Most of us are dissatisfied with something about our appearance, but for people with body dysmorphic disorder (BDD), perceived flaws become an obsession with distressing effects.
New research from Swinburne offers encouraging insights into the condition. Studies conducted by Professor Susan Rossell show that it is triggered by biological factors, illuminating options for treatment.
Professor Rossell, a cognitive neuropsychologist, worked with colleagues from St Vincent’s Hospital in Melbourne to study a visual network of the brain using MRI data. She found that the frontal and occipital brain regions in people with the condition were smaller than in a control group of unaffected individuals.
The results suggest that the visual networks of people with the disorder have particular characteristics, says Rossell. “People with BDD don’t move their eyes in the same way as other people. They don’t see the whole picture, and become overly focussed on small details.”
These differences also affect how the brain processes visual signals, she says. “The information going into the brain is piecemeal, and then that limited information is processed differently, due to differences in the cortex that deal with integration of visual information.”
Men and women affected by BDD become fixated with a perceived flaw in their appearance, usually a specific part of the body. In some cases, patients seek plastic surgery to ‘fix’ their ‘fault’ but cannot discern any difference afterwards.
Clinicians use mirror and visual training to help patients accurately look at and evaluate the body part they fixate on and the depression or anxiety that can result from BDD can be addressed by therapy.
Recognition of BDD’s neuro-biological basis offers opportunities to expand treatment approaches, Rossell says, including better screening before using plastic surgery. For people with the condition, she thinks her work may have a similar impact to other research she conducts on people who experience auditory hallucinations.
“When patients understand how auditory hallucinations work in the brain, it really reduces the stigma and stress for them,” she says. “They know it’s not a weird supernatural thing: it is part of their biology. They’re comforted by knowing there’s a reason for it.”