Effects of Body Dysmorphic Disorder - Research Paper Example

?Introduction Physical image of a person plays an essential role in his personal and social success. Satisfaction with one’s body is an important factor in development of confidence and high self-esteem. Sadly, there are many people in the world who are dissatisfied with their body, and suffer from extreme anxiety and over consciousness regarding their appearance. Their preoccupation with their body is so strong that it hampers their daily routine and develops problems in their social interactions. When the preoccupation with body becomes extreme, it becomes an obsession for a person and takes the shape of a mental disorder. This mental disorder is known as ‘body dysmorphic disorder.’ The fact that 1% of adults in general population suffer from ‘body dysmorphic disorder’ (BDD) shows that BDD is not a rare disorder (Hunt, Thienhaus & Ellwood, 2008). Interestingly, it has been found that in most cases of BDD, the obsession is baseless and only ‘psychological’ in nature (Phillips, 2005, p.3). Hence, it is not surprising to find that psychological problems like major depression, suicide and disability are found in higher rates in people suffering from BDD, than in general population (Hunt, Thienhaus & Ellwood, 2008). This proves that BDD can hamper a person’s life severely. If prevalence of BDD is to be reduced, then immediate steps are needed to be taken to treat the root cause of the problem, which lies in the thinking process of a person. Hence, the solution of body dysmorphic disorder lies not in changing the shape of body or in cosmetic surgery, but it lies in modifying the thinking process and cognition of a person. Definition Diagnosis of BDD is not an easy task as people suffering from BDD are known to display various symptoms. Hence, the DSM-IV has given the BDD’s diagnostic criteria by including those basic features which are found in ‘every person’ suffering from BDD (Phillips, 2005, p.27). According to DSM-IV, body dysmorphic disorder is defined as a disorder in which people are so “preoccupied with the idea that their appearance is defective in some way” that it “causes them significant distress” and “interferes with their functioning” (Phillips, 2005, p.27). It is also stated in the definition that even though some defects with appearance in people suffering from BDD are real, they are usually slight and hence, ignorable (Phillips, 2005, p.27).However, in most of the cases of BDD, the defects are not real but ‘imagined’ and hence, are not perceived by others (Phillips, 2005, p.27). From the definition, it is clear that BDD not only affects the psychological aspect of personality but also affects the personal and social aspect of a person. Effects Of BDD The daily life of people suffering from BDD is affected in various ways. The preoccupation with a slight or imagined defect in their appearance is so extreme that it makes them to spend long time in grooming rituals like “repeatedly combing hair or picking at their skin” (Insel, Turner & Ross, 2010, p.505). The preoccupation is usually severe in nature and causes severe distress in a person (Insel, Turner & Ross, 2010, p.505). People suffering from BDD feel very self-conscious in social situations and hence, make very few friends, avoid dating, and miss school or work in order to avoid social interactions (Insel, Turner & Ross, 2010, p.505). It has been found that many people suffering from BDD have never been married due to the fears associated with their looks (Rivera & Borda, 2001). The preoccupation with the defect leads to other psychological problems like obsessive-compulsive disorder (OCD) and social phobia (Insel, Turner & Ross, 2010, p.505). It has been found that 2% to 7% of people suffering from BDD undergo plastic surgery and even then, they remain unhappy with their appearance (Insel, Turner & Ross, 2010, p.505). This indicates that their obsession and preoccupation with appearance is not real but imaginary, and hence, their problem lies in their psychological make up. However, studies on BDD have revealed that along with psychological factors, even external factors are responsible for development of BDD in a person. Risk Factors BDD is quite under-researched disorder and hence, there is no clarity regarding the causal factors of BDD (Veale & Neziroglu, 2010, p.111). Genes, temperament, childhood adversity, physical stigmata etc., are commonly regarded as the causal factors of BDD (Veale & Neziroglu, 2010, p.111). However, it is also understood that external factors work as catalyst in developing BDD in people who suffer from biological vulnerability (Veale & Neziroglu, 2010, p.111). The combination of internal and external factors then leads to development of BDD in a person (Veale & Neziroglu, 2010, p.111). Some of the risk factors are discussed below. Genes Researches have revealed that like other psychiatric disorders, BDD can be transmitted through genes (Veale & Neziroglu, 2010, p.114). Study of family history data by Richter et al. (2004) has revealed that “6-10% of first degree family members have BDD” (Veale & Neziroglu, 2010, p.114). Study by Hollander et al. (1993) found that “17% of family members of 50 patients of BDD had OCD” (Rivera & Borda, 2001). Also, an investigative study by Bienvenu et al. (2000) revealed that occurrence of BDD is more frequent in people whose first family members have OCD (Veale & Neziroglu, 2010, p.114). This shows that BDD is genetic in nature and hence, people whose family members have OCD are more at risk of developing BDD. Childhood Adversity Sexual abuse in childhood is also found to be a risk factor in development of BDD. A study by Osman et al. (2004) revealed that 11% of childhood images were linked with sexual abuse (Veale & Neziroglu, 2010, p.117). It has been observed that incidences of rape and sexual abuse had caused the victims to develop negative image about their body (Veale & Neziroglu, 2010, p.117). The second childhood adversity that can develop BDD is insecure attachment. BDD can also result from the insecure attachment and poor parental bonding during childhood (Veale & Neziroglu, 2010, p.117). Lambrou (2006) found that people suffering from BDD scored significantly higher, compared to the general population, on the insecure attachment scale (Veale & Neziroglu, 2010, p.117). Phillips (2001) found that compared to the general population, people suffering from BDD had poor parenting care scores on the Parental Bonding Instrument (Veale & Neziroglu, 2010, p.117). The third childhood adversity that can cause BDD is the experience of being a victim of teasing. The experience of being teased for dermatological disorder like acne or other physical stigmata during adolescence, remains with the person even in his adulthood, and causes him to develop negative body image which results in development o f BDD (Veale & Neziroglu, 2010, p.117). However, it has also been found that clients experienced change in their body image after appearance of physical stigmata like acne, even if they were not teased (Veale & Neziroglu, 2010, p.117). This shows that the roots of BDD lie in the cognition process of a person. Treatment As BDD is related to the preoccupation with some physical defect, it will not be wrong to assume that BDD can be cured by getting that defect removed or modified by cosmetic surgery. However, it is not so. Even when people suffering from BDD are told by cosmetic surgeons that there are no defects to surgically correct, their preoccupation still persists (First & Tasman, 2010, p.405). It has been found that people suffering from BDD remain dissatisfied with their looks even after undergoing cosmetic surgery or other corrective measure (First & Tasman, 2010, p.405). In fact, in some cases the distress increases after surgery as they ‘perceive’ new defects resulting from surgery (First & Tasman, 2010, p.405). Hence, psychological treatment and counseling is one of the best treatments for people suffering from BDD. The therapy that has been found very effective in treating BDD is the cognitive behavior therapy. A study conducted by MacKay et al. (1997) revealed that CBT , and psycho-education sessions once every two weeks after that, were helpful in keeping the patients symptom-free for six months (Veale & Neziroglu, 2010, p.170). Moreover, he found that the levels of anxiety and depression had also lowered in the patients (Veale & Neziroglu, 2010, p.171). McKay found that the gains from CBT treatment were maintained even after two years (Veale & Neziroglu, 2010, p.171). This shows that CBT is a very effective treatment for BDD. Conclusion The discussion above shows that body dysmorphic disease is developed due to the negative body image formed in the mind of a person. The body defect is ‘imaginary’ or ‘perceived’ in most cases and hence, indicates problem with cognition. Hence, people suffering from BDD should be helped and encouraged to get their disorder treated through psychological counseling rather than through cosmetic surgery, as it is not their physical appearance that is the cause of their disorder but their perception and imagination about their appearance. References First, M.B. & Tasman, A. (2010). Clinical Guides To The Diagnosis And Treatment Of Mental Disorder (2nd Ed.). Hoboken, NJ: John Wiley & Sons, Inc. Hunt, T. J., M.D., Thienhaus, O., & Ellwood, A. (2008). The mirror lies: Body dysmorphic disorder. American Family Physician, 78(2), 217-22. Retrieved from http://search.proquest.com/docview/234253259?accountid=40795 Insel, P., Turner, R.E. & Ross, D. (2010). Discovering Nutrition (3rd ed.). Sudbury, MA: Jones and Bartlett Publishers. Phillips, K. (2005). The Broken Mirror: Understanding And Treating Body Dysmorphic Disorder. New York, NY: Oxford UP. Rivera, R. P & Borda, T. (2001).The etiology of body dysmorphic disorder. Psychiatric Annals, 31(9), 559-563. Retrieved from http://search.proquest.com/docview/217051480?accountid=40795 Veale, D. & Neziroglu, F. (2010). Body Dysmorphic Disorder: A Treatment Manual. Hoboken, NJ: John Wiley & Sons, Inc. Read More