Swinburne researchers conduct largest investigation into cognitive functioning in body dysmorphic disorder

A paper published by researchers at Swinburne’s Centre for Mental Health shows evidence that only a small subgroup of individuals experiencing body dysmorphic disorder have significant problems with cognitive functioning.

Past research has indicated that body dysmorphic disorder is uniformly associated with significant difficulties in cognitive functioning such as attention, memory and thought organisation. However, this latest paper, which has been published in the Australia and New Zealand Journal of Psychiatry suggests otherwise. It is based on the largest and most comprehensive investigation of cognition in body dysmorphic disorder to date.

What is body dysmorphic disorder?

Body dysmorphic disorder is a psychological disorder that affects approximately two percent of the population and is characterised by extreme body image concern. People with body dysmorphic disorder may perceive a small or non-existent physical attribute as a serious defect.

In some cases, their everyday functioning and quality of life can be severely affected. 

“Despite the potentially devastating impacts of body dysmorphic disorder, it remains relatively understudied,” says Swinburne’s Dr Amy Malcolm, lead author of the paper.

An area requiring further research is the cognitive functioning of individuals with body dysmorphic disorder. This is important as difficulties with specific functions such as memory, visual processes, reasoning and social cognition have been theorised to be significant in the development or maintenance of the disorder. However, it is crucial to understand whether these problems are experienced by all individuals with body dysmorphic disorder, or just some.

“Our study had two aims. First, to examine the cognitive profile of individuals with body dysmorphic disorder as compared to healthy individuals and, secondly, to explore whether different cognitive subgroups may be present within individuals with body dysmorphic disorder, ranging from intact to impaired cognitive performance,” Dr Malcolm explains.

Comparing cognitive functions

In this study, 65 individuals with body dysmorphic disorder had their cognitive functions tested to determine their performance against a healthy control group.

The cognitive functions tested included inhibition/flexibility, working memory, speed of processing, reasoning and problem-solving, visual learning, verbal learning, attention/vigilance and social cognition. 

Cognitive functions refer to the particular mental processes within a person’s psyche that are present regardless of the common circumstances.

In addition, cluster analysis was performed on the group with body dysmorphic disorder to identify the presence of different cognitive subgroups. Cluster analysis uses the test data to identify and group together participants who showed very similar patterns of cognitive functioning.

Shifting perceptions

“Our study showed that only a small subgroup of people with body dysmorphic disorder have significant problems with cognitive functioning while a large proportion either have no difficulties, or some mild difficulties,” says Dr Malcolm.

“Interestingly, our findings also suggest that cognitive ability seemed to have no relationship with the severity of body dysmorphic disorder symptoms,” she adds.

These findings point to a need for researchers to change the way they have been thinking about cognition and body dysmorphic disorder and adopt a more nuanced approach to treating and diagnosing these individuals.

“We should not assume that everyone has difficulties, however, it will be important to find out why only some people have significant problems because those individuals may need different treatment approaches,” Dr Malcolm concludes.