Body dysmorphic disorder: Some key issues for DSM-V

Depression and Anxiety (Impact Factor: 4.41). 06/2010; 27(6):573 - 591. DOI: 10.1002/da.20709
Source: PubMed


Body dysmorphic disorder (BDD), a distressing or impairing preoccupation with an imagined or slight defect in appearance, has been described for more than a century and increasingly studied over the past several decades. This article provides a focused review of issues pertaining to BDD that are relevant to DSM-V. The review presents a number of options and preliminary recommendations to be considered for DSM-V: (1) Criterion A may benefit from some rewording, without changing its focus or meaning; (2) There are both advantages and disadvantages to adding a new criterion to reflect compulsive BDD behaviors; this possible addition requires further consideration; (3) A clinical significance criterion seems necessary for BDD to differentiate it from normal appearance concerns; (4) BDD and eating disorders have some overlapping features and need to be differentiated; some minor changes to DSM-IV's criterion C are suggested; (5) BDD should not be broadened to include body integrity identity disorder (apotemnophilia) or olfactory reference syndrome; (6) There is no compelling evidence for including diagnostic features or subtypes that are specific to gender-related, age-related, or cultural manifestations of BDD; (7) Adding muscle dysmorphia as a specifier may have clinical utility; and (8) The ICD-10 criteria for hypochondriacal disorder are not suitable for BDD, and there is no empirical evidence that BDD and hypochondriasis are the same disorder. The issue of how BDD's delusional variant should be classified in DSM-V is briefly discussed and will be addressed more extensively in a separate article. Depression and Anxiety, 2010. © 2010 Wiley-Liss, Inc.

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    • "A growing amount of literature indicates that for both males and females, their perception of their own ''fatness,'' ''leanness'' and/or ''muscularity''—not just their actual weight status—plays a role in the extent to which they experience body dissatisfaction and body image distortion (Eisenberg et al. 2012). In addition, the perception of one's muscularity plays a critical role in the diagnosis of body dysmorphic disorder, a severe form of mental illness that has a lifetime prevalence of approximately 2 % (Phillips et al. 2010). Given this information, future work that incorporates perceptual measures of adiposity and muscularity and the extent to which these variables impact the body image distortion experiences of immigrant adolescents , is warranted. "
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    ABSTRACT: Immigrant adolescents represent a significant and growing proportion of the population in the United States. Yet, little is known about their experiences of body image distortion. This is particularly concerning given that body image distortion has been identified as a significant and modifiable risk factor for a number of mental illnesses, including depression and eating disorders. This study uses multi-level modeling to examine the associations between immigrant generational status, neighborhood immigrant concentration, sex, body dissatisfaction and risk for body image distortion. Data come from the National Longitudinal Study of Adolescent Health and includes 10,962 11-19 year olds (49.6 % female). First generation immigrant females were significantly more likely than 3rd generation-or-later adolescents to experience underweight body image distortion. There was no association between neighborhood immigrant concentration and risk for body image distortion. Body dissatisfaction was associated with greater risk for underweight and overweight body image distortion, with the magnitude of underweight distortion risk significantly greater among 1st generation immigrants. Interventions that encourage the development of a healthy body image have the potential to reduce the onset and duration of body image distortion among immigrant and non-immigrant adolescents.
    Journal of Youth and Adolescence 07/2015; 44(11). DOI:10.1007/s10964-015-0329-6 · 2.72 Impact Factor
    • "The literature on the neuroscientific correlates of body dysmorphia is in its infancy. The condition was described at the beginning of the last century, but was only added as dysmorphophobia to somatoform disorders in the DSM-Itr and as body dysmorphia to somatoform disorders in the DSM-IV (see Phillips et al., 2010, p. 574 for some historical details). Models, in particular those considering comprehensive neuroscientific explanations, are yet to be established with first accounts being recentþ put forward (e.g., Feusner, Neziroglu, Wilhelm, Mancusi, & Saxena, 2010). "
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    ABSTRACT: The major features in eating disorders are a preoccupation with food and its consumption and body dissatisfaction. Diagnostic manuals provide clusters of criteria according to which affected individuals can be categorized into one or other group of eating disorder. Yet, when considering the high proportion of comorbidities and ignoring the content of the symptoms (food, body), the major features seem to yield obsessional-compulsive, addictive, and impulsive qualities. In the present article, we review studies from the neuroscientific literature (mainly lesion studies) on eating disorder, obsessive-compulsive disorder, impulse control disorder, and addiction to investigate the possibility of a wider phenotype that can be related to a common brain network. The literature localizes this network to the right frontal lobe and its connectivities. This network, when dysfunctional, might result in a behavior that favors the preoccupation with particular thoughts, behaviors, anxieties, and uncontrollable urges that are accompanied by little scope for ongoing behavioral adjustments (e.g., impulse control). We reason that this network may turn out to be equally involved in understudied mental conditions of dysfunctional body processing such as muscle dysmorphia, body dysmorphic disorder (including esthetic surgery), and xelomelia. We finally consider previous notions of a wider phenotype approach to current diagnostic practice (using DSM), such as the possibility of a model with a reduced number of diagnostic categories and primary and secondary factors, and to etiological models of mental health conditions.
    European Psychologist 01/2015; 1(-1):1-10. DOI:10.1027/1016-9040/a000203 · 1.31 Impact Factor
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    • "Cognitive models of both OCD and BDD propose that maladaptive cognitions maintain and exacerbate these disorders (Rachman, 1997; Wilhelm & Neziroglu, 2002; Wilhelm & Steketee, 2006). A further discussion of the relationship between BDD and OCD, and the inclusion of BDD on the putative obsessivecompulsive spectrum is discussed elsewhere (for a review, see Phillips et al., 2010). The current paper will focus on the relationship between BDD and SAD. "
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    ABSTRACT: Social anxiety disorder and body dysmorphic disorder are considered nosologically distinct disorders. In contrast, some cognitive models suggest that social anxiety disorder and body dysmorphic disorder share similar cognitive maintenance factors. The aim of this study was to examine the effects of psychological treatments for social anxiety disorder on body dysmorphic disorder concerns. In Study 1, we found that 12 weekly group sessions of cognitive-behavioral therapy led to significant decreases in body dysmorphic symptom severity. In Study 2, we found that an attention retraining intervention for social anxiety disorder was associated with a reduction in body dysmorphic concerns, compared to a placebo control condition. These findings support the notion that psychological treatments for individuals with primary social anxiety disorder improve co-occurring body dysmorphic disorder symptoms.
    Journal of anxiety disorders 08/2013; 27(7):684-691. DOI:10.1016/j.janxdis.2013.07.005 · 2.68 Impact Factor
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