Made available in DSpace on 2016-04-04T18:27:33Z (GMT). No. of bitstreams: 1 Josy de Souza Moriyama-1.pdf: 538769 bytes, checksum: d9c9c18d8d0776782f67a5efca7e8c1b (MD5) Previous issue date: 2003-06-17 / The Body Dysmorphic Disorder (BDD) is diagnosed when there is an exaggerated preoccupation with some minimal or imagined defect in the appearance, which brings significative impairments to the person s life. It has been sought to investigate the development and maintenance of the BDD behaviors through the functional analysis and the concept of experential avoidance proposed by Hayes, Wilson, Gifford and Follette (1996). Seven people with characteristic behaviors of the BDD, their families and four plastic surgeons participated in this study. It has been used as instruments: instructions to orient surgeons about behaviors of the BDD, enabling them to identify and invite patients to participate in the research; an identification questionnaire with the purpose to select the sample; semi-structured interviews for the participant and their families, containing questions relating to the history of the participants life, families relationship, the beginning of the concern with the appearance, behaviors of the BDD and actual contingencies which maintains them. Ten patients responded to the identification questionnaire and seven of them were selected. Individual interviews were made with each of the participants and their families, according to the necessity of collecting complementary data. From the recording and transcription of the interviews, it has been made a clinic systematical study, in which, the behaviors were described and analyzed according to probable origin and actual functioning processes. Beyond the behaviors related to the preoccupations with the appearance, typical behaviors of other disorders were found (such as: Obsessive Compulsive Disorder, Depression, Social Phobia, Hypochondria) and standards of behavior known as personality features (such as: vanity, perfectionism, aggressiveness). The results pointed similar functional processes, among all the participants. Among the origin processes there were: the cohersitive education with few positive reinforcements in the childhood, past occurrence like accidents, comparisons and comments relating to the part of the body which they worried about. These contingencies, probably, influenced the strong emphasis on discriminative stimuli related to the appearance. Among the actual processes there have been identified: negative reinforcement, lack of positive reinforcements, secondary gains and strong cultural influences of the valorization of the appearance. As particular variables to each case there have been found: low development of skilful socially behaviors, models in the childhood, extremely critical mother concerning to the appearance, among others. It has been concluded that the actual functioning of the BDD is marked by experiential avoidance where the individuals start avoiding the private aversive stimuli, like the anxiety, thoughts about their appearance and about the reaction of the people against their appearance. This avoidance prevents them from exposing themselves to the social situations, resulting in consequences such as social isolation and depressive behaviors. Functional resemblances were demonstrated for all seven cases studied although some topographic behaviors were different, indicating the necessity in considering the functionality of the behaviors and not only the arbitrariness of the psychiatric classification based on symptoms. / O Transtorno Dism?rfico Corporal (TDC) ? diagnosticado quando h? uma preocupa??o t?o exagerada com algum defeito m?nimo ou imaginado na apar?ncia, que traz preju?zos significativos ? vida da pessoa. Buscou-se investigar o desenvolvimento e manuten??o de comportamentos do TDC atrav?s de an?lises funcionais e do conceito de esquiva experencial proposto por Hayes, Wilson, Gifford e Follette (1996). Participaram do estudo sete pessoas com comportamentos caracter?sticos do TDC, seus familiares e quatro cirurgi?es pl?sticos. Foram utilizados como instrumentos: roteiros para orientar cirurgi?es sobre comportamentos do TDC, possibilitando-os identificar e convidar pacientes seus para participarem da pesquisa; uma ficha de identifica??o dos participantes, para selecionar a amostra; roteiros de entrevistas semi-estruturadas para os participantes e seus familiares, com quest?es relativas ? hist?ria de vida dos participantes, rela??es familiares, in?cio das preocupa??es com a apar?ncia, comportamentos do TDC e conting?ncias atuais que os mantinham. Dez pacientes responderam ? ficha de identifica??o e sete foram selecionados. Entrevistas individuais foram feitas com cada participante e com seus familiares, de acordo com a necessidade de se coletar dados complementares. A partir da grava??o e transcri??o das entrevistas foi feito um estudo sistem?tico cl?nico em que os comportamentos foram descritos e analisados de acordo com prov?veis processos de origem e funcionamento atual. Al?m de comportamentos relacionados ?s preocupa??es com a apar?ncia, foram encontrados comportamentos t?picos de outros transtornos (como: Transtorno Obsessivo Compulsivo, Depress?o, Fobia Social, Hipocondria) e padr?es de comportamento conhecidos como tra?os de personalidade (como: vaidade, perfeccionismo, agressividade). Os resultados apontaram processos funcionais semelhantes, entre todos os participantes.

This cross-sectional quantitative study was conducted to assess the presence of muscle dysmorphia (MD) and a drive for muscularity (DFM) in 1,039 personal trainers using the Muscle Dysmorphia Inventory (MDI) and the Drive for Muscularity Scale (DMS). Muscle dysmorphia is considered a subtype of body dysmorphic disorder that can be exacerbated by an intense DFM, which may in turn lead to negative psychobehavioral outcomes. Because personal trainers are an unresearched population with regard to these 2 constructs, a multidisciplinary framework was used to ground the present research study. Independent variables were structured using a biopsychosocial foundation where the biological dimension was operationalized through the Body Comparison Scale, the psychological dimension through the Symptom Checklist-90-Revised, and the social dimension through the Sociocultural Attitudes Towards Appearance Questionnaire-4. Kendall's tau-b revealed that general appearance concerns, muscle concerns, and somatic features were positively related to both MD and a DFM. A DFM and MD were significantly, positively correlated with internalization of thin ideals, muscular/athletic ideals, family and peer pressures, but not media pressures. All psychological variables were significantly, positively related to MD and a DFM. The DMS was able to significantly predict scores on the MDI using hierarchal multiple regression. Trainers who displayed MD and DFM symptoms did so with little disparity between the sexes. Trainers are in a unique position of instruction as well as guidance, and therefore a better understanding of how MD presents in this specific fitness arena may impact not only personal trainers, but also their clients through increased body image disturbance awareness as well as provide a new population of interest for future MD research.

The purpose of this study was to investigate whether men with a large amount of Muscle Dysmorphia symptoms had a more favorable outlook and opinion of body work. Participants in the current study were a convenience sample of men recruited from undergraduate classes at Western Kentucky University and the community of Bowling Green Kentucky and Somerset Kentucky. A total of 215 men completed the study. Participants completed the Muscle Dysmorphia Inventory (MDI) and the Attitude-Behavior Questionnaire (ABQ). Results indicate scores on the MDI were significant predictors of scores on the ABQ. This suggests that men with a high number of Muscle Dysmorphia symptoms have a more favorable outlook and opinion of body work.

The aims of the studies were to assess body image perceptions, the role of stress and other possible associated psychopathologies within a non-clinical sample. The prevalence of body image concern is increasing and is widely considered as secondary to evolving socio-cultural trends. Negative self-perceptions about body image can be manifest as measurable indicators of physiological stress, or even psychopathology. This thesis describes two quantitative studies into the role and relevance of various causative factors in the development of negative body image in cohorts of volunteers drawn from the general population of the University of Bradford in West Yorkshire, UK. In Study One, subjects (n=360) completed a self-directed questionnaire that psychometrically measured satisfaction/dissatisfaction with personal appearance, queried which external sources influenced those opinions, and correlated these with demographic information. In particular, we sought to examine how a subject's opinion about their personal appearance varied with age, gender, ethnicity, mental health, relationship status, sexual orientation and Body Mass Index (BMI). Subjective views regarding personal appearance were determined by answers given to specific body image questions that revealed a subject's day-to-day appearance concerns, all preoccupations, and the extent to which these concerns resulted in distress, all social impairment. Overall, the results demonstrated that BMI values were positively correlated with personal appearance concerns. High BMI values correlated with greater dissatisfaction with personal appearance. Self ratings of appearance values were negatively correlated with BMI scores. Subjects who gave themselves high appearance ratings were relatively unaffected by media influence with regard to their image, compared to subjects rating themselves less attractive. These latter subjects also showed higher peer pressure scores in terms of both the amount of time they compared themselves to peers, and the degree to which peer comparisons affected their self-appearance ratings. Based on responses to the body image questions specifically, the entire cohort of subjects were categorised into principal clusters: those largely unaffected by any body image concerns; and those profoundly distressed by their self assessed body image. Perhaps the most interesting aspect of these findings is that the scores for this latter (n=17) group of subjects on the body image questions revealed a degree of personal distress this is almost identical to the scores expected from those people diagnosed with body dysmorphic disorder (BDD). Collectively, these results suggest that high BMI values in subjects negatively impact on self-appearance ratings, render subjects more prone to media messages that portray body image ideals, and elicit frequent comparisons with peers to validate self-image concerns. Furthermore, severely affected subjects with high BMI scores may show similar psychopathology to that of BDD sufferers. In Study Two, a small cohort of subjects (n=60) were given questionnaires and were interviewed to further investigate self-appearance ratings and mood/depressive traits. The body image questions used in Study One to assess image concerns and the magnitude of distress were repeated in Study Two. Mood and depressive state were measured using the validated Beck's Depression Inventory (BDI). In parallel, subjects completed the Derriford Appearance Scale 59 (DAS 59), which is a valid psychometric indication of an individual's perception of their appearance as 'normal' or 'disfigured', and used as a tool by plastic surgeons to inform decisions regarding the necessity for surgery to correct an individual's appearance. Physiological markers were recorded before and after exposure of subjects to a physical and a psychological stressor: these were saliva concentrations of cortisol and sIgA (an immune marker), blood glucose and blood pressure. The results of Study Two revealed no changes in scores for any of the physiological measures following stressors. BDI scores for most subjects fell within normal ranges, although females scored higher than males, but not at a pathological level. Those subjects with a history of mental illness or those who reported feeling a high degree of stress on a daily basis, or those who expressed greater self-appearance concerns, all had significantly elevated BDI values. Perhaps the most intriguing finding from Study Two, as in Study One, was that subjects again tended to fall within specific categories for body image concerns: those unaffected or minimally affected by body image concerns, and those (n=6) greatly and deleteriously affected by body image concerns. This subsection of subjects also scored very high on the DAS 59 for disfigurement. On the basis of these findings it would seem that body image concerns may be severe enough for some individuals for them to perceive themselves as actually being disfigured, or that the DAS 59 (a widely used assessment tool in plastic surgery), may not be entirely appropriate for assessment of an individual's need for surgery because it cannot distinguish between those genuinely disfigured and those merely expressing severe body image concerns.

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