Abstract
Body dysmorphic disorder (BDD) is a complex disease with multifactorial etiology and subsequent pathophysiology. The exact sequence of events, including what risk factors are crucial in the development of BDD, is still unknown. BDD is the result of multiple risk factors, including a combination of biological, psychological, and sociocultural etiologic agents, that culminate in the development of this disorder. First, the role of biological factors is discussed. Subjects with BDD often have altered neuroanatomy, impaired neuronal processing, quantitative differences in specific neurotransmitters, and a genetic predisposition to develop BDD. Next, an assessment of the psychological factors is considered, including the importance of childhood adversity and various personality traits. These factors are evaluated in the context of multiple learning theories in order to supplement the current understanding of BDD pathogenesis. Sociocultural factors including gender, culture, and media are also examined. Understanding the etiology and pathogenesis of BDD is crucial to the prevention and treatment of this disorder.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Carey P, Seedat S, Warwick J, van Heerden B, Stein DJ. SPECT imaging of body dysmorphic disorder. J Neuropsychiatr Clin Neurosci. 2004;16(3):357–9.
Trimble MR. Body image and the temporal lobes. Br J Psychiatry Suppl. 1988;2:12–4.
Rauch SL, Phillips KA, Segal E, Makris N, Shin LM, Whalen PJ, Jenike MA, Caviness VS, Jr., Kennedy DN. A preliminary morphometric magnetic resonance imaging study of regional brain volumes in body dysmorphic disorder. Psychiatry Res. 2003;122(1):13–9.
Feusner JD, Townsend J, Bystritsky A, McKinley M, Moller H, Bookheimer S. Regional brain volumes and symptom severity in body dysmorphic disorder. Psychiatry Res. 2009;172(2):161–7.
Phillips KA. The broken mirror: understanding and treating body dysmorphic disorder. New York: Oxford University Press; 2005.
Phillips KA. Understanding body dysmorphic disorder: an essential guide. New York: Oxford University Press, Inc.; 2009.
Atmaca M, Bingol I, Aydin A, Yildirim H, Okur I, Yildirim MA, Mermi O, Gurok MG. Brain morphology of patients with body dysmorphic disorder. J Affect Disord. 2010;123(1–3):258–63.
Deckersbach T, Savage CR, Phillips KA, Wilhelm S, Buhlmann U, Rauch SL, Baer L, Jenike MA. Characteristics of memory dysfunction in body dysmorphic disorder. J Int Neuropsychol Soc. 2000;6(6):673–81.
Feusner JD, Townsend J, Bystritsky A, Bookheimer S. Visual information processing of faces in body dysmorphic disorder. Arch Gen Psychiatry. 2007;64(12):1417–25.
Yaryura-Tobias JA, Neziroglu F, Chang R, Lee S, Pinto A, Donohue L. Computerized perceptual analysis of patients with body dysmorphic disorder: a pilot study. CNS Spectr. 2002;7(6):444–6.
Feusner JD, Moller H, Altstein L, Sugar C, Bookheimer S, Yoon J,Hembacher E. Inverted face processing in body dysmorphic disorder. J Psychiatr Res. 2010;44(15):1088–94.
Feusner JD, Hembacher E, Moller H, Moody TD. Abnormalities of object visual processing in body dysmorphic disorder. Psychol Med. 2011;41(11):2385–97.
Kaplan RA, Rossell SL, Enticott PG, Castle DJ. Own-body perception in body dysmorphic disorder. Cogn Neuropsychiatr. 2013;18(6):594–614.
Buhlmann U, McNally RJ, Wilhelm S, Florin I. Selective processing of emotional information in body dysmorphic disorder. J Anxiety Disord. 2002;16(3):289–98.
Buhlmann U, Wilhelm S, McNally RJ, Tuschen-Caffier B, Baer L, Jenike MA. Interpretive biases for ambiguous information in body dysmorphic disorder. CNS Spectr. 2002;7(6):435–6, 441–3.
Buhlmann U, Etcoff NL, Wilhelm S. Emotion recognition bias for contempt and anger in body dysmorphic disorder. J Psychiatr Res. 2006;40(2):105–11.
Buhlmann U, McNally RJ, Etcoff NL, Tuschen-Caffier B, Wilhelm S. Emotion recognition deficits in body dysmorphic disorder. J Psychiatr Res. 2004;38(2):201–6.
Stangier U, Adam-Schwebe S, Muller T, Wolter M. Discrimination of facial appearance stimuli in body dysmorphic disorder. J Abnorm Psychol. 2008;117(2):435–43.
Arienzo D, Leow A, Brown JA, Zhan L, Gadelkarim J, Hovav S, Feusner JD. Abnormal brain network organization in body dysmorphic disorder. Neuropsychopharmacol. 2013;38(6):1130–9. (Official publication of the American College of Neuropsychopharmacology)
Craven JL, Rodin GM. Cyproheptadine dependence associated with an atypical somatoform disorder. Can J psychiatry Rev canadienne de psychiatrie. 1987;32(2):143–5.
Hanes KR. Serotonin, psilocybin, and body dysmorphic disorder: a case report. J Clin Psychopharmacol. 1996;16(2):188–9.
Barr LC, Goodman WK, Price LH. Acute exacerbation of body dysmorphic disorder during tryptophan depletion. Am J Psychiatry. 1992;149(10):1406–7.
Perugi G, Giannotti D, Di Vaio S, Frare F, Saettoni M, Cassano GB. Fluvoxamine in the treatment of body dysmorphic disorder (dysmorphophobia). Int Clin Psychopharmacol. 1996;11(4):247–54.
Phillips KA, Albertini RS, Rasmussen SA. A randomized placebo-controlled trial of fluoxetine in body dysmorphic disorder. Arch Gen Psychiatry. 2002;59(4):381–8.
Phillips KA, Dwight MM, McElroy SL. Efficacy and safety of fluvoxamine in body dysmorphic disorder. J Clin Psychiatry. 1998;59(4):165–71.
Phillips KA, Najjar F. An open-label study of citalopram in body dysmorphic disorder. J Clin Psychiatry. 2003;64(6):715–20.
Marazziti D, Dell'Osso L, Presta S, Pfanner C, Rossi A, Masala I, Baroni S, Giannaccini G, Lucacchini A, Cassano GB. Platelet [3H]paroxetine binding in patients with OCD-related disorders. Psychiatry Res. 1999;89(3):223–8.
Bienvenu OJ, Samuels JF, Riddle MA, Hoehn-Saric R, Liang KY, Cullen BA, Grados MA, Nestadt G. The relationship of obsessive-compulsive disorder to possible spectrum disorders: results from a family study. Biol Psychiatry. 2000;48(4):287–93.
Phillips KA, Menard W, Fay C, Weisberg R. Demographic characteristics, phenomenology, comorbidity, and family history in 200 individuals with body dysmorphic disorder. Psychosomatics. 2005;46(4):317–25.
Phillips KA, Gunderson CG, Mallya G, McElroy SL, Carter W. A comparison study of body dysmorphic disorder and obsessive-compulsive disorder. J Clin Psychiatry. 1998;59(11):568–75.
Monzani B, Rijsdijk F, Iervolino AC, Anson M, Cherkas L, Mataix-Cols D. Evidence for a genetic overlap between body dysmorphic concerns and obsessive-compulsive symptoms in an adult female community twin sample. Am J Med Genet Part B, Neuropsychiatr Genet. 2012;159B(4):376–82. (The official publication of the International Society of Psychiatric Genetics)
Neziroglu F, Khemlani-Patel S, Veale D. Social learning theory and cognitive behavioral models of body dysmorphic disorder. Body Image. 2008;5(1):28–38.
Rieves LC, TF. Social developmental factors and women’s body image attitudes. J Soc Behav Personal. 1996;1(1996):63–78.
Cash TF, Winstead, BA, Janda, LH. The great American shape-up: Body image survey report. Psychol Today. 1986;20:20–37.
Smolak L. In: Pruzinsky TFCT editors Body image: A handbook of theory, research, and clinical practice. New York: Guilford Press; 2002:pp. 65–73.
Cash TF. Developmental teasing about physical appearance: retrospective descriptions and relationships with body image. Soc Behav Personal. 1995;23(2):123–30.
Didie ER, Tortolani CC, Pope CG, Menard W, Fay C, Phillips KA. Childhood abuse and neglect in body dysmorphic disorder. Child Abus Negl. 2006;30(10):1105–15.
Neziroglu F, Khemlani-Patel S, Yaryura-Tobias JA. Rates of abuse in body dysmorphic disorder and obsessive-compulsive disorder. Body Image. 2006;3(2):189–93.
Buhlmann U, Marques LM, Wilhelm S. Traumatic experiences in individuals with body dysmorphic disorder. J Nerv Ment Dis. 2012;200(1):95–8.
Osman S, Cooper M, Hackmann A, Veale D. Spontaneously occurring images and early memories in people with body dysmorphic disorder. Memory. 2004;12(4):428–36.
Veale D, Gournay K, Dryden W, Boocock A, Shah F, Willson R, Walburn J. Body dysmorphic disorder: a cognitive behavioural model and pilot randomised controlled trial. Behav Res Ther. 1996;34(9):717–29.
Buhlmann U, Etcoff NL, Wilhelm S. Facial attractiveness ratings and perfectionism in body dysmorphic disorder and obsessive-compulsive disorder. J Anxiety Disord. 2008;22(3):540–7.
Schieber K, Kollei I, de Zwaan M, Muller A, Martin A. Personality traits as vulnerability factors in body dysmorphic disorder. Psychiatry Res. 2013;210(1):242–6.
Veale D, Kinderman P, Riley S, Lambrou C. Self-discrepancy in body dysmorphic disorder. Br J Clin psychol/Br Psychol Soc. 2003;42(Pt 2):157–69.
Veale D, Ennis M, Lambrou C. Possible association of body dysmorphic disorder with an occupation or education in art and design. Am J Psychiatry. 2002;159(10):1788–90.
Veale D, Riley S. Mirror, mirror on the wall, who is the ugliest of them all? The psychopathology of mirror gazing in body dysmorphic disorder. Behav Res Ther. 2001;39(12):1381–93.
Phillips KA, McElroy SL. Personality disorders and traits in patients with body dysmorphic disorder. Compr Psychiatry. 2000;41(4):229–36.
Veale D. Body dysmorphic disorder. Postgrad Med J. 2004;80(940):67–71.
Buhlmann U, Wilhelm S. Cognitive factors in body dysmorphic disorder. Psychiatr Ann. 2004;34:922–6.
Wilhelm S, Phillips KA, Fama JM, Greenberg JL, Steketee G. Modular cognitive-behavioral therapy for body dysmorphic disorder. Behav Ther. 2011;42(4):624–33.
Neziroglu F, Pinto A, Yaryura-Tobias JA, McKay D. Overvalued ideation as a predictor of fluvoxamine response in patients with obsessive-compulsive disorder. Psychiatry Res. 2004;125(1):53–60.
Phillips KA, Menard W, Fay C. Gender similarities and differences in 200 individuals with body dysmorphic disorder. Compr Psychiatry. 2006;47(2):77–87.
Phillips KA, Diaz SF. Gender differences in body dysmorphic disorder. J Nerv Ment Dis. 1997;185(9):570–7.
Phillips KA. Body dysmorphic disorder: recognizing and treating imagined ugliness. World Psychiatry. 2004;3(1):12–7. (Official journal of the World Psychiatric Association)
Bernstein IH, Lin TD, McClellan P. Cross- vs. within-racial judgments of attractiveness. Percept Psychophys. 1982;32(6):495–503.
Bohne A, Keuthen NJ, Wilhelm S, Deckersbach T, Jenike MA. Prevalence of symptoms of body dysmorphic disorder and its correlates: a cross-cultural comparison. Psychosomatics. 2002;43(6):486–90.
Korkina MV. [The syndrome of dysmorphomania (dysmorphophobia) and the development of psychopathic personality]. Zhurnal nevropatologii i psikhiatrii imeni SS Korsakova. 1965;65(8):1212–7.
Ung EK, Fones CS, Ang AW. Muscle dysmorphia in a young Chinese male. Ann Acad Med, Singap. 2000;29(1):135–7.
Turkson SN, Asamoah V. Body dysmorphic disorder in a Ghanaian male: case report. East Afr Med J. 1999;76(2):111–4.
Yamada MK, K, Shigemoto, T. On dysmorphophobia. Bull Yamaguchi Med School. 1978;25:47–54.
Fontenelle LF, Mendlowicz MV, Mussi TC, Marques C, Versiani M. The man with the purple nostrils: a case of rhinotrichotillomania secondary to body dysmorphic disorder. Acta Psychiatr Scand. 2002;106(6):464–6; discussion 6.
Phillips KA, Wilhelm S, Koran LM, Didie ER, Fallon BA, Feusner J, Stein DJ. Body dysmorphic disorder: some key issues for DSM-V. Depress Anxiety. 2010;27(6):573–91.
Rhodes G. The evolutionary psychology of facial beauty. Ann Rev Psychol. 2006;57:199–226.
Feusner JD, Moody T, Hembacher E, Townsend J, McKinley M, Moller H, Bookheimer S. Abnormalities of visual processing and frontostriatal systems in body dysmorphic disorder. Arch Gen Psychiatry. 2010;67(2):197–205.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2015 Springer International Publishing Switzerland
About this chapter
Cite this chapter
Weiffenbach, A., Kundu, R. (2015). Body Dysmorphic Disorder: Etiology and Pathophysiology. In: Vashi, N. (eds) Beauty and Body Dysmorphic Disorder. Springer, Cham. https://doi.org/10.1007/978-3-319-17867-7_8
Download citation
DOI: https://doi.org/10.1007/978-3-319-17867-7_8
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-319-17866-0
Online ISBN: 978-3-319-17867-7
eBook Packages: MedicineMedicine (R0)