Childhood maltreatment, trauma common in body dysmorphic disorder

A history of childhood maltreatment and trauma was commonly found in adults with body dysmorphic disorder, and the severity of these events correlated with symptom severity, according to a study in Comprehensive Psychiatry.

“Exposure to traumatic events in childhood are associated with an increased risk of mental illness in general, whilst childhood adversities that are closely associated with maladaptive family functioning, such as family violence, parental mental illness or parental incarceration, carry a particularly high risk of developing a mental disorder later in life,” Amy Malcolm, PhD, a research fellow at Swinburne University of Technology’s Center for Mental Health in Australia, and colleagues wrote. “As such, investigation of broader childhood trauma in [body dysmorphic disorder (BDD)] in addition to maltreatment experiences may be informative in understanding potential risk factors for BDD.”

Researchers recruited 52 participants with BDD (56% women) and 57 matched participants (51% women) without mental illness through public and online ads and through BDD-specialized clinics. Participants completed the 28-item Childhood Trauma Questionnaire (CTQ) evaluating the incidence and severity of emotional, physical and sexual abuse and emotional and physical neglect in childhood, as well as a traumatic events checklist.

Incidence of physical abuse, sexual abuse or emotional neglect did not significantly differ between groups, although participants with BDD experienced significantly more emotional abuse and physical neglect. The BDD group also had significantly more types of maltreatment, with 75% having more than one, compared to 50.8% of the control group.

Participants with BDD reported significantly more severe emotional abuse, emotional and physical neglect and general maltreatment than their counterparts; data revealed no significant difference in severity of physical or sexual abuse.

Significantly more incidences of traumatic events and types of traumas occurred in the BDD group than the control group.

Within the BDD group, more severe overall maltreatment correlated with more severe symptoms, suicidal ideation and anxiety symptoms; having more types of maltreatment correlated with more severe symptoms and increased risk for mental comorbidities.

In the control group, more severe overall maltreatment, emotional abuse and emotional neglect significantly corresponded with more severe stress and anxiety, Malcolm and colleagues wrote.

Limitations included retrospective self-reporting of childhood trauma, nonexamination of maltreatment duration and conservative alpha adjustments in statistical analysis. Moving forward, the researchers suggested conducting research to bolster the current literature on childhood trauma and mistreatment in BDD.

“While the relevance of traumatic experiences is being increasingly acknowledged in BDD literature, there is still a paucity of empirical investigation in this area,” they wrote. “In particular, the examination of the specific processes which might confer an increased risk for BDD following childhood trauma or maltreatment will be an important area for further research development.”