The experiences of individuals with Body Dysmorphic Disorder: A systematic review and thematic synthesis, and The experience of living with Hidradenitis Suppurativa for affected individuals and their partners: An interpretative phenomenological analysis

Thomson, Kathryn 2022. The experiences of individuals with Body Dysmorphic Disorder: A systematic review and thematic synthesis, and The experience of living with Hidradenitis Suppurativa for affected individuals and their partners: An interpretative phenomenological analysis. ClinPsy Thesis, Cardiff University. Item availability restricted.

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Abstract

The current thesis explores the experiences of individuals with the psychological condition body dysmorphic disorder (BDD) and then couples affected by the dermatological condition Hidradenitis Suppurativa (HS). BDD is a distressing psychological condition where individuals are preoccupied with a perceived flaw in their appearance, often imagined or very slight and unnoticeable to others. The systematic review and thematic synthesis aimed to integrate the existing qualitative studies on the experiences for individuals with BDD. A systematic review protocol was developed and used to search for qualitative studies on BDD on six different databases. Guidelines for specifically conducting a systematic review were followed and 10 peerreviewed journal articles were found that met the inclusion criteria. All 10 articles were quality assessed. Thematic synthesis was used to integrate the data from the findings. Three major themes and ten subthemes were created in the thematic synthesis. The first major theme ‘self-objectification and the view of self’ captures how participants viewed themselves in relation to the perceived flaw, the all-encompassing preoccupation of the perceived flaw and the shame and disgust which some participants experienced towards themselves. The second major theme ‘control and protecting the self’ details how participants with BDD felt out of control with their appearance but the safety behaviours and avoidance they engaged in were counterproductive as the behaviours became consuming and led the participants to have a more restricted life. The final major theme ‘sociocultural influences and the impact of others in BDD’ discusses the role of sociocultural factors in the development of BDD and how others may help or hinder individuals’ experiences of BDD. The thematic synthesis contributes to the field by highlighting the role of shame and disgust in the lived experiences for people with BDD. In addition, the study supports the application of objectification theory in BDD but more research is needed on the experiences of males with differing sexual orientations and BDD. Services supporting people with BDD should ensure they are culturally appropriate, consider outreach initiatives and consider offering compassion focussed techniques alongside more established cognitive behavioural therapy. The thesis also suggests further areas of research in BDD. The second part of the thesis focuses on the experiences of couples where one person in the relationship has HS. HS is a dermatological condition where individuals experience painful flares with abscesses and scarring often presenting in intimate areas of the body. The empirical study is the first one to interview couples about their experiences of HS. Six couples participated with all twelve individuals interviewed separately. The methodological approach used in this study was Interpretative Phenomenological Analysis (IPA) as it is appropriate when topics are particularly important to participants. In IPA, the researcher is making sense of the participant making sense of their experiences and so it is important for the author to be reflective throughout the lifecycle of the study as this could influence data interpretation. Interviews were held over the videoconferencing platform, MS Teams. The aim of the study was to explore the couples’ experiences of HS with a specific focus on flares, pain, intimacy, relational functioning and accessing healthcare. Three major themes emerged from the study. The first theme ‘being unheard: a frustrating journey to receiving care’ highlighted the difficult experiences that the couples often faced when trying to access healthcare for flares, often due to a lack of sensitivity or knowledge of HS from healthcare professionals. The second theme ‘relational burden and dyadic coping’ details the impact of HS on the couple, their relationship and how they work together to identify solutions or make adjustments to any difficulties that arise. The final theme ‘self-disgust and selfconsciousness’ details the difficult emotions that people with HS experience such as shame and disgust. Whilst some of the patients with HS in the study could be very self-critical, the partners did not think of them or their HS symptoms in the same way. This study contributes to the field by highlighting the considerable impact of flares of HS for couples. To help improve the experience of accessing healthcare for flares, GPs and A&E staff should have further training on the emotional and psychological consequences of HS. Embedding psychological therapy in dermatology services may also help partners and patients cope with the experience of HS. Further research areas are also identified. Theoretical overlap between the two studies include appearance concerns contributing to disgust towards the self and feelings of shame. The study exploring the experiences for people with BDD is more focused on appearance concerns and their impact whereas the study with couples impacted by HS explores how couples cope with the condition, including pain, losses, remaining close when unable to be intimate and experiences of accessing healthcare.

Item Type:	Thesis (DClinPsy)
Date Type:	Completion
Status:	Unpublished
Schools:	Psychology
Subjects:	B Philosophy. Psychology. Religion > BF Psychology
Date of First Compliant Deposit:	3 October 2022
Last Modified:	10 Feb 2024 02:11
URI:	https://orca.cardiff.ac.uk/id/eprint/152970

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