Examining Body Dysmorphic Disorder (BDD) and body dysmorphic concerns in a clinical and non-clinical population

This thesis examines Body Dysmorphic Disorder (BDD) and body dysmorphic concerns in a clinical and non-clinical sample. The opening section of the thesis provides an outline of the clinical features, prevalence, onset and course of BDD and related concerns. This is followed by a literature review and examination of two related areas of research: (a) the evidence base for cognitive-behavioural psychological interventions for the treatment of BDD, and (b) studies investigating the potential role of internal and external perfectionism, shame and self-discrepancies in relation to the experience of BDD. The remainder of the thesis reports two empirical studies of aspects of BDD and dysmorphic concerns. Study 1 (n=4) reports a clinical evaluation of a cognitive-behavioural group therapy treatment of the disorder, employing both single-case experimental design methodology and analysis of average change pre- to post-therapy and at 6-month follow-up. Data indicated that BDD symptoms along with some problems such as depression and self-esteem responded favourably to treatment while problems like shame did not. Appearance-related and interaction-based social anxiety responded to treatment in two out of four clients. Study 2 (n=547) reports an investigation of the role of internal and external perfectionism, shame and self-discrepancies in relation to BDD. This employed an online survey methodology with a student sample, entailing completion of a number of self-report psychometric assessments. Results showed that external shame was the variable most strongly associated with body dysmorphic concern. Combined with discrepancies between actual and ideal self-concept, these two variables accounted for the greatest proportion of variance observed in dysmorphic concern scores. Outcomes are discussed in terms of the strengths and limitations of the study methodologies, existing literature on CBT and predictors of dysmorphic concern, and the possible need to include additional variables in the treatment of BDD