Sophie C Schneider1, Andrew J Baillie2, Jonathan Mond3, Cynthia M Turner4, Jennifer L Hudson5. 1. Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia. 2. Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia; NHMRC Centre of Research Excellence in Mental Health and Substance Use, Australia. 3. Centre for Rural Health, School of Health Sciences, University of Tasmania, Launceston, Australia; Centre for Health Research, School of Medicine, Western Sydney University, Sydney, Australia. 4. School of Psychology, Australian Catholic University, Brisbane, Australia. 5. Centre for Emotional Health, Department of Psychology, Macquarie University, Sydney, Australia. Electronic address: jennie.hudson@mq.edu.au.
Abstract
BACKGROUND: Body dysmorphic disorder (BDD) was categorised in DSM-5 within the newly created 'obsessive-compulsive and related disorders' chapter, however this classification remains subject to debate. Confirmatory factor analysis was used to test competing models of the co-occurrence of symptoms of BDD, obsessive-compulsive disorder, unipolar depression, anxiety, and eating disorders in a community sample of adolescents, and to explore potential sex differences in these models. METHODS: Self-report questionnaires assessing disorder symptoms were completed by 3149 Australian adolescents. The fit of correlated factor models was calculated separately in males and females, and measurement invariance testing compared parameters of the best-fitting model between males and females. RESULTS: All theoretical models of the classification of BDD had poor fit to the data. Good fit was found for a novel model where BDD symptoms formed a distinct latent factor, correlated with affective disorder and eating disorder latent factors. Metric non-invariance was found between males and females, and the majority of factor loadings differed between males and females. Correlations between some latent factors also differed by sex. LIMITATIONS: Only cross-sectional data were collected, and the study did not assess a broad range of DSM-5 defined eating disorder symptoms or other disorders in the DSM-5 obsessive-compulsive and related disorders chapter. CONCLUSIONS: This study is the first to statistically evaluate competing models of BDD classification. The findings highlight the unique features of BDD and its associations with affective and eating disorders. Future studies examining the classification of BDD should consider developmental and sex differences in their models.
BACKGROUND:Body dysmorphic disorder (BDD) was categorised in DSM-5 within the newly created 'obsessive-compulsive and related disorders' chapter, however this classification remains subject to debate. Confirmatory factor analysis was used to test competing models of the co-occurrence of symptoms of BDD, obsessive-compulsive disorder, unipolar depression, anxiety, and eating disorders in a community sample of adolescents, and to explore potential sex differences in these models. METHODS: Self-report questionnaires assessing disorder symptoms were completed by 3149 Australian adolescents. The fit of correlated factor models was calculated separately in males and females, and measurement invariance testing compared parameters of the best-fitting model between males and females. RESULTS: All theoretical models of the classification of BDD had poor fit to the data. Good fit was found for a novel model where BDD symptoms formed a distinct latent factor, correlated with affective disorder and eating disorder latent factors. Metric non-invariance was found between males and females, and the majority of factor loadings differed between males and females. Correlations between some latent factors also differed by sex. LIMITATIONS: Only cross-sectional data were collected, and the study did not assess a broad range of DSM-5 defined eating disorder symptoms or other disorders in the DSM-5 obsessive-compulsive and related disorders chapter. CONCLUSIONS: This study is the first to statistically evaluate competing models of BDD classification. The findings highlight the unique features of BDD and its associations with affective and eating disorders. Future studies examining the classification of BDD should consider developmental and sex differences in their models.
Authors: Þórhildur Ólafsdóttir; Bernhard Weidle; Tord Ivarsson; Davíð R M A Højgaard; Karin Melin; Judith Becker Nissen; Nor Christian Torp; Per Hove Thomsen; Gudmundur Skarphedinsson Journal: Child Psychiatry Hum Dev Date: 2022-01-11