The Legend of Dutchy the Chicken

pages 56-5

Rate of body dysmorphic disorder among patients seeking facial cosmetic procedures

Body dysmorphic disorder (BDD) is defined as a preoccupation with an imaginedor slight defect in appearance resulting in significant distress or impairment in important areas of functioning (APA, 2000). BDD patients are often concerned with facial features and are also likely to present to cosmetic surgery settings for treatment of their perceived defect (Phillips & Diaz, 1997). Studies have reported rates of BDD of 7-12 % in patients from cosmetic surgery and dermatology settings (Sarwer, Wadden, Pertschuk, &Whitaker, 1998; Phillips, Dufresne, Wilkel, & Vittorio, 2000). Methodological weaknesses, including lack of control groups, reliance on surgeons’ judgments of slight or minimal deformity, and the use of different measures to assess for BDD, necessitatefurther study of the rate of BDD in patients seeking cosmetic procedures.This study was designed to further establish the rate of BDD among patientsseeking cosmetic procedures. Ninety-one patients seeking facial cosmetic surgery and 50 patients seeking non-cosmetic facial procedures were recruited from a university cosmetic surgery practice, a university otorhinolaryngology practice, and a private cosmetic surgery practice. Prior to their initial visit, patients completed packets of questionnaires, including demographic questions and measures to assess body image dissatisfaction, BDD symptoms, and depression. Surgeons and nurses rated the severity of patient appearance concerns using a rating scale. Surgeons, nurses, and laypersons also rated a sample of patient photographs. Percentages of patients who screened positive for BDD on a self-report measure in combination with a surgeon rating of minimal or no deformity were calculated. Eight percent of the cosmetic group and 7% of the noncosmeticgroup met criteria for BDD. Patients with BDD symptoms reported greater depression and body image dissatisfaction as compared to patients without BDDsymptoms. There was poor diagnostic correspondence between the two self-reportmeasures of BDD. Nurses and surgeons rated defects similarly. Surgeons ratedappearance concerns as more noticeable as compared to laypersons. These resultssuggest that BDD is not uncommon among patients seeking facial cosmetic procedures.Ph.D., Clinical Psychology -- Drexel University, 200

Facilitating Positive Psychosocial Outcomes in Craniofacial Team Care: Strategies for Medical Providers

© 2019, American Cleft Palate-Craniofacial Association. Objective: Psychosocial issues associated with craniofacial diagnoses and the ongoing burden of care can impact the quality of life of patients and families, as well as treatment adherence and outcomes. Utilizing available literature and clinical expertise across 6 centers, the present article summarizes key psychosocial issues for the benefit of nonmental health medical providers and offers suggestions as to how all members of craniofacial teams can promote positive psychosocial outcomes. Results: Family adjustment across developmental phases is outlined, with strategies to support adaptive parental coping. Teasing is a common concern in craniofacial populations and medical providers can promote coping and social skills, as well as link families to mental health services when needed. Academic issues are described, alongside suggestions for medical providers to assist families with school advocacy and ensure access to appropriate services within the school setting. Medical providers are key in preparing patients and families for surgery, including consideration of medical, social, and logistical supports and barriers. As craniofacial care spans infancy to adulthood, medical providers are instrumental in assisting patients and families to navigate treatment transition periods. In addition to ongoing clinical team assessments, medical providers may utilize screening measures to identify and track patient and family adjustment in multiple areas of team care. Conclusions: Multidisciplinary providers play an important role in supporting positive adjustment in patients affected by craniofacial conditions and their families

Parent-Reported Family Functioning among Children with Cleft Lip/Palate

To examine family functioning related to sociodemographic and clinical characteristics in youth with cleft lip and/or palate (CL/P)

Sexual Functioning and Behavior of Men with Body Dysmorphic Disorder Concerning Penis Size Compared with Men Anxious about Penis Size and with Controls: A Cohort Study

Introduction: Little is known about the sexual functioning and behavior of men anxious about the size of their penis and the means that they might use to try to alter the size of their penis. Aim: To compare sexual functioning and behavior in men with body dysmorphic disorder (BDD) concerning penis size and in men with small penis anxiety (SPA without BDD) and in a control group of men who do not have any concerns. Methods: An opportunistic sample of 90 men from the community were recruited and divided into three groups: BDD (n = 26); SPA (n = 31) and controls (n = 33). Main Outcome Measures: The Index of Erectile Function (IEF), sexual identity and history; and interventions to alter the size of their penis. Results: Men with BDD compared with controls had reduced erectile dysfunction, orgasmic function, intercourse satisfaction and overall satisfaction on the IEF. Men with SPA compared with controls had reduced intercourse satisfaction. There were no differences in sexual desire, the frequency of intercourse or masturbation across any of the three groups. Men with BDD and SPA were more likely than the controls to attempt to alter the shape or size of their penis (for example jelqing, vacuum pumps or stretching devices) with poor reported success. Conclusion: Men with BDD are more likely to have erectile dysfunction and less satisfaction with intercourse than controls but maintain their libido. Further research is required to develop and evaluate a psychological intervention for such men with adequate outcome measures

Pediatric medical traumatic stress in individuals with craniofacial conditions

Purpose: This article reviews the literature focused on the psychological effects of craniofacial care for patients and their families. It provides an overview of pediatric medical traumatic stress associated with craniofacial conditions and related care along with a review of its risk and protective factors. Findings from studies of pediatric medical traumatic stress in craniofacial populations are also reviewed. Conclusion: The article concludes with strategies for identifying, addressing, and preventing medical traumatic stress in the context of craniofacial care. Specific implications for speech language pathologists are also shared with respect to ways of minimizing risks for medical traumatic stress in craniofacial care. Future directions are also delineated and include strategies to improve screening and support for patients with craniofacial conditions and their families, along with the development of interventions aimed at increasing resilience

The effect of training in reduced energy density eating and food self-monitoring accuracy on weight loss maintenance

Background: Failure to maintain weight losses in lifestyle change programs continues to be a major problem and warrants investigation of innovative approaches to weight control.Objective: The goal of this study was to compare two novel group interventions, both aimed at improving weight loss maintenance, with a control group.Methods and Procedures: A total of 103 women lost weight on a meal replacement&ndash;supplemented diet and were then randomized to one of three conditions for the 14-week maintenance phase: cognitive-behavioral treatment (CBT); CBT with an enhanced food monitoring accuracy (EFMA) program; or these two interventions plus a reduced energy density eating (REDE) program. Assessments were conducted periodically through an 18-month postintervention. Outcome measures included weight and self-reported dietary intake. Data were analyzed using completers only as well as baseline-carried-forward imputation.Results: Participants lost an average of 7.6 plusminus 2.6 kg during the weight loss phase and 1.8 plusminus 2.3 kg during the maintenance phase. Results do not suggest that the EFMA intervention was successful in improving food monitoring accuracy. The REDE group decreased the energy density (ED) of their diets more so than the other two groups. However, neither the REDE nor the EFMA condition showed any advantage in weight loss maintenance. All groups regained weight between 6- and 18-month follow-ups.Discussion: Although no incremental weight maintenance benefit was observed in the EFMA or EFMA + REDE groups, the improvement in the ED of the REDE group\u27s diet, if shown to be sustainable in future studies, could have weight maintenance benefits.<br /

Establishing an international interdisciplinary research network in craniofacial microsomia: The CARE Program

Craniofacial microsomia (CFM) is a broad clinical term used to describe a congenital condition most commonly involving the underdevelopment of the external ear, mandible, soft tissues, and facial nerve. Despite medical advances, understanding of the psychological health and healthcare experiences of individuals with CFM and their caregivers remains limited. This article describes a research program designed to address these knowledge gaps, and identify opportunities for psychosocial intervention and improved healthcare provision. The Craniofacial microsomia: Accelerating Research and Education (CARE) research program aims to: Conduct up to 160 narrative interviews with individuals and caregivers to validate a conceptual framework; Administer an online international survey of up to 800 individuals with CFM and caregivers to identify predictors of psychological distress; Perform up to 60 semi-structured interviews with healthcare providers and advocacy leaders to examine the extent to which current healthcare provisions address identified patient needs; and Establish a participant registry to build a longitudinal database and develop an international community. Teams in the USA and UK have been established, alongside an international, interdisciplinary Advisory Committee. Data analysis for Aim 1 is ongoing and informing the delivery of Aims 2-3. Aim 4 is also in development. A dedicated website serves as a recruitment tool, educational resource, and mechanism for engaging with the CFM community. The CARE program provides a comprehensive approach to understanding the experiences of individuals with CFM and their caregivers. Challenges encountered and lessons learned are shared for the benefit of the community