Body dysmorphic disorder symptom severity and intimate partner violence: the role of PTSD and DSO symptom domains

Background: Body dysmorphic disorder (BDD) is common among survivors of interpersonal trauma. However, the relationship between BDD symptoms and intimate partner violence (IPV), as well as the roles of posttraumatic stress disorder (PTSD) symptom domains and disturbances in self-organization (DSO) symptom domains, remain unclear.Objective: This longitudinal study, which included three waves of data collection (T1, T2, T3), examined: (1) BDD symptom severity as a concomitant of IPV; (2) associations between PTSD and DSO symptom domains and BDD symptom severity in IPV survivors; and (3) the mediating roles of PTSD and DSO symptom domains in the relationship between the degree of IPV exposure and BDD symptoms, while controlling for age, history of childhood abuse, and IPV polyvictimization.Method: An online survey was completed by a convenience sample of 422 adult women, 76.8% (n = 324) of whom reported IPV exposure. PTSD symptom domains, DSO symptom domains, and BDD symptom severity and covariates were assessed via self-report measures.Results: Analyses indicated higher BDD symptom severity and a greater proportion of clinically significant BDD symptoms at T3 among participants exposed to IPV at T1. A sense of threat, negative self-concept, and disturbed relationships at T2 were associated with elevated BDD symptom severity at T3. However, only negative self-concept mediated the relationship between the degree of IPV exposure and BDD symptom severity; greater IPV exposure at T1 was associated with increased negative self-concept at T2, which, in turn, was associated with higher BDD symptom severity at T3.Conclusions: The current findings suggest that IPV survivors are at heightened risk for BDD symptoms and highlight negative self-concept, a component of DSO, as a potential mechanism underlying this vulnerability.