Am I ugly or do I have BDD?: personal disclosure and social support on a body dysmorphic disorder online forum
Date
2016
Authors
Fisher, Eva E., author
Hallahan, Kirk, advisor
Rouner, Donna, committee member
Long, Marilee, committee member
Ogle, Jennifer, committee member
Williams, Elizabeth, committee member
Journal Title
Journal ISSN
Volume Title
Abstract
The current study used an emergent research design that employed qualitative content analysis to understand how individuals with body dysmorphic disorder (BDD) communicate with their peers in an online support forum (psychforum.com/body-dysmorphic-disorder). The purpose was to explore (a) the communication activities on the forum, (b) the personal experiences with BDD disclosed by participants, (c) the categories of social support sought and shared, and (d) the social support provided and roles performed by the most frequent posters to the forum. The data sample consisted of 911 messages posted by 225 participants during 2012. The primary communication activities on the forum were asking about other members’ personal experiences and seeking support, disclosing personal experiences and providing support, engaging in conversations, and storytelling. Personal disclosures included appearance concerns (feeling ugly, depressed, guilty, ashamed, angry, and suicidal), compulsive behaviors (plastic surgery, mirror/photograph checking, and social comparison), the impact on one’s personal life, and recovery from BDD (treatment, diagnosis, coping, and overcoming symptoms). Social support sought and shared included informational, emotional, and social network support. Informational support topics included diagnosis, treatment, overcoming symptoms, and recovery. Emotional support took the form of empathy, caring/concern, gratitude, encouragement, sympathy, compliments, and validation. Social network support reinforced that people who understand the disorder were present on the forum and could provide companionship. Although not common, unsupportive comments (disagreement, disapproval, criticism/sarcasm, and flaming) were also present. The five most frequent posters were emergent leaders whose supportive roles supplemented those of the two forum moderators. The most frequent poster was a male who played a lead role in providing informational and social network support, along with four frequent female posters whose primary contribution was providing emotional support. The five emergent leaders and moderators also performed functional roles, including greeter, advocate, arbiter, mediator/harmonizer, corroborator/validator, information/opinion giver, evaluator/critic, and encourager/cheerleader, that were critical to the successful functioning of the forum. The study discusses five key conclusions (themes) that offer valuable insight into how members communicated on the forum: (a) personal disclosure facilitated social support in initial posts and responses, (b) group members served primarily as support providers or support seekers whose behaviors were complementary and essential to the successful functioning of the forum, (c) contributions to the forum varied by gender with females providing more personal disclosure and social support than males, (d) the forum served as a coping mechanism where members shared coping strategies and coping assistance, and (e) the forum offered members peer support within an online community that supplemented the support received from other online and in-person sources. The study underscores the growing importance of peer-to-peer communication and contributes to the limited research on online support groups for individuals coping with serious mental illness. As a result of this investigation, health communication scholars will have an increased understanding of why individuals with stigmatized health conditions turn to their peers to find the support they need online. In addition, this study provides BDD researchers and clinicians with an increased awareness about the resources and support needed by those suffering from the disorder.