The structure relationship of body dysmorphic disorder (BDD) with early maladaptive schema and perceived emotional invalidation: the mediating Role of metacognition, body image and distress tolerance

The growing importance of physical attractiveness has led to the fact that sometimes social acceptance and interpersonal success depend on perfect and ideal appearance. Also, the decline in the quality of physical and psychological health due to concerns about body shape and fear of physical appearance led to a to investigate the structural relationship between body dysmorphic disorder and early maladaptive schemas and perceived emotional invalidation with emphasis on the mediating role of metacognition, body image, and distress tolerance.

The present research is descriptive-applied. The statistical population of this study consisted of all students studying in the country's universities at all levels of education. Among them, 297 people participated in the study as a sample using purposive sampling and through the website, of course, after informed consent. They completed the Yale-Brown Obsessive-Compulsive Scale for -BDD (Phillips et al., 1997), the Young Schema Questionnaire – Short Form (Welburn et al., 2002), the Distress Tolerance Scale (Simons and Gaher, 2005), the Perceived Invalidation of Emotion Scale (Zielinski,2016), the Body Dysmorphic Metacognitive Questionnaire (Rabiei et al.,2011), and the Body Image Concern Inventory (Littleton, Axsom, and Pury, 2005) were completed. The research data were analyzed by the structural equation modeling method and SPSS-15 and LISREL-8.5 software.

The results of modeling the structural equations of the research showed that the conceptual model of the research had a good fit with the experimental data. The present model can explain 68% of the symptoms of body dysmorphic disorder. The results of the Bootstrap test also showed that the disturbed body image variable is a mediating variable in the relationship between early maladaptive schemas and perceived emotional discrediting with symptoms of body dysmorphic disorder. In addition, the distress tolerance variable has a mediating role concerning early maladaptive schemas and body deformity disorder, so the direct relationship between early maladaptive schemas and perceived emotional invalidation with body dysmorphic disorder was not significant considering the mediating role of these variables.Discussion and

The results of this study support the full mediating role of distress tolerance and deformity body image in the relationship between early maladaptive schemas and perceived emotional discrediting with body deformity disorder, and may have practical clinical implications for evidence-based interventions for deformity.