In one of the worst examples of health reporting I’ve seen today, a bunch of news outlets have equated “symptoms of a disorder” with having the disorder itself. It may seem like a subtle difference, but in the world of mental health diagnosis, having a symptom of a disorder is not the same as having the disorder itself.
The study in question was conducted on people seeking treatment for a nose job. To assess patients’ psychopathology, the researchers administered a bunch of psychological tests to the patients before their rhinoplasty. One of those tests was the Yale-Brown Obsessive Compulsive Scale modified for body dysmorphic disorder.
Now, the researchers only found a 2 percent rate of body dysmorphic disorder (BDD) among the 226 patients they tested. That rate is right in line with expectations for this disorder.
But they found a significant 33 percent of patients scored in the “moderate to severe” range of symptom severity on the modified Yale-Brown test.
Health reporters and their editors apparently didn’t understand or appreciate this distinction.
Nose job patients often mentally ill, study says by David W. Freeman writing for CBS News notes:
Of patients who were seeking the procedure to correct a breathing problem, only about 2 percent showed symptoms of BDD. But of those who wanted a nose job for cosmetic reasons, 43 percent showed symtoms of the disorder.
BDD was especially common among people with a history of mental illness, as well as those who had already had a nose job and were seeking “revision” surgery.
See what he did there? He went from talking about “symptoms of BDD” to then talking about BDD.
He also confused what the researchers found. The study found 2 percent of patients in the study met the actual diagnostic criteria for body dysmorphic disorder. They then found 33 percent scored in the moderate to severe range on a test designed to measure the severity of BDD symptoms. The test that measures severity is not a diagnostic test — it is a severity measure.
Of course, this subtlety is bound to be lost on most journalists reading the study. What does it mean when a group of people score as such on a test? The researchers don’t say, really, and the test used wasn’t designed to be used on a population of people who haven’t already been diagnosed with body dysmorphic disorder.
High rate of mental illness in those who seek nose jobs by Deborah Kotz writing for the Boston Globe says:
In fact, one-third of nose job seekers had moderate to severe symptoms of the disorder, according to a study published this week in the Journal of Plastic and Reconstructive Surgery. That rose to 43 percent of those seeking nose jobs purely for aesthetic reasons — and not to, say, breathe easier.
No mention of the fact that having symptoms of a disorder doesn’t make you “mentally ill.” That would be like saying that any time someone felt lonely or isolated — symptoms of depression — they would also be “mentally ill.”
The article Mental Disorder Behind Many Nose Job Patients on Fox News notes:
Many of the people who get nose jobs have a mental illness in which they obsess over a mostly imaginary bodily flaw, a new Belgian study suggests.
Seriously? That’s not what the study said at all. You don’t have to take my word for it; you can read the study for yourself here (free).
Labels and terms should mean something, shouldn’t they? Symptoms of a mental health issue doesn’t mean a person has that disorder. And the researchers complicated matters by using a test not designed to measure something it was put to use for.
A poor research design choice in my opinion made the poor reporting on this story inevitable. But still… it’s no excuse if people had actually spent 10 minutes digesting the distinction while reading the study.
Here’s our more skeptical take on the study: People Who Seek out a Nose Job Worry About Their Appearance