Body Dysmorphic Disorder Case Study

It is no surprise that mental disorders such as Body Dysmorphic Disorder (BDD) and Obsessive Compulsive Disorder (OCD) constitute serious effects in human beings. Psychologists Hilary Weingarden (MA), Dr. Keith D. Renshaw, Dr. Sabine Wilhelm, PhD, Dr. June P. Tangney, and Jennifer DiMauro (MA), sought out to find the correlation between the disorders of BDD and OCD and their risk factors.The significance of this study lies in examining how shame and anxiety come into play with the four most concurrent severe outcomes of the disorders: depression elevation, suicide risk, functional impairment, and housebound rates. These researchers compared the risk factors of shame and anxiety between three groups: The BDD group, OCD group, and the Health Control (HCs) group. This case study was important because it enhanced an understanding for the disorders and the correlations in severities and outcomes where empirical information lacks the ability to do so. This research study was the first to empirically demonstrate the association between shame and anxiety with BDD and OCD compared to a health control group highlighting new and significant information.

In this study, the total sample of participants was 361 (HC=133, OCD=114, BDD=114). Although the numbers for

the disorder groups match, the health control group is larger, therefore, whatever results come out of this, the numbers will be skewed towards the HCs. The validity in recruiting participants was parallel for all groups: online recruitment. However, the website for the disorder groups was disorder oriented whereas the HCs group’s website was non-mental and non-health related. In addition, the HC group was significantly older than the BDD and OCD groups and there was a significant gender difference between the BDD group and HC group; predominantly female. Furthermore, it is important to realize that race did not vary significantly through the diagnostic groups with 78.6 % being Caucasian.The discrepancies lie in the skew of being predominantly female and predominantly white. In relations to the “Emotion” portion of class, anger is known to vary across genders because of the different hormone and testosterone levels in women and men, hence, emotions such as shame and anxiety may also vary across genders, therefore making he results invalid/specific to just one population.
As a method of analysis, the researchers of this study used path analysis which aims to provide estimates of the importance of correlations by identifying “paths” between things. First, the researchers examined group differences in two different focuses, “primary outcome variables” and “emotion variables”, that controlled the difference in demographic variables. Next, they examined the association between shame and anxiety and the outcomes (depression, suicide, housebound rate, and functional impairment) through multi group path analysis. Lastly, the researchers concluded analysis by stating that the “…model fit was evaluated using recommended cutoff values for the comparative fit index (CFI > 0.90 or 0.95) and root mean square error of approximation.” Overall, the method of analysis used was structurally organized and required actual mathematical computation deviating away from bias and subjectivity.
In conclusion, researchers found that there were “significant” paths between shame and anxiety in correlation to the four severe outcomes (with the exception of shame and housebound rates, and suicidality and OCD).

Results took into account group differences and intercepts, which also upheld validity. Ultimately, the psychologists found that, “For the BDD group, the path from shame to depression was moderately strong and significant...whereas for the OCD group, this path was weak and nonsignificant.” In other words, the outcome of depression is strongly tied with Body Dysmorphic Disorder, yet not strong for Obsessive Compulsive Disorder; essentially, the study proved that depression is not a result specific to

OCD.
For future research, this study supported a “reclassification into the same Obsessive Compulsive Related Disorders category” for both BDD and OCD. In light of the results form this study, shame and anxiety proved to be significant risk factors in these disorders, therefore allowing for the target of these two emotions during treatment. In terms of improvement, the researchers address that the emotions and outcomes in the heath control group had a more restricted range than those in the disorder groups, hence, this could have made detection of associations (between emotions and outcomes for HCs) difficult. Psychologists of the study propose that their BDD sample may have been less severe than normal because of the medium through which they were recruited and that it is important to realize that anxiety is not associated with suicidality in BDD and OCD in final models. Finally, the BDD sample was also questionable because the clinicians didn’t see participants in person in order to evaluate whether their disorder was real or imagined, hence, skewing data.