RESUMEN
Individuals with body dysmorphic disorder (BDD) often lack insight into the nature of their perceived appearance flaws that are slight, if they exist at all. Despite the generally held assumption that insight fluctuates over time within individuals with BDD, its temporal instability and associated features remain unstudied. We examined insight as a multidimensional, contextually embedded, and dynamic factor using ecological momentary assessment (EMA), further assessing affect and self-esteem as potentially associated states. Thirty individuals with BDD and 30 mentally healthy controls (HCs) completed 6 days of EMA (M = 8.54 assessments per day, N = 3075 assessments in total). Multilevel analyses revealed substantial intraindividual fluctuations of insight dimensions (across 30 min to hours) that were more pronounced for individuals with BDD than for HCs. Poorer insight correlated with higher negative affect, lower positive affect, and lower self-esteem at concurrent time points in the BDD group. Considering all predictors at the same time point, poorer insight was characterized by lower self-esteem and, partly, negative affect in the BDD group. Across time, self-esteem and insight influenced each other reciprocally, with comparatively stronger effects for the prediction of poorer insight by previously lower self-esteem. These findings demonstrate that insight is a highly variable phenomenon in BDD, further suggesting a clinically and etiologically relevant link between self-esteem and insight in symptom maintenance. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
Asunto(s)
Trastorno Dismórfico Corporal/psicología , Adulto , Afecto , Estudios de Casos y Controles , Evaluación Ecológica Momentánea , Femenino , Humanos , Masculino , Autoimagen , Adulto JovenRESUMEN
OBJECTIVE: Cognitive biases, such as memory, attention, and interpretation bias, are thought to play a central role in the development and maintenance of eating disorders (EDs). The aim of the present study was to investigate whether the interpretation bias is ED-specific or can be generalized to comorbid disorder-related threats in women with high levels of ED symptoms. METHOD: In an online study, we measured interpretation bias using the modified Sentence Word Association Paradigm (SWAP), comparing women with (n = 39) and without (sub)threshold eating disorders (n = 56). We assessed endorsement and rejection rates as well as reaction times in response to a positive/neutral or a negative ED-specific, social anxiety-specific (SAD), or generalized anxiety-specific (GAD) interpretive word following an ambiguous sentence. RESULTS: In ambiguous situations, women with high ED symptoms selected more negative (p < .001) and fewer positive/neutral ED-related interpretations (p < .001). Negative interpretations were endorsed significantly faster (p < .001), while positive interpretations were rejected faster in this group (p < .001). These women also manifested negative SAD-specific interpretation bias patterns in reaction time measures. Nevertheless, ED severity was best predicted by the endorsement of negative ED-specific stimuli, whereas ED and SAD reaction time measures seemed to have a negligible effect. DISCUSSION: The results indicate that the interpretation bias might be ED-specific. The SWAP can be a useful tool for the further investigation of the etiological relevance of the interpretation bias as well as for the development of modification training interventions.
Asunto(s)
Trastornos de Alimentación y de la Ingestión de Alimentos/epidemiología , Adolescente , Adulto , Sesgo , Femenino , Humanos , Masculino , Persona de Mediana Edad , Sensibilidad y Especificidad , Telemedicina , Adulto JovenRESUMEN
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.