Francheska M. Garcia, Matthew J. Krug, & Richard L. Miller
The Effects of Religiosity and Parenting
Styles on Body Dysmorphic Disorder
Texas A&M University-Kingsville
Body dysmorphic disorder (BDD) is a chronic mental disorder associated with excessive preoccupation with one’s body image. If not treated accordingly, intensification of the illness and deterioration of one´s physical and mental health may occur. In this study, 100 college students (50 males and 50 females) completed an anonymous survey. The study examined the impact of religiosity and parenting styles on BDD. The first hypothesis stated that individuals who exhibit high religiosity scores are less likely to exhibit symptoms of BDD. The second hypothesis stated that authoritarian parents would be more likely to provoke symptoms of BDD in participants. Results indicated that BDD is not directly correlated with religiosity. However, we found that high symptoms of BDD among females was directly related to mothers who were perceived to be authoritarian, especially if they were perceived to be the primary disciplinarian in the family. The findings suggest that a mother’s parenting style greatly affects their daughter’s likelihood of developing BDD.
Keywords: body dysmorphic disorder, religiosity, parenting styles
Individuals with body dysmorphic disorder (BDD) can't stop thinking about one or more perceived defects or flaws in their appearance — defects that are either minor or unobservable by others. Individuals with BDD obsess over their appearance and body image, repeatedly checking how they look and seeking reassurance that they look okay (Khanjani & Haghayegh, 2018). Individuals who exhibit symptoms of BDD experience heightened feelings of distress due to defects or flaws in appearance to the extent that an individual believes he/she is ugly, lacking charm, abnormal, or dysmorphic. BDD affects 1.7-2.4% of the general population of the United States and often begins in adolescents, 12-13 years old. Thus, the perceived defects and the repetitive behaviors involved in checking one’s appearance can cause significant distress and interfere with daily functioning.
Body dysmorphic disorder is prevalent in both males and females; however, their body image concerns are different (Reinsmith-Jones, Adedoyin, & Campbell, 2014). While females often focus on physical traits such as weight and slenderness, males often focus on muscle mass and thinning hair (Phillips & Diaz, 1997). A study conducted by Taqui and colleagues (2008), confirmed these different aspects of BDD when assessed among males and females. Though gender differences are a significant factor in the likeness of exhibiting symptoms of BDD, it has not been covered adequately in non-clinical samples (Taqui et al., 2008).
Studies have shown that dissatisfaction with one’s appearance has been increasing and is prevalent among the college student population (Sarwer, 2002). However, reported rates of BDD vary, with an estimated prevalence ranging from .07% in community samples to 13% among US college students (Bartsch, 2007). In a study conducted by Bartsch (2007), 383 out of 636 (62%) college students had concerns with the appearance of some part of their body, and 188 (30%) were preoccupied with a concern pertaining to a perceived defect. The current study assessed BDD symptoms among university students and what may influence them to develop these symptoms.
One possible contributing factor may be parenting styles. Parenting styles are defined as patterns for children’s training that are created by the normative interactions of parents and their reaction to a child’s behavior (Bahrami, Dolatshahi, Pourshahbaz, & Mohammadkhani, 2018). There are four types of parenting styles: authoritative, authoritarian, neglectful/uninvolved, and permissive (Baumrind, 1967; Maccoby & Martin, 1983). Authoritative parenting styles are shown to be high-affection and moderate demands towards children. Authoritarian parents uphold strict rules, high demands, and low responsiveness towards the child. Permissive parents exhibit much affection and responsiveness toward their children while paying little attention to their misdemeanors. Neglectful/uninvolved parents provide neither affection, support, nor responsiveness to their children.
In previous studies, parenting styles have been shown to affect a child’s likeliness of developing depression (King, Vidourek, & Merianos, 2016), academic performance (Rauf & Ahmed, 2017), self-compassion (Ahmed & Bhutto, 2016), and gender roles (Lin & Billingham, 2014). However, there is no specific literature that looks at the effects of parenting styles on their child’s likeliness of developing symptoms of BDD. In the current study, we examined whether parenting styles among mothers and fathers have an effect on the child’s likelihood of exhibiting symptoms of BDD. We also examined if the mother’s or father’s role of being the primary disciplinarian affected one’s likelihood of exhibiting symptoms of BDD.
Limited work has been done on the effects of religiosity on BDD, but the few existing studies suggest that high levels of religiosity result in a better relationship with one’s body image (Homan & Boyatzis, 2009). Richards and colleagues (2009) reported that those suffering from symptoms of BDD often lack a relationship with a “Higher Power.” The false belief that one is “unlovable” and “hated” by a higher power is common among those who suffer from symptoms of BDD (Richards et al., 2009). Previous research has confirmed a positive connection between a young adult’s relationship with religion and body image (Homan & Boyatzis, 2009). It was concluded that in normal, non-diagnosed women, religiosity and body image are often linked in a positive, healthy way (Boyatzis & Quinlan 2008).
Levels of religiosity among those who attend university have also been previously assessed. In a prior study conducted at a religious college among women, prayer was shown to be an effective coping mechanism for body image issues (Jacobs-Pilipski et al., 2005). Lower body satisfaction was reported among those who were open to changing their religious beliefs and acceptance of doubt as integral to faith (Boyatzis & McConnell, 2006). Though these women did not report a direct connection between religiosity and body image, qualitative data revealed a positive impact on body image when women exhibited high levels of religiosity (Boyatzis et al., 2006). In this study, we will attempt to replicate the relationship between religiosity and BDD.
Participants were 100 undergraduate students (50 females and 50 males) enrolled at Texas A&M University – Kingsville. Students were randomly selected in high-traffic locations on the university campus and asked to complete our surveys. We also asked professors to allow us to distribute the surveys in their classes. The average age for the sample size was 20, with ages ranging from 18-38. The ethnic makeup of the sample size consisted of 16 African Americans, 1 Asian, 2 Alaskan Natives, 13 European Americans, and 68 Hispanics.
Participants were first given demographic questions, including “what is your age” and “what is your socioeconomic status?” We then assessed the participant’s level of religiosity/spirituality with the Centrality of Religiosity Scale (CRS) developed by Huber and Huber (2009), which measures an individual’s centrality and importance or salience of religious meanings in personality. Students rated ten statements on 5 point Likert scales as to how often they participate in public religious practices, private religious practices, religious experience, and ideology (Huber & Huber, 2012). Questions reflected one’s religious practices and beliefs by including statements such as “How important is personal prayer for you?” and “How important is it to take part in religious services?”
The Body Dysmorphic Disorder Yale-Brown Obsessive Compulsive Scale (BDD-YBOCS was developed by Katherine Phillips and colleagues (1997) and was used to measure the severity of BDD symptoms in individuals showing excessive preoccupation and subjective distress with physical appearance (Brito, et al., 2015). The BDD-YBOC questionnaire consisted of 10 items using a 5 point Likert scale. The scale ranged from zero to four. Statements reflected one’s preoccupation, obsessions, and compulsive behaviors associated with the dissatisfaction of their physical appearance. This included statements such as “how much distress did your thoughts about your appearance cause you?” and “how much of your time was occupied by intrusive thoughts about a perceived defect or flaw in your appearance? How frequently did the thoughts occur?”
Participants were asked what parenting style they perceived their mother and father to have. Participants had to choose whether they perceived their mother and father to be permissive, authoritative, or authoritarian. They were given definitions for each term for clarity. For example, participants were asked “Which of the following parenting styles did you consider your father to be?” and “Which of the following parenting styles did you consider your mother to be?” Participants were also asked who the primary disciplinarian was in the family; mother or father.
The researchers distributed the survey in one 15-minute session. Surveys were distributed in classrooms with the permission of the professor or given to students in high-traffic areas at the university. Participants were asked to verbally consent to take part in the study and began the survey. Participants responded to the CRS in order to determine the individual’s centrality and importance of religiosity. They then answered the BDD-YBOC questionnaire to measure the severity of BDD symptoms they are experiencing. In addition, participants also provided their demographic information; race/ethnicity, age, sex, socioeconomic status, and level of education. Furthermore, participants provided information about which parenting style they perceived their mother and father to be and who the primary disciplinarian was in the family. Participants in classes who did not wish to take part in the survey could choose to participate in an alternative word search activity. Participants were thanked for their time and consideration. Data was input into the Statistical Package for the Social Sciences (SPSS), Version 25 and analyzed.
Consistent with previous research, female participants exhibited higher levels of BDD (M = 11.68) than males (M = 9.32) although the difference did not reach statistical significane, F(1, 99) = 3.61, p = .06. To determine the relationship between BDD and religiosity, we performed a Pearson correlation. Results indicated that there was no significant correlation between BDD and religiosity, r = -.059 p = .557.
To examine if a mothers’ or father’s parenting style effects their child’s likeliness of exhibiting symptoms of BDD, we performed one way analyses of variance on participants’ BDD scores as it related their parents’ style of parenting. Analysis of variance indicated a significant effect of mother’s parenting style on BDD, F(1, 99) = 3.98, p = .005. The mean BDD score for participants whose mother enacted an authoritarian parenting style was 14.1 while those whose mother enacted a permissive parenting style was 11.27 and an authoritative parenting style was 8.1. The impact of an authoritarian mother was greater for daughters (M = 15.69) than for sons (M = 12.73). Interestingly, daughters whose mothers enacted a permissive parenting styles were more likely to show symptoms of BDD (M = 14.28) than were sons (M = 9.86), F(2, 94) = 5.63, p = .005.
Analysis of variance indicated that father’s parenting style did not have a significant effect on their child’s likeliness of exhibiting symptoms of BDD, F(2, 99) = 1.20, p = .305.
An analysis of variance was conducted to assess if the role of being the primary disciplinarian was significant in effecting BDD. The results indicated that BDD symptoms were more likely for sons when the primary disciplinarian was their mother (M = 12.15) compared to when the primary disciplinarian was their father (M = 6.25), F(3, 94) = 3.26, p = .07. For daughters, the role of primary disciplinarian did not affect the occurrence of BDD. The mean for daughters for whom the primary disciplinarian was mother was 11.95 and for father was 12.06, F < 1.
In this study, we examined the effects of religiosity and parenting styles on BDD. The first hypothesis that individuals with high levels of religiosity are unlikely to exhibit symptoms of BDD was not supported. Data indicated no correlation between the participant’s level of religiosity and BDD. This could be that those who did and did not exhibit symptoms of BDD did not see religiosity as a significant factor. This could be due to the given population that we sampled. College students tend to not exhibit high levels of religiosity Hunsberger (1978), in part due to liberalization, along with being away from family and their religious beliefs.
The second hypothesis that authoritative parents are less likely to provoke symptoms of BDD in the participant was supported. Individuals who reported to have authoritative parents did not have prevalent symptoms of BDD. This could be that authoritative parents provide a comfortable and supportive environment for their child, making them feel more confident with their self-image.
The data revealed that female participants with authoritarian mothers exhibited high levels of BDD symptoms. Thus, female college students who have an authoritarian mother are more likely to develop BDD. This could be due to the strict parenting, high demands, and low responsiveness towards the child associated with the authoritarian parenting (Bahrami et al., 2018). Mothers also tend to have a greater impact on their daughters because of their being a role model. Having an authoritarian mother could heighten the increasing stress on the daughter to appease her mother.
The primary disciplinarian within the participant’s family was also examined in this study. Results revealed that it made a difference who the primary disciplinarian was for the participant to exhibit symptoms of BDD. It was shown that authoritarian mothers who were the primary disciplinarian had daughters exhibiting high rates of BDD. This could be due to the mother being the daughter’s role model and being under excessive, strict pressure of the mother.
Gender differences were also examined in the current study. Females were shown to exhibit higher rates of BDD than males, although the difference did not reach statistical significance. Higher BDD rates for females could be due to females being more body conscious than males, although the marginal size of the effect may mean that males are more self-conscious about their bodies than in previous times.. The results could also reveal such a gender difference due to the questions asked. Future studies could include more male-oriented BDD questions pertaining to muscle build, head hair, and height in addition to the gender-neutral questions previously provided. Male muscle dysmorphia may also be assessed to observe if males are more likely to exhibit symptoms of muscle dysmorphia related to their mother or fathers parenting style.
Including more questions that can apply to males and females will yield more concise results. The current study utilized gender-neutral questions pertaining to one’s preoccupation with their appearance but lacked questions that males can relate to. Future studies should include gender-neutral questions, male-oriented questions, and female-oriented questions.
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