This was later resolved with the revision of the DSM-III, which aided many by providing appropriate treatment for patients. BDD was initially considered non-delusional in European research, and was grouped with ‘monosymptomatic hypochondriacal psychoses’ – delusional paranoia disorders, before being introduced in the DSM-III. In 1991, the demographics of individuals who experience BDD were primarily single women aged 19 or older. This statistic has not changed over the decades, women are still considered the predominant gender to experience BDD. With the rise of social media platforms, individuals are easily able to seek validation and openly compare their physical appearance to online influences, finding more flaws and defects in their own appearance. This leads to attempts to conceal the defect such as seeking out surgeons to resolve the issue of ugliness.Universally, it is evident that different cultures place much emphasis on correcting the human body aesthetic, and that this preoccupation with body image is not exclusive to just one society; one example is the binding of women’s feet in Chinese culture.Whilst physically editing the body is not unique to any one culture, research suggests that it is more common throughout Western society and is on the rise. On close observation of contemporary Western societies, there has been an increase in disorders such as Body dysmorphic disorder, arising from ideals around the aesthetic of the human body. Scholars such as Nancy Scheper-Hughes have suggested such demand placed upon Western bodies has been around since the beginning of the 19th century, and that it has been driven by sexuality.
Nevertheless, the Q’eqchi’ women also showed the greatest distortion in their own body perception, estimating their physique to be slimmer than it actually was. It is thought this could be due to a lack of access to body monitoring tools such as mirrors, scales, technology, and clothing choices, but in this instance, body distortion does not seem to influence body satisfaction. This has also been shown in groups of lower-income African American women, where the acceptance of larger bodies is not necessarily equivalent to positive body image.Similar studies have noted a high prevalence of BDD in East Asian societies, where facial dissatisfaction is especially common, indicating that this is not just a Western phenomenon. Diagnosis
Estimates of prevalence and gender distribution have varied widely via discrepancies in diagnosis and reporting. In American psychiatry, BDD gained diagnostic criteria in the DSM-IV, having been historically unrecognized, only making its first appearance in the DSM in 1987, but clinicians knowledge of it, especially among general practitioners, is constricted. Meanwhile, shame about having the bodily concern, and fear of the stigma of vanity, makes many hide even having the concern.Via shared symptoms, BDD is commonly misdiagnosed as social anxiety disorder, obsessive-compulsive disorder, major depressive disorder, or social phobia. Social anxiety disorder and BDD are highly comorbid (within those with BDD, 12–68.8% also have SAD; within those with SAD, 4.8-12% also have BDD), developing similarly in patients -BDD is even classified as a subset of SAD by some researchers.