As with most mental disorders, BDD's cause is likely intricate, altogether
biopsychosocial, through an interaction of multiple factors, including genetic, developmental,
psychological,
social, and
cultural. BDD usually develops during early adolescence, In many cases, social anxiety earlier in life precedes BDD. Though
twin studies on BDD are few, one estimated its
heritability at 43%. Yet other factors may be
introversion, negative body image, perfectionism, heightened aesthetic sensitivity,
Childhood trauma The development of body dysmorphia can stem from trauma caused by parents/guardians, family, or close friends. In a study published in 2021 about the prevalence of childhood maltreatment among adults with body dysmorphia, researchers found that more than 75% of respondents had experienced some form of abuse as children. Indeed, the researchers found that adults who had a history of emotional neglect as children were especially vulnerable to BDD, though other forms of abuse, including physical and sexual abuse, were also identified as significant risk factors. As the children progress into their adult years, they start to visualise the abuse that has been done to their bodies, and start finding ways to hide, cover, or change it so they are not reminded of the trauma that they endured as an adolescent.
Social media Constant use of
social media and "
selfie taking" may translate into low self-esteem and body dysmorphic tendencies. The sociocultural theory of self-esteem states that the messages given by media and peers about the importance of appearance are internalized by individuals who adopt others' standards of beauty as their own. Due to excessive social media use and selfie taking, individuals may become preoccupied about presenting an ideal photograph for the public. Specifically, females' mental health has been the most affected by persistent exposure to social media. Girls with BDD present symptoms of low self-esteem and negative self-evaluation. Due to social media's expectations, a factor of why individuals have body dysmorphia can come from women comparing themselves with media images of ideal female attractiveness, a perceived discrepancy between their actual attractiveness and the media's standard of attractiveness is likely to result. Researchers in
Istanbul Bilgi University and
Bogazici University in Turkey found that individuals who have low self-esteem participate more often in trends of taking selfies along with using social media to mediate their interpersonal interaction in order to fulfill their self-esteem needs. The
self-verification theory, explains how individuals use selfies to gain verification from others through likes and comments. Social media may therefore trigger one's misconception about their physical look. Similar to those with body dysmorphic tendencies, such behavior may lead to constant seeking of approval, self-evaluation and even depression. In 2019 systematic review using
Web of Science,
PsycINFO, and
PubMed databases was used to identify social networking site patterns. In particular appearance focused social media use was found to be significantly associated with greater body image dissatisfaction. It is highlighted that comparisons appear between body image dissatisfaction and BDD symptomatology. They concluded that heavy social media use may mediate the onset of sub-threshold BDD. Individuals with BDD tend to engage in heavy plastic surgery use. In 2018, the plastic surgeon Dr. Tijon Esho coined term "
Snapchat Dysmorphia" to describe a trend of patients seeking plastic surgeries to mimic "filtered" pictures. Filtered photos, such as those on
Instagram and
Snapchat, often present unrealistic and unattainable looks that may be a causal factor in triggering BDD. 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. 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. Socio-cultural models depict and emphasise the way thinness is valued, and beauty is obsessed over in Western culture, where advertising, marketing, and social media play a large role in manicuring the "perfect" body shape, size, and look. The billions of dollars spent to sell products become causal factors of image conscious societies. Advertising also supports a specific ideal body image and creates a social capital in how individuals can acquire this ideal. However, personal attitudes towards the body do vary cross-culturally. Some of this variability can be accounted for due to factors such as food insecurity,
poverty, climate, and fertility management. Cultural groups who experience food insecurity generally prefer larger-bodied women. However, many societies that have abundant access to food also value moderate to larger bodies. This is evident in a comparative study of
body image, body perception, body satisfaction, body-related self-esteem, and overall
self-esteem of German, Guatemalan Q'eqchi' and Colombian women. Unlike the German and Colombian women, the Q'eqchi' women in this study live in the jungles of Guatemala and remain relatively removed from modern technology and secure food resources. The study found that the Q'eqchi' women did not have notably higher body satisfaction when compared to the German or Colombian women. 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. 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==