(PS5-12) An Examination of Gender Relations to Body Dysmorphic Disorder (BDD) and Its Association with Depression and Anxiety in Adolescents

Adolescent boys and girls tend to demonstrate similarities and differences in terms of their risk for psychopathology and presenting symptoms (Kistner, 2009). Body dysmorphic disorder (BDD) commonly emerges during early adolescence, and symptoms may differ among girls compared to boys; however, full criteria are often met by both groups (Phillips & Diaz, 1997; Schneider et al., 2016). Prior work has suggested that BDD is associated with comorbidity with other mental health problems, such as major depression and anxiety (Maestro et al., 2016). Symptoms of major depression and anxiety are most prevalent in girls, and the potential link between these symptoms and BDD indicates that gender may contribute to variations in anxiety and depression, and these emotional states, in turn, may influence the likelihood or severity of BDD. To date, little work has explored the association between gender and anxiety and depression in relation to BDD among adolescents. The current study will examine whether adolescent gender is indirectly associated with BDD symptoms through symptoms of anxiety and depression.

Three hundred twenty-four adolescents were recruited through social media. The participants completed a demographics form, the Revised Child Anxiety and Depression Scale, which was used to assess anxiety and depression symptoms (RCADS; Chorpita et al., 2000), and the Body Image Questionnaire-Child Version (BIQ-C; Veale, 2009), which was used to assess adolescent BDD symptoms. Data was analyzed using the PROCESS Macro in SPSS.

The omnibus regression model accounted for 47.3% of the variance in adolescent BDD symptoms. The association between adolescent gender and BDD symptoms was significant (path c: b = 8.51, p < .001). The direct effect of adolescent gender on BDD symptoms was also significant (path c’: b = 4.62, p = .004). Adolescent gender was associated with higher levels of anxiety (path a₁: b = 13.44, p < .001) and depression (path a₂: b =4.03, p < .001), such that adolescent girls reported higher anxiety and depression symptoms than adolescent boys.  Adolescent anxiety symptoms (path b₁: b = .18, p < .001) and depression symptoms (path b₂: b = .35, p =.027) were significantly associated with adolescent BDD symptoms. There were significant indirect effects of adolescent anxiety symptoms (path ab₁: b = 2.45, SE = .79, BC 95% CI [1.03, 4.19]) on the association between adolescent gender and adolescent BDD symptoms. Unexpectedly, and contrary to hypotheses, the indirect effect of depression symptoms was not significant.

The findings suggest that adolescent gender may influence BDD symptoms as well as symptoms of anxiety and depression. Moreover, anxiety symptoms may play a mediating role in the association between adolescent gender and BDD symptoms, while depression symptoms did not have a similar indirect effect. Gender remains an important factor in understanding the development of BDD as it relates to adolescent anxiety and depression symptoms.