Body Dysmorphic Disorder: New Research

Body Dysmorphic Disorder refers to the experience of being excessively concerned about and preoccupied by a perceived defect in one’s physical features. Unlike eating disorders, which mainly affect women, nearly as many men as women have body dysmorphic disorder. Body dysmorphic disorder is often related to childhood traumas like being teased about one’s looks, parental neglect, distress over parents’ divorce, or emotional, sexual or physical abuse. Recent research, abstracted below, also points to neurobiological underpinnings.

Abnormalities of Visual Processing and Frontostriatal Systems in Body Dysmorphic Disorder

Jamie D. Feusner, MD; Teena Moody, PhD; Emily Hembacher, BA; Jennifer Townsend, BA; Malin McKinley, MA; Hayley Moller; Susan Bookheimer, PhD

Arch Gen Psychiatry. 2010;67(2):197-205.

Context: Body dysmorphic disorder (BDD) is a psychiatric disorder in which individuals are preoccupied with perceived defects in their appearance, often related to their face. Little is known about its pathophysiology, although early research provides evidence of abnormal visual processing.

Objective: To determine whether patients with BDD have abnormal patterns of brain activation when visually processing their own face with high, low, or normal spatial resolution.

Design: Case-control study.

Setting: A university hospital.

Participants: Seventeen right-handed medication-free subjects with BDD and 16 matched healthy control subjects.

Intervention: Functional magnetic resonance imaging while viewing photographs of face stimuli. Stimuli were neutral-expression photographs of the patient’s own face and a familiar face (control stimuli) that were unaltered, altered to include only high spatial frequency (fine spatial resolution), or altered to include only low spatial frequency (low spatial resolution).

Main Outcome Measure: Blood oxygen level–dependent signal changes in the BDD and control groups during each stimulus type.

Results: Subjects with BDD showed relative hyperactivity in the left orbitofrontal cortex and bilateral head of the caudate for the unaltered own-face vs familiar-face condition. They showed relative hypoactivity in the left occipital cortex for the low spatial frequency faces. Differences in activity in frontostriatal systems but not visual cortex covaried with aversiveness ratings of the faces. Severity of BDD symptoms correlated with activity in frontostriatal systems and visual cortex.

Conclusions: These results suggest abnormalities in visual processing and frontostriatal systems in BDD. Hypoactivation in the occipital cortex for low spatial frequency faces may indicate either primary visual system abnormalities for configural face elements or top-down modulation of visual processing. Frontostriatal hyperactivity may be associated both with aversion and with symptoms of obsessive thoughts and compulsive behaviors.

Jamie D. Feusner; Teena Moody; Emily Hembacher; Jennifer Townsend; Malin McKinley; Hayley Moller; Susan Bookheimer, Abnormalities of Visual Processing and Frontostriatal Systems in Body Dysmorphic Disorder, Arch Gen Psychiatry. 2010;67(2):197-205.

Kathleen Young, Psy.D.

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This entry was posted in Abuse, Body Image, Eating Disorders, Emotional Abuse, Health, Mental Health, Physical Abuse, Psychologist, Sexual Abuse, Trauma and tagged , , , , , , , , , , , , . Bookmark the permalink.

3 Responses to Body Dysmorphic Disorder: New Research

  1. June says:

    I am not over it yet!


    Might be this blogs greatest post to date!!

  3. I’d do anything to not look in the mirror and see a monster.
    People don’t know about this battle. It’s…I hide it pretty well.
    My ex husband was a paedophile; his parents were just…nuts. Came from a very neglectful and not good background, there was a lot of abuse and a lot of insanity. My classmates from 1st grade on relentlessly bullied me. I was the UGLY GIRL for decades.
    Apparently my chin and jaw makes me look like Bruce Campbell in drag. That;s what my ex husband said. I’m appaerntly ugly and masculine.
    Even though my fiance is wonderful I’m somehow still so sad. I’m ugly. I can;t change it, so I became a bit of a crazy evangelical for a while. I still don’t wear makeup or pretty things or high heels. I still hide myself in long dresses that are two sizes too big, and i honestly kind of want to get a niqab to hide everything but my eyes.
    I’m scared that it’s only going to get worse as i get older.

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