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Final Body Dysmorphic Disorder

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Joy Spriggs

on 11 October 2012

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Transcript of Final Body Dysmorphic Disorder

Body Dysmorphic Disorder (BDD) Jamie Michel Somatoform Disorder
Preoccupation with an imagined defect in appearance. If a slight physical anomaly is present, the person’s concern is markedly excessive.
The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.
The preoccupation is not better accounted for by another mental disorder (e.g., dissatisfaction with body shape and size in Anorexia Nervosa). DSM-IV-TR Criteria Varies from person to person
Fixation with face, head, and/or body
Excessive grooming
Constant mirror checking/avoidance
Skin picking
Camouflaging Features 1886
First recognized by Italian psychiatrist Enrico Morselli as “dysmorphophobia”
reported that patients experienced sudden fears of deformity and painful desperation
Emil Kraepelin described it as a mental malfunction leading to beauty based hypochondriasis
Freud described one of his patients as being so preoccupied about his nose that he was unable to function outside of his obsessive thoughts History Prevalence Equally distributed across gender
Believed to affect 5 million Americans (1 in 100)
Number could be higher because many victims are afraid to step forward because they don’t want to be misunderstood as being vain
Reported in countries, including the US, Canada, Australia, China, Japan, South America, and Russia,
Onset: Adolescence Socio-Cultural Biological Causes ? Genetic factors
8% of individuals with BDD have a family member with a lifetime diagnosis of BDD
BDD shares heredity with OCD, as 7% of BDD patients were found to have a first-degree relative with OCD

Brain Structure
right temporal lobe lesions
reproduce many of the symptoms seen in BDD, including abnormal visual perception, distortion of body image, anxiety, somatic preoccupations, and delusions. Biological Causes Teasing by peers/family
Emphasis culture places on outer beauty Socio-Cultural Causes Panic Disorder Agoraphobia Social Phobia Obsessive- Compulsive Disorder Depression Misdiagnosis Skeptics call BDD a “Western” disorder
Adolescence may be too young to diagnosis
More research needs to be conducted Other Implications Michael Jackson?
O: Your father would tease you about your pimples and your nose?
MJ: Yes he called me ‘big nose’ and everyday he would tell me I’m ugly.
MJ: I used not to look at myself. I washed my face in the dark. I wouldn't want to look in the mirror.
O: Are you pleased now with the way you look?
MJ: I'm never pleased with anything. I am a perfectionist.
O: And so when you look in the mirror now and the image that looks back you, are there days when you say "Wow, I look good…?"
MJ: No, I try not to look in the mirror, I really do, because I'm never happy with what I see. Interview with Oprah Winfrey (1993) Therapy
Cognitive-Behavioral Therapy**
Exposure and Response Prevention Treatment Medication
Serotonin-Reuptake Inhibitor anti-depressants
Interferes with brain chemicals (neurotransmitters), such as serotonin
takes 2-4 weeks before their effect builds up and start to work-- may take up to 12 weeks to work fully American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author. 
Buhlmann, U., Reese, H. E., Renaud, S., & Wilhelm, S. (2008). Clinical considerations for the treatment of body dysmorphic disorder with cognitive-behavioral therapy. Body Image, 5(1), 39-49. doi: 10.1016/j.bodyim.2007.12
Didie, E.R., Kelly, M.M., & Phillips, K.A. (2010). Clinical features of body dysmorphic disorder. Psychiatric Annals, 40(7), 310-316.
Feusner, J.D., Neziroglu, F., Wilhelm, S., Mancusi, L., & Bohon, C. (2010). What causes bdd: research finding and a proposed model. Psychiatric Annals, 40(7), 349-355. doi: 10.3928/0048571320100701-08. References
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