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Tilstra-Ferrell EL, Braden A, Russin S. Military sexual trauma, combat trauma, and disordered eating among United States veterans: An exploration of underlying mechanisms. MILITARY PSYCHOLOGY 2024:1-12. [PMID: 38781487 DOI: 10.1080/08995605.2024.2336639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Accepted: 03/22/2024] [Indexed: 05/25/2024]
Abstract
Military sexual trauma (MST) and combat trauma (CT) survivors experience disproportionate risk for disordered eating. A survey of MST, CT, disordered eating, trauma-related self-blame, emotion regulation challenges, body dissatisfaction, and dissociation among military personnel with a history of military-related trauma was conducted. These survey-based cross-sectional data were analyzed via parallel mediation analyses and Analyses of Covariance (ANCOVA). Six parallel mediation analyses were conducted examining trauma-related self-blame, emotion regulation challenges, body dissatisfaction, and dissociation as mediators linking MST and CT, separately, with purging, restricting, and bingeing. ANCOVAs were also performed to examine differences in levels of bingeing, restriction, and purging among people exposed to MST, CT, both MST and CT, and neither. MST and CT exposure was indirectly related to bingeing via emotion regulation challenges. MST and CT was also indirectly related to both restriction and purging via emotion regulation challenges and trauma-related self-blame. Dissociation and body dissatisfaction were not significant mediators in any model. Participants endorsed high levels of disordered eating. Individuals exposed to both MST and CT reported greater bingeing, restricting, and purging than individuals exposed to either CT, MST, or neither. Findings highlight the nuanced symptoms that may increase risk for disordered eating among MST and/or CT survivors. Future treatment research should explore how addressing emotion regulation and trauma-related self-blame among individuals with MST and/or CT may help address disordered eating. Implications and future directions for this area of research are discussed.
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Affiliation(s)
| | - Abby Braden
- Department of Psychology, Bowling Green State University (BGSU), Ohio
| | - Sarah Russin
- Department of Psychology, Bowling Green State University (BGSU), Ohio
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2
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Szily D, Kelemen R, Nagy ZS, Szabó D, Unoka ZS. Disturbed body schema, perceptual body image, and attitudinal body image in patients with borderline personality disorder. Front Psychiatry 2023; 14:1168611. [PMID: 37822796 PMCID: PMC10562535 DOI: 10.3389/fpsyt.2023.1168611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 08/28/2023] [Indexed: 10/13/2023] Open
Abstract
Background Borderline personality disorder (BPD) is a severe mental disorder that affects attitudes toward the body. However, whether this condition also affects body schema and perceptual body image remains unclear. Previous questionnaire-based studies found dissatisfaction with one's body in patients with BPD. In addition to attitudinal body image, our study investigates whether body schema and perceptual body image are disturbed in patients with BPD. Method Our study included 31 patients diagnosed with BPD (25 women) and 30 healthy individuals (19 women) (Mage = 29 for both groups). The SCID-5-PD interview was used to determine personality disorder. Attitudinal body image was measured using the Body Attitude Test (BAT) factors. Body schema and perceptual body image were measured by two conditions of a body representation task, the body portraying method (BPM). Results BPD patients achieved higher scores in all three BAT factors and were more susceptible to misinformation in both conditions of BPM. Based on the results, BPD patients appear to have more negative attitudes toward their bodies and worse perceptual body image and body schema. Conclusion The novel finding of our study is that, besides the previously found attitudinal dissatisfaction with the body, individuals with BPD also show disturbances at the levels of body schema and perceptual body image. Our findings concerning disturbances in body schema and perceptual body need further research into their etiological factors and provide new therapeutic targets for the treatment of BPD.
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Affiliation(s)
- Dorottya Szily
- Doctoral School of Mental Health Sciences, Semmelweis University, Budapest, Hungary
| | | | - Zita S. Nagy
- OMINT-National Institute of Medical Rehabilitation, Budapest, Hungary
| | - Dominik Szabó
- Doctoral School of Mental Health Sciences, Semmelweis University, Budapest, Hungary
| | - Zsolt Szabolcs Unoka
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
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3
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McGrath LR, Oey L, McDonald S, Berle D, Wootton BM. Prevalence of body dysmorphic disorder: A systematic review and meta-analysis. Body Image 2023; 46:202-211. [PMID: 37352787 DOI: 10.1016/j.bodyim.2023.06.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 06/09/2023] [Accepted: 06/11/2023] [Indexed: 06/25/2023]
Abstract
Body dysmorphic disorder (BDD) is characterised by a preoccupation with a perceived defect in appearance. This preoccupation results in the completion of repetitive/time consuming behaviours to reduce distress. While the disorder results in considerable distress and impairment, the prevalence of the disorder is largely unknown, as BDD has not been examined in large epidemiological studies. The aim of the current study was to provide an estimate of BDD prevalence in a variety of settings using a meta-analytic approach using only studies that have made a diagnosis using a structured diagnostic interview. Twenty-two studies met criteria (n = 7159) and the pooled point-prevalence estimate for BDD was 11.3% across all studies with high levels of heterogeneity (I2 = 95.81). The pooled point-prevalence estimate was 20.0% in cosmetic/dermatology settings, 7.4% in mental health settings, and 6.7% in 'other' settings (including students and professional ballet dancers). The risk of bias assessment indicated questionable methodological quality in some of the included studies. While this study provides an important improvement on the existing literature there is a need to include BDD in epidemiological studies in order to have a more accurate understanding of the prevalence rate of this mental health condition in the community.
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Affiliation(s)
- Laura R McGrath
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology, Sydney, NSW, Australia
| | - Lilyan Oey
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology, Sydney, NSW, Australia
| | - Sarah McDonald
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology, Sydney, NSW, Australia
| | - David Berle
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology, Sydney, NSW, Australia
| | - Bethany M Wootton
- Discipline of Clinical Psychology, Graduate School of Health, University of Technology, Sydney, NSW, Australia.
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4
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Lekakis G, Constantian M, Most SP, Picavet V, Hellings PW. Novel Selection Tools in Rhinoplasty Patients. Facial Plast Surg 2022; 38:447-454. [PMID: 36100246 DOI: 10.1055/s-0042-1748314] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022] Open
Abstract
With no consensus document or guideline to help us compute the psychological make-up of rhinoplasty candidates and in the light of new perspectives of some key opinion leaders in the field of patient selection, the goals of this article are to offer a glimpse of the current literature together with the knowledge gaps, introduce some new tools for the preoperative consultation, help us identify who among our patients is at greatest risk for a poor outcome, and explain how childhood trauma can be linked to body shame and postoperative dissatisfaction.
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Affiliation(s)
- Garyfalia Lekakis
- Department of Otorhinolaryngology Head and Neck Surgery, Katholieke Universiteit Leuven, Leuven, Flanders, Belgium.,Department of Otorhinolaryngology Head and Neck Surgery, Hopital Moliere Longchamp, Brussel, Brussel, Belgium
| | - Mark Constantian
- Department of Surgery, University of Wisconsin-Madison Center for Health Systems Research and Analysis, Hollis, New Hampshire.,Department of Plastic Surgery, University of Virginia, Charlottesville, Virginia
| | - Sam P Most
- Division of Facial Plastic and Reconstructive Surgery, Stanford University School of Medicine, Stanford, California
| | - Valerie Picavet
- Department of ENT, ENT Practice Moser Gehrking Sauter and Partner, Augsburg, Germany
| | - Peter William Hellings
- Department of Otorhinolaryngology Head and Neck Surgery, Katholieke Universiteit Leuven, Leuven, Flanders, Belgium
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5
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Longobardi C, Badenes-Ribera L, Fabris MA. Adverse childhood experiences and body dysmorphic symptoms: A meta-analysis. Body Image 2022; 40:267-284. [PMID: 35085863 DOI: 10.1016/j.bodyim.2022.01.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 12/26/2021] [Accepted: 01/10/2022] [Indexed: 12/29/2022]
Abstract
Adverse childhood experiences (ACEs) are considered a risk factor for the development of various forms of mental disorders, including body dysmorphic disorder (BDD). The aim of the present work was to examine the association between ACEs and BDD symptomatology and to identify features of studies that might moderate this association. We conducted a three-level meta-analysis of 27 articles that included 9167 participants. Results showed that the types of ACE examined (total ACE, abuse, neglect, teasing, and bullying) were positively associated with BDD symptomatology. Specifically, a low to moderate association was found for ACE overall, defined as abuse, neglect, bullying, or teasing (r = 0.289, 95% confidence interval (CI) [.240,.337), for bullying (r = 0.282, 95% CI [.206,.354]), and for abuse (r = 0.223, 95% CI [.169,.276]) were found; and a moderate to large association was found for experienced teasing (r = 0.423, 95% CI [.360,.482]). In addition, moderator analyses of the association between ACE and BDD symptomatology resulted in a predictive model in which the type of ACE, type of sample, and gender of participants moderated the magnitude of the association between ACEs and BDD symptomatology.
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6
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The Prevalence of Adverse Childhood Experiences, Body Shame, and Revision Request Rate in 218 Plastic Surgery Patients: What Drives Postoperative Dissatisfaction? Plast Reconstr Surg 2021; 148:1233-1246. [PMID: 34644275 DOI: 10.1097/prs.0000000000008567] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND What drives patients who are unhappy despite good results? Adverse childhood experiences are common, can impair adult health, and can cause body shame. Neither adverse childhood experiences nor body shame has been studied in surgical patients. The authors report adverse childhood experience prevalences in a plastic surgical population and investigate associations from adverse childhood experiences to body shame and to postoperative dissatisfaction. METHODS Two hundred eighteen consecutive patients (86 percent aesthetic and 14 percent reconstructive) completed the Adverse Childhood Experiences Survey and the Experience of Shame Scale. A one-sample test of proportions, logistic regression, and mediation analysis assessed outcomes. RESULTS Compared to the Kaiser/Centers for Disease Control and Prevention medical population, our patients had higher overall adverse childhood experience prevalences (79.8 percent versus 64 percent), emotional abuse (41 percent versus 11 percent), emotional neglect (38 percent versus 15 percent), family substance abuse (36 percent versus 27 percent), and family mental illness (29 percent versus 19 percent, all p < 0.001). Fifty-two percent of our patients had body shame. Adverse Childhood Experiences score predicted body shame (OR, 1.22; p = 0.003). Compared to unshamed patients, body shame was associated with more adverse childhood experiences (85 percent versus 72 percent), higher median Adverse Childhood Experiences score (3.5 versus 2), more cosmetic operations (three versus zero), more health problems (three versus two), higher antidepressant use (39 percent versus 19 percent), substance abuse history (16 percent versus 5 percent), and demands for additional pain medication (18 percent versus 5 percent). Body shame predicted requests for surgical revision (49 percent versus 17 percent; OR, 4.61; all p ≤ 0.0001). CONCLUSIONS Adverse childhood experience were common in our patients. Adverse Childhood Experiences score predicted body shame, which predicted revision requests. If body shame preceded and drove surgery, revision requests were likely. Patients desiring revisions had recognizable characteristics. CLINICAL QUESTION/LEVEL OF EVIDENCE Risk, III.
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7
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Fontenelle LF, Albertella L, Brierley ME, Thompson EM, Destrée L, Chamberlain SR, Yücel M. Correlates of obsessive-compulsive and related disorders symptom severity during the COVID-19 pandemic. J Psychiatr Res 2021; 143:471-480. [PMID: 33958180 PMCID: PMC8548281 DOI: 10.1016/j.jpsychires.2021.03.046] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2020] [Revised: 03/06/2021] [Accepted: 03/24/2021] [Indexed: 01/04/2023]
Abstract
We investigated changes in the severity of obsessive-compulsive and related disorders (OCRDs) symptoms as a result of the COVID-19 pandemic. An Amazon Mechanical Turk sample of 829 individuals was evaluated with a series of instruments assessing the severity of the OCRDs before and during the pandemic. Additional questionnaires about sociodemographic factors, personal and family histories of OCRD, COVID-19 related events, compulsivity and impulsivity traits, schizotypal symptoms, and the severity of depression, anxiety and stress levels, were also used. Participants reported that OCD, hoarding disorder (HD) and skin picking disorder (SPD) symptoms significantly worsened during the pandemic along with increased disability, more affective symptoms and reduced quality of life. Female gender, a higher number of COVID-19 related stressful events, and higher pre-COVID-19 fear of harm and symmetry symptoms predicted more severe OCD symptoms during the pandemic, whereas lack of a HD diagnosis by a mental health professional and more severe schizotypal symptoms predicted worsened hoarding symptoms. Greater compulsivity traits were associated with more severe COVID-19 pandemic obsessive-compulsive and hoarding symptoms. These data indicate that the immense distress resulting from the COVID-19 included significant deterioration of OCRDs' symptoms, particularly of OCD, HD and SPD. It was also possible to identify a pre-pandemic profile of people most at risk of pandemic-related deterioration in OCRDs' symptoms, which may prove valuable for preventative initiatives in relation to the likely future waves of COVID-19 or of other communicable diseases. Future studies should follow up these findings longitudinally.
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Affiliation(s)
- Leonardo F. Fontenelle
- Turner Institute for Brain and Mental Health, Monash University, 770 Blackburn Road, Clayton, Victoria, 3168, Australia,Obsessive, Compulsive, and Anxiety Spectrum Research Program, Institute of Psychiatry, Federal University of Rio de Janeiro (UFRJ) & D’Or Institute for Research and Education (IDOR), Rio de Janeiro, Brazil,Corresponding author. Turner Institute for Brain and Mental Health, Monash University, 770 Blackburn Road, Clayton, Victoria, 3168, Australia
| | - Lucy Albertella
- Turner Institute for Brain and Mental Health, Monash University, 770 Blackburn Road, Clayton, Victoria, 3168, Australia
| | - Mary-Ellen Brierley
- Turner Institute for Brain and Mental Health, Monash University, 770 Blackburn Road, Clayton, Victoria, 3168, Australia
| | - Emma M. Thompson
- Turner Institute for Brain and Mental Health, Monash University, 770 Blackburn Road, Clayton, Victoria, 3168, Australia
| | - Louise Destrée
- Turner Institute for Brain and Mental Health, Monash University, 770 Blackburn Road, Clayton, Victoria, 3168, Australia
| | - Sam R. Chamberlain
- Department of Psychiatry, Faculty of Medicine, University of Southampton, & Southern Health NHS Foundation Trust, Southampton, UK
| | - Murat Yücel
- Turner Institute for Brain and Mental Health, Monash University, 770 Blackburn Road, Clayton, Victoria, 3168, Australia
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8
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Wayda-Zalewska M, Kostecka B, Kucharska K. Body Image in Borderline Personality Disorder: A Systematic Review of the Emerging Empirical Literature. J Clin Med 2021; 10:jcm10184264. [PMID: 34575375 PMCID: PMC8470847 DOI: 10.3390/jcm10184264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/17/2021] [Accepted: 09/17/2021] [Indexed: 12/02/2022] Open
Abstract
As an element of distorted self-image, body image disturbances may be relevant to borderline personality disorder (BPD). Therefore, this systematic review aims to critically discuss and summarize empirical findings in this matter. Based on the available theoretical models, three body image components were identified: (a) perception, (b) affect and cognition, and (c) general body dissatisfaction. We conducted a systematic search of the empirical literature published in English in the MEDLINE, PsycINFO, and Scopus databases until June 2021 using a priori eligibility criteria (BPD; BPD symptoms or features in nonclinical groups; quasipsychotic or psychotic symptoms were not considered). We included k = 10 records meeting the criteria. Compared with other analyzed groups, individuals diagnosed with BPD obtained higher scores in the three components of body image disturbances. The issue of body image in BPD is relatively understudied, although current research findings clearly indicate disturbances in all of the abovementioned body image components in individuals with BPD or significant relationships of these components with BPD traits or symptoms both in clinical and nonclinical samples. Eventually, possible practical implications and future research directions are also discussed.
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Affiliation(s)
- Magdalena Wayda-Zalewska
- Institute of Psychology, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warsaw, Poland; (M.W.-Z.); (K.K.)
| | - Barbara Kostecka
- II Department of Psychiatry, Medical University of Warsaw, 03-242 Warsaw, Poland
- Correspondence:
| | - Katarzyna Kucharska
- Institute of Psychology, Cardinal Stefan Wyszynski University in Warsaw, 01-938 Warsaw, Poland; (M.W.-Z.); (K.K.)
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9
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Personality functioning as a mediator of adult mental health following child maltreatment. J Affect Disord 2021; 291:126-134. [PMID: 34034217 DOI: 10.1016/j.jad.2021.05.006] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Revised: 05/02/2021] [Accepted: 05/05/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND The broad range of adverse health outcomes following child maltreatment (child maltreatment) underscores the need to investigate shared trajectories that contribute to associated physical and mental health problems. Previous research focused on different mechanisms, such as emotion regulation or attachment. In the present study, we propose personality functioning, comprising self- and interpersonal regulation and perception, to mediate between child maltreatment and mental and physical health. METHODS In a German representative sample (N = 2,508), we assessed remembered child maltreatment, levels of personality functioning, and different health outcomes in adulthood, namely somatic symptoms, general mental distress, and body dysmorphic concern. We conducted path analyses to investigate mediation effects in the total sample as well as in female and male subsamples. RESULTS Child maltreatment significantly predicted the assessed health outcomes and showed significant associations with lower levels of personality functioning. Personality functioning partially mediated all health outcomes assessed by significant indirect effects and lowered direct effects of child maltreatment on health outcomes. An exploratory analysis of different facets of personality functioning revealed a pronounced impact of identity perception and self-reflective capacities in mediating between child maltreatment and physical and mental health. Comparable results were found in female and male participants. LIMITATIONS Major limitations of the study are the reliance on cross-sectional data and the use of a screening measure to assess experienced child maltreatment. CONCLUSION Personality functioning may represent a transdiagnostic link to different somatic and psychological symptoms in the aftermath of child maltreatment.
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10
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Pellegrini L, Maietti E, Rucci P, Burato S, Menchetti M, Berardi D, Maina G, Fineberg NA, Albert U. Suicidality in patients with obsessive-compulsive and related disorders (OCRDs): A meta-analysis. Compr Psychiatry 2021; 108:152246. [PMID: 34062378 DOI: 10.1016/j.comppsych.2021.152246] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 05/03/2021] [Indexed: 11/28/2022] Open
Abstract
INTRODUCTION Previous meta-analyses showed that OCD is associated with a substantial risk of suicidal behaviours. Conclusive rates of suicidal ideation (current and lifetime) and suicide attempts based on pooled prevalence rates have not so far been calculated using meta-analysis for the other DSM-5 Obsessive-Compulsive and Related Disorders (OCRDs). OBJECTIVES This meta-analysis aims to separately calculate the pooled prevalence rates of lifetime suicide attempts and current or lifetime suicidal ideation in BDD, Hoarding Disorder (HD), Skin Picking Disorder (SPD) and Trichotillomania (TTM) and to identify factors associated with increased suicide rates. METHODS Our protocol was pre-registered with PROSPERO (CRD42020164395). A systematic review and meta-analysis following PRISMA reporting guidelines was performed by searching in PubMed/Medline, PsycINFO, Web of Science and CINAHL databases from the date of the first available article to April 20th, 2020. Stata version 15 was used for the statistical analysis. Given the small number of studies in TTM and SPD, the two grooming disorders were grouped together. Meta-analyses of proportions based on random effects (Der-Simonian and Laird method) were used to derive the pooled estimates. RESULTS Thirty-eigth studies (N = 4559 participants) were included: 23 for BDD, 8 for HD, 7 for Grooming Disorders. For BDD, the pooled prevalence of lifetime suicide attempts, current and lifetime suicidal ideation was, respectively 35.2% (CI:23.4-47.8), 37.2% (CI:23.8-51.6) and 66.1% (CI:53.5-77.7). For HD, the pooled prevalence of lifetime suicide attempts, current and lifetime suicidal ideation was 24.1% (CI:12.8-37.6), 18.4% (CI:10.2-28.3) and 38.3% (CI:35.0-41.6), respectively. For Grooming Disorders, the pooled prevalence of lifetime suicide attempts and current suicidal ideation were 13.3% (CI:5.9-22.8) and 40.4% (CI:35.7-45.3), respectively (no data available for lifetime suicidal ideation). CONCLUSIONS The OCRDs as a group are associated with relatively high rates of suicidal behaviour. Through indirect comparisons, we infer that BDD has the greatest risk. Comorbid substance abuse, possibly reflecting poor underlying impulse control, is associated with higher rates of suicidal behaviour in BDD. Our data emphasize the need for clinicians to consider the risk of suicidal behaviour in the management of patients presenting with all forms of OCRDs.
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Affiliation(s)
- Luca Pellegrini
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK; Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy.
| | - Elisa Maietti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Paola Rucci
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Sofia Burato
- Department of Medicine, Surgery and Health Sciences, UCO Clinica Psichiatrica, University of Trieste, Trieste, Italy
| | - Marco Menchetti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Domenico Berardi
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Italy
| | - Giuseppe Maina
- Rita Levi Montalcini Department of Neuroscience, University of Torino, Italy
| | - Naomi A Fineberg
- School of Life and Medical Sciences, University of Hertfordshire, Hatfield, UK; Hertfordshire Partnership University NHS Foundation Trust, Welwyn Garden City, UK; University of Cambridge School of Clinical Medicine, Cambridge, UK
| | - Umberto Albert
- Department of Medicine, Surgery and Health Sciences, UCO Clinica Psichiatrica, University of Trieste, Trieste, Italy
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11
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Constantian MB. Commentary on: Using Nasal Self-Esteem to Predict Revision in Cosmetic Rhinoplasty. Aesthet Surg J 2021; 41:657-660. [PMID: 33231626 DOI: 10.1093/asj/sjaa268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Mark B Constantian
- Department of Surgery (Plastic Surgery), St Joseph Hospital, Nashua, NH, USA
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12
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Oakes A, Collison J, Milne‐home J. Repetitive, Safe, and Automatic: The Experience of Appearance‐Related Behaviours in Body Dysmorphic Disorder. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/ap.12247] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Alissa Oakes
- School of Social Sciences and Psychology, Western Sydney University,
| | - James Collison
- School of Social Sciences and Psychology, Western Sydney University,
| | - Jo Milne‐home
- School of Social Sciences and Psychology, Western Sydney University,
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13
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Porter C, Palmier-Claus J, Branitsky A, Mansell W, Warwick H, Varese F. Childhood adversity and borderline personality disorder: a meta-analysis. Acta Psychiatr Scand 2020; 141:6-20. [PMID: 31630389 DOI: 10.1111/acps.13118] [Citation(s) in RCA: 158] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/15/2019] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The aim of this meta-analysis was to better understand the magnitude and consistency of the association between childhood adversity and borderline personality disorder (BPD) across case-control, epidemiological and prospective cohort studies. METHOD Following the review protocol (reference: CRD42017075179), search terms pertaining to adversity and BPD were entered into three search engines. Random-effects meta-analysis synthesised the size and consistency of the effects. RESULTS A total of 97 studies compared BPD to non-clinical (k = 40) and clinical (k = 70) controls. Meta-analysis of case-control studies indicated that individuals with BPD are 13.91 (95% CI 11.11-17.43) times more likely to report childhood adversity than non-clinical controls. This effect was smaller when considering retrospective cohort (OR: 2.59; 95% CI 0.93-7.30) and epidemiological (OR: 2.56, 95% CI 1.24-5.30) studies. Findings were significant across adversity subtypes with emotional abuse (OR: 38.11, 95% CI: 25.99-55.88) and neglect (OR: 17.73, 95% CI = 13.01-24.17) demonstrating the largest effects. Individuals with BPD were 3.15 (95% CI 2.62-3.79) times more likely to report childhood adversity than other psychiatric groups. CONCLUSIONS This meta-analysis corroborates theoretical proposals that exposure to adverse life experiences is associated with BPD. It highlights the importance of considering childhood adversity when treating people diagnosed with BPD.
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Affiliation(s)
- C Porter
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - J Palmier-Claus
- Spectrum Centre for Mental Health Research, Division of Health Research, Lancaster University, Lancaster, UK.,Lancashire Care NHS Foundation Trust, Lancashire, UK
| | - A Branitsky
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - W Mansell
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - H Warwick
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK
| | - F Varese
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, The University of Manchester, Manchester, UK.,Complex Trauma and Resilience Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
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14
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Nakamura M, Koo J. Personality disorders and the "difficult" dermatology patient: Maximizing patient satisfaction. Clin Dermatol 2017; 35:312-318. [PMID: 28511830 DOI: 10.1016/j.clindermatol.2017.01.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Personality disorders (PDs) are stable and enduring patterns of thought, feeling, and behavior that deviate from one's cultural norms and cause impairment in functionality. Patients with PDs are commonly encountered in the dermatologic setting and can be perceived by providers as "difficult." Given that PDs are chronic, rigid, and frustrating to deal with, it is important to be skillful in the approach to such patients, especially in the era of the value-based reimbursement system, in which patient satisfaction is crucial for reimbursement. This contribution discusses four PDs most commonly encountered in the dermatology setting: Borderline, histrionic, obsessive-compulsive, and narcissistic. Although the details regarding the approach to patients for each PD differ as discussed, once a PD is identified, there are few key management strategies that can be helpful in minimizing conflict and enhancing outcomes. In patients with PD, the presenting skin complaint is often a secondary problem, as there may be an underlying psychologic issue (somatization). Understanding the underlying psychologic aspect of the patients' dermatologic complaints and adapting behaviors to the patients' needs are fundamental for maximizing patient satisfaction.
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Affiliation(s)
- Mio Nakamura
- Department of Dermatology, University of California San Francisco School of Medicine, San Francisco, California.
| | - John Koo
- Department of Dermatology, University of California San Francisco School of Medicine, San Francisco, California
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Chosak A, Marques L, Greenberg JL, Jenike E, Dougherty DD, Wilhelm S. Body dysmorphic disorder and obsessive–compulsive disorder: similarities, differences and the classification debate. Expert Rev Neurother 2014; 8:1209-18. [DOI: 10.1586/14737175.8.8.1209] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Veale D, Matsunaga H. Body dysmorphic disorder and olfactory reference disorder: proposals for ICD-11. BRAZILIAN JOURNAL OF PSYCHIATRY 2014; 36 Suppl 1:14-20. [DOI: 10.1590/1516-4446-2013-1238] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
- David Veale
- Institute of Psychiatry and South London and Maudsley NHS Trust, UK
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Evren C, Cinar O, Evren B, Celik S. Relationship of self-mutilative behaviours with severity of borderline personality, childhood trauma and impulsivity in male substance-dependent inpatients. Psychiatry Res 2012; 200:20-5. [PMID: 22494705 DOI: 10.1016/j.psychres.2012.03.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2011] [Revised: 03/12/2012] [Accepted: 03/16/2012] [Indexed: 11/27/2022]
Abstract
The aim of this study was to investigate the relationship of self-mutilation (SM) with the severity of borderline personality features (BPF), childhood trauma and impulsivity in male substance-dependent inpatients. Participants were consecutively admitted comprising 200 male substance-dependent inpatients. Patients were investigated with the Self-mutilative Behaviour Questionnaire (SMBQ), the Childhood Trauma Questionnaire (CTQ-28), the Barratt Impulsiveness Scale (BIS-11) and the Borderline Personality Inventory (BPI). Among 200 subjects, 62.0% (n=124) were considered as the group with SM. Mean scores of CTQ-28 total and subscales (other than emotional abuse), BIS-11 total and attentional impulsiveness subscale and BPI were higher in the SM group. In the regression model, emotional neglect, attentional impulsiveness and drug dependency were the predictors of SM, whereas in the new model in which the severity of BPF was included emotional neglect and the severity of BPF predicted SM. Among those with SMB, physical neglect and the severity of BPF predicted the number of SM episodes. Thus, to better understand SMB among substance-dependent patients, clinicians must carefully evaluate BPF and history of childhood trauma among substance-dependent inpatients. In addition, results suggest that the relationship between SMB and BPF is more prominent in drug-dependent inpatients than alcohol-dependent inpatients.
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Affiliation(s)
- Cuneyt Evren
- Bakırköy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Alcohol and Drug Research, Treatment and Training Center (AMATEM), Istanbul, Turkey.
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Veale D, Daniels J. Cosmetic clitoridectomy in a 33-year-old woman. ARCHIVES OF SEXUAL BEHAVIOR 2012; 41:725-730. [PMID: 21837517 DOI: 10.1007/s10508-011-9831-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2011] [Revised: 07/19/2011] [Accepted: 07/20/2011] [Indexed: 05/31/2023]
Abstract
The Female Genital Mutilation Act (2003) in England allows for mental health exceptions for cosmetic surgery resulting from perceived abnormality. Similar legislation exists in other countries. There are no reported cases of clitoridectomy for cosmetic reasons or any discussion in the literature of mental health exceptions to the Act. This is a single case report on a 33-year-old married, heterosexual woman who had already had a cosmetic labiaplasty and was seeking a clitoridectomy for aesthetic reasons. At assessment, there were no psychiatric contra-indications or unrealistic expectations and the patient proceeded with a clitoridectomy. At 9 and 22 months follow-up, she was reassessed and was very pleased with the outcome. There were improvements in the satisfaction with her genital appearance, sexual satisfaction, and quality of life related to body image. Assessments for cosmetic clitoridectomy will continue to be rare, but this case may provide some guidance for practitioners who are confronted with such requests for body modification. However there remains only limited understanding of the motivation for such a request.
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Affiliation(s)
- David Veale
- NIHR Specialist Biomedical Research Centre for Mental Health at the South London and Maudsley NHS Foundation Trust and The Institute of Psychiatry, King's College London, 99 Denmark Hill, London, SE5 8AZ, UK.
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Alpay Ates M, Algul A, Semiz UB, Gecici O, Basoglu C, Ebrinc S, Cetin M. Clinical characteristics of self-mutilating behavior in Turkish male subjects with antisocial personality disorder: relationship to psychopathy. Int J Soc Psychiatry 2011; 57:237-47. [PMID: 19906770 DOI: 10.1177/0020764008099339] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS The aims of this study were to determine the characteristics of self-mutilation (SM) and examine the relationship between SM and psychopathy in male subjects with antisocial personality disorder (APD). METHODS APD diagnosis was established by the Structured Clinical Interview for DSM-III-R Axis II Disorders. Subjects (N = 116) were assessed using the Psychopathy Checklist-Revised and a semi-structured self-mutilation questionnaire form. RESULTS In males with APD, the percentages of psychopathy and SM were 48.3% (N =56) and 96.6% (N = 112), respectively. There were positive correlations between severity of psychopathy and severity, number, and frequency of SM. CONCLUSION Considerably high rates of SM and psychopathy were found in Turkish males with APD. The features of SM were associated with comorbidity of psychopathy. These results showed the importance of exploring the self-injurious behavior and psychopathy when diagnosed with APD.
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Affiliation(s)
- M Alpay Ates
- GATA Haydarpaşa Training Hospital, Department of Psychiatry, Istanbul, Turkey.
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