The temperament and character profile of a body dysmorphic disorder outpatient sample

Background Given the paucity in research investigating personality in body dysmorphic disorder (BDD), this study examined the temperament and character profile of BDD outpatients, and explored the relationship between BDD symptom severity and the temperament and character dimensions. Method Thirty-three consecutive BDD outpatients completed the Temperament and Character Inventory (TCI), Dysmorphic Concern Questionnaire (DCQ), Self-Rating Depression Scale (SDS) and the Social Interactional Anxiety Scale (SAIS). Thirty non-clinical controls completed the TCI, DCQ and Body Dysmorphic Disorder Questionnaire. Results Compared with non-clinical controls, BDD patients reported significantly higher Harm Avoidance (HA) scores (p < 0.001) and significantly lower Self-Directedness (SD; p <001) and Cooperativeness (C) scores (p = 0.04). The finding for C, however, may be confounded by age. For the BDD sample, DCQ scores were positively related to HA scores and negatively related to SD scores. Discussion Results suggest a temperament and character profile for BDD comprising high HA, low SD and possibly low C. High HA and low SD may represent non-specific risk factors in the development of BDD. Further research with siblings of cases and controls is required to demonstrate the causal role of antecedent personality traits. Additional research with larger samples is also required to investigate the possible confounding effects of delusionality, depression and social anxiety in the relationship between BDD and temperament and character.