مقایسه اختلالات خوردن و اختلال بدریخت انگاری در تصویر ذهنی از جسم و تنظیم روان شناختی

Eating and body dysmorphic disorders are two diagnoses with body image disturbance as a central feature. No empirical study of the similarity of these disorders or any controlled study of body dysmorphic disorder were available. The present study compared 45 women with anorexia or bulimia nervosa to 51 men and women with body dysmorphic disorder (BDD) and 50 nonclinical controls. The eating disorder patients were mainly preoccupied with weight and body shape. BDD subjects had more diverse physical complaints and reported more negative self-evaluation and avoidance due to appearance. However, the two groups showed equally severe body image symptoms overall, and were clearly abnormal compared with controls. Both types of patients had negative self-esteem, but eating disorder patients had more widespread psychological symptoms. In conclusion, the disorders are comparable on psychological measures. Explanations of the minor differences and questions for future research on the relation between eating and body dysmorphic disorders are presented.

The problem of body image in eating disorders deserves special attention. Few people who seek help for eating disorder symptoms are not overly concerned with their physical appearance 1 and 2and most people discover that changing body image is the hardest part of their recovery [3], yet standard eating disorder programs provide less therapy and have a smaller treatment effect for body image compared with eating behavior [4]. Body dysmorphic disorder (BDD) is the only other diagnosis in the American diagnostic manual [5]that is characterized by a disturbed body image. The essence of the diagnostic criteria for BDD is a preoccupation with an imagined or slight defect in physical appearance that is distressing or interfering [5]. The purpose of this article is to compare these two disorders. Important issues about body image and psychopathology in both disorders might be better understood if the relation between eating and body dysmorphic disorders was clarified. Because their common diagnostic feature is a disturbance of body image, we will compare the two disorders on a standard body image assessment. In addition, we also will examine overall psychological adjustment by comparing them on total mental health symptoms and self-esteem. In designing this study, we could not predict with reasonable certainty what differences, if any, might emerge between these conditions on standardized measures. Not only had no comparison been reported, but no controlled study whatsoever of psychopathology in BDD was available. The existing research led us to consider that mental health symptoms might be either more severe in BDD, more severe in eating disorders, or equivalent. Following are some reasons for these possibilities.