How do people with body dysmorphic disorder view themselves? A thematic analysis

Abstract

Objectives. To examine the accounts of people with body dysmorphic disorder (BDD) and qualitatively explore self perceptions. Methods. Eleven people with BDD were interviewed using a semi-structured schedule. Participants brought photographs of themselves and drew a self-portrait. Transcribed interviews were analysed using a thematic analysis. Results. The most common theme was increased threat perception resulting in disordered interpersonal relationships. Other themes included the wish for regularity and symmetry in appearance, an idealised childhood self, the duty to look good, and a focus on specific “defective” features rather than general ugliness. Conclusions. Using thematic analysis and visual methods, we identified core themes that appear to characterise the way individuals with BDD perceive themselves and their interpersonal relationships. Thematic analysis offers promise as a tool to explore the overlap between BDD and other putatively related mental health problems.

Key Words::

• Body dysmorphic disorder
• thematic analysis
• obsessive compulsive disorder spectrum

Acknowledgement

The authors would like to acknowledge Dr David Veale and Dr Martin Anson for kindly providing access to the Body Dysmorphic Disorder self-help group at The Priory, North London and for their helpful input on a previous draft of the manuscript.

Declaration of interest

Dr Fineberg has consulted for Lundbeck, Glaxo-Smith Kline, Servier, and Bristol Myers Squibb. Dr Fineberg has received research support from Lundbeck, Glaxo-SmithKline, Astra Zeneca, Wellcome, Cephalon, ECNP. Dr Fineberg has received honoraria for lectures at scientific meetings from Janssen, Jazz, Lundbeck, Servier, Astra Zeneca, Wyeth. Dr Fineberg has received financial support to attend scientific meetings from Janssen, Bristol Myers Squibb, Jazz, Lundbeck, Servier, Astra Zeneca, Wyeth, Cephalon, International College of OC Spectrum Disorders.