Hostname: page-component-cd9895bd7-gvvz8 Total loading time: 0 Render date: 2024-12-26T09:21:04.254Z Has data issue: false hasContentIssue false

A twin study of body dysmorphic concerns

Published online by Cambridge University Press:  30 November 2011

B. Monzani*
Affiliation:
Department of Psychosis Studies, King's College London, Institute of Psychiatry, London, UK
F. Rijsdijk
Affiliation:
Social, Genetic & Developmental Psychiatry Research Centre (SDGP), Institute of Psychiatry, London, UK
M. Anson
Affiliation:
The Centre for Anxiety Disorders and Trauma, South London and Mausdley NHS Trust, London, UK
A. C. Iervolino
Affiliation:
Department of Psychosis Studies, King's College London, Institute of Psychiatry, London, UK
L. Cherkas
Affiliation:
Deparment of Twin Research and Genetic Epidemiology, King's College London School of Medicine, UK
T. Spector
Affiliation:
Deparment of Twin Research and Genetic Epidemiology, King's College London School of Medicine, UK
D. Mataix-Cols
Affiliation:
Department of Psychosis Studies, King's College London, Institute of Psychiatry, London, UK Department of Psychology, King's College London, Institute of Psychiatry, London, UK
*
*Address for correspondence: B. Monzani, Department of Psychosis Studies, King's College London, Institute of Psychiatry, PO 69, De Crespigny Park Rd., London SE5 8AF, UK. (Email: [email protected])

Abstract

Background

Dysmorphic concern refers to an excessive preoccupation with a perceived or slight defect in physical appearance. It lies on a continuum of severity from no or minimal concerns to severe concerns over one's appearance. The present study examined the heritability of dysmorphic concerns in a large sample of twins.

Method

Twins from the St Thomas UK twin registry completed a valid and reliable self-report measure of dysmorphic concerns, which also includes questions about perceived body odour and malfunction. Twin modelling methods (female twins only, n=3544) were employed to decompose the variance in the liability to dysmorphic concerns into additive genetic, shared and non-shared environmental factors.

Results

Model-fitting analyses showed that genetic factors accounted for approximately 44% [95% confidence intervals (CI) 36–50%] of the variance in dysmorphic concerns, with non-shared environmental factors and measurement error accounting for the remaining variance (56%; 95% CI 50–63%). Shared environmental factors were negligible. The results remained unchanged when excluding individuals reporting an objective medical condition/injury accounting for their concern in physical appearance.

Conclusions

Over-concern with a perceived or slight defect in physical appearance is a heritable trait, with non-shared environmental factors also playing an important role in its causation. The results are relevant for various psychiatric disorders characterized by excessive concerns in body appearance, odour or function, including but not limited to body dysmorphic disorder.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andrew, T, Hart, DJ, Snieder, H, de Lange, M, Spector, TD, MacGregor, AJ (2001). Are twins and singletons comparable? A study of disease-related and lifestyle characteristics in adult women. Twin Research 4, 464477.CrossRefGoogle ScholarPubMed
APA (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. American Psychiatric Publication Inc.: Washington DC.Google Scholar
Biby, EL (1998). The relationship between body dysmorphic disorder and depression, self-esteem, somatization, and obsessive-compulsive disorder. Journal of Clinical Psychology 54, 489499.3.0.CO;2-B>CrossRefGoogle ScholarPubMed
Bienvenu, OJ, Samuels, JF, Riddle, MA, Hoehn-Saric, R, Liang, KY, Cullen, BA, Grados, MA, Nestadt, G (2000). The relationship of obsessive-compulsive disorder to possible spectrum disorders: results from a family study. Biological Psychiatry 48, 287293.CrossRefGoogle ScholarPubMed
Bohne, A, Wilhelm, S, Keuthen, NJ, Florin, I, Baer, L, Jenike, MA (2002). Prevalence of body dysmorphic disorder in a German college student sample. Psychiatry Research 109, 101104.CrossRefGoogle Scholar
Buhlmann, U, Cook, LM, Fama, JM, Wilhelm, S (2007). Perceived teasing experiences in body dysmorphic disorder. Body Image 4, 381385.CrossRefGoogle ScholarPubMed
Conroy, M, Menard, W, Fleming-Ives, K, Modha, P, Cerullo, H, Phillips, KA (2008). Prevalence and clinical characteristics of body dysmorphic disorder in an adult inpatient setting. General Hospital Psychiatry 30, 6772.CrossRefGoogle Scholar
Didie, ER, Tortolani, CC, Pope, CG, Menard, W, Fay, C, Phillips, KA (2006). Childhood abuse and neglect in body dysmorphic disorder. Child Abuse and Neglect 30, 11051115.CrossRefGoogle ScholarPubMed
Didie, ER, Walters, MM, Pinto, A, Menard, W, Eisen, JL, Mancebo, M, Rasmussen, SA, Phillips, KA (2007). A comparison of quality of life and psychosocial functioning in obsessive-compulsive disorder and body dysmorphic disorder. Annals of Clinical Psychiatry 19, 181186.CrossRefGoogle ScholarPubMed
Faravelli, C, Salvatori, S, Galassi, F, Aiazzi, L, Drei, C, Cabras, P (1997). Epidemiology of somatoform disorders: a community survey in Florence. Social Psychiatry and Psychiatric Epidemiology 32, 2429.CrossRefGoogle ScholarPubMed
Grant, JE, Kim, SW, Crow, SJ (2001). Prevalence and clinical features of body dysmorphic disorder in adolescent and adult psychiatric inpatients. Journal of Clinical Psychiatry 62, 517522.CrossRefGoogle ScholarPubMed
Hudson, JI, Hiripi, E, Pope, Jr. HG, Kessler, RC (2007). The prevalence and correlates of eating disorders in the National Comorbidity Survey Replication. Biological Psychiatry 61, 348358.CrossRefGoogle ScholarPubMed
Jorgensen, L, Castle, D, Roberts, C, Groth-Marnat, G (2001). A clinical validation of the Dysmorphic Concern Questionnaire. Australian and New Zealand Journal of Psychiatry 35, 124128.CrossRefGoogle ScholarPubMed
Joseph, J (2002). Twin studies in psychiatry and psychology: science or pseudoscience? Psychiatric Quarterly 73, 7182.CrossRefGoogle ScholarPubMed
Koran, LM, Abujaoude, E, Large, MD, Serpe, RT (2008). The prevalence of body dysmorphic disorder in the United States adult population. CNS spectrums 13, 316322.CrossRefGoogle ScholarPubMed
Macdonald, AM, Murray, RM, Clifford, CA (1991). The contribution of heredity to obsessional disorder and personality: a review of family and twin study evidence. InGenetic Issues in Psychosocial Epidemiology (ed. Tsuang, M. T., Kendler, K. S. and Lyons, M. J.), pp. 191212. Rutgers University Press: New Brunswick, NJ.Google Scholar
Mancuso, SG, Knoesen, NP, Castle, DJ (2010). The Dysmorphic Concern Questionnaire: a screening measure for body dysmorphic disorder. Australian and New Zealand Journal of Psychiatry 44, 535542.Google ScholarPubMed
Neale, MC, Cardon, LR (1992). Methodology for Genetic Studies of Twins and Families. Springer: Houten, The Netherlands.CrossRefGoogle Scholar
Oosthuizen, P, Lambert, T, Castle, DJ (1998). Dysmorphic concern: prevalence and associations with clinical variables. Australian and New Zealand Journal of Psychiatry 32, 129132.CrossRefGoogle ScholarPubMed
Otto, MW, Wilhelm, S, Cohen, LS, Harlow, BL (2001). Prevalence of body dysmorphic disorder in a community sample of women. American Journal of Psychiatry 158, 20612063.CrossRefGoogle Scholar
Pavan, C, Simonato, P, Marini, M, Mazzoleni, F, Pavan, L, Vindigni, V (2008). Psychopathologic aspects of body dysmorphic disorder: a literature review. Aesthetic Plastic Surgery 32, 473484.CrossRefGoogle ScholarPubMed
Phillips, KA (2005). The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder. Oxford University Press: New York.Google Scholar
Phillips, KA, Coles, ME, Menard, W, Yen, S, Fay, C, Weisberg, RB (2005 a). Suicidal ideation and suicide attempts in body dysmorphic disorder. Journal of Clinical Psychiatry 66, 717725.CrossRefGoogle ScholarPubMed
Phillips, KA, Menard, W, Fay, C, Weisberg, R (2005 b). Demographic characteristics, phenomenology, comorbidity, and family history in 200 individuals with body dysmorphic disorder. Psychosomatics 46, 317325.CrossRefGoogle ScholarPubMed
Rijsdijk, FV, Sham, PC (2002). Analytic approaches to twin data using structural equation models. Briefings in Bioinformatics 3, 119.CrossRefGoogle ScholarPubMed
Sarna, S, Kaprio, J, Sistonen, P, Koskenvuo, M (1978). Diagnosis of twin zygosity by mailed questionnaire. Human Heredity 28, 241254.CrossRefGoogle ScholarPubMed
Soundy, TJ, Lucas, AR, Suman, VJ, Melton, LJ 3rd (1995). Bulimia nervosa in Rochester, Minnesota from 1980 to 1990. Psychological Medicine 25, 10651071.CrossRefGoogle ScholarPubMed
Spector, TD, Williams, FM (2006). The UK Adult Twin Registry (TwinsUK). Twin Research and Human Genetics 9, 899906.CrossRefGoogle ScholarPubMed
Stangier, U, Janich, C, Adam-Schwebe, S, Berger, P, Wolter, M (2000). Screening for body dysmorphic disorder in dermatological outpatients. Dermatology and Psychosomatics/Dermatologie und Psychosomatik 4, 6671.CrossRefGoogle Scholar
Veale, D, Ennis, M, Lambrou, C (2002). Possible association of body dysmorphic disorder with an occupation or education in art and design. American Journal of Psychiatry 159, 17881790.CrossRefGoogle ScholarPubMed