Body Dysmorphic Disorder by Stacey Westfall

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Body Dysmorphic Disorderby Stacey Westfall
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DSM-IV-TR Diagnostic Criteria

• Preoccupation with an imagined defect in
  appearance. If a slight physical anomaly is
  present, the persons 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., anorexia nervosa).
• Body Dysmorphic Disorder is classified as a
  somatoform disorder

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Areas of Dissatisfaction

• Involve imagined or slight flaws, most commonly
  of the face and head. Such as thinning hair,
  acne, wrinkles, scars, veins, facial asymmetry or
  complexion.
• Other common preoccupations include the shape,
  size, or some other aspect of the nose, eyes,
  eyelids, eyebrows, ears, mouth, lips, teeth, jaw,
  or chin.
• Any body part may be the focus of concern the
  genitals, breasts, buttocks, abdomen, arms,
  hands, feet, legs, muscularity, etc.

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Associated FeaturesThese behaviors may consume
many hours a day
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Co-morbid Disorders

• Body dysmorphic disorder is related to other
  psychiatric disorders, but because of the lack of
  studies preformed, it is not clear whether the
  following disorders predispose, cause, or coexist
  with BDD.
• Major depressive disorder
• Obsessive-compulsive disorder
• Anxiety disorders, especially social phobia
• Eating disorders

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DIFFERENTIAL DIAGNOSIS Body dysmorphic disorder
should not be diagnosed if the excessive
preoccupation is restricted to

• Concerns about being fat
• Discomfort with or a sense of inappropriateness
  about his or her primary and secondary sex
  characteristics
• Mood-congruent thoughts involving appearance that
  occurs exclusively during a
• Embarrassment of defect in appearance, in which
  the concern is not impairing, persistent,
  distressing, and time consuming
• Obsessions or compulsions that are not limited
  to concerns about appearance

• Anorexia Nervosa
• Gender Identity Disorder
• Major Depressive Episode
• Social Phobia
• Obsessive Compulsive Disorder

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DIFFERENTIAL DIAGNOSIS

• Differentiation of SCHIZOPHRENIA
• Bizarre delusions, and prominent hallucinations
  are not seen in body dysmorphic disorder.
• However, individuals may be diagnosed with
  Delusional Disorder, Somatic Type, if the
  preoccupation of the imagined defect is with a
  delusional intensity.

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The Typical Course of BDD

• Body dysmorphic disorder usually begins in
  adolescent years.
• The age of onset is around 14-17 years of age,
  and may come on either gradual or abruptly.
• BDD tends to be a chronic disease.
• Throughout a lifetime, the symptoms may become
  less severe at times, but rarely will be in full
  remission.

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Statistics

• Prevalence of BDD is not known, but its thought
  to be common, about 2 of the population.
• Although women seem to show more signs or
  concerns regarding their appearance, BDD tends to
  be equally distributed between men and women.

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Statistics

• Body dysmorphic symptoms are experienced more in
  adolescent girls than boys.
• Generally, adolescent girls and boys have
  different areas of concern.
• Girls are more disturbed by their lower bodies
  (legs, buttocks) and weight related issues.
• Boys are more disturbed by their upper bodies,
  and overall muscle mass.

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Demographics

• As a group, African Americans are less
  dissatisfied with their bodies than Caucasians,
  Asians, and Hispanics. Caucasians predominantly
  are affected most by BDD.
• Both, gender and ethnic background contribute to
  a persons vulnerability.
• Being African American may lower the risk of
  developing body dysmorphic disorder.

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Etiology

• The cause of body dysmorphic disorder remains
  unexplained.
• Several psychological, sociological, and
  neurobiological theories have been proposed.
• Continuous teasing about a person's appearance
  during adolescent years.
• Current research suggests that BDD is caused by a
  chemical imbalance in the braina lack of the
  neurotransmitter, serotonin.
• Serotonin helps transmit the signals that control
  thinking, feeling, and behavior. It regulates
  mood. Lack of serotonin may cause people to see
  themselves in distorted ways.

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Treatment
The most common forms of treatment are

• Cognitive-Behavioral Therapy
• Individuals identify their negative thoughts and
  replace them with alternative beliefs
• Exposure and response prevention
• Selective Serotonin-Reuptake Inhibitors
• Selective Serotonin-Reuptake Inhibitors (SSRIs)
  or antidepressant medications reduce the
  obsessive dysmorphic thoughts, the emotional
  distress, and the associated ritualistic
  behavior.
• Treatment with only medicine proves to be
  ineffective, because nearly all patients who quit
  the medicine relapse.

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Current Issues

• Plastic Surgery
• Plastic surgery is an unsuccessful treatment
  option for BDD.
• Most individuals who seek plastic surgery walk
  away feeling that their defect is worse, and
  disfigured in another way.
• Those who do feel the defect has been improved,
  shift their obsession to another feature of their
  body.

• Some people try to fix their defect themselves.
• A man who thought the skin on his face was too
  loose, so he used a staple gun on both sides to
  try to keep it taunt. The staples fell out ten
  minutes later. He was lucky he didnt damage
  any facial nerves.

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• Body Integrity Identity Disorder (BIID)
• An overwhelming desire to be an amputee

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Muscle Dysmorphia

• People with muscle dysmorphia obsess about being
  small, and they think that they are little.
• Even if they have good muscle mass, they believe
  their muscles are inadequate.
• Individuals with muscle dysmorphia tend to work
  out compulsively, and have a regime of using
  steroids or over-the-counter products, protein
  shakes, and nutritional supplements.

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Dennis Avner (Stalking Cat)
Doctors say that Stalking Cat displays a form
of body dysmorphic disorder, which affects one's
perception of personal appearance to the point
of obsession.
Lil Kim
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Michael Jackson
Jocelyn Wildenstein(Cat women)