Body Dysmorphic Disorder & Body Image Dissatisfaction in Late Adulthood Iman Tahanur Tammy Hughes Marqueena Dunn Tiara Jones

Definition & Demographics  “approximately 50% of young women are highly dissatisfied with their current physical appearance… and this body dissatisfaction is also evident in older women” (Peat, Peyerl, & Muehlenkamp, 2008, p. 343). Body Dysmorphic Disorder (BDD) is in the category of obsessive–compulsive and related disorders. A new standard requires the presence of repetitive behaviors or mental acts in response to appearance concerns that other people may not ever see

Cultural Factors The Fear of Aging wrinkled and sagging skin, age spots, graying hair, hair loss, loss of teeth, and weight gain are all signs of aging “can prove very depressing and many people find it hard to see themselves in a positive light when they see a wrinkled face and a sagging body looking back in the mirror… there is a social stigma around the effects of the natural ageing process, and this can lead to very low self-esteem and the classic signs of body dysmorphic disorder"

Descriptions of the Problems/Challenges Many body dysmorphic disorder sufferers find it almost impossible not to think about their supposed flaws and on average spend 3 to 8 hours a day obsessing, with over a quarter of BDD patients spending over 8 hours a day. Weight has been found to be the most common concern among women of all ages. Liechty (2012) conducted a study on body image in older women between the ages of 60-70, and found that most felt a desire for thinness and a desire for change on some aspect of their physical appearance, but yet still expressed an overall satisfaction with their bodies. Mildred, who is an 80 year-old women, suffered from BDD for almost 70 years.

Resulting Consequences BDD patients perform repetitive, compulsive behaviors, which patients state to be time-consuming, uncontrollable, and difficult to resist. Many BDD patients go as far as to receive cosmetic surgery to correct their perceived flaws. 78%-81% of BDD patients have thoughts of committing suicide, while 24%-28% actually attempt to commit suicide. The American Society for Aesthetic Plastic Surgery claims that there were 84,685 surgical procedures among patients age 65 and older.

Family Issues 20% of people with BDD have an immediate family member with it also. It is not known whether BDD is inherited or learned from family members. This could suggest that both genetics and environmental factors is both necessary to develop BDD. Research suggests that coming from troubling backgrounds and traumatic childhoods can cause feelings of being insecure, lonely, and unloved which can lead to BDD.

Biological Factors Elevated risk for Body Dysmorphic Disorder in first degree relatives of individuals with Obsessive Compulsive Disorder Research predicts that Body Dysmorphic Disorder results from abnormal brain network organization Biological changes that take place in late adulthood can contribute to feelings of body dissatisfaction Could changes in the size/structure of the brain potentially contribute to BDD in late adulthood?

Psychological Factors DSM-5 has four diagnostic criteria; BDD symptoms cannot simultaneously meet criteria for eating disorders but the appearance concern must produce repetitive behaviors and clinically significant distress Some research classifies Body Dysmorphic Disorder as an OCD spectrum disorder Current research does not directly address BDD in late adults but instead focuses on “body dissatisfaction” Protective factors against BDD and body dissatisfaction include cognitive control, acceptance of aging, and the diminished importance of physical appearance

Social Factors  Body dissatisfaction crosses the lifespan but older adults are less likely to let it negatively affect their self- worth.  Older adults have a desire to be physically attractive are less likely to hinder their health  Comparing their bodies to others can influence self- perception  Women are viewed more negatively when they age in comparison to men

Ethical Considerations & Issues  Older adults need to be monitored closely for signs of self-objectification, appearance anxiety, low self-esteem, and disordered eating.  Practitioners need to be mindful of how a person’s culture may affect their perceptions on body image.  Practitioners need to advise and inform older adults on potentially harmful practices while working with them in order to find solutions.

Socio- Cultural Theory Theoretical Frameworks  Sociocultural theory suggests that an individual's mental functioning is related to cultural, institutional, and historical context.  As a result an older person's community in which they grow up can effect how they perceive beauty and themselves visually. “…people still move on to the next stage, but they will probably face problems due to the unresolved crises experienced at earlier stages. According to Erikson, we can reach the end of our lives without having fully resolved crises from earlier stages of development” (Rogers, 2013, p. 88). Erikson's Psychosocial Development Theory

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