Body Dismorphic Disorder: when low self-esteem is only the tip of the iceberg

Body Dismorphic Disorder: when low self-esteem is only the tip of the iceberg

A study recently published in Psychiatry Research (Grant et al., 2019) sought to investigate the prevalence of the Body Dismorphic Disorder (BDD) and the consequences of this condition on the physical and mental health of individuals.


Advertising message The BDD is characterized by a strong concern by the person for perceived physical defects, often focused on a single part of the body (APA, 2013). This concern causes severe discomfort and is associated with a greater suicidal risk than the non-clinical population (Phillips & Menard, 2006; Weingarden et al., 2016;).

People with BDD tend to be concerned about the characteristics of their face, such as the skin or the mouth (Phillips, 2014) even if some subjects report feeling uncomfortable on other parts of the body too (attention that the focus is not only on weight body, on the belly, on the hips or on the thighs: in that case one could think more of a Eating Disorder; APA, 2013). Inside the DSM-5, we find the BDD inserted in the section dedicated to obsessive-compulsive and related disorders, since there are some characteristics in common between Obsessive-Compulsive Disorder (DOC) and the BDD, in particular as regards compulsiveness (APA, 2013).

Several studies conducted in recent decades have highlighted the presence of strong correlations between BDD and depression (Cerea et al., 2018; Schneider et al., 2017), anxiety (Cerea et al., 2018) and substance abuse (Grant et al ., 2005); moreover, individuals with BDD have been shown to have significantly higher impulsivity and compulsiveness levels than controls (Jefferies-Sewell et al., 2017).

Advertising message In the present study, the authors analyzed the prevalence of BDD in a university sample, made up of 3,459 participants, assuming that the disorder would be associated with low self-esteem, poorer academic performance, higher rates of substance abuse , to depression and anxiety and, finally, to greater impulsivity and compulsiveness (Grant et al., 2019).

The results showed a 1.7% prevalence of the BDD in the sample analyzed (63% of which were females and 37% of males).

Compared to students who were not affected by BDD, those who showed the symptomatology of the disorder analyzed had had, or were at risk of putting in place in the future, a significantly greater number of risky sexual behaviors; in addition, they had a significantly higher amount than controls for depressive symptoms, anxious symptoms and symptoms related to Post-Traumatic Stress Disorder (PTSD).

Finally, BDD has been associated with higher impulsivity and compulsiveness scores, and with a greater greater propensity to make one of drugs or alcohol (Grant et al., 2019).

In conclusion, the authors highlight some characteristics of a disorder that has been attracting the attention of experts for only a few years: the low self-esteem affecting individuals with BDD, is only the tip of the iceberg.