Objective: The aim of this study was to investihate a structural model explaining Body Dysmorphic Disorder (BDD). This model investigated the influence of early maladaptive schemas (EMS), perfectionism, and negative affect on BDD, as mediated by emotion regulation.
Method: This descriptive-correlational study utilized structural equation modeling (SEM). The population consisted of adolescents aged 12 to 19 who were clients at beauty clinics in Bandar Abbas, Iran. A sample of 400 participants was selected using convenience sampling. The sample size was calculated using G*Power software based on pre-set parameters for effect size, statistical power, number of latent and observed variables, and significance level. Data were collected using the Body Dysmorphic Disorder Questionnaire (Littleton et al., 2005), Young Schema Questionnaire (YSQ; Young, 1998), Frost Multidimensional Perfectionism Scale (FMPS; Frost et al., 1990), and the Positive and Negative Affect Schedule (PANAS; Watson & Clark, 1988). Data analysis was performed using SPSS for descriptive statistics and Partial Least Squares (PLS) for inferential analysis and model testing.
Results: The results showed that early maladaptive schemas (β = 0.423, t = 7), negative affect (β = 0.254, t = 5), and perfectionism (β = 0.243, t = 5) were significant predictors of emotion regulation, collectively explaining 70.8% of its variance (R² = 0.708). Furthermore, the model demonstrated that negative affect (β = 0.393, t = 10), early maladaptive schemas (β = 0.230, t = 4), emotion regulation (β = 0.218, t = 4), and perfectionism (β = 0.140, t = 3) were all significant direct predictors of Body Dysmorphic Disorder. The comprehensive model successfully explained 78.5% of the variance in BDD (R² = 0.785). The bootstrapping analysis confirmed that emotion regulation played a significant mediating role in the relationship between EMS, perfectionism, negative affect, and BDD (p < 0.05).
Conclusions: The findings indicate that the proposed model for adolescent BDD demonstrates a good fit. Early maladaptive schemas, perfectionism, and negative affect appear to contribute to BDD symptoms both directly and indirectly, through their impact on individuals' emotion regulation abilities..