Individuals with body dysmorphic disorder (BDD) process visual information in a distorted way, even while viewing inanimate objects, according to a new UCLA study.
BDD is a severe mental illness, often debilitating, in which sufferers tend to obsess about minute body details, such as a single blemish or a small bump on the nose, rather than seeing their face as a whole. Those with body dysmorphic disorder often engage in repetitive, time-consuming behaviors, such as checking themselves in the mirror.
Many cannot leave the house because they are too embarrassed about their appearance, some undergo repeated and unnecessary plastic surgeries, and some become suicidal. The disorder affects an estimated 2 percent of the population and is thought to be especially common in people with obsessive-compulsive disorder.
Dr. Jamie Feusner, first author and UCLA assistant professor of psychiatry, and his team discovered that BDD patients show less brain activity while processing holistic visual elements that give the “big picture,” regardless of whether it is a face or an object.
“No study until this one has investigated the brain’s activity for visually processing objects in people with BDD,” said Feusner, director of the Obsessive-Compulsive Disorder Intensive Treatment Program at UCLA.
“This is an important step to figuring out what’s going wrong in the brains of people with BDD so we can develop treatments to change their perceptions of themselves.”
The study included 14 BDD patients (male and female ) and 14 healthy controls. Researchers used functional MRI (fMRI) to scan volunteers while they looked at digital photographs of houses—some were altered in specific ways so researchers could root out different elements of visual processing. For example, one altered set of images included very fine details, such as the shingles on the roof. Another set of altered images had hardly any detail and just gave a “holistic” view, such as the overall shape of the house and doors and windows.
The researchers discovered that patients with body dysmorphic disorder had abnormal brain activation patterns while looking at images of the less-detailed houses. In other words, the brain regions that process these visual elements displayed less activity than the healthy controls. Significantly, the more severe their BDD symptoms, the less activity there was in the brain regions responsible for processing an image holistically.
“The study suggests that BDD patients have general abnormalities in visual processing,” Feusner said.
“But we haven’t yet determined whether abnormal visual processing contributes as a cause to developing BDD or is the effect of having BDD. So it’s the chicken-or-the-egg phenomenon.
“Many psychological researchers have long believed that people with body-image problems such as eating disorders only have distorted thoughts about their appearance, rather than having problems in the visual cortex, which precedes conscious thought. This study, along with our previous ones, shows that people with BDD have imbalances in the way they see details versus the big picture when viewing themselves, others and even inanimate objects.”
Thirty percent of those with body dysmorphic disorder also suffer from an eating disorder—also linked to having a distorted self-view. Feusner is now enrolling patients with anorexia nervosa to study whether they also process visual information in a distorted way, to compare them with BDD patients. This information would be used to develop treatments to help people re-adjust their perception of themselves.
The research appears in the journal Psychological Medicine.
Source: University of California