What is Body Dysmorphic Disorder?

Body dysmorphic disorder (BDD) is a brain disorder that creates faulty and inaccurate perceptions about your appearance. For some people you can even have delusional beliefs that make you think the flaws you see are an accurate perception.

Here is the criteria for this according to the diagnostic and statistical manual of mental disorders 5th edition.

Preoccupation with one or more perceived defects or flaws in physical appearance that are not observable or appear slight to others.

You perform repetitive behaviors in response to the appearance concerns.

The preoccupation causes distress or impairment in social, occupational, or other important areas of functioning.

The preoccupation is not better explained by concerns with body fat or weight in an individual whose symptoms meet diagnostic criteria for an eating disorder.

The majority of people (about 2/3) start having this problem in childhood or adolescence. The most common body area to be focused on is the face or head. The head would be things like insisting your ears are too large or misaligned.

In this video I discuss a case of what body dysmorphic disorder looks like and use examples from that case to discuss the criteria.

Body dysmorphic disorder is grouped with the obsessive-compulsive disorders because of the obsession with having a physical flaw with your body and the rituals and behaviors you engage in. Likewise, the way we treat this disorder is similar to OCD, a combination of medication and cognitive behavior therapy.

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Here are some helpful resources
Resources
• Phillips KA. The broken mirror. New York: Oxford University Press; 2005.
Body Dysmorphic Foundation https://bddfoundation.org

References
Barnhill, John, et.al. Obsessive-Compulsive and Related Disorders DSM-5® Clinical Cases. August 2013

Feusner JD, Hembacher E, Moller H, Moody TD. Abnormalities of object visual processing in body dysmorphic disorder. Psychol Med. 2011;41(11):2385–2397.

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