A Comparison of Self-Esteem and Perfectionism in Anorexia Nervosa and Body Dysmorphic Disorder

Abstract

Previous studies have identified phenotypic similarities between anorexia nervosa (AN) and body dysmorphic disorder (BDD), which share the common feature of negative body image. Studies comparing endophenotypes that may cut across both disorders-as suggested by the National Institute of Mental Health's Research Domain Criteria-are limited. Sixty-nine individuals (AN, n = 24; BDD, n = 23; mentally healthy controls [MHCs], n = 22) completed diagnostic interviews and self-reports assessing self-esteem and perfectionism. Clinical groups showed greater perfectionism in almost all subdimensions as well as poorer self-esteem compared with MHCs, with no clinical group differences when controlling for level of depression. Depression was a mediator of the relationship between symptom severity and self-esteem in both clinical groups. Comparable low self-esteem and greater perfectionism in AN and BDD corroborated existing etiological models and previous studies. Depression was a significant contributor to negative self-esteem in both disorders.

Perfectionism and selective attention predict dysmorphic concern in an Australian university population

“…Reflecting perfectionistic concerns and checking of detail (Stairs et al, 2012), that was uniquely predictive. These findings are consistent with the BDD and eating disorder literature, in which doubts about actions were higher in the clinical groups compared to controls (Buhlmann, Etcoff et al, 2008;Hartmann et al, 2015). Thus, it is possible that detailed checking is a pervasive symptom characteristic of T A B L E 1 Descriptive statistics and Pearson r correlations for perfectionism, dot-probe, dysmorphic concern, depression, anxiety, and stress scores .63** Indicates where one item from the DASS-21 anxiety scale produced an item-total correlation of .35 but was retained for conceptual relevance.…”

“…Both types of perfectionism were found to be important risk factors for eating disorders. There are some discrepant findings concerning the specific subtypes of perfectionism characteristic of BDD, with one study (Hartmann, Thomas, Greenberg, Matheny, & Wilhelm, 2015) finding that compared to controls, the eating disorder and BDD group endorsed higher perfectionistic strivings and concerns. Conversely, in a related study comprised of BDD and OCD participants (Buhlmann, Etcoff, & Wilhelm, 2008), compared to controls, the treatment groups differed on perfectionistic concerns only.…”

The role of self‐esteem in the treatment of patients with anorexia nervosa – A systematic review and meta‐analysis

“…Again, differences between groups were not detected (Jacobi et al, 2004). However, in each case, one study demonstrated that AN patients had significantly lower self-esteem scores than patients with a purging disorder with loss of control and body dysmorphic disorder (Goldschmidt et al, 2016;Hartmann et al, 2014).…”

“…Only one study compared individuals with AN to those with a binge-eating disorder. However, in each case, one study demonstrated that AN patients had significantly lower self-esteem scores than patients with a purging disorder with loss of control and body dysmorphic disorder (Goldschmidt et al, 2016;Hartmann et al, 2014). However, in each case, one study demonstrated that AN patients had significantly lower self-esteem scores than patients with a purging disorder with loss of control and body dysmorphic disorder (Goldschmidt et al, 2016;Hartmann et al, 2014).…”

Accept, distract, or reframe? An exploratory experimental comparison of strategies for coping with intrusive body image thoughts in anorexia nervosa and body dysmorphic disorder

“…Recruitment and participant selection was performed for a larger project and a comparable description can be found in other studies from this project (Hartmann et al, 2013;Hartmann et al, 2014). We recruited participants for all groups through flyers and advertisement (n¼ 37), intakes in outpatient clinics (n¼ 24), and residential settings (n¼ 15).…”