The Causes Of Body Dysmorphic Disorder

Another pimple? A bad hair day? At one time or another, nearly everyone is concerned with some aspect of their appearance. But when that concern becomes an obsession, an all-consuming fixation that interferes with normal functioning, body dysmorphic disorder may be the cause. Body dysmorphic disorder (BDD) is characterized by an extreme preoccupation with what is believed to be defects in one’s appearance (Bjornsson, Didie, & Phillips, 2010). These imperfections are often minimal or even non-existent but are very real and distressing to those afflicted with BDD.

BDD affects approximately .07% to 2.4% of the general population and 2% to 13% of adult students. The actual rates may be much high given the nature of BDD in that those afflicted often conceal their symptoms and go undiagnosed. These numbers suggest that BDD is more common than the more studied and publicized disorders of schizophrenia or anorexia nervosa.

BDD usually begins in childhood or adolescence. In a study of 428 adults with BDD, 66% of the subjects had onset before the age of 18, with the most common age being 12-13 years old (Bjornsson, Didie, Grant, Menard, Stalker & Phillips, 2013).

BDD causes significant dysfunction, with sufferers spending hours each day thinking about and tending to the perceived flaws; engaging in time-consuming rituals of mirror-checking, excessive grooming, and attempted camouflaging of the defect. Substantial professional, social and academic impairments are the result. In a 2005 study of 200 BDD sufferers, Phillips, Menard, Fay and Weisberg found subjects often missed work or school, 37.6% of subjects were unemployed, a much higher rate than the general population, and 11% of subjects dropped out of school because of BDD. BD...

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...rphic disorder. Psychiatry Research: Neuroimaging, 172, 161–167.

Phillips, K.A. (2001). Body dysmorphic disorder. Somatoform and factitious disorders. Washington: American Psychiatric Publishing.

Phillips, K. A., Menard, W., Fay, C., Weisberg, R. (2005). Demographic characteristics, phenomenology, comorbidity, and family history in 200 individuals with body dysmorphic disorder. Psychosomatics, 46(4).

Phillips, K. A., Wilhelm, S., Koran, L. M., Didie, E. R., Fallon, B., Feusner, J.D., Stein, D. J. (2010). Body dysmorphic disorder: Some key issues for DSM-V. Depression and Anxiety, 27(6), 573-91.

Rauch, S. L., Phillips, K. A., Segal, E., Makris, N., Shin, L. M., Whalen, P. J., . . . Kennedy, D. N. (2003). A preliminary morphometric magnetic resonance imaging study of regional brain volumes in body dysmorphic disorder. Psychiatry Research: Neuroimaging 122 (1), 13–19.