(PS3-C67) Clinical Characteristics of Sexual Minority Individuals with Body Dysmorphic Disorder

Objective: Body dysmorphic disorder (BDD) is a common disorder associated with substantial comorbidity, impairment, and poor quality of life. Research on subcultural variations in the presentation of BDD is limited but may have important implications for the assessment and treatment of the disorder. In particular, sexual minority (SM) status is associated with elevated rates of psychopathology in the general population, but research on SM individuals with BDD is scarce. In the present study we examined clinical features of BDD in self-identified SM (i.e., gay, lesbian, bisexual, queer, other) relative to heterosexual individuals.

Method: Adults with primary BDD (N=272; 21.7% SM; Age M(SD)=31.05(12.2); 73% female; 72% White) recruited through an outpatient BDD clinic were included (current study represents secondary analysis of baseline data collapsed across four studies). Participants completed self-report and clinician-administered measures of demographic and clinical characteristics (body parts of concern, BDD severity, BDD insight, global severity, depression, and quality of life). A z-score was calculated to index depression across studies from the BDI-II, QIDS-SR, or DASS-D. Independent sample t-tests and chi-square tests were used to examine group differences in the association between clinical characteristics and SM status.

Results: The SM group (M=26.06+6.9) was significantly younger than the heterosexual group (M=32.08+12.6, [t(260)=3.536, p< .001]). Among women, the SM group endorsed a significantly greater number of body parts of concern ([t(185)=-3.821], p< .001) and was more likely to report concerns with body build (10.1 vs 40%), shoulders (2.7 vs 23.7%), and chin/jaw (13.4 vs. 47.4%; p< .0001 in all cases) than the heterosexual group. These results remained significant when controlling for age. There were no group differences in other body parts of concern and parts of concern did not differ between heterosexual and SM males. We found no significant group differences in BDD or global severity, insight, depression, or quality of life.

Conclusion: SM and non-SM individuals with BDD were similar across clinical features. However, SM women endorsed a greater number of body parts of concern and were more likely to be preoccupied with body build, shoulders, and jaw, possibly reflecting nuanced beauty ideals within the SM community. The younger age of SM individuals may reflect a societal shift in the acceptance and/or disclosure of SM status over time. Limitations include a primarily White, female sample and insufficient power to examine nonbinary gender identity. Future studies should replicate this research in larger, more inclusive samples to explore interactions between BDD and its associated features, SM status, and other diverse identities.