Background and Objectives: Body dysmorphic disorder is a serious mental disorder characterized by symptoms related to delusional concerns about the body. The purpose of this study was to investigate the structural relationship between body dysmorphic disorder and psychological distress in university students, taking into account the mediating role of perfectionism and difficulty in emotion regulation.
Methods and Materials: In the present descriptive study, the statistical population included all the students of Islamic Azad University of Shahr-e-Qods Branch who were studying in this university in the academic year of 2022-2023. Using convenience sampling method, 336 of these students were selected and answered to the online form of Oosthuizen et al.'s Body Dysmorphic Questionnaire (1998), Hoviyat & Felt's Multidimensional Perfectionism Questionnaire (1991), Gretz and Romer's Difficulty in Emotion Regulation Scale (2004) and Kessler's Psychological Distress Questionnaire (2002). Pearson's correlation coefficient was used to check the association between research variables, and the conceptual model was checked using structural equation modeling.
Results: The results showed that body dysmorphic disorder affects psychological distress through perfectionism (p<0.001). Moreover, body dysmorphic disorder affects psychological distress through difficulty in regulating emotions (p<0.05).
Conclusions: The current study suggested that body dysmorphic disorder, mediated by perfectionism and difficulty in emotion regulation, plays a role in the occurrence of psychological distress in students. Accordingly, clinical psychologists and psychiatrists should consider the findings of this study as important theoretical and practical implications in the field of student psychopathology.
Keywords: Body dysmorphic disorder, Psychological distress, Perfectionism, Emotional regulation, Students

Funding: This study did not have any funds.
Conflict of interest: None declared.
Ethical considerations: The Ethics Committee of Islamic Azad University, Shahr-e-Qods Branch, approved the study (IR.IAU.QODS.REC.1402.103).
Authors’ contributions:
- Conceptualization: Leila Barekati
- Methodology: Leila Barekati, Mitra Ghasemi, Leila Shokouhi Amir Abadi
- Data collection: Leila Barekati
- Formal analysis: Leila Barekati
- Supervision: Mitra Ghasemi, Leila Shokouhi Amir Abadi
- Project administration: Leila Barekati
- Writing – original draft: Leila Barekati
- Writing – review & editing: Leila Barekati, Mitra Ghasemi, Leila Shokouhi Amir Abadi