Development and Validation of a Measure for Metacognitive Factors in Body Dysmorphic Disorder Patients
Affiliation(s)
1 Department of Psychiatry, Shahrekord University of Medical Science, Shahrekord, Iran. 2 Department of Clinical Psychology, Baqiyatallah University of Medical Sciences, Tehran, Iran. 3 Departments of Psychiatry, AJA University of Medical Science, Tehran, Iran. 4 Departments of Psychology, Yazd University, Yazd, Iran.
1 Department of Psychiatry, Shahrekord University of Medical Science, Shahrekord, Iran. 2 Department of Clinical Psychology, Baqiyatallah University of Medical Sciences, Tehran, Iran. 3 Departments of Psychiatry, AJA University of Medical Science, Tehran, Iran. 4 Departments of Psychology, Yazd University, Yazd, Iran.
ABSTRACT
Background and Objectives: Recent studies explored the relationships between metacognitive beliefs and body dysmorphic disorder. The purpose of this study was to develop and validate one self-report scale of metacognitive factor about body dysmorphic. Methods: Development of this scale involved three steps: 1) items generated from a qualitative study with lecture and care professionals, 2) expert panel review, and 3) pilot test. A factor analysis of the responses from 600 participants suggested the creation of a 25-item scale. Results: Study showed that scores on the 25-item measure correlated with five theoretically related constructs, including positive and negative metacognitive beliefs about body dysmorphic, thought-fusion and metacognitive control strategies. Convergent validity of Body Dysmorphic Metacognitive Scale (BDMCS) with Yale-Brown Obsessive Compulsive Scale was modified for Body Dysmorphic Disorder (BDD) and Thought Fusion Instrument (r = 0.44, r = 0.52, P < 0.001). The factors were able to determine 83.14 percent of the variance. The Cronbach’s alpha for the five factors was above 0.83. Additionally, results have been shown to possess good psychometric properties. Conclusions: The scales may prompt future research into BDD and facilitate clinical assessment and case formulation.
KEYWORDS
Body Dysmorphic Disorder, Metacognition, Metacognitive Beliefs about Body Dysmorphic, Self-Report Scale
Body Dysmorphic Disorder, Metacognition, Metacognitive Beliefs about Body Dysmorphic, Self-Report Scale
Cite this paper
Nikfarjam, M. , Rabiei, M. , Donyavi, V. and Mahmoodabadi, H. (2015) Development and Validation of a Measure for Metacognitive Factors in Body Dysmorphic Disorder Patients. International Journal of Clinical Medicine, 6, 334-341. doi: 10.4236/ijcm.2015.65043.
Nikfarjam, M. , Rabiei, M. , Donyavi, V. and Mahmoodabadi, H. (2015) Development and Validation of a Measure for Metacognitive Factors in Body Dysmorphic Disorder Patients. International Journal of Clinical Medicine, 6, 334-341. doi: 10.4236/ijcm.2015.65043.
References
[1] Van Ameringen, M., Patterson, B. and Simpson, W. (2014) DSM-5 Obsessive-Compulsive and Related Disorders: Clinical Implications of New Criteria. Depression and Anxiety, 31, 487-493.
http://dx.doi.org/10.1002/da.22259 [2] Goodman, W.K. (2014) Obsessive Compulsive and Related Disorders. Psychiatric Clinics of North America, 37, xi-xii.
http://dx.doi.org/10.1016/j.psc.2014.06.005 [3] Rabiei, M., Donyavi, V., Nikfarjam, M. and Nezhady, M.A.M. (2015) Validation of a Classification System for Obsessive-Compulsive and Related Disorders Based on DSM-5. Open Journal of Psychiatry, 5, 137-143.
http://dx.doi.org/10.4236/ojpsych.2015.52015 [4] Vulink, N.C., Sigurdsson, V., Kon, M., Bruijnzeel-Koomen, C.A., Westenberg, H.G. and Denys, D. (2006) Stoornis in de lichaamsbeleving bij 3-8% van de patienten op de poliklinieken Dermatologie en Plastische Chirurgie [Body Dysmorphic Disorder in 3-8% of Patients in Outpatient Dermatology and Plastic Surgery Clinics]. Nederlands Tijdschrift voor Geneeskunde, 150, 97-100. [5] 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.
http://dx.doi.org/10.1016/j.brat.2004.12.006 [6] 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.
http://dx.doi.org/10.1016/j.jbtep.2011.09.013 [7] 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.
http://dx.doi.org/10.4236/ijcm.2015.63022 [8] Wells, A. (2000) Emotional Disorders and Metacognition: Innovative Cognitive Therapy. John Wiley & Sons, Chichester, New York, ix, 236 p. [9] Wells, A. and Matthews, G. (1996) Modelling Cognition in Emotional Disorder: The S-REF Model. Behaviour Research and Therapy, 34, 881-888. [10] 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. [11] Cooper, M. (2003) Emotional Disorders and Metacognition: Innovative Cognitive Therapy. British Journal of Clinical Psychology, 42, 105-106. [12] Rabiei, M., Salahian, A., Bahrami, F. and Palahang, H. (2011) Construction and Standardization of the Body Dysmorphic Metacognition Questionnaire. The Journal of Mazandaran University of Medical Sciences, 21, 43-52. [13] Cooper, M. and Osman, S. (2007) Metacognition in Body Dysmorphic Disorder—A Preliminary Exploration. Journal of Cognitive Psychotherapy, 21, 148-155.
http://dx.doi.org/10.1891/088983907780851568 [14] Veale, D. (2004) Advances in a Cognitive Behavioural Model of Body Dysmorphic Disorder. Body Image, 1, 113-125.
http://dx.doi.org/10.1016/S1740-1445(03)00009-3 [15] Hollander, E. and Benzaquen, S.D. (1997) The Obsessive-Compulsive Spectrum Disorders. International Review of Psychiatry, 9, 99-109. [16] 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. [17] 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. [18] Wells, A., Gwilliam, P. and Cartwright-Hatton, S. (2001) The Thought Fusion Instrument (Unpublished Self-Report Scale). Unpublished Scale Manchester, University of Manchester, Manchester. [19] Khoramdel, K., Rabiei, M., Molavi, H. and Neshatdoost, H.T. (2010) Psychometric Properties of Thought Fusion Instrument (TFI) in Students. Iranian Journal of Psychiatry and Clinical Psychology, 16, 74-78. [20] Nunnally, J. and Bernstein, I. (1994) Psychometric Theory. 3rd Edition, McGraw-Hill, New York. [21] Floyd, F.J. and Widaman, K.F. (1995) Factor Analysis in the Development and Refinement of Clinical Assessment Instruments. Psychological Assessment, 7, 286-299.
http://dx.doi.org/10.1037/1040-3590.7.3.286
[1] Van Ameringen, M., Patterson, B. and Simpson, W. (2014) DSM-5 Obsessive-Compulsive and Related Disorders: Clinical Implications of New Criteria. Depression and Anxiety, 31, 487-493.
http://dx.doi.org/10.1002/da.22259 [2] Goodman, W.K. (2014) Obsessive Compulsive and Related Disorders. Psychiatric Clinics of North America, 37, xi-xii.
http://dx.doi.org/10.1016/j.psc.2014.06.005 [3] Rabiei, M., Donyavi, V., Nikfarjam, M. and Nezhady, M.A.M. (2015) Validation of a Classification System for Obsessive-Compulsive and Related Disorders Based on DSM-5. Open Journal of Psychiatry, 5, 137-143.
http://dx.doi.org/10.4236/ojpsych.2015.52015 [4] Vulink, N.C., Sigurdsson, V., Kon, M., Bruijnzeel-Koomen, C.A., Westenberg, H.G. and Denys, D. (2006) Stoornis in de lichaamsbeleving bij 3-8% van de patienten op de poliklinieken Dermatologie en Plastische Chirurgie [Body Dysmorphic Disorder in 3-8% of Patients in Outpatient Dermatology and Plastic Surgery Clinics]. Nederlands Tijdschrift voor Geneeskunde, 150, 97-100. [5] 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.
http://dx.doi.org/10.1016/j.brat.2004.12.006 [6] 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.
http://dx.doi.org/10.1016/j.jbtep.2011.09.013 [7] 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.
http://dx.doi.org/10.4236/ijcm.2015.63022 [8] Wells, A. (2000) Emotional Disorders and Metacognition: Innovative Cognitive Therapy. John Wiley & Sons, Chichester, New York, ix, 236 p. [9] Wells, A. and Matthews, G. (1996) Modelling Cognition in Emotional Disorder: The S-REF Model. Behaviour Research and Therapy, 34, 881-888. [10] 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. [11] Cooper, M. (2003) Emotional Disorders and Metacognition: Innovative Cognitive Therapy. British Journal of Clinical Psychology, 42, 105-106. [12] Rabiei, M., Salahian, A., Bahrami, F. and Palahang, H. (2011) Construction and Standardization of the Body Dysmorphic Metacognition Questionnaire. The Journal of Mazandaran University of Medical Sciences, 21, 43-52. [13] Cooper, M. and Osman, S. (2007) Metacognition in Body Dysmorphic Disorder—A Preliminary Exploration. Journal of Cognitive Psychotherapy, 21, 148-155.
http://dx.doi.org/10.1891/088983907780851568 [14] Veale, D. (2004) Advances in a Cognitive Behavioural Model of Body Dysmorphic Disorder. Body Image, 1, 113-125.
http://dx.doi.org/10.1016/S1740-1445(03)00009-3 [15] Hollander, E. and Benzaquen, S.D. (1997) The Obsessive-Compulsive Spectrum Disorders. International Review of Psychiatry, 9, 99-109. [16] 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. [17] 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. [18] Wells, A., Gwilliam, P. and Cartwright-Hatton, S. (2001) The Thought Fusion Instrument (Unpublished Self-Report Scale). Unpublished Scale Manchester, University of Manchester, Manchester. [19] Khoramdel, K., Rabiei, M., Molavi, H. and Neshatdoost, H.T. (2010) Psychometric Properties of Thought Fusion Instrument (TFI) in Students. Iranian Journal of Psychiatry and Clinical Psychology, 16, 74-78. [20] Nunnally, J. and Bernstein, I. (1994) Psychometric Theory. 3rd Edition, McGraw-Hill, New York. [21] Floyd, F.J. and Widaman, K.F. (1995) Factor Analysis in the Development and Refinement of Clinical Assessment Instruments. Psychological Assessment, 7, 286-299.
http://dx.doi.org/10.1037/1040-3590.7.3.286