Body dysmorphic disorder : an exploration of object relations and sociocultural influences

Body dysmorphic disorder (BDD) is an intriguing and troubling disorder that involves preoccupations with appearance “flaws” not noticeable to others. Individuals with the disorder are distressed, and their concern can be debilitating. Research and theory about this intriguing disorder remains in preliminary stages. Several aspects of the disorder have not been well-explored theoretically or empirically. Some of the more important unexplored areas include (1) characteristic personality and interpersonal styles among those with BDD that suggest underlying object relations ego deficits; (2) possible gender differences in terms of appearance concerns, which suggest the influence of sociocultural factors; and (3) the healthier end of the BDD spectrum, which includes people with more normative levels of appearance concern. This dissertation focused on the above factors. A thorough review of BDD was provided, and then object relations theory and sociocultural theories were used to understand BDD while maintaining a broader hermeneutic perspective. It was proposed that BDD is a manifestation of underlying weaknesses in object relations functioning that have been molded into a particular form via sociocultural pressures around appearance. A study was conducted to investigate this proposal. Data were collected from 130 adult participants. Variables assessing object relations ego functioning were used as predictor variables in a multiple regression equation with BDD symptomatology as the criterion variable. A small but significant portion (19.9%) of the variance in BDD symptomatology was accounted for by the object relations variables. Potential gender differences in appearance concerns were also explored using cross-tabulation of frequency data and chisquare analyses. Results indicated that there were gender differences in appearance concerns for the 130 participants. However, as expected, features of concern did not differ for people with different levels of BDD symptomatology (high, medium, and low). The implications of these findings were discussed. A hermeneutic exploration of the disorder, the present inquiry, the findings, and appearance concerns was also provided.