Psychiatr Q (2006) 77:223–229
Social Functioning in Body Dysmorphic Disorder:
Elizabeth R. Didie, Ph.D. · Christina Tortolani, M.A. ·
Mary Walters, Ed.M. · William Menard, B.A. ·
Christina Fay, B.A. · Katharine A. Phillips, M.D.
Published online: 7 September 2006
Springer Science+Business Media, Inc. 2006
Abstract Individuals with body dysmorphic disorder (BDD) have markedly poor social
functioning; however, previous reports may underestimate impairment. Scoring on certain
functioning measures such as the Social Adjustment Scale-Self Report (SAS-SR) potentially
excludes more severely ill individuals from some domains, thereby possibly underestimating
functional impairment. To explore this issue, 73 individuals with BDD who reported having
no primary relationship (and were therefore excluded from scoring on the SAS-SR Primary
Relationship domain) were compared to 58 individuals with BDD who had a primary
relationship. Subjects without a primary relationship had signiﬁcantly poorer global social
adjustment on several measures. They also had poorer scores on the Global Assessment
of Functioning Scale and greater severity of BDD and depressive symptoms at a trend
level. These ﬁndings suggest that the SAS-SR may underestimate social impairment. This
underestimation may pertain to other domains of functioning, other disorders, and certain
other functioning and quality of life measures.
Keywords Body dysmorphic disorder
Body dysmorphic disorder (BDD) is a relatively common disorder that consists of a
distressing or impairing preoccupation with an imagined or slight defect in appearance
. Individuals with BDD have very poor psychosocial functioning, markedly poor quality
E. R. Didie, Ph.D. (
) · C. Tortolani, M.A. · M. Walters, Ed.M. · W. Menard, B.A. · C. Fay, B.A. ·
K. A. Phillips, M.D.
345 Blackstone Blvd., Providence, RI 02906, USA
E. R. Didie, Ph.D. · K. A. Phillips, M.D.
Department of Psychiatry and Human Behavior, Brown Medical School,
Providence, RI, USA