RESUMO
O transtorno dismórfico corporal é encontrado com uma certa frequência nos atendimentos relacionados à estética. Entretanto, permanece subdiagnosticado devido à dificuldade de diferenciar uma insatisfação pessoal natural com a imagem corporal de uma queixa patológica. Para os pacientes com TDC, o incômodo gerado pelo seu "defeito" costuma ser desproporcional ao que observamos no exame físico. Além disso, na tentativa de corrigir aquilo que não lhe agrada, ele se submete a diversos procedimentos cirúrgicos que, em grande parte das vezes, considerará insuficiente para a resolução do seu problema. Nesse sentido, buscamos, com este trabalho, ampliar as discussões já existentes na literatura especializada. Assim, assumindo a escassa bibliografia, tencionamos, além de construir discussões acerca dessa afecção, o que pode contribuir para a identificação dos traços desse transtorno, evitando, por conseguinte, a realização de procedimentos cirúrgicos desnecessários e nortear as ações do especialista no que diz respeito à possibilidade de uma disputa judicial.
Body dysmorphic disorder (BDD) is found with a certain frequency in aesthetic-related care. However, it is underdiagnosed due to the difficulty in differentiating a personal dissatisfaction with body image of a pathological complaint. For BDD patients, the discomfort generated by their "defect" is often disproportionate to that observed on physical examination. In addition, in an attempt to correct their "defect", the patients undergoes various surgical procedures, which are often considered insufficient by the patients to solve their problem. Hence, this study aimed to expand the already existing discussions in the specialized literature. Since there are only a few studies on the topic, we plan to discuss this condition so as to contribute towards identification of the characteristics of this disorder, thus, avoiding unnecessary surgical procedures and guiding the specialist's actions in case of a legal dispute.
Assuntos
Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Pacientes , Cirurgia Plástica/métodos , Procedimentos de Cirurgia Plástica/efeitos adversos , Procedimentos de Cirurgia Plástica/métodos , Transtornos Dismórficos Corporais/cirurgia , Transtornos Dismórficos Corporais/complicações , Transtornos Dismórficos Corporais/fisiopatologia , Transtornos Dismórficos Corporais/reabilitaçãoRESUMO
The Tripartite Influence Model posits that parents, peers and media influences mediated by internalization and appearance social comparison are predictors of body dissatisfaction, a key risk factor for eating disorders. However, the Tripartite Influence Model has not been tested in Brazil where the people are known to have high levels of body image and appearance concerns. This study aimed to test an adapted Tripartite Influence Model of body dissatisfaction and disordered eating behaviors among Brazilian women. A sample of 741 undergraduate students (Mage = 23.55 years, SD = 4.09) completed measures of sociocultural influences, internalization of body ideal, social appearance comparison, body dissatisfaction, muscularity dissatisfaction, disordered eating and body change behaviors. Structural equation modeling analyses indicated that the proposed etiological model for Brazilian women has good fit indexes (χ2(2064) = 6793.232; p = 0.0001; χ2/gl = 3.29; CFI = 0.82; PCFI = 0.79; RMSEA = 0.056 [IC90% = 0.053-0.057]). Parent and media influences were related with both internalization and social comparison, while peer influence with social comparison. A full mediation model was found, with both internalization and social comparison contributing to body dissatisfaction. Finally, body dissatisfaction was associated with disordered eating behaviors. The findings inform the importance of considering cultural aspects that influence body image and eating behaviors, and highlight the validity of the proposed etiological model for Brazilian women, that can be used for research and clinical purposes.
Assuntos
Transtornos Dismórficos Corporais/fisiopatologia , Comportamento Alimentar , Transtornos da Alimentação e da Ingestão de Alimentos/etiologia , Modelos Psicológicos , Adulto , Transtornos Dismórficos Corporais/etnologia , Transtornos Dismórficos Corporais/psicologia , Brasil/epidemiologia , Estudos Transversais , Ego , Comportamento Alimentar/etnologia , Transtornos da Alimentação e da Ingestão de Alimentos/epidemiologia , Transtornos da Alimentação e da Ingestão de Alimentos/etnologia , Transtornos da Alimentação e da Ingestão de Alimentos/psicologia , Feminino , Humanos , Meios de Comunicação de Massa , Avaliação Nutricional , Poder Familiar/etnologia , Influência dos Pares , Escalas de Graduação Psiquiátrica , Reprodutibilidade dos Testes , Fatores de Risco , Autorrelato , Sexismo/etnologia , Sexismo/psicologia , Normas Sociais/etnologia , Estresse Psicológico/etnologia , Estresse Psicológico/fisiopatologia , Estresse Psicológico/psicologia , Adulto JovemRESUMO
CONTEXT AND OBJECTIVE: Rhinoplasty is one of the most sought-after esthetic operations among individuals with body dysmorphic disorder. The aim of this study was to cross-culturally adapt and validate the Body Dysmorphic Symptoms Scale. DESIGN AND SETTING: Cross-cultural validation study conducted in a plastic surgery outpatient clinic of a public university hospital. METHODS: Between February 2014 and March 2015, 80 consecutive patients of both sexes seeking rhinoplasty were selected. Thirty of them participated in the phase of cultural adaptation of the instrument. Reproducibility was tested on 20 patients and construct validity was assessed on 50 patients, with correlation against the Yale-Brown Obsessive Compulsive Scale for Body Dysmorphic Disorder. RESULTS: The Brazilian version of the instrument showed Cronbach's alpha of 0.805 and excellent inter-rater reproducibility (intraclass correlation coefficient, ICC = 0.873; P < 0.001) and intra-rater reproducibility (ICC = 0.939; P < 0.001). Significant differences in total scores were found between patients with and without symptoms (P < 0.001). A strong correlation (r = 0.841; P < 0.001) was observed between the Yale-Brown Obsessive Compulsive Scale for Body Dysmorphic Disorder and the Body Dysmorphic Symptoms Scale. The area under the receiver operating characteristic curve was 0.981, thus showing good accuracy for discriminating between presence and absence of symptoms of body dysmorphic disorder. Forty-six percent of the patients had body dysmorphic symptoms and 54% had moderate to severe appearance-related obsessive-compulsive symptoms. CONCLUSIONS: The Brazilian version of the Body Dysmorphic Symptoms Scale is a reproducible instrument that presents face, content and construct validity.
Assuntos
Transtornos Dismórficos Corporais/psicologia , Rinoplastia/psicologia , Traduções , Adolescente , Adulto , Idoso , Transtornos Dismórficos Corporais/fisiopatologia , Brasil , Comparação Transcultural , Feminino , Humanos , Idioma , Masculino , Pessoa de Meia-Idade , Variações Dependentes do Observador , Satisfação do Paciente , Escalas de Graduação Psiquiátrica , Psicometria , Reprodutibilidade dos Testes , Sensibilidade e Especificidade , Inquéritos e Questionários , Adulto JovemRESUMO
We investigated body image in patients with rheumatoid arthritis (RA), correlating it with self-esteem, function, and quality of life. Forty-three RA patients and 39 control individuals from the community between 18 and 70 years of age and paired for gender, age, and body mass index (BMI) were evaluated. Patients were assessed for body image [Body Dysmorphic Disorder Examination (BDDE)], self-esteem (Rosenberg Self-Esteem Scale), function [Health Assessment Questionnaire (HAQ)] and quality of life [Short Form-36 (SF-36)]. The RA group had a mean age of 51.6 years, BMI 26.01, and disease duration 12.2 years. Most participants were categorized in functional class I. The BDDE score of the RA group (51.8) was significantly higher than in the control group (22.6) (p < 0.001). Rosenberg Self-Esteem Scale, HAQ and some SF-36 subscales were worse in the RA group than in the control group. These scores had a direct correlation with body image scores (p < 0.001). Individuals with RA had a worse body image than individuals without this condition. Body image was directly correlated with self-esteem, function, and quality of life.