Phenomenology and Epidemiology of Body Dysmorphic Disorder

2012 ◽  
Author(s):  
Megan M. Kelly ◽  
Katharine A. Phillips
Keyword(s):  
Psychotic Disorders ◽  
Body Dysmorphic Disorder ◽  
Repetitive Behaviors ◽  
Clinical Settings ◽  
Obsessive Compulsive ◽  
Prevalence Data ◽  
Compulsive Disorder ◽  
Bodily Appearance ◽  
Excessive Grooming

Body dysmorphic disorder (BDD) is an often severe DSM-IV disorder characterized by distressing or impairing preoccupations with imagined or slight defects in appearance. Individuals with BDD suffer from time-consuming obsessions about their bodily appearance and excessive repetitive behaviors (for example, mirror checking, excessive grooming, and skin picking). Functioning and quality of life are typically very poor, and suicidality rates appear markedly elevated. While prevalence data are still limited, they suggest that BDD affects 0.7% to 2.4% of the population; however, BDD typically goes unrecognized in clinical settings. In this chapter we discuss demographic and clinical features of BDD, prevalence, and morbidity. In addition, we discuss BDD’s relationship to obsessive compulsive disorder, hypochondriasis, and psychotic disorders.

A teenager who spends hours scrutinizing her skin

2021 ◽  
pp. 129-136
Author(s):  
Kevin M. Hill
Keyword(s):  
Selective Serotonin Reuptake Inhibitors ◽  
Body Dysmorphic Disorder ◽  
Behavioral Therapy ◽  
Repetitive Behaviors ◽  
Obsessive Compulsive ◽  
Trial Duration ◽  
Reasonable Approach ◽  
High Doses ◽  
Mental Acts ◽  
Excessive Grooming

Body dysmorphic disorder (BDD) is an obsessive-compulsive and related disorder characterized by a preoccupation with a perceived defect or flaw in physical appearance that is not observable or appears slight to others. Individuals with BDD engage in repetitive behaviors or mental acts in response to appearance concerns such as comparing, excessive grooming, skin picking, mirror checking, or reassurance seeking. Females are much more likely to be affected and the disorder typically begins in adolescence. Many patients do not divulge their symptoms to medical providers unless specifically asked. The first-line medication class for BDD is selective serotonin reuptake inhibitors (SSRIs). Patients with BDD tend to require relatively high doses of SSRIs, and a relatively longer trial duration of 12 to 16 weeks is required to determine response. Research on the most effective psychotherapeutic treatments remains limited; however, cognitive behavioral therapy (CBT) may be a reasonable approach.

Obsessive Compulsive Spectrum Disorders in Children and Adolescents

2012 ◽  
Author(s):  
Eric A. Storch ◽  
Omar Rahman ◽  
Mirela A. Aldea ◽  
Jeannette M. Reid ◽  
Danielle Bodzin ◽  
...  
Keyword(s):  
Children And Adolescents ◽  
Clinical Characteristics ◽  
Body Dysmorphic Disorder ◽  
Repetitive Behaviors ◽  
Future Research ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Augmentation Strategies ◽  
Spectrum Disorders

This chapter reviews the literature on obsessive compulsive spectrum disorders (i.e., obsessive compulsive disorder, body dysmorphic disorder, trichotillomania, Tourette syndrome, and varied body-focused repetitive behaviors) in children and adolescents. For each disorder, data on phenomenology, associated clinical characteristics, etiology, and treatment are reviewed. The chapter concludes with a discussion of future research and clinical directions, such as novel augmentation strategies, diagnostic classification of obsessive compulsive spectrum disorders, and methods of maximizing treatment outcome.

Obsessive–Compulsive and Related Disorders

2018 ◽  
Author(s):  
Lara J. Farrell ◽  
Sharna L. Mathieu ◽  
Cassie Lavell
Keyword(s):  
Body Dysmorphic Disorder ◽  
Psychological Treatment ◽  
Behavioral Therapy ◽  
Repetitive Behaviors ◽  
Evidence Based ◽  
Obsessive Compulsive ◽  
Empirically Supported Treatment ◽  
Compulsive Disorder ◽  
Empirically Supported ◽  
Evidence Based Treatments

Obsessive compulsive and related disorders (OCRDs) in children and adolescents represent a cluster of conditions that significantly interfere in the lives of sufferers and their families. These disorders involve repetitive behaviors and often a preoccupation with distressing, obsessional thoughts. OCRDs include obsessive–compulsive disorder (OCD), body dysmorphic disorder (BDD), hoarding disorder, trichotillomania, and excoriation disorder. The severity, functional impairment, and associated health conditions of these disorders call for timely evidence-based assessment and treatment. Evidence-based assessments include structured and semistructured interviews. Interviews allow for the assessment of symptoms, comorbid conditions, and differential diagnoses. Evidence-based psychological treatment for OCD and BDD in youth involves cognitive behavioral therapy with exposure and response prevention; research is required to determine evidence-based assessment and treatments for less studied OCRDs; identify factors that predict poorer response to evidence-based treatment; develop approaches to augment evidence-based treatments for nonresponders; and further the reach of empirically supported treatment.

scholarly journals The Mouse Who Couldn't Stop Washing: Pathologic Grooming in Animals and Humans

CNS Spectrums ◽  
2009 ◽  
Vol 14 (9) ◽  
pp. 503-513 ◽  
Author(s):  
Jamie D. Feusner ◽  
Emily Hembacher ◽  
Katharine A. Phillips
Keyword(s):  
Animal Models ◽  
Basic Science ◽  
Body Dysmorphic Disorder ◽  
Science Literature ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Naturally Occurring ◽  
Psychiatric Conditions ◽  
Complex Cognition ◽  
Excessive Grooming

ABSTRACTThe basic science literature is replete with descriptions of naturally occurring or experimentally induced pathological grooming behaviors in animals, which are widely considered animal models of obsessive-compulsive disorder (OCD). These animal models rely largely on observed similarities between animal behaviors and human OCD behaviors, and on studies of animal pathological grooming disorders that respond to serotonin enhancing drugs. However, current limitations in assessment of complex cognition and affect in animals precludes the field's ability to match the driving primary processes behind observable phenomenology in animal “OCD” with human behavioral disorders. We propose that excessive grooming behaviors in animals may eventually prove to be equally, or possibly more relevant to, other conditions in humans that involve pathological grooming or grooming-like behaviors, such as trichotillomania, body dysmorphic disorder, olfactory reference syndrome, compulsive skin-picking, and onychophagia. Research is needed to better understand pathological grooming behaviors in both humans and animals, as animal models have the potential to elucidate pathogenic mechanisms and inform the treatment of these psychiatric conditions in humans.

Face and Object Perception in Body Dysmorphic Disorder versus Obsessive-Compulsive Disorder: The Mooney Faces Task

2017 ◽  
Vol 23 (6) ◽  
pp. 471-480 ◽  
Author(s):  
Wei Lin Toh ◽  
David J. Castle ◽  
Susan L. Rossell
Keyword(s):  
Obsessive Compulsive Disorder ◽  
Body Dysmorphic Disorder ◽  
Clinical Symptoms ◽  
Object Perception ◽  
Repetitive Behaviors ◽  
The Other ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Perceptual Anomalies ◽  
Mental Acts

AbstractObjectives: Body dysmorphic disorder (BDD) is characterized by repetitive behaviors and/or mental acts occurring in response to preoccupations with perceived defects or flaws in physical appearance. There are some similarities, but also important differences, between BDD and obsessive-compulsive disorder (OCD), not just in terms of core clinical symptoms, but possibly in the domain of perception. This study compared the nature and extent of perceptual anomalies in BDD versus OCD and health controls (HC), using a modified Mooney task. Methods: We included 21 BDD, 19 OCD, and 21 HC participants, who were age-, sex-, and IQ-matched. A set of 40 Mooney faces and 40 Mooney objects arranged in three configurations (i.e., upright, inverted, or scrambled) were presented under brief (i.e., 500 ms) free-viewing conditions. Participants were asked to decide whether each image represented a human face, an object, or neither in a forced-choice paradigm. Results: The BDD group showed significantly reduced face and object inversion effects relative to the other two groups. This was accounted for by BDD participants being significantly more accurate in identifying inverted Mooney faces and objects than the other participants. Conclusions: These data were interpreted as reflecting an overreliance on independent components at the expense of holistic (configural) processing in BDD. (JINS, 2017, 23, 471–480)

Differentiating Body Dysmorphic Disorder from Normal Appearance Concerns and Other Mental Disorders

2017 ◽  
Author(s):  
Katharine A. Phillips
Keyword(s):  
Anxiety Disorder ◽  
Social Anxiety ◽  
Psychotic Disorders ◽  
Body Dysmorphic Disorder ◽  
Obsessive Compulsive ◽  
Normal Appearance ◽  
Compulsive Disorder ◽  
Illness Anxiety ◽  
Hair Pulling Disorder ◽  
Skin Picking Disorder

This chapter discusses differentiation of body dysmorphic disorder (BDD) from disorders that may be misdiagnosed as BDD or that present differential diagnosis challenges: eating disorders, major depressive disorder, obsessive-compulsive disorder, trichotillomania (hair-pulling disorder), excoriation (skin-picking) disorder, illness anxiety disorder, social anxiety disorder, agoraphobia, panic disorder, generalized anxiety disorder, schizophrenia and other psychotic disorders, gender dysphoria, avoidant personality disorder, olfactory reference syndrome, and several other constructs. This chapter also discusses how to differentiate BDD from normal appearance concerns and from problematic preoccupation with obvious physical defects.BDD is commonly misdiagnosed as another mental disorder. Sometimes misdiagnosis occurs because patients are too embarrassed and ashamed to reveal their appearance concerns; in such cases, BDD symptoms that are more readily observable (such as social anxiety) may be assigned an incorrect diagnosis while BDD goes undetected. In other cases, BDD symptoms are recognized but are misdiagnosed as another disorder. BDD must be differentiated from other conditions so appropriate treatment can be instituted.

A Comparison of Quality of Life and Psychosocial Functioning in Obsessive-Compulsive Disorder and Body Dysmorphic Disorder

2007 ◽  
Vol 19 (3) ◽  
pp. 181-186 ◽  
Author(s):  
Elizabeth R. Didie ◽  
Anthony Pinto ◽  
Maria Mancebo ◽  
Steven A. Rasmussen ◽  
Katharine A. Phillips ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Obsessive Compulsive Disorder ◽  
Psychosocial Functioning ◽  
Body Dysmorphic Disorder ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

Why Can’t I Stop Thinking About It?

2015 ◽  
Vol 74 (2) ◽  
pp. 75-82 ◽  
Author(s):  
Monique C. Pfaltz ◽  
Beatrice Mörstedt ◽  
Andrea H. Meyer ◽  
Frank H. Wilhelm ◽  
Joe Kossowsky ◽  
...  
Keyword(s):  
Thought Suppression ◽  
Positive Association ◽  
Repetitive Behaviors ◽  
Thought Processes ◽  
Obsessive Compulsive ◽  
Vulnerability Factor ◽  
Compulsive Disorder ◽  
Order Factor ◽  
Maladaptive Thought ◽  
Severe Anxiety

Obsessive-compulsive disorder (OCD) is a severe anxiety disorder characterized by frequent obsessive thoughts and repetitive behaviors. Neuroticism is a vulnerability factor for OCD, yet the mechanisms by which this general vulnerability factor affects the development of OCD-related symptoms are unknown. The present study assessed a hierarchical model of the development of obsessive thoughts that includes neuroticism as a general, higher-order factor, and specific, potentially maladaptive thought processes (thought suppression, worry, and brooding) as second-order factors manifesting in the tendency toward obsessing. A total of 238 participants completed questionnaires assessing the examined constructs. The results of mediator analyses demonstrated the hypothesized relationships: A positive association between neuroticism and obsessing was mediated by thought suppression, worry, and brooding. Independent of the participant’s sex, all three mediators contributed equally and substantially to the association between neuroticism and obsessing. These findings extend earlier research on hierarchical models of anxiety and provide a basis for further refinement of models of the development of obsessive thoughts.

scholarly journals Mindfulness-based and acceptance-based programmes in the treatment of obsessive–compulsive disorder: a study protocol for a systematic review and meta-analysis

BMJ Open ◽  
2021 ◽  
Vol 11 (6) ◽  
pp. e050329
Author(s):  
Johannes Julian Bürkle ◽  
Johannes Caspar Fendel ◽  
Stefan Schmidt
Keyword(s):  
Systematic Review ◽  
Depressive Symptoms ◽  
Obsessive Compulsive Disorder ◽  
Meta Analysis ◽  
Sensitivity Analyses ◽  
Secondary Outcome ◽  
Controlled Trials ◽  
Obsessive Compulsive ◽  
Compulsive Disorder

IntroductionCognitive–behavioural therapy (CBT) with exposure and response prevention is the recommended standard for the treatment of obsessive–compulsive disorder (OCD). However, a high proportion of patients refuse this treatment, do not respond or relapse shortly after treatment. Growing evidence suggests that mindfulness-based and acceptance-based programmes (MABPs) are an effective option for the treatment of OCD. This systematic review and meta-analysis will examine the effectiveness of MABPs in treating OCD. We also aimed to explore potential moderators of the programmes’ effectiveness.Methods and analysisWe will systematically search MEDLINE, Embase, PsycINFO, PSYINDEX, Web of Science, CINAHL and Cochrane Register of Controlled Trials (no language restrictions) for studies that evaluate the effect of MABPs on patients with OCD. We will conduct backward and forward citation searches of included studies and relevant reviews and contact corresponding authors. The primary outcome will be pre-post intervention change in symptom severity. A secondary outcome will be change in depressive symptoms. Two reviewers will independently screen the records, extract the data and rate the methodological quality of the studies. We will include both controlled and uncontrolled trials. Randomised controlled trials will be meta-analysed, separately assessing between-group effects. A second meta-analysis will assess the within-group effect of all eligible studies. We will explore moderators and sources of heterogeneity such as the specific programme, study design, changes in depressive symptoms, hours of guided treatment, control condition and prior therapy (eg, CBT) using metaregression and subgroup analyses. We will perform sensitivity analyses using follow-up data. A narrative synthesis will also be pursued. We will use the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to assess the quality of the evidence.Ethics and disseminationEthical approval is not required. Results will be published in peer-reviewed journals and presented at international conferences.

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