, exercisers and sedentary female students. Body shame predicted disordered eating in all groups of women. Students high in body shame reported higher levels of disordered eating, body dissatisfaction, appearance-related exercise motives, fluid manipulation-related behaviour and lower self-esteem, regardless of their physical activity level. The results show that internalization of the sociocultural body standards provide a mechanism through which different physical activity levels are associated with negative eating and physical activity-related outcomes in college-aged women.

Negative predictors for satisfaction in patients seeking facial cosmetic surgery: a systematic review

NARCIS (Netherlands)

Herruer, J.M.; Prins, J.B.; Heerbeek, N. van; Verhage-Damen, G.W.; Ingels, K.J.A.O.

2015-01-01

BACKGROUND: Facial cosmetic surgery is becoming more popular. Patients generally indicate they are satisfied with the results. Certain patient characteristics, however, have been described as negative predictors for satisfaction. Psychopathology such as body dysmorphic disorder and personality

Body image and borderline personality disorder among psychiatric inpatients.

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Sansone, Randy A; Chu, Jamie W; Wiederman, Michael W

2010-01-01

With the exclusion of studies in individuals with eating disorders, few investigators have examined body image issues in patients with borderline personality disorder (BPD). In this study, we examined among psychiatric inpatients relationships between body image and BPD. In a cross-sectional sample of convenience, we surveyed 126 women in an inpatient psychiatric unit using 5 measures for body image and 2 measures for BPD. Using standardized cutoffs for BPD diagnosis, participants with BPD demonstrated a number of differentiating features with regard to body image issues. Explicitly, BPD did not seem to be related to being self-conscious about one's appearance, although BPD was related to being more self-conscious, in general. Individuals with BPD were not more invested in their appearance as a source of self-definition but evaluated their own appearance more negatively and were more likely to believe that attractiveness is an important factor for happiness and acceptance. Although BPD was not related to perceptions about the strength and competence of one's own body, those with BPD indicated less comfort and trust in their own bodies. In general, it appeared that body image measures that were more perceptually grounded were more likely to be similar to non-BPD participants, whereas body image measures that were more cognitively grounded were more likely to be statistically significantly different in comparison with non-BPD participants. Psychiatric inpatients with BPD demonstrate a number of disturbances in body image. Copyright © 2010 Elsevier Inc. All rights reserved.

Investigation of eating disorders in cancer patients and its relevance with body image

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Seyyed Abbas Hossein

2015-01-01

Full Text Available Background: Eating disorder is one of the most common health problems with clinical and psychological consequences, which can affect body image in cancer patients. Similar studies in this area for checking the status of this disorder and its relevance with body image in patients with cancer are limited. Therefore, this study was designed with the aim of determination of eating disorders in patients with cancer and their relevance with body image. Materials and Methods: The research was a cross-correlation study. It was carried out in Sayed-Al-Shohada Hospital affiliated to the Isfahan University of Medical Sciences in 2013. Two hundred and ten patients with cancer were selected and were asked tocomplete the demographic and disease characteristics questionnaire, the Multidimensional Body-Self Relations Questionnaire (MBSRQ, and eating disorders questionnaire. SPSS statistical software, version 14 was used for statistical analysis′-Test, analysis of variance (ANOVA, and Pearson correlation coefficient were used for analyzing the obtained data. Results: The mean values of age, body mass index (BMI, and duration of illness were 48.2 ± 13.20 years, 24.6 ± 4.6kg/m 2 , and 25.64 ± 21.24months, respectively. Most patients were married (87%, without university education (96%, unemployed (67%, and with incomes below their requirement (52%. Most patients were diagnosed with breast cancer (36.5%. They received chemotherapy as the main treatment (56.2%. In addition, mean ± SD of eating disorders and body image were 12.84 ± 4.7 and184.40 ± 43.68, respectively. Also, 49.7% of patients with cancer had an eating disorder. Among these, 29% had experiences of anorexia and 20.7% had bulimia. There was a significant negative correlation between the score of body image and eating disorders (r = −0.47, P = 0.01. Conclusions: Findings of this study showed that most patients with cancer had experienced symptoms of eating disorders. This may lead to a negative

Body attitudes in patients with eating disorders at presentation and completion of intensive outpatient day treatment.

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Exterkate, Cecile C; Vriesendorp, Patricia F; de Jong, Cor A J

2009-01-01

Due to the importance of the distorted body experience in eating disorder diagnosis and treatment, we wanted to explore body attitudes of patients with eating disorders before and after 5 months of intensive specialized outpatient day treatment. We assessed 193 patients diagnosed with Anorexia Nervosa (AN), Bulimia Nervosa (BN) and Eating Disorder Not Otherwise Specified (EDNOS) using the Body Attitude Test (BAT), Body Mass Index (BMI), Eating Disorder Evaluation Scale (EDES) and Symptom Checklist 90 (SCL-90). Eating disorder subtypes differed in BMI, total body attitudes and negative appreciation of body size at intake, but not at termination of treatment. Following treatment, all patient groups reported large improvements in eating disorder pathology and all but the AN-Restrictive (AN-R) group, reported large improvements in overall psychological functioning. The AN patients demonstrated significant improvement in BMI, however the Anorexia Nervosa purging (AN-P) and Anorexia Nervosa restrictive (AN-R) subtypes differed in their changes in body attitudes. AN-R patients indicated no significant improvement in body attitudes. AN-P patients improved in total body attitudes, except one subscale. Patients with Bulimia Nervosa non-purging (BN-NP) subtype, Bulimia Nervosa purging (BN-P) subtype and EDNOS demonstrated similar improvements in total body attitudes (BAT). Body attitudes provide important insights into differences between eating disorder diagnostic categories and their treatment responsiveness.

Illusory changes in body size modulate body satisfaction in a way that is related to non-clinical eating disorder psychopathology.

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Catherine Preston

Full Text Available Historically, body size overestimation has been linked to abnormal levels of body dissatisfaction found in eating disorders. However, recently this relationship has been called into question. Indeed, despite a link between how we perceive and how we feel about our body seeming intuitive, until now lack of an experimental method to manipulate body size has meant that a causal link, even in healthy participants, has remained elusive. Recent developments in body perception research demonstrate that the perceptual experience of the body can be readily manipulated using multisensory illusions. The current study exploits such illusions to modulate perceived body size in an attempt to influence body satisfaction. Participants were presented with stereoscopic video images of slimmer and wider mannequin bodies viewed through head-mounted displays from first person perspective. Illusory ownership was induced by synchronously stroking the seen mannequin body with the unseen real body. Pre and post-illusion affective and perceptual measures captured changes in perceived body size and body satisfaction. Illusory ownership of a slimmer body resulted in participants perceiving their actual body as slimmer and giving higher ratings of body satisfaction demonstrating a direct link between perceptual and affective body representations. Change in body satisfaction following illusory ownership of a wider body, however, was related to degree of (non-clinical eating disorder psychopathology, which can be linked to fluctuating body representations found in clinical samples. The results suggest that body perception is linked to body satisfaction and may be of importance for eating disorder symptomology.

Illusory Changes in Body Size Modulate Body Satisfaction in a Way That Is Related to Non-Clinical Eating Disorder Psychopathology

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Preston, Catherine; Ehrsson, H. Henrik

2014-01-01

Historically, body size overestimation has been linked to abnormal levels of body dissatisfaction found in eating disorders. However, recently this relationship has been called into question. Indeed, despite a link between how we perceive and how we feel about our body seeming intuitive, until now lack of an experimental method to manipulate body size has meant that a causal link, even in healthy participants, has remained elusive. Recent developments in body perception research demonstrate that the perceptual experience of the body can be readily manipulated using multisensory illusions. The current study exploits such illusions to modulate perceived body size in an attempt to influence body satisfaction. Participants were presented with stereoscopic video images of slimmer and wider mannequin bodies viewed through head-mounted displays from first person perspective. Illusory ownership was induced by synchronously stroking the seen mannequin body with the unseen real body. Pre and post-illusion affective and perceptual measures captured changes in perceived body size and body satisfaction. Illusory ownership of a slimmer body resulted in participants perceiving their actual body as slimmer and giving higher ratings of body satisfaction demonstrating a direct link between perceptual and affective body representations. Change in body satisfaction following illusory ownership of a wider body, however, was related to degree of (non-clinical) eating disorder psychopathology, which can be linked to fluctuating body representations found in clinical samples. The results suggest that body perception is linked to body satisfaction and may be of importance for eating disorder symptomology. PMID:24465698

Avoiding Psychological Pitfalls in Aesthetic Medical Procedures.

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Wang, Qiuyu; Cao, Chuan; Guo, Rui; Li, Xiaoge; Lu, Lele; Wang, Wenping; Li, Shirong

2016-12-01

To assess the prevalence of body dysmorphic disorder (BDD) in an aesthetic surgery setting in the region of Southwest China, and to ascertain the differences in terms of body images between patients in the aesthetic setting and general Chinese population. This study tracked patient satisfaction with their body image changes while undergoing aesthetic medical procedures to identify whether the condition of patients who were presenting with BDD symptoms or their psychological symptoms could be improved by enhancing their appearance. Additionally, this study explored whether there was improvement in quality of life (QoL) and self-esteem after aesthetic medical procedures. A total of 106 female patients who were undergoing aesthetic medical procedures for the first time (plastic surgery, n = 26; minimally invasive aesthetic treatment, n = 42; and aesthetic dermatological treatment, n = 38) were classified as having body dysmorphic disorder symptoms or not having body dysmorphic disorder symptoms, based on the body dysmorphic disorder examination (BDDE), which was administered preoperatively. These patients were followed up for 1 month after the aesthetic procedures. The multidimensional body self-relations questionnaire-appearance scales (MBSRQ-AS) and rosenberg self-esteem scale (RSE-S) were used to assess patients' preoccupation with appearance and self-esteem pre-procedure and 1 month post-procedure. Additionally, 100 female healthy control participants were recruited as a comparative group into this study and they were also assessed using BDDE, MBSRQ-AS, and RSE-S. A total of 14.2 % of 106 aesthetic patients and 1 % of 100 healthy controls were diagnosed with BDD to varying extents. BDDE scores were 72.83 (SD ± 30.7) and 68.18 (SD ± 31.82), respectively, before and after the procedure for the aesthetic patient group and 43.44 (SD ± 15.65) for the healthy control group (F = 34.28; p aesthetic patients (pre-procedure) and female adult norms from

A Case with Mental Retardation, Gynecomastia and Dysmorphic Features

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Ozge Ozalp Yuregir

2012-03-01

Full Text Available The 17 years old boy was diagnosed as Borjeson Forsmann Lehmann Syndrome who was referred to our Genetic Diagnosis Center for his dysmorphic features, obesity, gynecomasty and mental retardation . There are so many diseases in differantial diagnosis of obesity and mental retardation that BFLS is a rare one of them. We aimed to discuss the findings of the patient clinically diagnosed as BFLS within the scope of literature. [Cukurova Med J 2012; 37(1: 60-63

Body uneasiness, eating disorders, and muscle dysmorphia in individuals who overexercise.

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Segura-García, Cristina; Ammendolia, Antonio; Procopio, Leonardo; Papaianni, Maria C; Sinopoli, Flora; Bianco, Carmelina; De Fazio, Pasquale; Capranica, Laura

2010-11-01

This study aimed to investigate exercise dependence, body and eating concerns of active individuals in relation to muscle dysmorphia (MD) and eating disorders (EDs). One hundred and thirty-four active individuals (86 men, 48 women) and 20 ED women were divided into 4 groups according to their sex and the difference between their actual and desired body weight (group A: men who wanted to gain weight; group B: men who wanted to lose weight; group C: women who wanted to lose weight; group D: ED women). The Eating Disorder Inventory 2, Body Uneasiness Test, and Muscle Dysmorphia Inventory questionnaires were administered. All women desired to reduce their body weight, whereas 55% of men wanted to increase their muscle mass, also using anabolic steroids and food integrators. All groups showed a similar use of diuretics and laxatives (range 10-21%). The findings highlighted the presence of minor body image disorders in groups B and C. Conversely, body image was remarkably altered in groups D and A. Recognizing main MD traits, physical trainers should recommend further psychological counseling. Information should also be provided to gym clients regarding the health risks associated with purgative behaviors, use of steroids, and abuse of food supplements.

Body image in patients with mental disorders : Characteristics, associations with diagnosis and treatment outcome

NARCIS (Netherlands)

Scheffers, Mia; van Busschbach, Jooske T; Bosscher, Ruud J; Aerts, Liza C; Wiersma, Durk; Schoevers, Robert A

Objective: Despite the increasing recognition in clinical practice of body image problems in other than appearance related mental disorders, the question remains how aspects of body image are affected in different disorders. The aim of this study was to measure body image in patients with a variety

'The body remembers': narrating embodied reconciliations of eating disorder and recovery.

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Eli, Karin

2016-01-01

After severe illness, there are stories: narrative strands to suture discontinuities of identities, practices, and lives. But within these narratives of illness and recovery, the body's discontinuities stand apart, striking in the materiality of change, in the tangible multiplicity of bodies - healthy, ill, recovering, recovered - that a person can call one's own. Based on longitudinal research interviews with Israeli women who identified as recovered from long-term eating disorders (fieldwork conducted in 2005-2006 and in 2011), this paper explores how these bodily discontinuities are expressed, drawing particular attention to the narrative role of embodied memory in linking past and present-tense bodies and selves. Embodied memory, as narrated by the participants, is deeply, sometimes surprisingly, embedded in lived experience, imbuing recovered bodies with moments of sensory continuity, the past coming into presence through forms of sensation and perception learned at the height of disorder. Examining narrative moments of sensory remembrance, this paper analyses how participants narrate embodied memory as a mode of reflection, self-protection, and dynamic integration, wherein the experience of disorder informs practices of recovery, and the body becomes a site for the reconciliation of past and present.

Differences for gender, weight and exercise in body image disturbance and eating disorder symptoms.

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Varnado-Sullivan, P J; Horton, R; Savoy, S

2006-09-01

Differences for gender, weight, exercise frequency and type for eating disorder symptoms and body image disturbance were examined. Further understanding of male body image disturbance was the primary goal. Males (n=200) and females (n=233) completed measures to assess eating disorder symptoms and multiple components of body image disturbance. Measures were modified to be more appropriate for males. Females endorsed higher levels of eating and body concerns. Males were divided between a desire to maintain, increase or decrease their size. Higher weight and exercise frequency was associated with increased body image concern and eating disorder symptoms, particularly for males. Exercise frequency was also linked to higher self-esteem for males. Males who used muscle-enhancing supplements indicated increased social pressures and concern for appearance, and a desire to increase their size. The findings support that weight and exercise frequency affect eating disorder symptoms and body image disturbance. Males appear to exhibit body image disturbance, which is related to their current weight status. Results support the call for further development of measures that more adequately address male concerns.

Eating Disorder Risk and Body Dissatisfaction Based on Muscularity and Body Fat in Male University Students

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Mayo, Carrie; George, Valerie

2014-01-01

Objective: To investigate the relationship between risk of eating disorders, body dissatisfaction, and perceptual attractiveness in male university students. Participants: Research was conducted January-April 2012 and involved 339 male and 441 female students. Methods: Eating disorder risk was assessed with the Eating Attitudes Test (EAT) and body…

Risk for eating disorders modulates startle-responses to body words.

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Herbert, Cornelia; Kübler, Andrea; Vögele, Claus

2013-01-01

Body image disturbances are core symptoms of eating disorders (EDs). Recent evidence suggests that changes in body image may occur prior to ED onset and are not restricted to in-vivo exposure (e.g. mirror image), but also evident during presentation of abstract cues such as body shape and weight-related words. In the present study startle modulation, heart rate and subjective evaluations were examined during reading of body words and neutral words in 41 student female volunteers screened for risk of EDs. The aim was to determine if responses to body words are attributable to a general negativity bias regardless of ED risk or if activated, ED relevant negative body schemas facilitate priming of defensive responses. Heart rate and word ratings differed between body words and neutral words in the whole female sample, supporting a general processing bias for body weight and shape-related concepts in young women regardless of ED risk. Startle modulation was specifically related to eating disorder symptoms, as was indicated by significant positive correlations with self-reported body dissatisfaction. These results emphasize the relevance of examining body schema representations as a function of ED risk across different levels of responding. Peripheral-physiological measures such as the startle reflex could possibly be used as predictors of females' risk for developing EDs in the future.

Risk for eating disorders modulates startle-responses to body words.

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Cornelia Herbert

Full Text Available Body image disturbances are core symptoms of eating disorders (EDs. Recent evidence suggests that changes in body image may occur prior to ED onset and are not restricted to in-vivo exposure (e.g. mirror image, but also evident during presentation of abstract cues such as body shape and weight-related words. In the present study startle modulation, heart rate and subjective evaluations were examined during reading of body words and neutral words in 41 student female volunteers screened for risk of EDs. The aim was to determine if responses to body words are attributable to a general negativity bias regardless of ED risk or if activated, ED relevant negative body schemas facilitate priming of defensive responses. Heart rate and word ratings differed between body words and neutral words in the whole female sample, supporting a general processing bias for body weight and shape-related concepts in young women regardless of ED risk. Startle modulation was specifically related to eating disorder symptoms, as was indicated by significant positive correlations with self-reported body dissatisfaction. These results emphasize the relevance of examining body schema representations as a function of ED risk across different levels of responding. Peripheral-physiological measures such as the startle reflex could possibly be used as predictors of females' risk for developing EDs in the future.

The Relationship between Body Image Coping Strategy and Eating Disorders among Iranian Adolescent Girls

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Malihe Farid

2016-01-01

Full Text Available Background: Due to physical and psychological changes during puberty, most common problem of young people is body image defined as degree of size, shape and general appearance. Wrong perception of body image and dissatisfaction with body image in people can lead to eating disorders and stress. Peace of mind is in fact a mental mechanism that people use it to reduce physical and emotional strains coping with stressful situations. The aim of this study was to determine the type of coping strategy of adolescent girls and its relationship with their eating disorders. Methods: This is study is a cross-sectional study in which 573 female adolescent of Karaj participated. Two-Stage Random Sampling was used in this study. In this study, to assess people who are at risk of eating disorder, the nutritional approach assessment questionnaire of EAT-26 was used, while Strategy Inventory Body Image Coping- BICSI questionnaire was used to determine the type of coping strategy. Results: In this study, the mean age of participants was 16.6 (±26/1 (19- 14 years. In this study, 23.7% of participants had an eating disorder. Mental image of an individual of his body had significant correlation with eating disorder (P= 0.000. Kruskal-Wallis test showed a significant relationship between the type of coping strategy adopted by adolescent girls and eating disorder score of them (P= 0.007. The relationship between coping strategy and body image and having or not having the eating disorder was determined by Chi-square test at the borderline level (P= 0.054. Conclusion: In this study, results showed that there is relationship between coping strategy of adolescent girls and the eating disorder score of adolescent girls. The highest score was assigned to getting involved with body image, followed by avoidance and rational acceptance. Since the use of inappropriate coping strategies is associated with negative results such as eating disorders and depression, it is expected

A Case with Mental Retardation, Gynecomastia and Dysmorphic Features

Directory of Open Access Journals (Sweden)

Ozge Ozalp Yuregir

2012-02-01

Full Text Available The 17 years old boy was diagnosed as Borjeson Forsmann Lehmann Syndrome who was referred to our Genetic Diagnosis Center for his dysmorphic features, obesity, gynecomasty and mental retardation . There are so many diseases in differantial diagnosis of obesity and mental retardation that BFLS is a rare one of them. We aimed to discuss the findings of the patient clinically diagnosed as BFLS within the scope of literature. [Cukurova Med J 2012; 37(1.000: 60-63

Relationship between body dissatisfaction and disordered eating: mediating role of self-esteem and depression.

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Brechan, Inge; Kvalem, Ingela Lundin

2015-04-01

The purpose of this study was to investigate the hypothesis that the effect of body dissatisfaction on disordered eating behavior is mediated through self-esteem and depression. If the effect of body dissatisfaction on disordered eating can be explained by self-esteem and depression, treatment may benefit from focusing more on self-esteem and depression than body dissatisfaction. We also hypothesized body image importance to be associated with lower self-esteem, stronger symptoms of depression, and more disordered eating. The results showed that the effect of body dissatisfaction on disorder eating was completely mediated, whereas the effect of body image importance was partly mediated. Both self-esteem and depression were significant mediators. Body image importance and self-esteem had a direct effect on restrained eating and compensatory behavior. Depression had a direct effect on binge eating. This effect was significantly stronger among women. Depression also had a direct effect on restrained eating. This effect was positive among women, but negative among men. The results support emotion regulation and cognitive behavioral theories of eating disorders, indicating that self-esteem and depression are the most proximal factors, whereas the effect of body dissatisfaction is indirect. The results point out the importance of distinguishing between different symptoms of bulimia. Depression may cause binge eating, but compensatory behavior depends on self-esteem and body image importance. The results suggest that women may turn to both binge eating and restrained eating to escape awareness of negative emotions, whereas men focus on eating to a lesser extent than women. Existing treatment focuses on eating behavior first and mechanisms such as self-esteem and depression second. The results from this study suggest that an earlier focus on self-esteem and depression may be warranted in the treatment of disordered eating. Copyright © 2015 Elsevier Ltd. All rights

The role of media literacy in body dissatisfaction and disordered eating: A systematic review.

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McLean, Siân A; Paxton, Susan J; Wertheim, Eleanor H

2016-12-01

This study comprised a systematic review of literature examining empirical relationships between levels of media literacy and body dissatisfaction and disordered eating. The review aimed to integrate research on this topic. Electronic databases were searched for key concepts: media literacy, body dissatisfaction, and disordered eating. Media literacy measures were coded for consistency with media literacy constructs. Sixteen eligible studies were identified. Cross-sectional outcomes depended upon the media literacy construct assessed. Some relationships between high scores on measures consistent with media literacy constructs and low scores on body dissatisfaction and related attitudes were found. Media literacy-based interventions revealed improvements in media literacy constructs realism scepticism, influence of media, and awareness of media motives for profit, and improvements in body-related variables, but not disordered eating. Further research examining relationships between theoretically driven media literacy constructs and body and eating concerns is needed. Recommendations are made for evaluating media literacy-based eating disorder prevention. Copyright © 2016 Elsevier Ltd. All rights reserved.

Body image flexibility: A predictor and moderator of outcome in transdiagnostic outpatient eating disorder treatment.

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Pellizzer, Mia L; Waller, Glenn; Wade, Tracey D

2018-04-01

Predictors of attrition and predictors and moderators of outcome were explored in a transdiagnostic sample of patients who received ten-session cognitive behavioral therapy (CBT-T) for nonunderweight eating disorders. Body image flexibility, a protective positive body image construct, was hypothesized to be a significant moderator. Data from two case series were combined to form a sample of 78 participants who received CBT-T. Baseline measures of body image, negative affect, personality, and motivation (readiness to change and self-efficacy) were included as potential predictors. Global eating disorder psychopathology at each assessment point (baseline, mid- and post-treatment, 1- and 3-month follow-up) was the outcome variable. Predictors of attrition were assessed using logistic regression, and multilevel modeling was applied for predictors and moderators of outcome. Body image flexibility emerged as the strongest predictor and moderator of global eating disorder psychopathology, followed by body image avoidance. Body checking, negative affect, personality beliefs, and self-efficacy were significant predictors of global eating disorder psychopathology. Higher body image flexibility predicted lower global eating disorder psychopathology at every assessment point. Further research is required to replicate findings and explore the benefit of focusing on positive body image in treatment. © 2018 Wiley Periodicals, Inc.

Mental health impairment in underweight women: do body dissatisfaction and eating-disordered behavior play a role?

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Hay Phillipa

2011-07-01

Full Text Available Abstract Background We sought to evaluate the hypothesis that mental health impairment in underweight women, where this occurs, is due to an association between low body weight and elevated levels of body dissatisfaction and/or eating-disordered behaviour. Methods Subgroups of underweight and normal-weight women recruited from a large, general population sample were compared on measures of body dissatisfaction, eating-disordered behaviour and mental health. Results Underweight women had significantly greater impairment in mental health than normal-weight women, even after controlling for between-group differences in demographic characteristics and physical health. However, there was no evidence that higher levels of body dissatisfaction or eating-disordered behaviour accounted for this difference. Rather, underweight women had significantly lower levels of body dissatisfaction and eating-disordered behaviour than normal-weight women. Conclusions The findings suggest that mental health impairment in underweight women, where this occurs, is unlikely to be due to higher levels of body dissatisfaction or eating-disordered behaviour. Rather, lower levels of body dissatisfaction and eating-disordered behaviour among underweight women may counterbalance, to some extent, impairment due to other factors.

Phelan-McDermid syndrome in two adult brothers: Atypical bipolar disorder as its psychopathological phenotype?

NARCIS (Netherlands)

Verhoeven, W.M.A.; Egger, J.I.M.; Willemsen, M.H.; Leijer, G.J.M. de; Kleefstra, T.

2012-01-01

The 22q13.3 deletion, or Phelan-McDermid syndrome, is characterized by global intellectual disability, generalized hypotonia, severely delayed or absent speech associated with features of autism spectrum disorder, and minor dysmorphisms. Its behavioral phenotype comprises sleep disturbances,

Phelan-McDermid syndrome in two adult brothers: atypical bipolar disorder as its psychopathological phenotype?

NARCIS (Netherlands)

Verhoeven, W.M.; Egger, J.I.; Willemsen, M.H.; de Leijer, G.J.; Kleefstra, T.

2012-01-01

The 22q13.3 deletion, or Phelan-McDermid syndrome, is characterized by global intellectual disability, generalized hypotonia, severely delayed or absent speech associated with features of autism spectrum disorder, and minor dysmorphisms. Its behavioral phenotype comprises sleep disturbances,

Phelan-McDermid syndrome in two adult brothers: Atypical bipolar disorder as its psychopathological phenotype?

NARCIS (Netherlands)

W.M.A. Verhoeven (Wim); J.I.M. Egger (Jos); M.H. Willemsen; G.J.M. de Leijer (Gert); T. Kleefstra (Tjitske)

2012-01-01

textabstractThe 22q13.3 deletion, or Phelan-McDermid syndrome, is characterized by global intellectual disability, generalized hypotonia, severely delayed or absent speech associated with features of autism spectrum disorder, and minor dysmorphisms. Its behavioral phenotype comprises sleep

A conceptual model of factors contributing to the development of muscle dysmorphia.

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Grieve, Frederick G

2007-01-01

Muscle dysmorphia is a recently described subcategory of Body Dysmorphic Disorder. It is most prevalent in males and has a number of cognitive, behavioral, socioenviornmental, emotional, and psychological factors that influence its expression. An etiological model describing these influences is presented for evaluation. Nine variables (body mass, media influences, ideal body internalization, low self-esteem, body dissatisfaction, health locus of control, negative affect, perfectionism, and body distortion) were identified through the use of extant literature on muscle dysmorphia and through extrapolation from literature involving women and eating disorders. The functional relationships among these variables are described and implications of the model are discussed.

Ring chromosome 9 in a girl with developmental delay and dysmorphic features

DEFF Research Database (Denmark)

la Cour Sibbesen, Else; Jespersgaard, Cathrine; Alosi, Daniela

2013-01-01

In this report, we describe a female child with dysmorphic features and developmental delay. Chromosome microarray analysis followed by conventional karyotyping revealed a ring chromosome 9 with a 12 Mb deletion at 9pter-p23 and a 540 kb deletion at 9q34.3-qter. Four percent of the analyzed cells...

Congenital axis dysmorphism in a medieval skeleton : …secunda a vertendo epistropheus….

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Travan, Luciana; Saccheri, Paola; Toso, Francesco; Crivellato, Enrico

2013-05-01

We describe here the axis dysmorphism that we observed in the skeletal remains of a human child dug up from a fifteenth century cemetery located in north-eastern Italy. This bone defect is discussed in the light of pertinent literature. We performed macroscopical examination and CT scan analysis of the axis. Axis structure was remarkably asymmetric. Whilst the left half exhibited normal morphology, the right one was smaller than normal, and its lateral articular surface showed horizontal orientation. In addition, the odontoid process appeared leftward deviated and displayed a supplementary articular-like facet situated on the right side of its surface. These findings suggest a diagnosis of unilateral irregular segmentation of atlas and axis, a rare dysmorphism dependent upon disturbances of notochordal development in early embryonic life. Likewise other malformations of the craniovertebral junction, this axis defect may alter the delicate mechanisms of upper neck movements and cause a complex series of clinical symptoms. This is an emblematic case whereby human skeletal remains may provide valuable information on the anatomical defects of craniovertebral junction.

Factors related to depression and eating disorders: self-esteem, body image, and attractiveness.

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Grubb, H J; Sellers, M I; Waligroski, K

1993-06-01

To test hypotheses that women suffering from some form of eating disorder would experience lower self-esteem and higher depression and that women with lower self-esteem and greater depression would rate their attractiveness lower and see themselves as heavier than less depressed individuals, 42 college undergraduate women were individually administered the Eating Disorders Inventory, Beck Depression Inventory, Coopersmith Self-esteem Inventory, and a Body Image/Attractiveness Perception Scale. A Pearson correlation indicated a substantial relation between scores on depression and scores on eating disorders, but nonsignificant values between self-esteem scores and scores on either eating disorders or on depression. Depression scores correlated significantly with rated body size, but not attractiveness, while self-esteem scores were significantly correlated with rated attractiveness, not body size. These results contradict literature on the relation between self-esteem and depression. Directions for additional research are discussed.

Mutations in HIVEP2 are associated with developmental delay, intellectual disability, and dysmorphic features

NARCIS (Netherlands)

Steinfeld, Hallie; Cho, Megan T.; Retterer, Kyle; Person, Rick; Schaefer, G. Bradley; Danylchuk, Noelle; Malik, Saleem; Wechsler, Stephanie Burns; Wheeler, Patricia G.; van Gassen, Koen L I; Terhal, P. A.; Verhoeven, Virginie J M; van Slegtenhorst, Marjon A.; Monaghan, Kristin G.; Henderson, Lindsay B.; Chung, Wendy K.

Human immunodeficiency virus type I enhancer binding protein 2 (HIVEP2) has been previously associated with intellectual disability and developmental delay in three patients. Here, we describe six patients with developmental delay, intellectual disability, and dysmorphic features with de novo likely

Physical Appearance Concern Questionnaire (PACQ in Iranian Population

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Katayoun Khademi

2011-10-01

Full Text Available Objectives: The purpose of this study is to make questionnaire for screening body dysmorphic disorder sufferers in cosmetic clinics. Methods: A sample of 150 female patients with age average 29.4 years completed Physical Appearance Concern Questionnaire. It has been used as screening tool for screening patients with body dysmorphic disorder symptoms in cosmetic clinics. Results: Result of reliability analysis (α=0.908 and validity have shown the effectiveness of this questionnaire for recognizing individuals with BDD symptoms. Discussion: Physical appearance concern questionnaire can be used in cosmetic clinics for identifying BDD sufferers among clients, with score for the severity of symptoms. Almost all of the researches have been studying in cosmetic clinics or dermatology settings and there is no investigation for people with special needs, thus further research is required in the development of a screening questionnaire or interview for identifying patients with BDD with special needs.

Three-dimensional navigation is more accurate than two-dimensional navigation or conventional fluoroscopy for percutaneous sacroiliac screw fixation in the dysmorphic sacrum: a randomized multicenter study.

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Matityahu, Amir; Kahler, David; Krettek, Christian; Stöckle, Ulrich; Grutzner, Paul Alfred; Messmer, Peter; Ljungqvist, Jan; Gebhard, Florian

2014-12-01

To evaluate the accuracy of computer-assisted sacral screw fixation compared with conventional techniques in the dysmorphic versus normal sacrum. Review of a previous study database. Database of a multinational study with 9 participating trauma centers. The reviewed group included 130 patients, 72 from the navigated group and 58 from the conventional group. Of these, 109 were in the nondysmorphic group and 21 in the dysmorphic group. Placement of sacroiliac (SI) screws was performed using standard fluoroscopy for the conventional group and BrainLAB navigation software with either 2-dimensional or 3-dimensional (3D) navigation for the navigated group. Accuracy of SI screw placement by 2-dimensional and 3D navigation versus conventional fluoroscopy in dysmorphic and nondysmorphic patients, as evaluated by 6 observers using postoperative computerized tomography imaging at least 1 year after initial surgery. Intraobserver agreement was also evaluated. There were 11.9% (13/109) of patients with misplaced screws in the nondysmorphic group and 28.6% (6/21) of patients with misplaced screws in the dysmorphic group, none of which were in the 3D navigation group. Raw agreement between the 6 observers regarding misplaced screws was 32%. However, the percent overall agreement was 69.0% (kappa = 0.38, P dysmorphic proximal sacral segment. We recommend the use of 3D navigation, where available, for insertion of SI screws in patients with normal and dysmorphic proximal sacral segments. Therapeutic level I.

Increasing body image flexibility in a residential eating disorder facility: Correlates with symptom improvement.

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Lee, Eric B; Ong, Clarissa W; Twohig, Michael P; Lensegrav-Benson, Tera; Quakenbush-Roberts, Benita

2018-01-01

The purpose of this study was to examine the effects of changes in body image psychological flexibility over the course of treatment on various outcome variables. Participants included 103 female, residential patients diagnosed with an eating disorder. Pretreatment and posttreatment data were collected that examined body image psychological flexibility, general psychological flexibility, symptom severity, and other outcome variables. Changes in body image psychological flexibility significantly predicted changes in all outcome measures except for obsessive-compulsive symptoms after controlling for body mass index, depression, and anxiety. Additionally, these results were maintained after controlling for general psychological flexibility, contributing to the incremental validity of the BI-AAQ. This study suggests that changes in body image psychological flexibility meaningfully predict changes in various treatment outcomes of interest, including eating disorder risk, quality of life, and general mental health. Findings indicate that body image psychological flexibility might be a viable target for eating disorder treatment.

Body image and eating disordered behavior in a community sample of Black and Hispanic women.

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Hrabosky, Joshua I; Grilo, Carlos M

2007-01-01

The current study examined body image concerns and eating disordered behaviors in a community sample of Black and Hispanic women. In addition, this study explored whether there are ethnic differences in the correlates or in the prediction of body image concerns. Participants were 120 (67 Black and 53 Hispanic) women who responded to advertisements to participate in a study of women and health. Participants completed a battery of established self-report measures to assess body image, eating disordered behaviors, and associated psychological domains. Black and Hispanic women did not differ significantly in their self-reports of body image, eating disordered behaviors, or associated psychological measures. Comparisons performed separately within both ethnic groups revealed significant differences by weight status, with a general graded patterning of greater concerns in obese than overweight than average weight groups. In terms of predicting body image, multiple regression analyses testing a number of variables, including BMI, performed separately for Black and Hispanic women revealed that eating concern and depressive affect were significant predictors of body image concern for both groups. Overall, Black and Hispanic women differed little in their self-reports of body image, eating-disordered features, and depressive affect. Higher weight was associated with a general pattern of increased body image concerns and features of eating disorders in both groups and with binge eating in Black women. Eating concerns and depressive affect emerged as significant independent predictors of body image for both ethnic groups.

Body weight concerns: Cross-national study and identification of factors related to eating disorders

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da Silva, Wanderson Roberto; Santana, Moema de Souza; Maroco, João; Maloa, Benvindo Felismino Samuel

2017-01-01

Background Body weight concerns are common among individuals with eating disorders, and this construct can be assessed using psychometric instruments. The Weight Concerns Scale (WCS) is commonly used to assess body weight concerns. Aims To evaluate the psychometric properties of the WCS with Brazilian, Portuguese, and Mozambican female college students; to estimate body weight concerns; and to identify factors related to eating disorders. Methods Confirmatory factor analysis was performed. Factorial, convergent, concurrent, and divergent validity, as well as reliability, were assessed. Cross-national invariance was tested by means of multigroup analysis. Structural models were tested using the WCS as the dependent variable, while demographic and academic variables and body mass index were used as independent variables. Logistic models were tested to estimate the likelihood of eating disorders being developed in specific groups. Results Participants were 2,068 female students. The psychometric properties of the WCS were adequate for the Portuguese sample; however, for the Brazilian and Mozambican samples, it was necessary to correlate the errors of two items to improve model fit. The WCS did not show cross-national invariance. The variables “thoughts about dropping out of college,” “medication use because of studies,” “medication and supplements use for body change,” “body mass index,” “socioeconomic status,” “age,” and “performance in course” were significant predictors of body weight concerns. Overall, 24.4% (95% confidence interval = 22.9–26.7) of the students were likely to develop eating disorders. Students under 21 years old, who use medication and supplements for body change, and who were classified as overweight/obese have increased likelihood of developing eating disorders. Conclusion The WCS showed good psychometric properties with Brazilian, Portuguese, and Mozambican students; however, it did not show cross

A novel mutation in GMPPA in siblings with apparent intellectual disability, epilepsy, dysmorphism, and autonomic dysfunction.

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Gold, Wendy A; Sobreira, Nara; Wiame, Elsa; Marbaix, Alexandre; Van Schaftingen, Emile; Franzka, Patricia; Riley, Lisa G; Worgan, Lisa; Hübner, Christian A; Christodoulou, John; Adès, Lesley C

2017-08-01

GMPPA encodes the GDP-mannose pyrophosphorylase A protein (GMPPA). The function of GMPPA is not well defined, however it is a homolog of GMPPB which catalyzes the reaction that converts mannose-1-phosphate and guanosine-5'-triphosphate to GDP-mannose. Previously, biallelic mutations in GMPPA were reported to cause a disorder characterized by achalasia, alacrima, neurological deficits, and intellectual disability. In this study, we report a female proband with achalasia, alacrima, hypohydrosis, apparent intellectual disability, seizures, microcephaly, esotropia, and craniofacial dysmorphism. Exome sequencing identified a previously unreported homozygous c.853+1G>A variant in GMPPA in the proband and her affected sister. Their unaffected parents were heterozygous, and unaffected brother homozygous wild type for this variant. Lymphoblast cells from the affected sisters showed complete loss of the GMPPA protein by Western blotting, and increased levels of GDP-mannose in lymphoblasts on high performance liquid chromatography. Based on our findings and the previous report describing patients with an overlapping phenotype, we conclude that this novel variant in GMPPA, identified by exome sequencing in the proband and her affected sister, is the genetic cause of their phenotype and may expand the known phenotype of this recently described glycosylation disorder. © 2017 Wiley Periodicals, Inc.

Neural basis of limb ownership in individuals with body integrity identity disorder

NARCIS (Netherlands)

van Dijk, Milenna T.; van Wingen, Guido A.; van Lammeren, Anouk; Blom, Rianne M.; de Kwaasteniet, Bart P.; Scholte, H. Steven; Denys, Damiaan

2013-01-01

Our body feels like it is ours. However, individuals with body integrity identity disorder (BIID) lack this feeling of ownership for distinct limbs and desire amputation of perfectly healthy body parts. This extremely rare condition provides us with an opportunity to study the neural basis

Strategic memory in adults with anorexia nervosa: are there similarities to obsessive compulsive spectrum disorders?

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Sherman, Bonnie J; Savage, Cary R; Eddy, Kamryn T; Blais, Mark A; Deckersbach, Thilo; Jackson, Safia C; Franko, Debra L; Rauch, Scott L; Herzog, David B

2006-09-01

There is growing interest in the relationship between anorexia nervosa (AN) and obsessive-compulsive (OC) spectrum disorders (e.g., OCD, body dysmorphic disorder [BDD]). Previous neuropsychological investigations of OC spectrum disorders have identified problems with the efficient use of strategy on complex measures of learning and memory. This study evaluated nonverbal strategic memory in AN outpatients using an approach previously applied to OC spectrum disorders. Eighteen patients with AN and 19 healthy control participants completed the Rey-Osterrieth Complex Figure Test (RCFT), a widely used measure of nonverbal strategic planning, learning, and memory. Individuals with AN differed significantly from healthy controls in the organizational strategies used to copy the RCFT figure, and they recalled significantly less information on both immediate and delayed testing. Multiple regression analyses indicated that group differences in learning were mediated by copy organizational strategies. These results are identical to study findings in OCD and BDD, indicating important shared neuropsychological features among AN and these OC spectrum disorders. As in OCD and BDD, the essential cognitive deficit in AN was impaired use of organizational strategies, which may inform our understanding of the pathophysiology of AN and potentially offer treatment implications. Copyright (c) 2006 by Wiley Periodicals, Inc.

Body dysmorphia, self-mutilation and the reconstructive surgeon.

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Chan, James Kwok-Kwan; Jones, Sophie M; Heywood, Anthony J

2011-01-01

Body dysmorphic disorder (BDD) is a disabling preoccupation with a slight or an imagined defect in appearance. It is recognised in some patients who present to the plastic surgeon requesting multiple cosmetic procedures. Very rarely, BDD patients may wish for amputation of a healthy limb and may even mutilate themselves deliberately in order to necessitate amputation. These patients pose a diagnostic challenge as BDD is uncommon and they are often uncooperative whilst appearing mentally sound. Furthermore, they raise difficult ethical and legal issues for the surgeon. Although there is some guidance for the management of BDD patients seeking elective amputation, there is currently none for the management of those who present in the emergency setting. Illustrated by the case of a man who, having failed to find a complicit surgeon, attempted self-amputation of the hand, we review the relevant ethical, legal and management issues with advice by the British Medical Association and General Medical Council. Copyright © 2010 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.

Body Image and Eating Disorders among Female Students: A Pilot Nutritional Psychology Study in Ghana

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Comfort Nora Ntim

2015-04-01

Full Text Available Body image and eating disorders have emerged as an essential facet of bio-psychosocial well-being. Although considered less prevalent in Ghana than in the West, body image and eating disorders are issues of global concern. One hundred (100 female participants with a mean age of approximately 21 years were recruited after informed consent for this pilot study. Results showed a positive correlation between body image and eating disorders. In addition, there was no significant difference between the levels of university education on female body image and eating distortions in Ghana. These findings underscore the importance for more future studies in nutritional psychology and related clinical management.

Diagnóstico diferencial do transtorno obsessivo-compulsivo

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Albina R Torres

2001-10-01

Full Text Available Obsessive-compulsive disorder (OCD has clinical features that overlap in various degrees with many other mental disorders. As a result, the differential diagnosis sometimes can be difficult. This review briefly summarizes the phenomenologic similarities and differences between OCD and the following disorders: depression, phobias, hypochondriasis and body dysmorphic disorder, Tourette syndrome and tic disorder, obsessive-compulsive personality disorder, impulse control and eating disorders, generalized anxiety, panic and post-traumatic stress disorders, and delusional and schizophrenic disorders. The accurate diagnosis is essential for adequate treatment planning and management.

Body integrity identity disorder and the ethics of mutilation.

OpenAIRE

Song, Robert

2013-01-01

The rare phenomenon in which a person desires amputation of a healthy limb, now often termed body integrity identity disorder, raises central questions for biomedical ethics. Standard bioethical discussions of surgical intervention in such cases fail to address the meaning of bodily integrity, which is intrinsic to a theological understanding of the goodness of the body. However, moral theological responses are liable to assume that such interventions necessarily represent an implicitly docet...

Body integrity identity disorder crosses culture: case reports in the Japanese and Chinese literature

NARCIS (Netherlands)

Blom, Rianne M.; Vulink, Nienke C.; van der Wal, Sija J.; Nakamae, Takashi; Tan, Zhonglin; Derks, Eske M.; Denys, Damiaan

2016-01-01

Body integrity identity disorder (BIID) is a condition in which people do not perceive a part of their body as their own, which results in a strong desire for amputation or paralyzation. The disorder is likely to be congenital due to its very early onset. The English literature describes only

Unique associations between young adult men's emotional functioning and their body dissatisfaction and disordered eating.

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Griffiths, Scott; Angus, Douglas; Murray, Stuart B; Touyz, Stephen

2014-03-01

Research on emotional functioning, body dissatisfaction, and disordered eating in males is predominated by studies of negative affect and emotion regulation. Other aspects of emotional functioning, namely emotion recognition and attentional biases toward emotional stimuli, have received little empirical attention. The present study investigated the unique associations between different aspects of men's emotional functioning and their disordered eating attitudes, muscularity dissatisfaction, and body fat dissatisfaction. Results from 132 male undergraduates showed that muscularity dissatisfaction was uniquely associated with both emotion regulation difficulties and an attentional bias toward rejecting faces. Body fat dissatisfaction was not uniquely associated with any aspect of emotional functioning. Disordered eating was uniquely associated with emotion regulation difficulties. Collectively, the results indicate differences in the patterns of associations between men's emotional functioning and their body dissatisfaction and disordered eating. Copyright © 2013 Elsevier Ltd. All rights reserved.

Apotemnophilia or body integrity identity disorder: a case report review.

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Bou Khalil, Rami; Richa, Sami

2012-12-01

Apotemnophilia or body integrity identity disorder (BIID) denotes a syndrome in which a person is preoccupied with the desire to amputate a healthy limb. In this report, we review the available case reports in the literature in order to enhance psychiatrists' and physicians' comprehension of this disorder. A search for the case reports available via MEDLINE was done since the first case report published by Money et al in 1977 till May 2011, using the following terms: apotemnophilia, self-demand amputation, body integrity identity disorder, and BIID. In all, 14 case reports were found relevant to our search. The desire to amputate one's healthy limb seems to be related to a major disturbance in the person's perception of one's own identity, where limb amputation can relieve temporarily the patient's feeling of distress without necessarily and uniformly adjusting the patient's own identity misperception. More investigations are needed in this domain in order to develop noninvasive treatment strategies that approach this aspect of the patient's distress within a globalist perspective. In addition, the health professionals' awareness regarding this disorder is required to ensure professional management of patients' suffering.

Borderline Personality Disorder is Associated with Lower Confidence in Perception of Emotional Body Movements

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Morten eKaletsch

2014-11-01

Full Text Available Much recent research has shown that personality disorders are associated with an altered emotion perception. Whereas most of this research was conducted with stimuli such as faces, the present study examined possible differences in the perception of emotions expressed via body language and body movements. 30 patients with borderline personality disorder and 30 non-patients observed video scenes of emotional human interactions conveyed by point–light displays, rated the depicted valence, and judged their confidence in this rating. Patients with borderline personality disorder showed no altered emotion perception (i.e., no biased perception in either a negative or a positive direction. They did not perceive and evaluate depicted emotions as being more extreme than healthy controls. However, patients with borderline personality disorder showed less confidence in their perception of depicted emotions, especially when these were difficult to identify. The findings extend insights on altered emotion perception in persons with borderline personality disorder to include the field of body movements.

Conceptualizing body dissatisfaction in eating disorders within a self-discrepancy framework: a review of evidence.

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Lantz, Elin L; Gaspar, Monika E; DiTore, Rebecca; Piers, Amani D; Schaumberg, Katherine

2018-02-09

Body dissatisfaction, the negative subjective evaluation of one's body, is associated with many negative psychological and physical health consequences. One conceptualization of body dissatisfaction includes an experience of discrepancy between perceived actual and ideal body shapes. This paper reviews the literature on three facets of body dissatisfaction from the framework of self-discrepancy theory: perceptions of current weight, ideal body weight, and the relative importance of conforming to ideals. We review components of body dissatisfaction among healthy individuals and eating-disordered individuals. We also address the conceptualization's relationship among body dissatisfaction, weight history, and dieting to expand the impact of body dissatisfaction research and to provide more information on the nature and treatment of eating disorders.

The relationship of sex and sexual orientation to self-esteem, body shape satisfaction, and eating disorder symptomatology

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Chetra eYean

2013-11-01

Full Text Available There is increasing interest in understanding what role, if any, sex and sexual orientation play in body dissatisfaction, its correlates to distress, and its relationship to disordered eating. The goals of the present study were to examine: (a differences in sex and sexual orientation in internalization of societal pressure to modify physical appearance, components of body image dissatisfaction, self-esteem, and eating disorder symptomatology and (b whether the internalization-eating disorder symptomatology was mediated by the different components of body image dissatisfaction and low self-esteem. The present data support several key trends in the literature: men generally reported less body dissatisfaction, internalization of socio-cultural standards of beauty, drive for thinness, and disordered eating, but a greater drive for muscularity than women; results also indicated that different components of body image dissatisfaction and low self-esteem partially mediated the relationship between internalization and eating disorder symptomatology. Gay men reported significantly more body dissatisfaction, internalization, eating disorder symptomatology, drive for thinness, and drive for muscularity than heterosexual men. Compared to heterosexual women, lesbians reported increased drive for muscularity, lower self-esteem, and lower internalization; however, they did not significantly differ on body dissatisfaction, drive for thinness or disordered eating. Correlation coefficients between body shape dissatisfaction and several aspects of mental distress were significantly larger for gay men than heterosexual men; the same coefficients did not differ between lesbian women and heterosexual women. Results of path analyses indicated that the relationship between internalization and disordered eating differs for gay and heterosexual men but not for lesbian and heterosexual women. These results call attention to lesbians as a generally understudied population.

The relationship of sex and sexual orientation to self-esteem, body shape satisfaction, and eating disorder symptomatology.

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Yean, Chetra; Benau, Erik M; Dakanalis, Antonios; Hormes, Julia M; Perone, Julie; Timko, C Alix

2013-01-01

There is increasing interest in understanding what role, if any, sex and sexual orientation play in body dissatisfaction, its correlates to distress, and its relationship to disordered eating. The goals of the present study were to examine: (a) differences in sex and sexual orientation in internalization of societal pressure to modify physical appearance, components of body image dissatisfaction, self-esteem, and eating disorder symptomatology and (b) whether the internalization-eating disorder symptomatology was mediated by the different components of body image dissatisfaction and low self-esteem. The present data support several key trends in the literature: men generally reported less body dissatisfaction, internalization of socio-cultural standards of beauty, drive for thinness, and disordered eating, but a greater drive for muscularity than women; results also indicated that different components of body image dissatisfaction and low self-esteem partially mediated the relationship between internalization and eating disorder symptomatology. Gay men reported significantly more body dissatisfaction, internalization, eating disorder symptomatology, drive for thinness, and drive for muscularity than heterosexual men. Compared to heterosexual women, lesbians reported increased drive for muscularity, lower self-esteem, and lower internalization; however, they did not significantly differ on body dissatisfaction, drive for thinness or disordered eating. Correlation coefficients between body shape dissatisfaction and several aspects of mental distress were significantly larger for gay men than heterosexual men; the same coefficients did not differ between lesbian women and heterosexual women. Results of path analyses indicated that the relationship between internalization and disordered eating differs for gay and heterosexual men but not for lesbian and heterosexual women. These results call attention to lesbians as a generally understudied population.

Out of my real body: cognitive neuroscience meets eating disorders

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Riva, Giuseppe

2014-01-01

Clinical psychology is starting to explain eating disorders (ED) as the outcome of the interaction among cognitive, socio-emotional and interpersonal elements. In particular two influential models—the revised cognitive-interpersonal maintenance model and the transdiagnostic cognitive behavioral theory—identified possible key predisposing and maintaining factors. These models, even if very influential and able to provide clear suggestions for therapy, still are not able to provide answers to several critical questions: why do not all the individuals with obsessive compulsive features, anxious avoidance or with a dysfunctional scheme for self-evaluation develop an ED? What is the role of the body experience in the etiology of these disorders? In this paper we suggest that the path to a meaningful answer requires the integration of these models with the recent outcomes of cognitive neuroscience. First, our bodily representations are not just a way to map an external space but the main tool we use to generate meaning, organize our experience, and shape our social identity. In particular, we will argue that our bodily experience evolves over time by integrating six different representations of the body characterized by specific pathologies—body schema (phantom limb), spatial body (unilateral hemi-neglect), active body (alien hand syndrome), personal body (autoscopic phenomena), objectified body (xenomelia) and body image (body dysmorphia). Second, these representations include either schematic (allocentric) or perceptual (egocentric) contents that interact within the working memory of the individual through the alignment between the retrieved contents from long-term memory and the ongoing egocentric contents from perception. In this view EDs may be the outcome of an impairment in the ability of updating a negative body representation stored in autobiographical memory (allocentric) with real-time sensorimotor and proprioceptive data (egocentric). PMID:24834042

Out of my real body: cognitive neuroscience meets eating disorders.

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Riva, Giuseppe

2014-01-01

Clinical psychology is starting to explain eating disorders (ED) as the outcome of the interaction among cognitive, socio-emotional and interpersonal elements. In particular two influential models-the revised cognitive-interpersonal maintenance model and the transdiagnostic cognitive behavioral theory-identified possible key predisposing and maintaining factors. These models, even if very influential and able to provide clear suggestions for therapy, still are not able to provide answers to several critical questions: why do not all the individuals with obsessive compulsive features, anxious avoidance or with a dysfunctional scheme for self-evaluation develop an ED? What is the role of the body experience in the etiology of these disorders? In this paper we suggest that the path to a meaningful answer requires the integration of these models with the recent outcomes of cognitive neuroscience. First, our bodily representations are not just a way to map an external space but the main tool we use to generate meaning, organize our experience, and shape our social identity. In particular, we will argue that our bodily experience evolves over time by integrating six different representations of the body characterized by specific pathologies-body schema (phantom limb), spatial body (unilateral hemi-neglect), active body (alien hand syndrome), personal body (autoscopic phenomena), objectified body (xenomelia) and body image (body dysmorphia). Second, these representations include either schematic (allocentric) or perceptual (egocentric) contents that interact within the working memory of the individual through the alignment between the retrieved contents from long-term memory and the ongoing egocentric contents from perception. In this view EDs may be the outcome of an impairment in the ability of updating a negative body representation stored in autobiographical memory (allocentric) with real-time sensorimotor and proprioceptive data (egocentric).

Perception ofown body by women with borderline personality disorder – preliminary studies

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Aleksandra Szepietowska

2014-03-01

Full Text Available Aim: Analysis of the way women with borderline personality disorder (BPD perceive their bodies. Methods: The body perception was presented as a psychological model manifested in the attitude to one’s own body, the way of sensing and interpreting the bodily sensations, mental identification with the body, and the feeling of comfort in interpersonal closeness and social exposure situations. Material and methods: Twenty eight women took part in the study: 14 of them met the BPD criteria, 14 constituted a comparative group (selection by pairs. Three instruments were used: The Symptom Checklist-90 (SCL-90, self-constructed questionnaire examining one’s own body perception (Body Perception Scale – Skala Percepcji Ciała, SPC, and Borderline Scale from Structured Clinical Interview for DSM-IV Axis II Disorders (SCID-II to confirm BPD symptoms. Results: Women with BPD perceive their bodies more negatively in all examined aspects, as compared to those without personality disorders. Predominant are negative emotions towards one’s body and lack of confidence in one’s attraction for other people. Less intense become such traits as: the impression of perceptive changes, difficulty in identification with the body appearance, and avoidance of close physical contacts. Comparisons of SCL-90 results show that in women with BPD all psychopathological symptoms are more severe. These patients are characterized by an increased level of depressiveness, obsessive-compulsive traits, paranoid ideation, and psychoticism. The results profile shows a similar pattern of symptoms in both groups and it is not the type but severity of psychopathological symptoms that differentiates them.

Major depressive disorder alters perception of emotional body movements

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Morten eKaletsch

2014-01-01

Full Text Available Much recent research has shown an association between mood disorders and an altered emotion perception. However, these studies were conducted mainly with stimuli such as faces. This is the first study to examine possible differences in how people with major depressive disorder (MDD and healthy controls perceive emotions expressed via body movements. 30 patients with MDD and 30 healthy controls observed video scenes of human interactions conveyed by point–light displays (PLDs. They rated the depicted emotions and judged their confidence in their rating. Results showed that patients with MDD rated the depicted interactions more negatively than healthy controls. They also rated interactions with negative emotionality as being more intense and were more confident in their ratings. It is concluded that patients with MDD exhibit an altered emotion perception compared to healthy controls when rating emotions expressed via body movements depicted in PLDs.

Marked Body Shape Concerns in Female Patients Suffering from Eating Disorders: Relevance of a Clinical Sub-Group.

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Lucie Gailledrat

Full Text Available Concerns about body shape and weight are core diagnostic criteria for eating disorders although intensity varies between patients. Few studies have focused on the clinical differences relative to the intensity of these concerns. Nonetheless, they might have a prognostic value. This study was aimed at identifying the characteristics associated with marked body shape concerns in patients with an eating disorder. Data was collected from a systematic and standardized clinical assessment of outpatients seeking treatment in our department for eating disorders. Only female patients, suffering from anorexia nervosa or bulimia nervosa, and with "no / mild" or "marked" body shape concerns according to the Body Shape Questionnaire, were included for the present study. We focused on sociodemographic characteristics, eating disorder characteristics, axis 1 disorders, types of attachment, self-esteem and dissociation. A multiple logistic regression was performed to identify factors related to "marked" body shape concerns. In our sample (123 participants, with a mean age of 24.3 years [range 16-61], 56.9% had marked concerns with body shape. Marked body shape concerns were associated with a major depressive episode (OR = 100.3, the use of laxatives (OR = 49.8, a high score on the item "body dissatisfaction" of the Eating Disorders Inventory scale (OR = 1.7, a higher minimum body mass index (OR = 1.73, and a high score on the item "loss of control over behavior, thoughts and emotions" from the dissociation questionnaire (OR = 10.74. These results are consistent with previous studies, and highlight the importance of denial.

Effects of an Appearance-Focused Interpretation Training Intervention on Eating Disorder Symptoms.

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Summers, Berta J; Cougle, Jesse R

2018-03-13

Previous research suggests that computerized interpretation bias modification (IBM) techniques may be useful for modifying thoughts and behaviours relevant to eating pathology; however, little is known about the utility of IBM for decreasing specific eating disorder (ED) symptoms (e.g. bulimia, drive for thinness). The current study sought to further examine the utility of IBM for ED symptoms via secondary analyses of an examination of IBM for individuals with elevated body dysmorphic disorder (BDD) symptoms (see Summers and Cougle, 2016), as these disorders are both characterized by threat interpretation biases of ambiguous appearance-related information. We recruited 41 participants for a randomized trial comparing four sessions of IBM aimed at modifying problematic social and appearance-related threat interpretation biases with a placebo control training (PC). At 1-week post-treatment, and relative to the PC, the IBM group reported greater reductions in negative/threat interpretations of ambiguous information in favour of positive/benign biases. Furthermore, among individuals with high pre-treatment bulimia symptoms, IBM yielded greater reductions in bulimia symptoms compared with PC at post-treatment. No treatment effects were observed on drive for thinness symptoms. The current study suggests that cognitive interventions for individuals with primary BDD symptoms may improve co-occurring ED symptoms such as bulimia.

Body-Related Social Comparison and Disordered Eating among Adolescent Females with an Eating Disorder, Depressive Disorder, and Healthy Controls

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Daniel Le Grange

2012-09-01

Full Text Available The purpose of this study was to investigate the association between body-related social comparison (BRSC and eating disorders (EDs by: (a comparing the degree of BRSC in adolescents with an ED, depressive disorder (DD, and no psychiatric history; and (b investigating whether BRSC is associated with ED symptoms after controlling for symptoms of depression and self-esteem. Participants were 75 girls, aged 12–18 (25 per diagnostic group. To assess BRSC, participants reported on a 5-point Likert scale how often they compare their body to others’. Participants also completed a diagnostic interview, Eating Disorders Inventory-2 (EDI-2, Beck Depression Inventory-II (BDI-II, and Rosenberg Self-Esteem Scale (RSE. Compared to adolescents with a DD and healthy adolescents, adolescents with an ED engaged in significantly more BRSC (p ≤ 0.001. Collapsing across groups, BRSC was significantly positively correlated with ED symptoms (p ≤ 0.01, and these associations remained even after controlling for two robust predictors of both ED symptoms and social comparison, namely BDI-II and RSE. In conclusion, BRSC seems to be strongly related to EDs. Treatment for adolescents with an ED may focus on reducing BRSC.

Body-related social comparison and disordered eating among adolescent females with an eating disorder, depressive disorder, and healthy controls.

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Hamel, Andrea E; Zaitsoff, Shannon L; Taylor, Andrew; Menna, Rosanne; Le Grange, Daniel

2012-09-01

The purpose of this study was to investigate the association between body-related social comparison (BRSC) and eating disorders (EDs) by: (a) comparing the degree of BRSC in adolescents with an ED, depressive disorder (DD), and no psychiatric history; and (b) investigating whether BRSC is associated with ED symptoms after controlling for symptoms of depression and self-esteem. Participants were 75 girls, aged 12-18 (25 per diagnostic group). To assess BRSC, participants reported on a 5-point Likert scale how often they compare their body to others'. Participants also completed a diagnostic interview, Eating Disorders Inventory-2 (EDI-2), Beck Depression Inventory-II (BDI-II), and Rosenberg Self-Esteem Scale (RSE). Compared to adolescents with a DD and healthy adolescents, adolescents with an ED engaged in significantly more BRSC (p ≤ 0.001). Collapsing across groups, BRSC was significantly positively correlated with ED symptoms (p ≤ 0.01), and these associations remained even after controlling for two robust predictors of both ED symptoms and social comparison, namely BDI-II and RSE. In conclusion, BRSC seems to be strongly related to EDs. Treatment for adolescents with an ED may focus on reducing BRSC.

Overweight and Body Image Perception in Adolescents with Triage of Eating Disorders

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Roberta Stofeles Cecon

2017-01-01

Full Text Available Purpose. To verify the influence of overweight and alteration in the perception of the corporal image during the triage of eating disorders. Method. A food disorder triage was performed in adolescents with 10 to 19 years of age using the Eating Attitudes Test (EAT-26, Children’s Eating Attitudes Test (ChEAT, and Bulimic Investigatory Test Edinburgh (BITE, as well as a nutritional status evaluation. The perception of body image was evaluated in a subsample of adolescents with 10 to 14 years of age, using the Brazilian Silhouette Scale. The project was approved by the Human Research Ethics Committee of the Federal University of Viçosa, Minas Gerais, Brazil. Results. The prevalence of eating disorder triage was 11.4% (n=242 for the 2,123 adolescents evaluated. Overweight was present in 21.1% (n=447 of the students, being more prevalent in the early adolescence phase, which presented levels of distortion of 56.9% (n=740 and dissatisfaction of 79.3% (n=1031. Body dissatisfaction was considered as a risk factor, increasing by more than 13 times the chance of TA screening. Conclusion. Overweight was correlated with the ED triage and body dissatisfaction was considered as a risk factor, increasing the chances of these disorders by more than 13 times.

An autosomal recessive leucoencephalopathy with ischemic stroke, dysmorphic syndrome and retinitis pigmentosa maps to chromosome 17q24.2-25.3

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Bouhouche Ahmed

2012-03-01

Full Text Available Abstract Background Single-gene disorders related to ischemic stroke seem to be an important cause of stroke in young patients without known risk factors. To identify new genes responsible of such diseases, we studied a consanguineous Moroccan family with three affected individuals displaying hereditary leucoencephalopathy with ischemic stroke, dysmorphic syndrome and retinitis pigmentosa that appears to segregate in autosomal recessive pattern. Methods All family members underwent neurological and radiological examinations. A genome wide search was conducted in this family using the ABI PRISM linkage mapping set version 2.5 from Applied Biosystems. Six candidate genes within the region linked to the disease were screened for mutations by direct sequencing. Results Evidence of linkage was obtained on chromosome 17q24.2-25.3. Analysis of recombination events and LOD score calculation suggests linkage of the responsible gene in a genetic interval of 11 Mb located between D17S789 and D17S1806 with a maximal multipoint LOD score of 2.90. Sequencing of seven candidate genes in this locus, ATP5H, FDXR, SLC25A19, MCT8, CYGB, KCNJ16 and GRIN2C, identified three missense mutations in the FDXR gene which were also found in a homozygous state in three healthy controls, suggesting that these variants are not disease-causing mutations in the family. Conclusion A novel locus for leucoencephalopathy with ischemic stroke, dysmorphic syndrome and retinitis pigmentosa has been mapped to chromosome 17q24.2-25.3 in a consanguineous Moroccan family.

Limb amputations in fixed dystonia: a form of body integrity identity disorder?

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Edwards, Mark J; Alonso-Canovas, Araceli; Schrag, Arnette; Bloem, Bastiaan R; Thompson, Philip D; Bhatia, Kailash

2011-07-01

Fixed dystonia is a disabling disorder mainly affecting young women who develop fixed abnormal limb postures and pain after apparently minor peripheral injury. There is continued debate regarding its pathophysiology and management. We report 5 cases of fixed dystonia in patients who sought amputation of the affected limb. We place these cases in the context of previous reports of patients with healthy limbs and patients with chronic regional pain syndrome who have sought amputation. Our cases, combined with recent data regarding disorders of mental rotation in patients with fixed dystonia, as well as previous data regarding body integrity identity disorder and amputations sought by patients with chronic regional pain syndrome, raise the possibility that patients with fixed dystonia might have a deficit in body schema that predisposes them to developing fixed dystonia and drives some to seek amputation. The outcome of amputation in fixed dystonia is invariably unfavorable. Copyright © 2011 Movement Disorder Society.

Clinical and biochemical presentation of siblings with COG-7 deficiency, a lethal multiple O- and N-glycosylation disorder.

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Spaapen, L.J.; Bakker, J.A.; Meer, S.B. van der; Sijstermans, H.J.; Steet, R.A.; Wevers, R.A.; Jaeken, J.

2005-01-01

Congenital disorders of glycosylation (CDG) represent a group of inherited multiorgan diseases caused by defects in the biosynthesis of glycoproteins. We report on two dysmorphic siblings with severe liver disease who died at the age of a few weeks. Increased activities of lysosomal enzymes in

Non-suicidal self-injury in patients with eating disorders: prevalence, forms, functions, and body image correlates.

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Pérez, Sandra; Marco, Jos H; Cañabate, Montse

2018-04-12

More than one third of patients with eating disorders report NSSI. Moreover, negative attitudes and feelings toward the body, body dissatisfaction, and body image disturbances have been linked to NSSI in community and clinical samples. However, there is a lack of studies exploring NSSI frequency and functions and the specific relationship between multidimensional body image dimensions and NSSI in eating disorder patients. First, we explored the frequency, types, and functions of NSSI in a sample of 226 Spanish female participants with eating disorders (ED). Second, we explored differences in NSSI and body image depending on the ED restrictive-purgative subtype; and third, we explored differences in body dissatisfaction, body image orientation, and body investment in eating disorder patients without NSSI (n = 144), with NSSI in their lifetime (n = 19), and (b) with NSSI in the previous year (n = 63). Of the overall sample, 37.1% (n = 89) had a history of self-injury during their lifetime, and 27.1% (n = 65) had self-injured in the previous year. Among the types of ongoing NSSI, the most frequent were banging (64.6%) and cutting (56.9%). Restrictive vs purgative patients differed on NSSI lifetime, Appearance Evaluation, Body Areas Satisfaction, Body Protection and Feelings and Attitudes toward the Body. Moreover, significant differences were found on Appearance Evaluation, Body Areas Satisfaction, Positive Feelings and Attitudes towards the Body, Body Protection, and Comfort with physical contact, between participants without a history of self-injury and both NSSI groups. Body dissatisfaction and body investment have been found to be variables related to NSSI. Thus, the present study highlights the importance of working on body image in ED patients to reduce the frequency of NSSI. Copyright © 2018 Elsevier Inc. All rights reserved.

A Meta-Analysis Examining the Influence of Pro-Eating Disorder Websites on Body Image and Eating Pathology.

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Rodgers, Rachel F; Lowy, Alice S; Halperin, Daniella M; Franko, Debra L

2016-01-01

Previous research has indicated that exposure to pro-eating disorder websites might increase eating pathology; however, the magnitude of this effect is unknown. This study aimed to conduct a systematic review and meta-analysis to examine the effect of exposure to pro-eating disorder websites on body image and eating pathology. Studies examining the relationship between exposure to pro-eating disorder websites and eating pathology-related outcomes were included. The systematic review identified nine studies. Findings revealed significant effect sizes of exposure to pro-eating disorder websites on body image dissatisfaction (five studies), d = .41, p = .003; dieting (six studies), d = .68, p eating disorder websites on body image and eating pathology, highlighting the need for enforceable regulation of these websites. Copyright © 2015 John Wiley & Sons, Ltd and Eating Disorders Association.

Body attitudes in patients with eating disorders at presentation and completion of intensive outpatient day treatment.

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Exterkate, C.C.; Vriesendorp, P.F.; Jong, C.A.J. de

2009-01-01

Due to the importance of the distorted body experience in eating disorder diagnosis and treatment, we wanted to explore body attitudes of patients with eating disorders before and after 5 months of intensive specialized outpatient day treatment. We assessed 193 patients diagnosed with Anorexia

Body Mass Disorders in Healthy Short Children and in Children with Growth Hormone Deficiency.

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Tomaszewski, Paweł; Milde, Katarzyna; Majcher, Anna; Pyrżak, Beata; Tiryaki-Sonmez, Gul; Schoenfeld, Brad J

2018-01-01

The aim of the study was to determine the degree of adiposity and the incidence of body mass disorders, including abdominal obesity, in healthy short children and children with growth hormone deficiency. The study included 134 short children (height hormonal disorders and 71 patients (35 boys and 36 girls) with growth hormone deficiency. Basic somatic features were assessed and the study participants were categorized according to the percentage of body fat (%FAT), body mass index (BMI), and waist-to-height ratio (WHtR). We found that there were no significant differences in %FAT and the incidence of body weight disorders depending on gender or diagnosis. %FAT deficit was observed in 12-21% of the participants and underweight in almost every fourth child. Overweight involved 3-14% of the participants and obesity was diagnosed in isolated cases (0-3%); both were considerably lower compared to the estimates based on %FAT. Using the cut-off points of WHtR, abdominal adiposity was observed in 3-15% of the participants. In conclusion, quite a large number of short children (between 25 and 50%) are characterized by abnormal body fat or body mass index values. The results indicate a limited usefulness of BMI in evaluating the incidence of overweight and obesity in children characterized by a height deficit.

Body shape perception and dieting in preadolescent British Asian girls: links with eating disorders.