权益分类	功能权益	普通用户	{{item.name}}会员
{{category.name}}	{{benefitItem.name}}

Shame as a Risk Factor for Severe and Costly Outcomes in Body Dysmorphic Disorder

羞耻感是导致身体变形障碍严重且代价高昂的结果的危险因素

基本信息

批准号：
8739026
负责人：
Hilary Weingarden
金额：
$ 2.46万
依托单位：
GEORGE MASON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2013
资助国家：
美国
起止时间：
2013-09-18 至 2015-06-30
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/8739026
关键词：
Accounting Address Advertisements Anecdotes Anxiety Appearance Bipolar Disorder Body Dysmorphic Disorder Case Study Clinic Clinical Cognitive Therapy Data Defect Depression and Suicide Diagnostic Disease Eating Disorders Emotions Employee Strikes Evaluation Feeling suicidal Functional disorder Goals Health Impairment Individual Interest Group Internet Intervention Interview Lead Link Major Depressive Disorder Measures Mental Depression Mental disorders National Institute of Mental Health Nature Obsessive-Compulsive Disorder Occupational Outcome Pain Participant Pathology Patient Self-Report Public Health Recruitment Activity Research Risk Risk Factors Role Sampling Secure Severities Shame Societies Specific qualifier value Suicide Support Groups Techniques Telephone Testing Unemployment Variant base clinical practice cost economic cost experience psychologic public health relevance research study screening severe mental illness social web site

项目摘要

DESCRIPTION (provided by applicant): Body dysmorphic disorder (BDD) is a severe mental illness associated with extremely negative consequences. Most notably, the degree of unemployment, social dysfunction, comorbid major depressive disorder, and suicidality appear higher in BDD than in most other psychological disorders, including related disorders like obsessive compulsive disorder (OCD). Together, these outcomes produce substantial psychological and economic costs to the individual, as well as significant economic costs to society, making BDD a serious public health concern. Surprisingly, scant research has studied risk factors that may help to explain these elevated negative outcomes in BDD, as compared to other disorders. The present study addresses this gap by testing shame as a central risk factor for more severe outcomes in those with BDD vs. healthy individuals and individuals with OCD. Clinical anecdotes discuss shame as a central, destructive emotion in BDD, and broader emotions research links shame to each of the negative outcomes that are elevated among those with BDD. However, no scientific research has investigated the degree of shame in BDD vs. healthy individuals or those with related disorders (e.g., OCD), nor is there research examining how shame relates to the severe outcomes in BDD. Aim 1 is to conduct the first empirical evaluation of general shame as a central, robust risk factor accounting for more severe outcomes (i.e., social and occupational impairment, depression, suicidality) in BDD vs. healthy control participants and participants with OCD. Additionally, information about the specific nature of shame within BDD has important clinical implications. In particular, body shame appears central and nearly universal to BDD. Thus, it may be that, beyond the more universal experience of body shame in BDD, it is individuals with elevated general shame who are at greatest risk for the most severe negative outcomes in BDD. Aim 2 is, thus, to evaluate whether general shame is a stronger risk factor than body shame for the negative outcomes documented within BDD. Participants will be recruited for the three groups (BDD, OCD comparison, healthy control) through advertisements posted on online BDD, OCD, or non-mental health related forums, support groups, and clinic websites. Participants will provide self-report data through a secure online website. To verify the well-established self-report screening measures, a randomly selected subsample from each group will be called to complete a diagnostic interview via phone. An Internet-based approach was chosen because of the severe avoidance and impairment in BDD, the primary group of interest (e.g., 30% may be housebound). Thus, samples recruited from clinics or research labs would likely be biased, with less severe outcomes and shame. In keeping with NIMH Strategic Objective 2.3, the overarching goal of this project is to identify shame as a malleable and robust risk factor for serious and costly outcomes in BDD, a disorder of high public health concern. This information has the potential to provide new targets for BDD treatment and to minimize the painful and costly consequences that BDD sufferers currently experience.

描述(申请人提供)：躯体变形障碍(BDD)是一种严重的精神疾病，与极其负面的后果有关。最值得注意的是，BDD患者的失业程度、社会功能障碍、并发的严重抑郁障碍和自杀倾向似乎高于大多数其他心理障碍，包括强迫症(OCD)等相关障碍。总而言之，这些结果给个人造成了巨大的心理和经济代价，也给社会带来了巨大的经济代价，使BDD成为一个严重的公共卫生问题。令人惊讶的是，与其他疾病相比，很少有研究研究可能有助于解释BDD中这些升高的负面结果的风险因素。目前的研究通过测试羞耻感作为BDD患者与健康人和强迫症患者更严重后果的中心风险因素来解决这一差距。临床轶事讨论羞耻是BDD的核心、破坏性情绪，更广泛的情绪研究将羞耻与BDD患者中升高的每一种负面结果联系起来。然而，没有科学研究调查BDD与健康人或有相关障碍(如强迫症)的人的羞耻程度，也没有研究羞耻与BDD的严重后果之间的关系。目标1是对一般羞耻感进行首次经验性评估，将其作为BDD与健康对照参与者和强迫症参与者之间更严重的后果(即社会和职业损害、抑郁、自杀)的一个核心、强大的风险因素。此外，有关BDD中羞耻的具体性质的信息具有重要的临床意义。特别是，身体耻辱似乎是BDD的核心，而且几乎是普遍的。因此，除了BDD中更普遍的身体耻辱经历之外，BDD中最严重的负面后果的风险最大的可能是一般羞耻感升高的个人。因此，目标2是评估对于BDD中记录的负面结果，总体羞耻是否是比身体羞耻更强的风险因素。参与者将通过在线BDD、强迫症或非心理健康相关论坛、支持小组和诊所网站上发布的广告招募到三个小组(BDD、强迫症对照和健康对照)。参与者将通过一个安全的在线网站提供自我报告数据。为了验证完善的自我报告筛查措施，将从每组中随机选择一个子样本，通过电话完成诊断性访谈。选择基于互联网的方法是因为BDD的严重回避和损害，这是主要的兴趣群体(例如，30%可能呆在家里)。因此，从诊所或研究实验室招募的样本可能会有偏见，结果不会那么严重，也不会感到羞耻。为了与NIMH战略目标2.3保持一致，该项目的总体目标是确定羞耻是导致BDD严重和代价高昂的一个可延展性和强大的风险因素，BDD是一种高度公共卫生关切的疾病。这些信息有可能为BDD治疗提供新的靶点，并将BDD患者目前经历的痛苦和代价高昂的后果降至最低。