Background
Body dysmorphic disorder: psychological disorder related to body image. The fear of having a deformity.
The researchers decided to carry out the study after a patient admitted to spending 6 hours staring at himself in the mirrors.
This prompted the researchers to find out if mirror gazing and BDD has a relationship.
Aim:
To investigate the function, frequency and role of mirror gazing in BDD patients.
Method:
Sample:
- 52 PPs diagnosed with BDD
- 55 control PPs with no BDD recruited from personal contacts of the researchers.
- Matched pairs design – on sex and age.
Procedure:
All participants were to complete the self-report mirror gazing questionnaire – told to base it on behaviour of the last or previous month.
If they said they engaged with long sessions most days, they would complete that questionnaire first and then the ‘short’ sessions one.
Independent variable: the diagnosis of BDD in a person.
Dependent variable: the results of the questionnaire about mirror gazing
Design:
- Questionnaire to gather information on the function, frequency and role of mirror gazing.
- Long sessions – longest time during the day that the person spends in front of mirror. E.g. getting ready.
| Section | Type of questions |
| Length of time mirror gazing | Average duration of ‘long’ session.
Estimate maximum time of one occasion spent in front of mirror. Average duration of ‘short’ sessions. |
| Motivation before looking in a mirror | 12- item sections, how much they agreed with the statements. ‘I have to make myself look my best’, ‘ I need to see what I like about myself’.
Asked to note anything else motivating them. |
| Focus of attention | Asked to rate concentration on mirror on a scale of +4 (I am entirely focused on an impression or feeling that I get about myself) to -4 (I am entirely focused on my reflection in the mirror) |
| Distress before and after looking into the mirror | Rate the level of distress on a scale of 1-10. 1 represents ‘not distressed at all’ and 10 ‘extremely distressed’.
Before looking in the mirror. Immediately after looking in the mirror. After resisting the urge to look in a mirror. |
| Behaviour in front of the mirror | Estimate the percentage of time they engaged in a range of nine behaviours while mirror gazing. Add up 100%.
– Trying to hide defects or enhance appearance by make-up. – Combing/styling hair. – Trying to make skin smooth by squeezing spots. – Plucking/removing hair or shaving. – Comparing self with an image in mind. – Try to see something different in mirror. – Feeling skin with fingers. – Practising the best position to show in public. – Measuring parts of face. They could list other behaviours. |
| Type of light preferred | Asked whether light was important.
Visual analogue from ‘natural daylight’ to ‘artificial light’. |
| Type of reflective surface | Asked if they used a series of mirrors or any reflective features. |
| Mirror avoidance | Asked if they avoided any types of mirror or situations involving mirrors |
Results:
| Section | Key results |
| Length of time mirror gazing | Mean duration for long session for BDD was 72.5 minutes but only 21.3 for controls.
Duration for short session was 4.8 minutes in BDD and 5.5 in controls (no big difference) |
| Motivation before looking in a mirror | BDD more likely to at least agree with 12 items. Controls more likely to be interested in being presentable.
BDD use of mirror when depressed. |
| Focus of attention | BDD patients focused on internal impressions and feelings rather than reflection during long sessions – contrast to controls.
BDD more likely to focus on one part of the face. |
| Distress before and after looking in the mirror | Both sessions, BDD more distressed than controls. After long sessions, BDD feeling more distressed.
More distress if they resisted gazing. |
| Behaviour in front of the mirror | Long sessions:
BDD and controls same time engaging with make-up, combing hair, picking spots and feeling skin. BDD more likely to compare the image in mirror with the one in their mind. Short sessions: BDD more likely to use mirror for checking make-up, practising best position to pull and comparing image. BDD listed many other behaviours they engaged in e.g. combing eyebrows, washing rituals.
|
| Type of light preferred | No significant difference. |
| Type of reflective surface | Long sessions:
BDD more likely to use series of mirrors (52.4%) compared to controls (6.7%). Short sessions: Both used shop windows. BDD reported wide variety of surfaces they would use e.g. cutlery, vehicles. |
| Mirror avoidance | 2/3 of BDD and 14% of controls reported avoiding certain mirrors.
4 typed by BDD: – To avoid looking at certain defect. – To avoid mirrors labelled bad or unsafe – associated with bad image. – Using private mirrors – avoiding those in public. – Flipping between avoidance and gazing. |
Conclusion:
BDD patients hold several problematic beliefs and behaviours in their mirror use compared to controls.
Mirror gazing in BDD does not follow a simple model of compulsive checking and is best conceptualised as a series of idiosyncratic and complex safety behaviours, that is designed to prevent a feared outcome.
Strengths:
- Control: both sample groups were matched by sex and age, therefore individual differences were less likely to affect the results.
- Standardised procedure: the questionnaire was very standardised when talking about long and short sessions, and it was the same for all participants. Therefore, the results are more likely to be reliable and replicable.
- Validity: BDD patients were more likely to admit all their mirror-gazing activities because they did not have to reveal information face to face. Therefore, the validity of the results should increase
Weaknesses:
- Demand characteristics: since it was a case study in a laboratory with researchers present, the patients may have answered differently to real life because they wanted to appear socially desirable.
- Low generalisability: The results were restricted to sex and age, and probably culture since the PPs were all from the same area. Therefore, the results would not be generalizable to teenagers or people outside of the age studied. The sample was not representative of the population.
- Low ecological validity: the case study was conducted in a laboratory; therefore, it was not in the natural environment of the participants. This may have contributed to the participants answering differently than they would have in a real life scenario.
CIE A Level Psychology 