lecture BDD Flashcards
Body dimorphic disorder
+classified s obsessive-compulsive disorder
+Preoccupat with a perceived defect or flaw in physical appearance that is not visible to others
+Repetive behavior ( mirror checking, grooming, ) or mental acts ( comparing their appearance with other s) in response to their appearance concerns
+Significant distress or impairment in social cognition or other important areas
+ not only weight ; mostly face head, muscles ( Muscle dimorphia) skin genitals
+2 % of world population from wich 27 % attempted suivide
Comorbidty
Depression OCD Social anxiety disorder Subatance abuse personality disorder
Behavior
excessive grooming
Camouflaging or hiding body parts
avoidance
why?
Sective attention
Importance of esthetics ( having a job in beauty or design industry)
BDD patients show more activity in left hemisphere wich is responsible for analytical processing => BDD patients have larger detail processing all the time ( due to genetics or training )
Right hemisphere is for holistic processing
2 factor conditioning model
2 factor conditioning model
Biologicals predisposition => operate conditionig+ social learning => classical conditioning => operant conditioning =>BDD
Treatment
plastic surgery Cognitive therapy positive mirror tranig task concentration training• Clomipramine ( antidepressant)
Cosmetic surgery
+only helps temporarily
+outer appearance still main aspect of self-estemm
+patiets then find other parts od their body they are not satisfied with
+ Pastic surgeons should first seek out motivation through for example questionnaires / working with psychologists
task concentration training
3 phases:
• Gaining insight to attentional processes and the effects of directing attention to the self
• Learning to direct attention eternally instead of internally in non-threatening situations
• Learning to direct attention internally in threatening situations
Forms
Aims to help the patient focus on the task in front of him away from themselves. it helps them reduce their perception of how anxiety changes their body. thus interrupting the vicious cycle of body induced Anxiety
¬ Rationale and registration of the attention in social situations
¬ TCT exercised in treatment sessions 8 listening & talking exercises)
¬ TCT in non-threatening non-social situationss (e.g., walking through a forest, listening to music, summarizing the news)¬ TCT in non-threatening social situations(e.g., summarizing a telephone conversation)¬ TCT in threatening situations
TCT threatening situation s
1.Ask patient to describe a BDD situation
2.Ask: On what was your attention predominantly focussed? On what else? What else? (%)
3.Define the task
4. Make concrete on what the attention should be
focussed, given the task
5.Conduct a roleplay/exposure, instruction: direct all attention to the task
6.Discuss afterwards, ask: how much attention ( %) on self, task, environment?
cognitive therapy
Back to rationale (see model) • Registration of automatic thoughts • Thoughts investigation • Formulation of rational thought • Living accordingly • Behavioural experiments
Potential thoughts
My skin is spotty, which makes me ugly
• With this .. (e.g., nose) I am very unattractive and they will laugh at m
exposure
• Aimed to disconfirm your thought • What are you going to do? (e.g., go outside without make-up) • What are you afraid that might happen? • Did it happen? (how can you tell?)
Maintenance of BDD
¬ Self-direction attention = important problem
¬ Attention can be directed internally or externally
A successful social interaction requires a proper balance
consequences of heightened self-focused attention
Seeing/ hearing oneself as from the outside
• Increased emotions
• Heightened (awareness of) arousal
• Concentration problems, blocking
• Socially unskilled/ unkind behaviour
• Not able to process (objective) information,
relying on internally generated information
• Tendency to evaluate onese
working mantance idle of BDD
Bodily feature Selective attention thought s behavior emotions schemas Depression & anxitety Behavioral repertoire
