Makings of BDD Archives

The Genetics and Neuropsychology of BDD

January 18, 2016 By Stephen

Genetics of BDD

Recent research has shown that genetic factors are likely to play an important role in the etiology of BDD.

Eight percent of individuals with BDD have a family member with a lifetime diagnosis of BDD, which is four to eight times the prevalence in the general population.

BDD shares heredity with obsessive-compulsive disorder (OCD), as family studies have shown that 7% of BDD patients were found to have a first-degree relative with OCD, and first-degree relatives of OCD probands have a six times higher lifetime prevalence of BDD than do relatives of controls.

Functional Imaging in BDD

Recently, the first functional imaging study to compare BDD patients to controls examined visual information processing of faces, with respect to spatial frequency.

Twelve BDD patients and twelve healthy controls underwent functional magnetic resonance imaging (fMRI) while matching photographs of faces.

Some of the faces were digitally altered to remove the high or low spatial frequencies, which created images that contained configural or detail information, respectively.

BDD participants showed greater left hemisphere activity relative to controls for all face tasks, particularly in lateral aspects of the prefrontal cortex and the temporal lobe. They also activated dorsal anterior cingulate gyrus for the low spatial frequency (LSF) face task.

Controls, on the other hand, activated left-sided prefrontal cortex and dorsal anterior cingulate gyrus only for the high spatial frequency (HSF) face task.

Greater left-sided activity for LSF and normal faces suggests a predominance of detail encoding and analysis, a pattern evident in controls only for HSF faces. This suggests that BDD patients may process faces in a piecemeal manner, while healthy controls’ perception of faces may be more configural and holistic.

These laterality patterns in the BDD participants suggest a bias for local, or detail-oriented, processing of faces over global processing.

The results from these study suggest that BDD participants show fundamental differences from controls in visual processing, with different laterality of activation patterns in areas representing an extended visual processing network, and abnormal amygdala activation.

These abnormalities may be associated with BDD patients’ apparent perceptual distortions; they may focus in excruciating detail on specific facial features and lose the larger, overall context of the whole face.

As this experiment used others’ faces and not their own, it will be important for future studies to investigate the processing of their own faces as they may experience greater distortions and because of the possibility of the influence of emotional arousal.

Neuropsychology of BDD

Deficits in organizational strategies in BDD patients, who tended to use a strategy of focusing on details rather than recalling the overall organization and properties of visual stimuli or verbal information,

Other studies have shown that BDD patients exhibit selective processing of threat and distraction by emotional cues, similar to patients with anxiety disorders

These data demonstrate that BDD patients are vulnerable to distraction by emotional cues in general, and by words and situations related to their current concerns in particular.

These patterns of cognitive and emotional processing suggest that BDD may be related to anxiety disorders such as social phobia.

The Makings of BDD Part 2

June 29, 2015 By Stephen

When I was in high school the first dance I ever attended was during my sophomore year.

It was the winter formal and I was asked to attend with my friend as part of a double-blind date. Although it wasn’t placebo-controlled.

I was excited. I had never had a “real date” before and this was an opportunity to have a good time and get to know somebody new.

My friend assured me that my date was not only very nice but quite attractive. I don’t remember feeling nervous, I liked to dance, I considered myself a friendly person and figured we would have a good time together.

When we arrived I met Jackie. A knockout blond, with long slender legs and a beautiful winter formal dress. She was gorgeous. When we met she smiled casually, we took hands and jumped into the back seat of the limo Jamie’s parents had rented for the 4 of us.

We arrived at the gymnasium snapped some photos and then it happened. She ditched me.

Holy Zit

I remember having a big zit on my nose for the evening of the dance, I was self-conscious about it. It had started to appear the day before the dance and then on the big day it came out to play. I was angry at the powers that be for having to endure this large, red, painful blemish that would not only haunt me for the night but likely for the entirety of the upcoming month.

I was already very self-conscious about my acne and envied all the guys and girls with clear skin and great complexions. Especially all those attractive teenagers on the Clearasil commercials.

My date was one of them.

Jackie had a kind smile, she was naturally pretty and it never crossed my mind that when we got to the dance she would simply walk away and leave. My friend Jamie went with them, his girlfriend and my date were best friends after all, I didn’t blame him.

It felt horrible to be left behind like this, not necessarily because I was abandoned, but because I was abandoned before I had even had the chance to meet my date. She ditched me because I wasn’t up to her standards. In my mind, she ditched me for all the reasons I hated myself. My bad complexion, my big teeth, my funky hair, my short stature, my braces and most of all, that big zit on my nose.

I was relegated to the gymnasium bleachers to think carefully about my shortcomings as a human being.

It wasn’t the first time I had to sit by and watch the cool guys get the girls. As a nice guy I was always there, doing what nice guys do; keeping everyone else happy, smiling to the world outside, while inside I felt self-conscious and ashamed.

I did return with Jamie, his girlfriend and my “date” in the Limo later that night. Back at their house they were headed inside to play some drinking games. I didn’t drink so I called my mom and she came and picked me up.

I saw Jackie years later, she was a bridesmaid for one of my best friends weddings. I was serving as best man. We were both with groups of our high school friends. We talked and laughed and shared stories along with the other’s in the room. I am not sure she even remembered what she did that night years before.

But this incident solidified a feeling I had about myself already. It was the reality test and confirmation I needed to prove that my negative feelings towards myself were not merely assumptions, but they were, in fact, true.

Although I would go on to attend many more high school dances after this one, this, being my first, stuck. It is amazing how this incident from over 24 years ago still affects me today.

These, my friends, are the makings of BDD.

Read part 1: Acne and the makings of Body Dysmorphic Disorder

Acne and The Makings of Body Dysmorphic Disorder

October 4, 2012 By Stephen

MY ESCAPE

I am thirty five, day one of this blog should have started over 18 years ago. But I was living in denial. The constant mirror checking, the self hatred, the shame, the fear of catching my reflection in a car window… The inability to enter a dressing room.

As a man the shame was even greater. I had to hide it even deeper. I am not vain, in fact I love everybody for who they are… Except for one person. Myself.

ACNE

It began with Acne when I was in high school. I would stare at each pimple in contempt. It was a small thing at first. And then I lost control. Everything I did to prevent each pimple only made things worse. They hurt, not just emotionally but physically. I could feel them on my face and I could feel people looking into them, looking past me.

It started as one, but as hormones took over one became many. And after time they would leave a small scar, a mark on my skin, and shame was all that was left.

I would admire those who were scarred more than me who did not seem to care.

What I never understood was the casual response of others to my facial scarring . I told very few people of my concerns over my skin and when I did it was only because I ran out of other options. When I was 16 I approached my mom seeking a trip to the doctor to find some kind of treatment for my skin. She provided reassurance that my teenage acne was just a phase, and that mine was really not that bad.

In desperation I tried every product I could get my hands on.

First it was benzoyl peroxide 10%, several iterations of Oxy and Clearasil, this turned into excessive face washing. I would carry skin cleansing alcohol pads in my bag at all times. I would sneak into the bathroom during my breaks to wash my face. Only in this clean and non oily state would I find a bit of peace. And then the oil would return, It was a disgusting layer that I was always conscious of.

The oil to me was a breeding ground for more acne and I was on the offensive. But the more I washed my face the more acne I would acquire. The acne blemishes seemed to always come at the wrong time. My first high school dance welcomed several new lesions. Those would remain for several months. Much longer than my date who left me after we entered the gymnasium. Further proof, in my mind, that I was gross and unworthy of affection.

I finally made it to a dermatologist who started me on oral antibiotics. This helped so much! After the first month when the acne became worse I found my face clear for almost 3 whole months. My confidence grew leaps and bounds, I would look at myself with affection for the first time. I remember this time quite well, it was the first time I could talk to someone face to face without the feeling of the blemishes on my face.

And then the antibiotics stopped working, the acne seemed to become worse, and now unstoppable. I retreated to what I knew best.

Washing and salicylic acid and topical antibiotics and more checking.

The avoidance of mirrors. The occasional avoidance of life.