Understanding the experience of relational accommodation for caregivers of an individual with body dysmorphic disorder: An interpretative phenomenological analysis

Psychol Psychother. 2026 Apr 23. doi: 10.1111/papt.70067. Online ahead of print.

ABSTRACT

OBJECTIVES: This study explored experiences of Relational Accommodation (RA) for caregivers and significant others living with an adult with Body Dysmorphic Disorder (BDD) and how they respond to BDD symptoms. BDD is under-researched. In paediatric and/or obsessive-compulsive populations, RA has been found to negatively impact the lives of caregivers. To date, very little is understood about RA in caregivers for adults with BDD and how this impacts the phenomenology of BDD. Given the high suicidality rates in BDD populations, and somewhat conservative treatment outcomes, a greater understanding is needed.

DESIGN: Eight caregivers, recruited from a BDD research conference and online support groups, were interviewed online about their experiences cohabiting with a loved one with BDD.

METHODS: Interviews were transcribed and subject to Interpretative Phenomenological Analysis (IPA).

RESULTS: Four Group Experiential Themes were interpreted from participants’ accounts: RA occurs in the context of Distress; RA and Self-concept are intertwined; Relational Gains and Losses; and Understanding of RA and BDD changes over time. Participant experiences of RA mirrored the OCD and/or paediatric BDD literature confirming the importance of this experience in BDD and extended existing knowledge by highlighting nuanced differences specific to being a caregiver of an adult with BDD.

CONCLUSIONS: Improved parent- and clinician-specific guidance around RA and parent peer support groups should be considered. Future research should seek to recruit a more diverse representation of the adult caregiver experience, including that beyond the parent-child dynamic.

PMID:42025579 | DOI:10.1111/papt.70067