Recent research published in the Journal of Affective Disorders has discovered that parents who exhibit excessive control and intrusion in their child’s life may contribute to the development of body image concerns in adulthood.
Dysmorphic concern, characterized by an intense focus on perceived flaws in appearance and sometimes compulsive-like behaviors (e.g. picking at the skin), can have a significant impact upon physical and mental wellbeing.
While a key symptom of Body Dysmorphic Disorder, dysmorphic concern can also be detected in other various psychiatric and medical contexts, and even more generally in non-clinical individuals who do not have any disorders.
Yet, limited research has been conducted on the factors contributing to dysmorphic concern. A recent study has suggested a strong association between dysmorphic concern and childhood trauma, which encompasses various forms of maltreatment, including parental overcontrol.
“Parental overcontrol can be likened to emotional abuse as it exposes the child to the care of a frightened caregiver, a world perceived as always threatening, and a weak and endangered view of self,” described the study authors, who were led by Elena De Rossi from the European University of Rome in Italy.
To further investigate this association between parental overcontrol and dysmorphic concern in adults, an online survey was conducted with 508 females and 206 males aged 18 to 77 years.
The severity of dysmorphic concern was assessed using the Body Image Concern Inventory questionnaire, parental overcontrol was evaluated by focusing on the “overcontrol” section of the Measure Of Parental Style questionnaire, and finally the exposure to different types of childhood trauma was measured using the Childhood Trauma Questionnaire – Short Form.
Sociodemographic and clinical information was also collected, such as tobacco/alcohol use, and the presence of psychiatric/neurological disorders.
Statistical analyses were conducted, which confirmed that parental overcontrol was associated with the severity of dysmorphic concern. This was found to be an independent association – meaning that the two factors are robustly connected and not dependent on, or influenced by, any other factors.
The authors proposed a theory that could explain this significant relationship, “Parental attitudes of replacing the child in managing his or her own life may create a sense of self characterized by defectiveness, frailty and inadequacy, and may foster perceptions of the world as demanding, threatening, [and] judgmental. Involving body image, these altered internal representations would explain dysmorphic concern through shame, anxiety, and the expectation of social rejection.”
In other words, excessive parental control can lead the child to develop feelings of inadequacy and weakness, resulting in the child perceiving the world as a challenging and critical place from which they seek protection. These altered views ultimately manifest in feelings of embarrassment and anxiety in how they view their own body.
An alternate explanation for the relationship was also hypothesized by the researchers: “parental intrusiveness may undermine the child’s ability to self-identify and manage internal states, leading to automatic dysfunctional strategies to respond to perceived body faultiness and social apprehension”.
Simply put, extreme control and involvement of parents in their children’s lives may not allow their children to learn how to manage their own emotions and thoughts, which may cause the child to develop unhelpful strategies of dealing with their own body image issues and social worries.
The authors highlight some limitations. The sex ratio in the study was unbalanced, with a high proportion of females undergoing the study (71%). The study design also relied on retrospective self-report measures. That is, participants were asked to recall past experiences from memory, which may have elements of bias.
Nevertheless, these findings have significant implications for prevention policies and clinical interventions, emphasizing the importance of evaluating parenting behavior and parent-child relationships in individuals with high levels of dysmorphic concern.
The study, “Parental overcontrol is associated with dysmorphic concern severity: A cross-sectional study”, was authored by Elena De Ross, Benedetto Farina, Mauro Adenzato, Giuseppe Alessio Carbone, Rita B. Ardito and Claudio Imperatori.
