Phenomenology of men with body dysmorphic disorder concerning penis size compared to men anxious about their penis size and to men without concerns: A cohort study

Abstract

Men with body dysmorphic disorder (BDD) may be preoccupied with the size or shape of the penis, which may be causing significant shame or impairment. Little is known about the characteristics and phenomenology of such men and whether they can be differentiated from men with small penis anxiety (SPA) (who do not have BDD), and men with no penile concerns. Twenty-six men with BDD, 31 men with SPA, and 33 men without penile concerns were compared on psychopathology, experiences of recurrent imagery, avoidance and safety-seeking behaviours. Men with BDD had significantly higher scores than both the SPA group and no penile concern group for measures of imagery, avoidance, safety seeking and general psychopathology. The groups differed on the phenomenology of BDD specific to penile size preoccupation clearly from the worries of SPA, which in turn were different to those of the men without concerns. The common avoidance and safety seeking behaviours were identified in such men that may be used clinically.

Environmental and physical risk factors for men to develop body dysmorphic disorder concerning penis size compared to men anxious about their penis size and men with no concerns: A cohort study

“…The same dataset was used to describe the phenomenology and characteristics of men with BDD concerning penis size (Veale et al, 2015b). The Queen Square NHS Research Ethics Committee granted ethics permission for the research (Reference 11/LO/0803).…”

“…In addition, there were no significant differences in the numbers of participants who self-measured their size from each group and so any bias that was introduced is likely to be small. It is possible that some of the risk may be mediated by general psychopathology but there was no significant difference between the BDD and SPA groups for co-morbidity (Veale et al, 2015b). The experience of teasing is based on self-report, which has a confirmatory bias based on hindsight.…”

“…We use the term "small penis anxiety" (SPA) to describe a condition that consists of dissatisfaction or worry about penis size where the man does not fulfil the criteria for BDD (Wylie & Eardley, 2007). In a previous study with this dataset (Veale et al, 2015b, in press), we identified men with BDD who had significantly higher scores than both the SPA group and no penile concern group for measures of imagery, avoidance, safety seeking and depression. They experienced significant interference in their life in terms of relationships and intimacy.…”

“…In order to tightly control the variable of interest, the focus of this study is on men in whom the size or shape of the penis is the main, if not their exclusive, preoccupation causing significant distress and shame (Veale et al, 2014(Veale et al, , 2015b. We use the term "small penis anxiety" (SPA) to describe a condition that consists of dissatisfaction or worry about penis size where the man does not fulfil the criteria for BDD (Wylie & Eardley, 2007).…”

Am I normal? A systematic review and construction of nomograms for flaccid and erect penis length and circumference in up to 15 521 men

“…Men may present to urologists or sexual medicine clinics with a concern with their penis size, despite their size falling within a normal range. This type of concern is commonly known as ‘small penis anxiety’ or ‘small penis syndrome’ . Some men who are preoccupied and severely distressed with the size of their penis may also be diagnosed with body dysmorphic disorder (BDD), where the preoccupation, excessive self‐consciousness and distress is focussed on their penis size or shape .…”