IJCM  Vol.6 No.3 , March 2015
Body Image and Meta-Worry as Mediators of Body Dysmorphic Disorder
Objectives: Meta-worry and attitudes towards the body have been largely overlooked as potential risk factors for body dysmorphic disorder (BDD) despite theorizing that a negative body image may play a critical role in the development of this disorder. Participants: The purpose of this study was to evaluate the fit of a theoretical model specifying body image and meta-worry as mediators between cognitive, metacognitive beliefs and body dysmorphic disorder(BDD) in a nonclinical sample of 635 participants (304 male and 331 female). Results: The data supported the model, and meta-worry and body image significantly mediated the relationship between cognitive, metacognitive beliefs and BDD. These findings provide essential preliminary evidence that body image may represent a necessary but not sufficient risk factor for BDD and that treatment for BDD should consider targeting body-related pathology in addition to meta-worry. Conclusion: The model may prompt future research into body dysmorphic disorder.
Cite this paper: Donyavi, V. , Rabiei, M. , Nikfarjam, M. and Nezhady, B. (2015) Body Image and Meta-Worry as Mediators of Body Dysmorphic Disorder. International Journal of Clinical Medicine, 6, 170-176. doi: 10.4236/ijcm.2015.63022.

[1]   Van Ameringen, M., Patterson, B. and Simpson, W. (2014) DSM-5 Obsessive-Compulsive and Related Disorders: Clinical Implications of New Criteria. Depress Anxiety, 31, 487-493.

[2]   Vulink, N.C., Sigurdsson, V., Kon, M., Bruijnzeel-Koomen, C.A., Westenberg, H.G. and Denys, D. (2006) Body Dysmorphic Disorder in 3%-8% of Patients in Outpatient Dermatology and Plastic Surgery Clinics (Stoornis in de lichaamsbeleving bij 3-8% van de patienten op de poliklinieken Dermatologie en Plastische Chirurgie). Nederlands Tijdschrift Voor Geneeskunde, 150, 97-100.

[3]   Williams, J., Hadjistavropoulos, T. and Sharpe, D. (2006) A Meta-Analysis of Psychological and Pharmacological Treatments for Body Dysmorphic Disorder. Behaviour Research and Therapy, 44, 99-111.

[4]   Rabiei, M., Mulkens, S., Kalantari, M., Molavi, H. and Bahrami, F. (2012) Metacognitive Therapy for Body Dysmorphic Disorder Patients in Iran: Acceptability and Proof of Concept. Journal of Behavior Therapy and Experimental Psychiatry, 43, 724-729.

[5]   Sheppard, L.C. (2002) Emotional Disorders and Metacognition: Innovative Cognitive Therapy. Psychological Medicine, 32, 750-752.

[6]   Cooper, M. (2003) Emotional Disorders and Metacognition: Innovative Cognitive Therapy. British Journal of Clinical Psychology, 42, 105-106.

[7]   Wells, A. and Matthews, G. (1996) Modelling Cognition in Emotional Disorder: The S-REF Model. Behaviour Research and Therapy, 34, 881-888.

[8]   Papageorgiou, C. and Wells, A. (2003) An Empirical Test of a Clinical Metacognitive Model of Rumination and Depression. Cognitive Therapy and Research, 27, 261-273.

[9]   Cooper, M. (2007) Metacognition in Body Dysmorphic Disorder—A Preliminary Exploration. Journal of Cognitive Psychotherapy, 21, 148-155.

[10]   Veale, D. (2004) Advances in a Cognitive Behavioural Model of Body Dysmorphic Disorder. Body Image, 1, 113-125.

[11]   Kostanski, M., Fisher, A. and Gullone, E. (2004) Current Conceptualisation of Body Image Dissatisfaction: Have We Got It Wrong? Journal of Child Psychology and Psychiatry, and Allied Disciplines, 45, 1317-1325.

[12]   Rabiei, M., Salahian, A., Bahrami, F. and Palahang, H. (2011) Construction and Standardization of the Body Dysmorphic Metacognition Questionnaire. Journal of Mazandaran University of Medical Sciences, 21, 43-52.

[13]   Phillips, K.A., Hollander, E., Rasmussen, S.A., Aronowitz, B.R., DeCaria, C. and Goodman, W.K. (1997) A Severity Rating Scale for Body Dysmorphic Disorder: Development, Reliability, and Validity of a Modified Version of the Yale-Brown Obsessive Compulsive Scale. Psychopharmacology Bulletin, 33, 17-22.

[14]   Rabiei, M., Khormdel, K., Kalantari, K. and Molavi, H. (2010) Validity of the Yale-Brown Obsessive Compulsive Scale Modified for Body Dysmorphic Disorder (BDD) in Students of the University of Isfahan. Iranian Journal of Psychiatry and Clinical Psychology, 15, 343-350.

[15]   Weissman, A. and Beck, A. (1978) Development and Validation of the Dysfunctional Attitude Scale: A Preliminary Investigation. Proceedings of the Annual Meeting of the American Educational Research Association, Toronto, 27-31 March 1978, 1-13.

[16]   Moore, M.T., Fresco, D.M., Segal, Z.V. and Brown, T.A. (2014) An Exploratory Analysis of the Factor Structure of the Dysfunctional Attitude Scale-Form A (DAS). Assessment, 21, 570-579.

[17]   Osman, A., Gutierrez, P.M., Schweers, R., Fang, Q., Holguin-Mills, R.L. and Cashin, M. (2010) Psychometric Evaluation of the Body Investment Scale for Use with Adolescents. Journal of Clinical Psychology, 66, 259-276.

[18]   Wells, A. (2000) Emotional Disorders and Metacognition: Innovative Cognitive Therapy. John Wiley & Sons, New York, 236 p.

[19]   Gignac, G.E., Palmer, B., Bates, T. and Stough, C. (2006) Differences in Confirmatory Factor Analysis Model Close-Fit Index Estimates Obtained from AMOS 4.0 and AMOS 5.0 via Full Information Maximum Likelihood No Imputation: Corrections and Extension to Palmer et al. (2003). Australian Journal of Psychology, 58, 144-150.

[20]   Cooper, M.J., Grocutt, E., Deepak, K. and Bailey, E. (2007) Metacognition in Anorexia Nervosa, Dieting and Non-Dieting Controls: A Preliminary Investigation. British Journal of Clinical Psychology, 46, 113-117.