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Rejection sensitivity higher among patients with body dysmorphic disorder

Fear of being rejected by others is significantly elevated among individuals with body dysmorphic disorder, according to recent study findings published in Body Image.

“People with [body dysmorphic disorder] obsess about physical features or attributes they believe are ugly or hideous, often spending hours looking in the mirror and taking extraordinary measures to try to correct imperfections only they can see,” Katharine Phillips, MD, director of the body dysmorphic disorder (BDD) program at Rhode Island Hospital, said in a press release. “So they are particularly sensitive to what they believe is rejection from others based on these or other perceived flaws. This study suggests that those with BDD experience an increased expectation of personal rejection, often to the detriment of their overall health and quality of life.”

Phillips and colleagues evaluated 46 patients with BDD to determine their personal and appearance-based rejection sensitivity scores compared with published norms to determine scores among them.

“Generally speaking, no one enjoys being rejected or feeling embarrassed,” Phillips said. “But for people with BDD, feelings of being rejected by others are exacerbated, sometimes to the point where individuals are debilitated by these concerns, even if the rejection was simply perceived not real.”

There was a positive association between personal rejection and appearance-based rejection sensitivity scores (P=.002).

More severe BDD symptoms, depression symptoms, poorer physical functioning, poorer general health, poorer social functioning and poorer mental health functioning were all associated with higher personal rejection sensitivity scores. Similarly, higher appearance-related rejection sensitivity was associated with more severe BDD symptoms, depression symptoms and poorer general health.

“More research is needed to help patients and their families better understand BDD and associated rejection sensitivity,” Phillips said. “Studies are also needed to help clinicians determine the best treatment to help patients who are suffering with BDD lead lives that are as productive and satisfying as possible.”

Disclosure: The study was funded in part by the Department of Veterans Affairs, Veterans Health Administration, the National Institute of Mental Health and a VISN 1 Early Career Developmental Award.