Biomedical subjects

Elizabeth R Didie

Publications and source records attributed to Elizabeth R Didie.

9 recordsLinked to original sources

PubMed2006

Childhood abuse and neglect in body dysmorphic disorder.

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 Questionnaire and were interviewed with other reliable and valid measures. RESULTS: Of these subjects, 78.7% reported a history of childhood maltreatment: emotional neglect (68.0%), emotional abuse (56.0%), physical abuse (34.7%), physical neglect (33.3%), and sexual abuse (28.0%). Forty percent of subjects reported severe maltreatment. Among females (n=52), severity of reported abuse and neglect were .32-.57 standard deviation units higher than norms for a health maintenance organization (HMO) sample of women. Severity of sexual abuse was the only type of maltreatment significantly associated with current BDD severity (r=.23, p=.047). However, severity of sexual abuse did not predict current BDD severity in a simultaneous multiple regression analysis with age and current treatment status. There were other significant associations with childhood maltreatment: history of attempted suicide was related to emotional (p=.004), physical (p=.014), and sexual abuse (p=.038). Childhood emotional abuse was associated with a lifetime substance use disorder (r=.26, p=.02), and physical abuse was negatively associated with a lifetime mood disorder (r=-.37, p=.001). CONCLUSIONS: A high proportion of individuals with BDD reported childhood abuse and neglect. Certain types of abuse and neglect appear modestly associated with BDD symptom severity and with gender, suicidality, and certain disorders.

Adult↗

PubMed2006

Clinical features and correlates of major depressive disorder in individuals with body dysmorphic disorder.

BACKGROUND: Body dysmorphic disorder (BDD) and major depressive disorder (MDD) appear highly comorbid. However, MDD in individuals with BDD has received little investigation. METHODS: The prevalence and characteristics of comorbid MDD were assessed in 178 BDD subjects. BDD subjects with current comorbid MDD (n=68) were compared to BDD subjects without current comorbid MDD (n=96) on demographic and clinical characteristics. Predictors of current MDD were determined using logistic regression. RESULTS: 74.2% of subjects had lifetime MDD, and 38.2% had current MDD. The melancholic subtype was most common, and a majority of depressed subjects had recurrent episodes. Mean onset of BDD occurred at a younger age than MDD. Subjects with current comorbid MDD had many similarities to those without MDD, although those with comorbid MDD had more severe BDD. Subjects with comorbid MDD were also more likely to have an anxiety or personality disorder, as well as a family history of MDD. They also had greater social anxiety, suicidality, and poorer functioning and quality of life. Current MDD was independently predicted by a personality disorder and more severe BDD. LIMITATIONS: It is unclear how generalizable the results are to the community or to subjects ascertained for MDD who have comorbid BDD. The study lacked a comparison group such as MDD subjects without BDD. CONCLUSIONS: MDD is common in individuals with BDD. Individuals with current MDD had greater morbidity in some clinically important domains, including suicidality, functioning, and quality of life. A personality disorder and more severe BDD independently predicted the presence of current MDD.

Activities of Daily Living↗

PubMed2006

Clinical features of body dysmorphic disorder in adolescents and adults.

Body dysmorphic disorder (BDD) usually begins during adolescence, but its clinical features have received little investigation in this age group. Two hundred individuals with BDD (36 adolescents; 164 adults) completed interviewer-administered and self-report measures. Adolescents were preoccupied with numerous aspects of their appearance, most often their skin, hair, and stomach. Among the adolescents, 94.3% reported moderate, severe, or extreme distress due to BDD, 80.6% had a history of suicidal ideation, and 44.4% had attempted suicide. Adolescents experienced high rates and levels of impairment in school, work, and other aspects of psychosocial functioning. Adolescents and adults were comparable on most variables, although adolescents had significantly more delusional BDD beliefs and a higher lifetime rate of suicide attempts. Thus, adolescents with BDD have high levels of distress and rates of functional impairment, suicidal ideation, and suicide attempts. BDD's clinical features in adolescents appear largely similar to those in adults.

Adolescent↗

PubMed2006

Tanning in body dysmorphic disorder.

Tanning in body dysmorphic disorder (BDD) has not previously been studied. In this study, 200 subjects with BDD were evaluated with measures to examine the prevalence of BDD-related tanning--i.e., darkening one's skin color by direct exposure to sunlight or artificial light which is motivated by a desire to improve a perceived appearance defect (i.e., a BDD concern). We also examined clinical characteristics of individuals who engaged in BDD-related tanning. 25% (95% CI, 19.0%-31.0%) of subjects reported BDD-related tanning. Among tanners, the skin was the most common body area of concern (84.0%). All tanners experienced functional impairment due to BDD, 26% had attempted suicide, and quality of life was markedly poor. 52% of tanners had received dermatologic treatment, which was usually ineffective for BDD symptoms. Tanners were more likely than non-tanners to compulsively pick their skin. In conclusion, tanning--a behavior with well-known health risks--is a relatively frequent BDD-related behavior.

Adolescent↗

PubMed2006

Social functioning in body dysmorphic disorder: assessment considerations.

Individuals with body dysmorphic disorder (BDD) have markedly poor social functioning; however, previous reports may underestimate impairment. Scoring on certain functioning measures such as the Social Adjustment Scale-Self Report (SAS-SR) potentially excludes more severely ill individuals from some domains, thereby possibly underestimating functional impairment. To explore this issue, 73 individuals with BDD who reported having no primary relationship (and were therefore excluded from scoring on the SAS-SR Primary Relationship domain) were compared to 58 individuals with BDD who had a primary relationship. Subjects without a primary relationship had significantly poorer global social adjustment on several measures. They also had poorer scores on the Global Assessment of Functioning Scale and greater severity of BDD and depressive symptoms at a trend level. These findings suggest that the SAS-SR may underestimate social impairment. This underestimation may pertain to other domains of functioning, other disorders, and certain other functioning and quality of life measures.

Adult↗

PubMed2005

Binge eating and psychological distress: is the degree of obesity a factor?

The purpose of the present study was to examine whether individuals with Binge Eating Disorder (BED) demonstrate comparable levels of eating pathology and psychological distress independent of weight status. Male and female participants with BED (N = 96) completed the Questionnaire on Eating and Weight Patterns-Revised; Beck Depression Inventory (BDI), Symptom Checklist (SCL)-90-Revised, and Eating Disorder Inventory-2 (EDI-2). Participants were divided into categories of normal/overweight, obese, and severely obese based on their body mass index (BMI). Analysis of variance was performed using scores on the psychological measures with subjects grouped according to weight status. Participants with BED did not differ on any of the measures of psychological or eating symptoms regardless of weight status. These results replicate and extend previous findings, suggesting that binge eating pathology independent of weight status, accounts for psychological distress among binge eaters.

Adult↗

PubMed2003

Beauty and society.

Beauty is an abstract construct. We all have our own ideas about what is and is not beautiful--a particular song or painting, a man or woman. Accurately describing what exactly "it" is that makes the song, painting or person beautiful, however, is a daunting task. In this article, we attempt to make the case that beauty and physical attractiveness is a serious matter. We begin with a discussion of the role of beauty in evolutionary theory. Next, we turn to theories of the physiology of beauty, which focus on physical characteristics such as pathogen resistance, averageness, physical symmetry, body ratios, and youthfulness. We then describe changes in the societal standards of beauty through a discussion of the relatively recent history of mass media images of beauty. We then use the psychological construct of body image to begin to understand the nature of beauty on an individual level. The article concludes with a discussion of the things that we do to make ourselves more beautiful.

Beauty↗

PubMed2003

Body dysmorphic disorder in cosmetic surgery patients.

This article discusses body dysmorphic disorder (BDD) among cosmetic surgery patients. BDD is characterized as a preoccupation with a slight or imagined defect with some aspect of physical appearance that leads to significant disruption in daily functioning. Although the prevalence of BDD within the general population is unknown, recent evidence suggests that the disorder may be overrepresented among persons who seek cosmetic medical treatments. Preliminary evidence suggests that persons with BDD do not benefit from cosmetic treatments and frequently experience a worsening of their BDD symptoms. Thus, identification of BDD symptomotology has become an important part of determining patients' appropriateness for cosmetic procedures.

Body Image↗

PubMed2003

Factors that influence the decision to undergo cosmetic breast augmentation surgery.

BACKGROUND: This study examined the factors that motivate women to seek cosmetic breast augmentation surgery. METHODS: Twenty-five breast augmentation surgery candidates completed measures of body image dissatisfaction, sociocultural influences on physical appearance, marital and sexual satisfaction, and self-report questionnaires that assessed other motivations for surgery. Thirty physically similar women who were not interested in breast augmentation also completed the measures. RESULTS: Replicating previous studies, breast augmentation candidates, compared with controls, reported greater dissatisfaction with their breasts. The two groups, however, did not differ on overall body image dissatisfaction or greater awareness or internalization of sociocultural influences on physical appearance. Breast augmentation patients reported more positive sexual functioning compared with controls. CONCLUSIONS: Overall, breast augmentation patients appeared to be motivated by their feelings about their breasts rather than direct or indirect influence from external sources, such as romantic partners or sociocultural representations of beauty. These findings provide new information on the motivations behind breast augmentation and dispute several stereotypes about the factors that influence the pursuit of this surgery.

Adult↗