Beauty and the beast: Psychobiologic and evolutionary perspectives on body dysmorphic disorder (original) (raw)
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The role of aesthetic sensitivity in body dysmorphic disorder
Journal of Abnormal Psychology, 2011
Individuals with a higher aesthetic sensitivity may be more vulnerable to developing body dysmorphic disorder (BDD). Aesthetic sensitivity has 3 components: (a) perceptual, (b) emotional, and (c) evaluative. Individuals with BDD (n ϭ 50) were compared with a control group of individuals with an education or employment in art and design related fields (n ϭ 50) and a control group of individuals without aesthetic training (n ϭ 50). A facial photograph of each participant was manipulated to create a 9-image symmetry continuum. Presented with the continuum on a computer, participants were required to select and rate the image representing their self-actual, self-ideal, idea of perfect, most physically attractive, most pleasure, and most disgust. Control symmetry continua examined the specificity of the disturbance. As predicted, BDD participants displayed no distortion in their perceptual processing but were disturbed in their negative emotional/evaluative processing of their self-image. A significant discrepancy between their self-actual and self-ideal, resulting from an absent self-serving bias in their self-actual (a bias exhibited by controls) appears to be the source of their disturbance. They also overvalued the importance of appearance and self-objectified. These aesthetic evaluations may predispose individuals to BDD and/or maintain the disorder.
Body Dysmorphic Disorder: Neurobiological Features and an Updated Model
Zeitschrift für Klinische Psychologie und Psychotherapie, 2013
Body dysmorphic disorder (BDD) affects approximately 2 % of the population and involves misperceived defects of appearance along with obsessive preoccupation and compulsive behaviors. There is evidence of neurobiological abnormalities associated with symptoms in BDD, although research to date is still limited. This review covers the latest neuropsychological, genetic, neurochemical, psychophysical, and neuroimaging studies, and synthesizes these findings into an updated (yet still preliminary) neurobiological model of the pathophysiology of BDD. We propose a model in which visual perceptual abnormalities, along with frontostriatal and limbic system dysfunction, may combine to contribute to the symptoms of impaired insight, obsessive thoughts, and compulsive behaviors expressed in BDD. Further research is necessary to gain a greater understanding of the etiology of BDD symptoms and their evolution over time.
Selective attention to imagined facial ugliness is specific to body dysmorphic disorder
Body Image, 2012
Cognitive-behavioral models postulate that biases in selective attention are key factors contributing to susceptibility to and maintenance of body dysmorphic disorder (BDD). Visual attention in particular toward the imagined defect in appearance may be a crucial element. The present study therefore examined whether individuals with BDD showed increased visual attention to flaws in their own and in unfamiliar faces. Twenty individuals with BDD, 20 individuals with social phobia, and 20 mentally healthy individuals participated in an eye-tracking experiment. Participants were instructed to gaze at the photographs of 15 pictures of themselves and several unfamiliar faces. Only patients with BDD showed heightened selective visual attention to the imagined defect in their own face, as well to corresponding regions in other, unfamiliar faces. The results support the assumption that there is a specific attentional bias in BDD.
The pathophysiology of body dysmorphic disorder
Body Image, 2008
Body dysmorphic disorder (BDD) is an often severe and disabling condition, affecting up to 2% of the population. Despite its prevalence and clinical significance, very little is known about the pathophysiology of BDD. However, clues to its possible neurobiological substrates and abnormalities in information processing are starting to emerge. This article reviews findings from genetic, brain lesion, neuroimaging, neuropsychological, and psychopharmacological studies that have allowed us to develop a tentative model of the functional neuroanatomy of BDD. There is likely a complex interplay of dysfunctions in several brain networks underlying the pathophysiology of BDD. A combination of dysfunctions in frontal-subcortical circuits, temporal, parietal, and limbic structures, and possibly involving hemispheric imbalances in information processing, may produce both the characteristic symptoms and neurocognitive deficits seen in BDD. An improved understanding of the pathophysiology of BDD will be crucial to guide the development of better treatments. #
International Journal of Cognitive Therapy, 2011
Body Dysmorphic Disorder (BDD) has only recently received attention in current research. As such, little is understood with regards to the underlying cognitive impairments and neurobiological substrates implicated in this disorder. The current report provides first, a review of the background of BDD; second, a description of the clinical features of three BDD cases; and last, the outcomes from a cognitive assessment administered to three BDD cases. The cognitive assessment included (a) executive function, (b) facial affect perception, and (c) general social cognition. All three BDD cases illustrated many of the disorder's clinical features such as excessive disproportionate concerns about their appearance, repetitive (checking) behaviours, and camouflaging. Further, they experience significant distress and impairment in social, occupational, and other important areas of functioning. They also demonstrated poor self-esteem, greater self-ambivalence, and more pronounced delusional thinking than a comparison group of ten healthy controls. The cognitive assessment demonstrated deficits in executive functioning and facial affect perception, but not in general social cognition. The findings implicate frontalamygdala and temporal-parietal pathology in BDD although neuroimaging studies are needed to confirm this speculation. The implications of our findings for the treatment of BDD are discussed.
Journal of Obsessive-Compulsive and Related Disorders, 2014
The descriptive phenomenology of Body Dysmorphic Disorder (BDD) is well known in terms of the content of the beliefs, the attentional biases and the nature of the repetitive behaviors. Less has been written about the function of BDD symptoms in relationship to a perceived threat of a distorted body image and past aversive experiences. This article therefore explores the functional and evolutionary contexts of the phenomenology of BDD as part of threat based safety strategies. The attentional bias and checking are discussed in terms of threat detection and monitoring. Behaviors such as comparing self with others and camouflaging appearances have the function of monitoring and avoiding social threats such as social contempt, shame, rejection and ridicule from others. These fears may be rooted in early aversive emotional memoires. People with BDD may find it difficult to engage in therapy if they do not have a good understanding of the context and function of their behaviors and if the memories of past aversive experiences (e.g., of rejections and shame) have not been emotionally processed. In addressing these social threats we discuss how the mammalian attachment and affiliation based emotions need to be recruited as part of the therapeutic process. These affiliative processing systems underpin a compassionate orientation to working with people with BDD and their capacity for engaging in the change process.
Visual Information Processing of Faces in Body Dysmorphic Disorder
Archives of General Psychiatry, 2007
Context: Body dysmorphic disorder (BDD) is a severe psychiatric condition in which individuals are preoccupied with perceived appearance defects. Clinical observation suggests that patients with BDD focus on details of their appearance at the expense of configural elements. This study examines abnormalities in visual information processing in BDD that may underlie clinical symptoms. Objective: To determine whether patients with BDD have abnormal patterns of brain activation when visually processing others' faces with high, low, or normal spatial frequency information.
Body dysmorphic disorder (BDD) concerns may be on a continuum with normal appearance concerns, differing only quantitatively. As emerging evidence suggests that an increased aesthetic sensitivity plays a role in BDD, individuals withBDD(n = 50) were compared with a control group of individuals with an education or employment in art and design related fields (n = 50) and a control group of individuals without aesthetic training (n = 50). Participants completed a demographic questionnaire and a series of measures for depression, BDD symptomatology, and body image. Most controls (with and without aesthetic training) reported appearance concerns and expressed comparable ideals to those with BDD. However, BDD participants differed by using negative, emotive, and morally based descriptions for their defect(s), spending a greater time preoccupied with their defect(s) causing increased interference with functioning, performing appearance-related behaviors more frequently, and experiencing greater distress when performing those behaviors.
CNS spectrums, 2017
Introduction Body dysmorphic disorder (BDD) is a debilitating disorder, characterized by obsessions and compulsions relating specifically to perceived appearance, and which has been newly classified within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Obsessive-Compulsive and Related Disorders grouping. Until now, little research has been conducted into the cognitive profile of this disorder. Participants with BDD (n=12) and participants without BDD (n=16) were tested using a computerized neurocognitive battery investigating attentional set-shifting (Intra/Extra Dimensional Set Shift Task), decision-making (Cambridge Gamble Task), motor response-inhibition (Stop-Signal Reaction Time Task), and affective processing (Affective Go-No Go Task). The groups were matched for age, IQ, and education. In comparison to controls, patients with BDD showed significantly impaired attentional set-shifting, abnormal decision-making, impaired response inhibition, an...