Body Dysmorphic Disorder (BDD): A Comprehensive Review
Introduction
Body Dysmorphic Disorder (BDD) is a relatively rare yet often devastating psychiatric disorder characterized by excessive preoccupation with an imagined or slight defect in one’s appearance (American Psychiatric Association, 2013). The disorder is associated with substantial psychological and social impairment, and is associated with a high risk of suicide (Phillips et al., 2005). This paper provides a comprehensive review of the literature on BDD, including etiology, assessment, and treatment.
Etiology
BDD is thought to result from a combination of genetic and environmental factors (Phillips et al., 2005; Koran et al., 2007). Twin studies suggest that genetic factors play a role in the development of BDD, with heritability estimates ranging from 0.80 to 0.92 (Phillips et al., 2005). Additionally, environmental factors such as early life trauma, negative experiences regarding appearance, and perfectionism have been implicated in the etiology of BDD (Phillips et al., 2005; Koran et al., 2007).
Assessment
The Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM-5; American Psychiatric Association, 2013) provides diagnostic criteria for BDD. These criteria include preoccupation with an imagined or slight defect in appearance, repetitive behaviors or mental acts to address the perceived defect, and clinically significant distress or impairment in social, occupational, or other areas of functioning. Further, the DSM-5 notes that the preoccupation must cause clinically significant distress or impairment and must not be better explained by another mental disorder.
Treatment
The most commonly used treatments for BDD are cognitive-behavioral therapy (CBT) and medication (Phillips et al., 2005). CBT has been found to be effective in reducing symptoms of BDD (Phillips et al., 2005; Koran et al., 2007). Commonly used CBT strategies include exposure and response prevention, cognitive restructuring, and social skills training (Phillips et al., 2005). Medication is also used to treat BDD; serotonin reuptake inhibitors (SSRIs) are the most commonly used medications, and have been found to be effective in reducing BDD symptoms (Phillips et al., 2005).
Conclusion
BDD is a relatively rare yet often devastating psychiatric disorder characterized by excessive preoccupation with an imagined or slight defect in one’s appearance. The disorder is associated with substantial psychological and social impairment, and is associated with a high risk of suicide. The etiology of BDD is thought to be due to a combination of genetic and environmental factors. Diagnostic criteria for BDD are provided by the DSM-5. The most commonly used treatments for BDD are CBT and medication.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.
Koran, L. M., Abujaoudeh, M., Davenport, T. A., & Goodman, W. K. (2007). Body dysmorphic disorder: A review of current research. CNS Spectrums, 12, 860-868.
Phillips, K. A., Didie, E. R., & Menard, W. (2005). Body dysmorphic disorder: A review of conceptualizations, assessment, and treatment strategies. Harvard Review of Psychiatry, 13, 194–205.