Abstract
The topic of body dysmorphic disorder (BDD) among adolescents is well documented, and so is the peer conformity in relation to teenagers’ decision making process. However, there are solely secondary references to how peer conformity influence decision making process among adolescence diagnosed with BDD, which is why, the aim of the proposed research is to investigate this relationship. The hypothesis suggest that adolescence diagnosed with BDD take extreme approaches in relationship to peer conformity, which further influence their decision making process.
The methods section describes the research methodology, the focus group, the descriptive research design, also presenting information about participants. Eight adolescents from two schools in Clayton, Victoria, Australia, aged between 12 and 16 years old, four diagnosed with BDD and four non – diagnosed will be asked to discuss about peer relationship and the need of belonging.
The implications of the study, in case the hypothesis is sustained, refer to the nature of the development of the adolescence with BDD disorder, which can help specialists in diagnosing and treating this condition.
Key words: body dysmorphic disorder (BDD), adolescence, peer conformity, focus group.
Introduction
Adolescence is a critical phase in individuals’ development process, as they confront with various changes and challenges that can shape their personality. One such challenge is peer conformity, a strong process that influences adolescents’ thinking, behavior and implicitly their decision making (Ashfort & Winston LeCroy, 2010). Another challenge that is common among teenagers is their obsession for perfection, expressed by exaggerating their small flaws up to the point that they perceive them as deformities (Phillips et al., 2010). This over – concern for small imperfections is known as body dysmorphic disorder (BDD). BDD is a DSM-IV disorder that has been diagnosed for more than a century, causing emotional and psychiatric distress for people diagnosed with this condition (Phillips, 2009).
Foo (2010) and Buhlmann, Cook, Fama and Wilhemn (2007) indicate that peer conformity can generate various decision making outcomes that can span across opposing poles, from self – isolation and avoiding grooming to obsessing over changes for correcting the perceived deformities. Phillips (2009) adds that due to their perceived deformities some avoid swimming. Fo (2010), on the other hand, finds that giving into the stress to overpass a perceived deformity, caused by BDD, fall into unhealthy habits, such as tanorexia (severe preoccupation with one’s complexion).
In the social interaction, adolescence often face the summons of adjusting or integrating into a group of youngsters and the predilection to conform to the group’s standards is the main criteria for fitting in (Watson and Skinner, 2004). The above – presented behaviors are coping mechanisms to overcome an imagined disorder and gain peers’ compliments and acceptance by conforming with the beauty standards that peer promote and adhere to (Fo, 2010). Because fitting in demands conforming to peers’ set of formal and informal rules and behavioral guidelines, adolescents with BDD are likely to find this task more difficult than non – BDD teenagers, being blocked by their own imagined or exaggerated flaws (Phillips, 2009). Lack of peer conformity may attract teasing, poor peer relations and even bullying, resulting into developing emotional abuse issues and turning to self – isolation (Veale & Neziroglu, 2010; Buhlman, Cook & Wilhelm, 2007). Watson and Skinner note that teasing, during adolescence, attracts negative self – evaluation and the continuous comparison with others.
Veale and Neziroglu (2010) note that BDD is an under-researched topic compared to other mental health problems, although it is a highly distressful psychiatric disorder. Furthermore, the relationship between peer conformity and decision making in adolescence with BDD is even less researched, with solely few writings documenting it as a secondary focus.
The aim of the research paper will be to identify specifically how the adolescents diagnosed with body dysmorphic disorder react to peer conformity and how peer conformity influence the decision making skills of BDD teenagers.
Aligned with the relevant readings that reference peer conformity and decision making respectively body dysmorphic disordered in adolescence, the hypothesis of the research will be: teenagers diagnosed with BDD are sensitive to peers’ opinion and they deal with their perceived deformities by extremely confirming to peers’ influence in their decision makings, or experiencing self – isolation and disconformity from peers.
Method
The chosen method for the proposed research will be based on a qualitative design, namely the focus group. Focus group facilitates group communication through the intermediation of the researcher who engages participants in interaction and active discussions regarding the research topic, allowing people to express their thoughts and to explore why they think the way they do (Kitzinger, 1995).
Participants
It is recommended to have around six to twelve participants, in a session of 90 to 120 minutes (Fortune, Reid & Miller, 2013). For the effectiveness of data collection, the study participants will not know each other, because focus group best work when people in the group are strangers to one another, although they share similar background, which permit them to freely express their thoughts (Patton, 2015). The research participants will be selected from nearby high schools, such as Westall Secondary College or Mount Waverly Secondary College Junior, where there can be found eight respondents, aged between 12 to 16 years old. It will be intended to reach a gender balance, but there will not be applied race or ethnicity criteria. There will be an equal number of BCC participants and non BCC subjects. In terms of sampling method, the convenience sampling will best answer the research needs, considering that this method permits the selection of participants based on availability and easy access (Patton, 2015).
Design
The research design will be descriptive research, which will be useful in examining the studied phenomenon in its current state, based on observation or exploration of correlation between different variables (Williams, 2008). The study will integrate dependent variables (age, gender) and independent variable (peer influence on decision making).
Procedure
In a focus group the confidentiality of participants cannot be guaranteed, because the meeting is recorded and emotions analyzed (Patton, 2015). However, ethical research recommend fair treatment for samples and not disclosing the data on the participants’ identities to other institutions (Fortune, Reid and Miller, 2013). For collecting non – biased data, the participants will be naïve, knowing solely that they will participate in a social research, not the topic of the research (Fortune, Reid and Miller, 2013). They will be requested to discuss about their relationships with their peers and how important it is for them to belong to groups and adjust to groups’ behaviors, and they will be expected to interact freely, asking questions to one another, under researcher’s moderation.
Results
The data will be collected through video recording and moderator’s notes and they will be analyzed through coding participants’ answers, by grouping similar answers or opinions in categories (Patton, 2015). The coding method is based on a three – levels, namely open coding (labeling recordings), axial coding (defining whether topics are substantial enough to become core concepts) and selective coding (finding relevant instances where the concept is represented) (Fortune, Reid & Miller, 2013). The results will compare the codes of BDD respondents with those of non – BDD respondents and if the first group registers a visibly higher positive rate to being influenced by peers in their decision makings, the hypothesis will be confirmed.
Discussion
The results can either confirm or disconfirm the hypothesis. In case the hypothesis is confirmed, the results would imply that the teenagers diagnosed with BDD experience either an exaggerated desire to copy their peers, up to the point of changing their physical appearance to please, or that they repelled by their appearance and hide away from their peers (Foo, 2010; Phillips, 2009). The second instance does not imply that adolescence are not influenced by their peers in their decision making processes, but it rather informs that they accumulate high levels of frustration and distress that affect their development (Veale & Neziroglu, 2010). Exaggerated peer conformity can also affect adolescence development, as they will not explore their individuality, but adopt a desired ideal that they will aim to attain by modifying different aspects of their bodies that they consider deformity (Phillips et al., 2010). In case the results disconfirm the hypothesis, this outcome would imply that there are more complex processes that guide the decision making skills of adolescents diagnosed with BDD, and future research should be specifically dedicated to identifying the criteria of this process.
However, considering that the proposed research is based on a qualitative design, the focus group methodology can also impact the study results, because the respondents are not sufficient in number to be considered representative for their population (Patton, 2015). Furthermore, focus group that gathers BDD and non – BDD can generate biased responses, as the second group could experience sympathy with the first and try to relate with them, and the other way around, which can affect the validity of the data. In addition to the qualitative research method which is a limitation of the study, because it does not allow an accurate reflection of the studied phenomena, other potential limitations include the skillset of the researcher, difficulty in controlling and integrating the variables and a subjective data interpretation.
The proposed study would investigate a social phenomenon that has not been researched before in relationship with BDD teenagers. The study will offer specialists a different approach on BDD, indicating how this disorder can affect adolescents’ development by impacting their decision making under peer influence or pressure to conform, which might help in diagnosing and treating the condition, by acknowledging potential effects.
References
Ashford, J.B. and Winston LeCroy, C. (2010) Human behavior in the social environment. Belmont: Cengage Learning.
Buhlman, U., Cook, L.M., Fama, J.M. & Wilhelm, S. (2007) Perceived teasing experience in body dysmorphic disorder. Body Image. 4(4): 381-385.
Foo, S.Y.Y. (2010) The beauty trap: How the pressure to conform to society’s and media’s standards of beauty leave women experiencing body dissatisfaction. Auckland: Auckland University of Technology.
Fortune, A.E., Reid, W.J. & Miller, R. (2013) Qualitative research in social work. New York: Columbia University Press.
Kitzinger, J. (1995) Introducing focus group. BMJ. 311(29): 299-302.
Patton, M.Q. (2015) Qualitative research & evaluation methods: Integrating theory and practice. Fourth eds. New York: Sage.
Phillips, K.A., Wilhelm, S., Koran, L., Didie, E., Fallon, B.A., Feusner, J. & Stein, D.J. (2010) Body dysphormic disorder: Some key issues for DSM-V. Depression and Anxiety. 27: 573-591.
Phillips, K.A. (2009) Understanding body dysmorphic disorder. New York: Oxford University Press.
Veale, D. & Neziroglu, F. (2010) Body dysmorphic disorder: A treatment manual. West Sussex: John Wiley & Sons Ltd.
Watson, T.S. & Skinner, C.H. (2004) Encyclopedia of school psychology. New York: Kluwer Academic.
Williams, C. (2007) Research methods. Journal of Business & Economic Research. 5(3): 65-72.
