Delaney, Zoe; (2024) Emotionally unstable personality disorder traits in young people with obsessive-compulsive disorder and body dysmorphic disorder: Clinical correlates and treatment outcomes. Doctoral thesis (D.Clin.Psy), UCL (University College London).

Text Thesis_final_volume1_Delaney.pdf - Other Access restricted to UCL open access staff until 1 October 2025. Download (12MB)

Abstract

This thesis focuses on co-occurring mental health conditions and symptoms in Body Dysmorphic Disorder (BDD) and is presented in three parts. Part One is a systematic review and meta-analysis assessing the prevalence of current co-occurring mental health conditions in BDD. Thirty-eight studies were included in the review. The majority of BDD participants had at least one co-occurring mental health condition, with the most prevalent being major depressive disorder, social anxiety disorder and avoidant personality disorder. Moderating factors, such as study setting and design, were identified. Further research is needed to understand the relationship between the most common co-occurring mental health conditions and BDD. Clinicians should also consider assessing for co-occurrence, and making the necessary adaptations to treatment, when needed, when working with individuals with BDD. Part Two is a naturalistic cohort study exploring the role of emotionally unstable personality disorder (EUPD) traits in young people with obsessive-compulsive disorder (OCD), BDD and comorbid OCD-BDD. Participants were 393 young people referred to a specialist outpatient service for OCD and BDD in young people. Routine outcome measures were analysed, with findings showing that possible EUPD was more common in young people with BDD than OCD. EUPD traits were also associated with greater symptom severity, functional impairment and historical suicide attempts. Further research is needed to understand the role of EUPD traits in young people with OCD and BDD in non-specialist services. Clinicians should also consider screening for EUPD traits when working with young people with OCD and BDD, given the poorer clinical picture. Part Three is a critical appraisal of conducting the doctoral research thesis. This includes reflections on both the systematic review and empirical paper, focusing on the methodology and analysis process, implications of the findings, and the trainee’s experience of conducting the research.

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