Body Dysmorphic Disorder, Research Paper Example

Overview and Definition

Body Dysmorphic Disorder (BDD) is a complex condition that is characterized by a distorted belief regarding body image, including “persistent and intrusive preoccupations with an imagined or slight defect in one’s appearance” (Anxiety and Depression Association of America, 2015). This type of disorder is debilitating for many patients because it impacts their beliefs regarding their physical appearance and in one or more body parts, as they become obsessed to the degree that they experience “severe emotional distress and difficulties in daily functioning” (ADAA, 2015). These characteristics often exhibit serious dissatisfaction with one’s physical appearance, when there is likely to be no real cause for concern from a realistic perspective (ADAA, 2015). This condition is most likely to impact teenagers and adolescents, and males and females have identified with the condition in one form or another (ADAA, 2015).

Overview of Chronic Illness

In the United States, approximately one percent of all persons have been diagnosed with BDD, and it is commonly considered to be caused by environmental and biological factors that may include serotonin dysfunction, personality characteristics, genetic predisposing factors, and personal experiences, all of which impact the perception of one’s physical appearance (ADAA, 2015). This disorder also reflects a need to further examine the emotional context and consequences of BDD, particularly as it causes serious emotional harm to many persons in different ways (ADAA, 2015). For example, they may obsess with what they perceive as a flawed weakness in their physical appearance to the extent that it interferes with daily activities, communication and social interactions with others, and different types of relationships (ADAA, 2015). The condition affects some patients in dramatic fashion and they are unable to reconcile the idea of leaving their homes to interact with others in social settings; furthermore, some individuals may consider suicide as the only feasible alternative (ADAA, 2015).

Patients with BDD may develop different types of behaviors that become obsessive over time, including but not limited to hiding their appearance through camouflaging, looking at themselves in the mirror repeatedly, grooming, and frequently changing clothing, among other behaviors (ADAA, 2015). Patients with BDD often face the risk of developing other mental health conditions or disorders that may exacerbate their symptoms and create new challenges for individuals, such as depression, social anxiety disorder, and obsessive-compulsive disorder, among others (ADAA, 2015). Many patients with BDD do not realize the extent to which their condition affects their daily lives, as they may lose touch with reality and are unable to recognize how their behaviors harm themselves and those around them. It is important for patients to obtain the appropriate diagnosis so that viable treatment methods are considered and these persons are able to resume a life under normal conditions (ADAA, 2015).

Patients with BDD are often diagnosed through laboratory testing, physical examinations, and psychological evaluations, all of which may contribute to a definitive diagnosis and subsequent treatment strategy (Mayo Clinic, 2015). It is important for patients to receive the best possible opportunities for specialized treatment to address this condition and to recognize how their behaviors limit their ability to conduct a normal life (Mayo Clinic, 2015). Patients with BDD must be diagnosed with the aforementioned criteria, as well as the characteristics set forth in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This reflects the importance of understanding the nature of the condition and to ensure that it does not overlap with other classified conditions that may include obsessive-compulsive disorder, among others (Mayo Clinic, 2015).

Significance of Issue as Related to Chronic Illness

The nature of body dysmorphic disorder is highly complex and challenging from a mental health perspective, as it reflects a need to better understand the nature of its causes, related symptoms, and treatment alternatives. Most importantly, patients must be properly evaluated and diagnosed in order to achieve the intended results in treating the condition and must also receive supportive therapy and guidance in order to identify the root causes of the condition and its long-term impact on affected patients. When an individual becomes obsessed with one or more body parts or features such as the face, teeth, breasts, wrinkles, or acne, and it affects his or her ability to conduct a normal routine, a serious problem is evident that must be addressed in an effective manner (Ahmed, 2014). In addition, patients are often asked a series of questions regarding their appearance and behavior, including whether or not looks worry them, how much time is spent thinking about one’s appearance, one’s weight (thin or fat), and how these thoughts affect daily living in the form of emotional responses (Ahmed, 2014). These questions enable clinicians to define if a patient meets the criteria for BDD and the extent to which it has affected a patient’s life in different ways (Ahmed, 2014).

It is important for patients to receive the appropriate attention and focus regarding their condition because if it continues without attention and treatment, it may progress and become even more debilitating than in its current state. Patients require the appropriate level of attention and a definitive diagnosis in order to experience positive outcomes as related to the disease, along with other factors that may influence their ability to overcome the condition and/or manage it effectively in daily living with some of the most common treatment alternatives that are available. Patients must be provided with the tools and resources that are required to manage this condition in a comprehensive manner and to be mindful of how their behaviors disrupt their lives and the lives of others around them. When the appropriate treatment is available, patients are likely to respond to these alternatives in a favorable manner and will better recognize the extent of the problem and how it impacts their lives.

Patients with BDD often experience very low self-esteem and are highly self-conscious regarding their appearance. It is known that “Body image is a multidimensional construct that includes cognitive, behavioral, attitudinal, and emotional components… individuals diagnosed with body dysmorphic disorders, characterized by an exaggerated concern with a slight or imagined “defect” in appearance, show lower implicit and explicit self-esteem with respect to both healthy people and subclinical populations” (Richetin, Xaiz, Maravita, & Perugini, 2012, p. 254). Under these conditions, it is very difficult for patients with BDD to possess a high level of self-esteem, particularly as they experience low self-worth and do not believe that their physical appearance is entirely appropriate for public view. As a result, patients often retreat and become largely uncomfortable in their own skin, and this reflects the importance of understanding the nature of BDD and why it wreaks havoc on individual perceptions of reality and self-esteem regarding one’s body image.

Evidence-Based Interventions

Patients with body dysmorphic disorder require expert knowledge and treatment in order to effectively manage this type of diagnosis; therefore, it is important for professionals to utilize evidence-based knowledge and practice in order to apply treatments that have been proven effective in prior research. For example, patients with BDD may benefit from modular cognitive-behavioral therapy, whereby patients receive standardized approaches including exposure, response prevention, and perceptual retraining in order to effectively manage their condition and to achieve a greater sense of normalcy (Wilhelm et.al, 2014). This type of therapy has also been proven not only to aid in the treatment of BDD, but also improve depressive symptoms and disability as a result of the condition, and is largely characterized by a high patient satisfaction rate in many patients (Wilhelm et.al, 2014). This type of therapeutic intervention reflects the importance of understanding the psychological nature of BDD and how it impacts patient health and wellbeing in different ways.

For patients who have been diagnosed with BDD, there is a greater need to understand the nature of the condition and the treatments that are available. Some of the pharmacological treatments that are commonly known as serotonin-reuptake inhibitors (SRIs), which aid in reducing obsessive behaviors and thoughts in patients; these drugs are often prescribed for social anxiety disorder, depression, and obsessive-compulsive disorder (Rhode Island Hospital, 2015). Common therapies include fluvoxamine (Luvox), sertraline (Zoloft), fluoxetine (Prozac), paroxetine (Paxil), and escitalopram (Lexapro), among others, and these drugs are often beneficial in alleviating many of the symptoms associated with BDD, including some of the thoughts that contribute to the common behaviors that are observed (Rhode Island Hospital, 2015). Therefore, patients who are diagnosed with BDD may receive one or more of these medications as a first alternative in order to determine if they are effective in alleviating its symptoms; however, patients must take their medications carefully and as prescribed in order to prevent further complications and to all the medication to have time to work in the appropriate manner (Rhode Island Hospital, 2015). Most importantly, patients must routinely seek guidance from their healthcare providers in order to ensure that the condition is properly managed and that its symptoms are minimized as best as possible (Rhode Island Hospital, 2015). There must be a greater emphasis on understanding the nature of BDD and its symptoms in order to determine which treatments will be most effective in managing the condition over the long-term in order to prevent further complications for these patients.

Some patients with BDD may consider suicide and require immediate attention; therefore, they must obtain support from their healthcare provider in order to obtain a definitive support and treatment plan (Rhode Island Hospital, 2015). There must be a greater emphasis on the development of new strategies to address suicidality in these patients and to determine the underlying factors that may be key contributors to this state (Rhode Island Hospital, 2015). It is also important to identify the key factors that influence the condition as a whole and what is required to facilitate a treatment plan that will eliminate suicidal thoughts and support the growth of knowledge in this treatment. Prior evidence-based solutions are a critical component of this process, but other factors must also be considered that will emphasize the importance of comprehensive therapeutic interventions to support patients who experience BDD and require an effective intervention.

For nurses working with patients who have BDD in different settings, there must be a greater emphasis on the development of strategies that will accommodate their needs and also influence their ability to be successful in daily living without further complications. Furthermore, the root causes of each case of BDD must be well understood and create an environment in which patients are able to obtain guidance and understand their behaviors more effectively. Therefore, nurses must be trained in order to advance their knowledge of body dysmorphic disorder and how it is different from conditions with similar characteristics, such as obsessive-compulsive disorder. Nurses must be able to identify some of the distinguishing features of the condition and how it impacts patient behaviors in different ways, and in particular, be able to recognize some of the factors that affect this condition, such as personal appearance. It is necessary to identify the primary symptoms of BDD and be able to discuss possible diagnoses and therapeutic interventions that will have the greatest impact on patients. Nurses must be sensitive to the needs of this vulnerable patient population and be able to identify how to best support patients who require treatment. It is the responsibility of nurses to conduct interventions that are professional and which are sensitive because these patients are likely to possess serious psychological concerns that require their assistance.

Summary and Conclusion

Body dysmorphic disorder (BDD) is characterized by a significant emphasis on one or more body parts or characteristics that patients view as physical flaws. The condition is highly debilitating in many ways and limits the ability of many patients to engage in routine social interactions on different levels. These patients may also exhibit other symptoms that commonly associated with depression, social anxiety disorder, and obsessive-compulsive disorder. It is important for patients to be comprehensively evaluated by expert professionals in order to obtain the appropriate diagnosis and an adequate treatment plan that will meet their needs. This process also demonstrates the need to examine treatment and therapeutic options that are successful in the treatment of this condition, including pharmacological therapies and cognitive-behavioral interventions, among others. Prior evidence regarding these treatments must be explored in order to determine their efficacy and value to this patient population. In addition, nurses must be able to provide adequate care and treatment to these patients by possessing expert knowledge and the ability to provide support to these patients in an effective manner. There must be a greater emphasis on understanding the condition and its relationship to self-esteem in order to be successful in achieving the desired treatment goals and objectives without further complications for these patients.

References

Ahmed, I. (2014). Body dysmorphic disorder. Retrieved from http://emedicine.medscape.com/article/291182-overview

Anxiety and Depression Association of America (2015). Body dysmorphic disorder (BDD). Retrieved from http://www.adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/body-dysmorphic-disorder-bdd

Kelly, M. M., Didie, E. R., & Phillips, K. A. (2014). Personal and appearance-based rejection sensitivity in body dysmorphic disorder. Body image, 11(3), 260-265.

Mayo Clinic (2015). Body dysmorphic disorder. Retrieved from http://www.mayoclinic.org/diseases-conditions/body-dysmorphic-disorder/basics/tests-diagnosis/con-20029953

Rhode Island Hospital (2015). The body dysmorphic disorder program at Rhode Island Hospital. Retrieved from http://www.rhodeislandhospital.org/services/body-dysmorphic-disorder-program/treatments-for-bdd.html

Richetin, J., Xaiz, A., Maravita, A., & Perugini, M. (2012). Self-body recognition depends on implicit and explicit self-esteem. Body image, 9(2), 253-260.

Wilhelm, S., Phillips, K. A., Didie, E., Buhlmann, U., Greenberg, J. L., Fama, J. M., … & Steketee, G. (2014). Modular cognitive-behavioral therapy for body dysmorphic disorder: a randomized controlled trial. Behavior therapy, 45(3), 314-327.