MEDIAÇÃO DO PERFECCIONISMO ENTRE DISMORFIA CORPORAL E DEPRESSÃO NO CONTEXTO DA COVID-19
DOI:
https://doi.org/10.4067/s0718-50652024000100220Palabras clave:
depressão, transtorno dismórfico corporal, perfeccionismo, aparência físicaResumen
O estudo analisou as relações entre os sintomas depressivos, sintomas dismórficos corporais (SDC) e perfeccionismo da aparência física (PAF) em adultos. Participaram 677 pessoas, com uma idade média de 25,8 anos. Foi aplicado o questionário sociodemográfico, Body Dysmorphic Symptoms Scale (BDSS), o Questionário de Saúde do Paciente (PHQ-9) e a Escala de Perfeccionismo de Aparência Física (PAPS). A aparição de sintomas positivos para a depressão foi de 59,7%, enquanto para o sintoma dismórfico corporal foi de 26,1%. O PAPS obteve uma pontuação média de 37,6. Na análise de mediação, SDC e PAF obtiveram um efeito positivo direto sobre os sintomas depressivos. O SDC e o PAF puderam prever significativamente a variabilidade nos sintomas depressivos, demonstrando uma mediação parcial entre as variáveis. Concluiu-se que o modelo apresentou mediação parcial através da análise das variáveis, constituindo uma possível explicação para o desenvolvimento de sintomas depressivos em indivíduos com SDC.
Citas
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). https://doi.org/10.1176/appi.books.9780890425787
Beilharz, F., Phillipou, A., Castle, D., Jenkins, Z., Cistullo, L., & Rossell, S. (2019). Dysmorphic concern in anorexia nervosa: Implications for recovery. Psychiatry Research, 273, 657-661. https://doi.org/10.1016/j.psychres.2019.01.102
Bergunde L., & Dritschel, B. (2020). The shield of self-compassion: A buffer against disordered eating risk from physical appearance perfectionism. PLoS ONE, 15(1), e0227564. https://doi.org/10.1371/journal.pone.0227564
Borroni, S., Ruotolo, G., Grazioli, V., & Fossati, A. (2022). Perfectionistic self-presentation and body dysmorphic features in a sample of community-dwelling adult women. Official Journal of the Italian Society of Psychopathology, 28, 135-141. https://doi.org/10.36148/2284-0249-473
Bueno-Notivol, J., Gracia-García, P., Olaya, B., Lasheras, I., López-Antón, R., & Santabárbara, J. (2021). Prevalence of depression during the COVID-19 outbreak: A meta-analysis of community-based studies. International Journal of Clinical and Health Psychology, 21(1), 100196. https://doi.org/10.1016/j.ijchp.2020.07.007
Chai, L., Yang, W., Zhang, J., Chen, S., Hennessy, D. A., & Liu, Y. (2020). Relationship between perfectionism and depression among Chinese college students with self-esteem as a mediator. OMEGA-Journal of Death and Dying, 80(3), 490-503. https://doi.org/10.1177/0030222819849746
Creswell, J.W. (2010). Projeto de pesquisa: Métodos qualitativo, quantitativo e misto (3ª ed.). Artmed.
Czepiel, D., & Koopman, H. M. (2021). Does physical appearance perfectionism predict disordered dieting? Current Psychology, 1-11. https://doi.org/10.1007/s12144-020-01308-9
Dattany, S., Roser, M., & Ritchie, H. (2021). Mental health. Our World in Data. https://ourworldindata.org/mental-health
Esmaeilnia, M., Dousti, Y., & Mirzaian, B. (2018). The role of early maladaptive schema and perfectionism on body dysmorphic disorder mediating through thought fusion, meta-worry, anxiety, and attributional style: A structural model. Avicenna Journal of Neuro Psychophysiology, 5(4), 169-178. https://doi.org/10.32598/ajnpp.4.3.280
Ettman, C. K., Abdalla, S. M., Cohen, G. H., Sampson, L., Vivier, P. M., & Galea, S. (2020). Prevalence of depression symptoms in US adults before and during the COVID-19 pandemic. JAMA Network Open, 3(9), e2019686-e2019686, 1-12. https://doi.org/10.1001/jamanetworkopen.2020.19686
Fang, A., Matheny, N. L., & Wilhelm, S. (2014). Body dysmorphic disorder. Psychiatric Clinics, 37(3), 287-300. http://dx.doi.org/10.1016/j.psc.2014.05.003
Faro, A., Bahiano, M. D. A., Nakano, T. D. C., Reis, C., Silva, B. F. P. D., & Vitti, L. S. (2020). COVID-19 e saúde mental: a emergência do cuidado. Estudos de Psicologia (Campinas), 37, 1-14. https://doi.org/10.1590/1982-0275202037e200074
Ferreira, L., Corazza, J. F., Francisco, J. N., & Neves, A. N. (2018). Tradução e adaptação cultural da Escala de Perfeccionismo para Aparência Física (PAPS) para a língua portuguesa no Brasil. Revista Brasileira de Ciências do Esporte, 40, 266-272. https://doi.org/10.1016/j.rbce.2018.03.002
França, K., Roccia, M. G., Castillo, D., ALHarbi, M., Tchernev, G., Chokoeva, A., Lotti, T., & Fioranelli, M. (2017). Body dysmorphic disorder: history and curiosities. Wiener Medizinische Wochenschrift, 167(1), 5-7. https://doi.org/10.1007/s10354-017-0544-8
GBD 2019 Mental Disorders Collaborators. (2022). Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. The Lancet Psychiatry, 9(2), 137-150. https://doi.org/10.1016/S2215-0366(21)00395-3
Hakim, R. F., Alrahmani, D. A., Ahmed, D. M., Alharthi, N. A., Fida, A. R., & Al-Raddadi, R. M. (2021). Association of body dysmorphic disorder with anxiety, depression, and stress among university students. Journal of Taibah University Medical Sciences, 16(5), 689-694. https://doi.org/10.1016/j.jtumed.2021.05.008
Hayes, A. F. (2022). Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach (3rd ed.). The Guildford Press.
He, W., Shen, C., Wang, C., Jia, Y., Wang, J., & Wang, W. (2018). Body dysmorphic disorder patients: Their affective states, personality disorder functioning styles and body image concerns. Personality and Individual Differences, 131, 1-6. https://doi.org/10.1016/j.paid.2018.04.015
Hewitt, P. L., Flett, G. L., & Mikail, S. F. (2017). Perfectionism: A relational approach to conceptualization, assessment, and treatment. Guilford Press.
Johnson, S., Williamson, P., & Wade, T. D. (2020). Perfectionism and selective attention predict dysmorphic concern in an Australian university population. Australian Psychologist, 55(2), 143-155. https://doi.org/10.1111/ap.12423
Kang, W. H., Loo, M. Y., Leong, X. M., Ooi, Y. F., Teo, W. Q., Neoh, T. J., & Ling, W. C. (2022). Body dysmorphic disorder and depression among male undergraduate students in a Malaysian University. Frontiers in Psychiatry, 13, 977238. https://doi.org/10.3389/fpsyt.2022.977238
Kola, L., Kohrt, B. A., Hanlon, C., Naslund, J. A., Sikander, S., Balaji, M., ... & Patel, V. (2021). COVID-19 mental health impact and responses in low-income and middle-income countries: reimagining global mental health. The Lancet Psychiatry, 8(6), 535-550. https://doi.org/10.1016/S2215-0366(21)00025-0
Krebs, G., de la Cruz, L. F., & Mataix-Cols, D. (2017). Recent advances in understanding and managing body dysmorphic disorder. Evidence-Based Mental Health, 20(3), 71-75. http://dx.doi.org/10.1136/eb-2017-102702
Krebs, G., Quinn, R., & Jassi, A. (2019). Is perfectionism a risk factor for adolescent body dysmorphic symptoms? Evidence for a prospective association. Journal of Obsessive-compulsive and Related Disorders, 22, 100445. https://doi.org/10.1016/j.jocrd.2019.100445
Kroenke, K., Spitzer, R. L., & Williams, J. B. (2001). The PHQ-9: validity of a brief depression severity measure. Journal of General Internal Medicine, 16(9), 606–613. https://doi.org/10.1046/j.1525-1497.2001.016009606.x
Lo, A., & Abbott, M. J. (2013). Review of the theoretical, empirical, and clinical status of adaptive and maladaptive perfectionism. Behaviour Change, 30(2), 96-116. https://doi.org/10.1017/bec.2013.9
MacKinnon, D. P., Fairchild, A. J., & Fritz, M. S. (2007). Mediation Analysis. Annual Review of Psychology, 58(1), 593–614. http://dx.doi.org/10.1146/annurev.psych.58.110405.085542
Magson, N. R., Oar, E. L., Fardouly, J., Johnco, C. J., & Rapee, R. M. (2019). The preteen perfectionist: an evaluation of the perfectionism social disconnection model. Child Psychiatry & Human Development, 50(6), 960-974. https://doi.org/10.1007/s10578-019-00897-2
McComb, S. E., & Mills, J. S. (2021). Young women’s body image following upwards comparison to Instagram models: The role of physical appearance perfectionism and cognitive emotion regulation. Body Image, 38, 49-62. https://doi.org/10.1016/j.bodyim.2021.03.012
McComb, S. E., & Mills, J. S. (2022). The effect of physical appearance perfectionism and social comparison to thin-, slim-thick-, and fit-ideal Instagram imagery on young women’s body image. Body Image, 40, 165-175. https://doi.org/10.1016/j.bodyim.2021.12.003
Minty, A., & Minty, G. (2021). The prevalence of body dysmorphic disorder in the community: A systematic review. Global Psychiatry Archives, 4(2), 130-154. https://doi.org/10.52095/gp.2021.8113
Nogueira-Neves, A., Francisco, J. N., Corazza, J., Carvalho, R. L. D. P., & Ferreira, L. (2019). Propriedades psicométricas da versão em português Brasileiro da Physical Appearance Perfectionism Scale. Cuadernos de Psicología del Deporte, 19(1), 302-314. http://scielo.isciii.es/scielo.php?script=sci_arttext&pid=S1578-84232019000100302&lng=es&tlng=
Norton, P. J., & Roberge, P. (2017). Transdiagnostic therapy. Psychiatric Clinics, 40(4), 675-687. https://doi.org/10.1016/j.psc.2017.08.003
Osório, F. de Lima, Vilela Mendes, A., Crippa, J. A., & Loureiro, S. R. (2009). Study of the discriminative validity of the PHQ‐9 and PHQ‐2 in a sample of Brazilian women in the context of primary health care. Perspectives in Psychiatric Care, 45(3), 216-227. https://doi.org/10.1111/j.1744-6163.2009.00224.x
Perugi, G., Akiskal, H. S., Giannotti, D., Frare, F., Di Vaio, S., & Cassano, G. B. (1997). Gender-related differences in body dysmorphic disorder (dysmorphophobia). The Journal of nervous and mental disease, 185(9), 578-582. https://doi.org/10.1097/00005053-199709000-00007
Phillips, K. A., & Kelly, M. M. (2021). Body dysmorphic disorder: clinical overview and relationship to obsessive-compulsive disorder. Focus, 19(4), 413-419. https://doi.org/10.1176/appi.focus.20210012
Pourani, M. R., & Ghalamkarpour, F. (2022). Perceived impact of COVID‐19 pandemic on body dysmorphic disorder and anxiety among population seeking cosmetic procedures. Journal of Cosmetic Dermatology, 21(4), 1352-1355. https://doi.org/10.1111/jocd.14833
Rajkumar, R. P. (2020). COVID-19 and mental health: A review of the existing literature. Asian Journal of Psychiatry, 52, 102066. https://doi.org/10.1016/j.ajp.2020.102066
Ramos, T. D., Brito, M. J. A. D., Piccolo, M. S., Rosella, M. F. N. D. S. M., Sabino Neto, M., & Ferreira, L. M. (2016). Body Dysmorphic Symptoms Scale for patients seeking esthetic surgery: Cross-cultural validation study. Sao Paulo Medical Journal, 134, 480-490. https://doi.org/10.1590/1516-3180.2016.0068160416
Rnic, K., Hewitt, P. L., Chen, C., Flett, G. L., Jopling, E., & LeMoult, J. (2021). Examining the link between multidimensional perfectionism and depression: A longitudinal study of the intervening effects of social disconnection. Journal of Social and Clinical Psychology, 40(4), 277-303. https://doi.org/10.1521/jscp.2021.40.4.277
Ryding, F. C., & Kuss, D. J. (2020). The use of social networking sites, body image dissatisfaction, and body dysmorphic disorder: A systematic review of psychological research. Psychology of Popular Media, 9(4), 412. http://dx.doi.org/10.1037/ppm0000264
Santos, I. S., Tavares, B. F., Munhoz, T. N., Almeida, L. S. P. D., Silva, N. T. B. D., Tams, B. D., Patella, A. M., & Matijasevich, A. (2013). Sensibilidade e especificidade do Patient Health Questionnaire-9 (PHQ-9) entre adultos da população geral. Cadernos de Saúde Pública, 29, 1533-1543. https://doi.org/10.1590/0102-311X00144612
Schaeuffele, C., Schulz, A., Knaevelsrud, C., Renneberg, B., & Boettcher, J. (2021). CBT at the crossroads: The rise of transdiagnostic treatments. International Journal of Cognitive Therapy, 14(1), 86-113. https://doi.org/10.1007/s41811-020-00095-2
Schulte, J., Schulz, C., Wilhelm, S., & Buhlmann, U. (2020). Treatment utilization and treatment barriers in individuals with body dysmorphic disorder. BMC Psychiatry, 20, Article 69. https://doi.org/10.1186/s12888-020-02489-0
Simon, P. D., Cu, S. M. O., De Jesus, K. E. M., Go, N. T. S., Lim, K. T. F., & Say, C. L. C. (2022). Worried about being imperfect? The mediating effect of physical appearance perfectionism between Instagram addiction and body esteem. Personality and Individual Differences, 186, 111346. https://doi.org/10.1016/j.paid.2021.111346
Singh, A. R., & Veale, D. (2019). Understanding and treating body dysmorphic disorder. Indian Journal of Psychiatry, 61(Suppl 1), S131–S135. https://doi.org/10.4103/psychiatry.IndianJPsychiatry_528_18
Suh, H., Kim, S., & Lee, D. G. (2021). Review of Perfectionism Research From 1990 to 2019 Utilizing a Text-Mining Approach. Review of General Psychology, 25(3), 283-303. https://doi.org/10.1177/10892680211018827
Summers, B. J., Aalbers, G., Jones, P. J., McNally, R. J., Phillips, K. A., & Wilhelm, S. (2020). A network perspective on body dysmorphic disorder and major depressive disorder. Journal of Affective Disorders, 262, 165-173. https://doi.org/10.1016/j.jad.2019.11.011
Tomás Benlloch, M. C., (2022). A propósito de la vigorexia: Más allá de un trastorno dismórfico. Delimitación diagnóstica y causas de este trastorno. Revista Española de Drogodependencias, 47(2), 73-83. https://doi.org/10.54108/10019
Wong, W. W., Rangaprakash, D., Diaz-Fong, J. P., Rotstein, N. M., Hellemann, G. S., & Feusner, J. D. (2022). Neural and behavioral effects of modification of visual attention in body dysmorphic disorder. Translational Psychiatry, 12(1), 1-10. https://doi.org/10.1038/s41398-022-02099-2
World Health Organization. (2021). Mental health atlas 2020. https://apps.who.int/iris/bitstream/handle/10665/345946/9789240036703-eng.pdf
Yang, H., & Stoeber, J. (2012). The physical appearance perfectionism scale: Development and preliminary validation. Journal of Psychopathology and Behavioral Assessment, 34, 69-83. https://doi.org/10.1007/s10862-011-9260-7
Publicado
Cómo citar
Número
Sección
Licencia
Derechos de autor 2024 Luiz Lima-Silva, André Faro
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
