Researchers Investigate the Role of Visual Processing in Body Dysmorphic Disorder
> 12/5/2007 11:41:24 AM

Abnormal visual processing may contribute to the symptoms of body dysmorphic disorder (BDD), according to a study published in the latest edition of the journal Archives of General Psychiatry. BDD, which affects about 1.7% of Americans, involves a distorted self image, where individuals focus obsessively on minor or perceived physical flaws. A group of researchers headed by Dr. Jamie Feusner compared brain scans of those with BDD to those without the disorder and observed differences in the way the brains of people with BDD processed visual stimuli.

The researchers showed black and white photographs of neutral faces to 12 subjects with BDD and 13 healthy control subjects. In a series of tasks, the subjects were asked to pick out the two matching faces from a group of three. The photographs were altered to encompass different spatial frequencies. Low spatial frequency (LSF) photographs, which appear blurry, illustrate the spatial relationship between facial features, while high spatial frequency (HSF) photographs, which resemble a line drawing of a face, convey facial details. Unaltered photographs, which have a normal spacial frequency (NSF), were also included. Using fMRI scans, the researchers found that subjects with BDD processed visual stimuli differently than the control subjects. Those with BDD had greater activity in the left side of the brain, which is specialized for detail oriented and analytic functions. Additionally, the brain regions involved in visual processing of NSF and LSF photographs for subjects with BDD were also active in control subjects viewing HSF photographs. These results fit well with clinical observations that patients with BDD are often preoccupied primarily with facial characteristics and tend to focus on details rather than the whole.

The researchers acknowledge that the small sample size of their study may have limited the interpretation of some of its results, and they include suggestions for future studies on the topic. Other factors they would like to see examined include the visual processing of subjects viewing their own faces or inanimate objects, the severity of BDD symptoms, and the subjects' perception of emotions while viewing faces.

BDD has not been widely studied, although it can occur alongside eating disorders and obsessive compulsive disorder and, like these disorders, severely interferes with normal functioning. Individuals with BDD often undergo serious and unnecessary cosmetic operations to fix imagined flaws and may never be satisfied with the results. Many grapple with depression and social isolation. About a quarter attempt suicide. The more we learn about the mechanisms behind BDD, the more likely we will be to create more effective therapies for it. Hopefully more researchers will investigate the differences in brain activity between those with conditions like BDD and those without these disorders.

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