Nonlinear relationships between anxiety and visual processing of own and others' faces in body dysmorphic disorder
Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
11/2012; 204(2-3). DOI: 10.1016/j.pscychresns.2012.09.003
Individuals with body dysmorphic disorder (BDD) often experience anxiety, as well as perceptual distortions of appearance. Anxiety has previously been found to impact visual processing. This study therefore tested the relationship between anxiety and visual processing of faces in BDD. Medication-free participants with BDD (N=17) and healthy controls (N=16) viewed photographs of their face and a familiar face during functional magnetic resonance imaging. Blood-oxygen-level dependent signal changes in regions involved in anxiety (amygdala) and detailed visual processing (ventral visual stream-VVS) were regressed on anxiety scores. Significant linear relationships between activity in the amygdala and VVS were found in both healthy controls and individuals with BDD. There was a trend of a quadratic relationship between anxiety and activity in the right VVS and a linear relationship between anxiety and activity in the left VVS for the BDD sample, and this was stronger for own-face stimuli versus familiar-face. Results suggest that anxiety symptoms in BDD may be associated with activity in systems responsible for detailed visual processing. This may have clinical implications related to heightened perceptual distortions associated with anxiety.
Available from: Steven Silverstein
- "The amygdala is also connected to both the ventral and dorsal visual streams; through these pathways, top-down signals may be carried to the visual cortex to enhance visual processing for emotionally salient stimuli (Furl et al., 2013), which may shift balances in global and local processing. In individuals with BDD, Bohon et al. (2012) found associations between brain activity in amygdala and in the ventral visual stream, as well as an association between anxiety and ventral visual stream activity, suggesting that arousal may increase processing of details in this population. "
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ABSTRACT: People with schizophrenia are impaired at organizing potentially ambiguous visual information into well-formed shape and object representations. This perceptual organization (PO) impairment has not been found in other psychiatric disorders. However, recent data on body dysmorphic disorder (BDD), suggest that BDD may also be characterized by reduced PO. Similarities between these groups could have implications for understanding the RDoC dimension of visual perception in psychopathology, and for modeling symptom formation across these two conditions. We compared patients with SCZ (n=24) to those with BDD (n=20), as well as control groups of obsessive-compulsive disorder (OCD) patients (n=20) and healthy controls (n=20), on two measures of PO that have been reliably associated with schizophrenia-related performance impairment. On both the contour integration and Ebbinghaus illusion tests, only the SCZ group demonstrated abnormal performance relative to controls; the BDD group performed similarly to the OCD and CON groups. In addition, on both tasks, the SCZ group performed more abnormally than the BDD group. Overall, these data suggest that PO reductions observed in SCZ are not present in BDD. Visual processing impairments in BDD may arise instead from other perceptual disturbances or attentional biases related to emotional factors.
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Available from: Jamie Feusner
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ABSTRACT: Anorexia nervosa (AN) and body dysmorphic disorder (BDD) are psychiatric disorders that involve distortion of the experience of one's physical appearance. In AN, individuals believe that they are overweight, perceive their body as "fat," and are preoccupied with maintaining a low body weight. In BDD, individuals are preoccupied with misperceived defects in physical appearance, most often of the face. Distorted visual perception may contribute to these cardinal symptoms, and may be a common underlying phenotype. This review surveys the current literature on visual processing in AN and BDD, addressing lower- to higher-order stages of visual information processing and perception. We focus on peer-reviewed studies of AN and BDD that address ophthalmologic abnormalities, basic neural processing of visual input, integration of visual input with other systems, neuropsychological tests of visual processing, and representations of whole percepts (such as images of faces, bodies, and other objects). The literature suggests a pattern in both groups of over-attention to detail, reduced processing of global features, and a tendency to focus on symptom-specific details in their own images (body parts in AN, facial features in BDD), with cognitive strategy at least partially mediating the abnormalities. Visuospatial abnormalities were also evident when viewing images of others and for non-appearance related stimuli. Unfortunately no study has directly compared AN and BDD, and most studies were not designed to disentangle disease-related emotional responses from lower-order visual processing. We make recommendations for future studies to improve the understanding of visual processing abnormalities in AN and BDD.
Available from: sciencedirect.com
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ABSTRACT: The recognition of self-face is a unique and complex phenomenon in many aspects, including its associated perceptual integration process, its emergence during development, and its socio-motivational effect. This may explain the failure of classical attempts to identify the cortical areas specifically responsive to self-face and designate them as a unique system related to ‘self’. Neuroimaging findings regarding self-face recognition seem to be explained comprehensively by a recent forward-model account of the three categories of self: the physical, interpersonal, and social selves. Self-face-specific activation in the sensory and motor association cortices may reflect cognitive scrutiny due to prediction error or task-induced top-down attention in the physical internal schema related to the self-face. Self-face-specific deactivation in some amodal association cortices in the dorsomedial frontal and lateral posterior cortices may reflect adaptive suppression of the default recruitment of the social-response system during face recognition. Self-face-specific activation under a social context in the ventral aspect of the medial prefrontal cortex and the posterior cingulate cortex may reflect cognitive scrutiny of the internal schema related to the social value of the self. The multi-facet nature of self-face-specific activation may hold potential as the basis for a multi-dimensional diagnostic tool for the cognitive system.
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