Body Dysmorphic Disorder (BDD) is an increasingly common anxiety disorder characterised by obsessive concerns with body image and perception which is prevalent more so in children and youth.
Causes and Risk Factors:
- Abuse or Neglect: Mistreatment, particularly during childhood either by a parent or at school increases the risk of developing obsessive compulsive disorders such as BDD[1]
- Family and Genetics: Those with a family member with BDD are at higher risk of developing the disorder too, mainly due to learnt behaviours. Some genetic traits can increase risk too, including those that overlap with OCD[2]
- Other Mental Disorders: Having other mental disorders such as anxiety or OCD increase vulnerability to developing BDD[3]
- Fear of Isolation: Someone may be made to feel that they need to shape their appearance to be accepted by a certain group such as models or bodybuilders, which can increase the risk of BDD
- Perfectionism: Individuals who have neurotic personalities are likely to become obsessive about their appearance, often exacerbated by the constant presentation of ‘perfect’ male and female bodies in the media[4]
Treatments:
- Cognitive Behavioural Therapy (CBT): CBT helps the patient recognise and understand their triggers for insecurities and anxiety surrounding body image. It helps them recognise that these beliefs are irrational and harmful and form a more realistic and positive view of their appearance.
- Exposure and Response Prevention: This is a common aspect of CBT when treating BDD, involving gradual exposure to a stimulus that can trigger body related anxiety such as being in crowded places. The ‘response prevention’ aspect involves working with the patient to reduce compulsive behaviours, such as constant mirror checking.
- Medication: Selective Serotonin Reuptake Inhibitors (SSRIs), typically used to treat depression can be effective in reducing BDD symptoms through regulating neurotransmitter levels[5]
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596
[1] Himanshu, A. K., Kaur, A., & Singla, G. (2020). Rising dysmorphia among adolescents: A cause for concern. Journal of family medicine and primary care, 9(2), 567.
[2] Monzani, B., Rijsdijk, F., Iervolino, A. C., Anson, M., Cherkas, L., & Mataix-Cols, D. (2012). Evidence for a genetic overlap between body dysmorphic concerns and obsessive-compulsive symptoms in an adult female community twin sample. American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics, 159B(4), 376–382. https://doi.org/10.1002/ajmg.b.32040
[3] Chandler, C. G., Grieve, F. G., Derryberry, W. P., & Pegg, P. O. (2009). Are anxiety and obsessive-compulsive symptoms related to muscle dysmorphia. International Journal of Men’s Health, 8(2), 143-154.
[4] Himanshu, A. K., Kaur, A., & Singla, G. (2020). Rising dysmorphia among adolescents: A cause for concern. Journal of family medicine and primary care, 9(2), 567.
[5] Vashi, N. A. (2016). Obsession with perfection: Body dysmorphia. Clinics in Dermatology, 34(6), 788-791.