Multidimensional assessment of body image in eating disorders, body dysmorphic disorder, obesity, and clinical controls.

摘要

Body image is a multidimensional construct that consists of cognitive, affective; behavioral, and perceptual elements. Although "body image disturbance" is a defining characteristic for eating disorders and body dysmorphic disorder, and is also associated with obesity, its definition has been unclear within the literature. Furthermore, little research has been performed in comparing these various clinical groups on diverse measures of body image. The purpose of the current study is to understand the multidimensionality of body image in individuals suffering from an eating disorder, body dysmorphic disorder, or obesity. Assessments included measures of body image evaluation, investment, schematicity, emotional distress, overweight preoccupation, behavioral coping, and quality of life, as well as a new integrative measure of body image disturbance. One hundred and seventy-seven (125 women and 52 men) participants were recruited from nine clinical sites and were placed into five groups based on their disorder: eating disorder (n = 19), body dysmorphic disorder ( n = 54), obesity (n = 24), female psychiatric controls (n = 34), and male psychiatric controls ( n = 35). Groups were compared on a variety of selected variables, including demographic measures, body mass index (BMI), and six standardized psychometric instruments (12 measures) of body image. On measures of global and body-area specific appearance evaluation, the ED, BDD, and Obese groups were statistically equivalent, although significantly more dissatisfied than the clinical controls. However, with respect to other body image dimensions, the Obese group did not differ from their gender-matched clinical controls, while the ED and BDD groups reported significantly greater body image distress, overweight preoccupation, self-evaluative investment, maladaptive coping strategies, and poorer body image quality of life than the Obese and clinical controls. Although the ED and BDD groups were statistically equivalent on most body image measures, the participants with BDD did report more overall body image disturbance, while the ED group, as would be expected, reported greater weight preoccupation. Implications of these findings and directions for future research are discussed.