Skip to main content Accessibility help
×
Home

A twin study of body dysmorphic concerns

  • B. Monzani (a1), F. Rijsdijk (a2), M. Anson (a3), A. C. Iervolino (a1), L. Cherkas (a4), T. Spector (a4) and D. Mataix-Cols (a1) (a5)...

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.

Copyright

Corresponding author

*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: benedetta.monzani@kcl.ac.uk)

References

Hide All
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.
APA (2000). Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. American Psychiatric Publication Inc.: Washington DC.
Biby, EL (1998). The relationship between body dysmorphic disorder and depression, self-esteem, somatization, and obsessive-compulsive disorder. Journal of Clinical Psychology 54, 489499.
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.
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.
Buhlmann, U, Cook, LM, Fama, JM, Wilhelm, S (2007). Perceived teasing experiences in body dysmorphic disorder. Body Image 4, 381385.
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.
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.
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.
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.
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.
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.
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.
Joseph, J (2002). Twin studies in psychiatry and psychology: science or pseudoscience? Psychiatric Quarterly 73, 7182.
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.
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.
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.
Neale, MC, Cardon, LR (1992). Methodology for Genetic Studies of Twins and Families. Springer: Houten, The Netherlands.
Oosthuizen, P, Lambert, T, Castle, DJ (1998). Dysmorphic concern: prevalence and associations with clinical variables. Australian and New Zealand Journal of Psychiatry 32, 129132.
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.
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.
Phillips, KA (2005). The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder. Oxford University Press: New York.
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.
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.
Rijsdijk, FV, Sham, PC (2002). Analytic approaches to twin data using structural equation models. Briefings in Bioinformatics 3, 119.
Sarna, S, Kaprio, J, Sistonen, P, Koskenvuo, M (1978). Diagnosis of twin zygosity by mailed questionnaire. Human Heredity 28, 241254.
Soundy, TJ, Lucas, AR, Suman, VJ, Melton, LJ 3rd (1995). Bulimia nervosa in Rochester, Minnesota from 1980 to 1990. Psychological Medicine 25, 10651071.
Spector, TD, Williams, FM (2006). The UK Adult Twin Registry (TwinsUK). Twin Research and Human Genetics 9, 899906.
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.
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.

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed