Body image disturbance

Body Image Disturbance (BID), also known as Body Dysmorphic Disorder (BDD), is a significant and often debilitating mental health condition characterized by a preoccupation with one or more perceived defects or flaws in physical appearance, which are not observable or appear slight to others. This condition falls under the umbrella of Obsessive-Compulsive and Related Disorders in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5).

Definition and Symptoms

Body Image Disturbance involves persistent and intrusive thoughts about perceived physical imperfections, leading to significant distress or impairment in social, occupational, or other important areas of functioning. Individuals with BID may engage in repetitive behaviors (e.g., mirror checking, excessive grooming, skin picking) or mental acts (e.g., comparing their appearance with that of others) in response to the appearance concerns.

Symptoms of BID can vary widely but commonly include:

• Excessive preoccupation with a perceived flaw in appearance that is not observable or appears minor to others.
• Engaging in behaviors aimed at fixing or hiding the perceived flaw.
• Frequently seeking reassurance about one’s appearance from others.
• Avoidance of social situations or activities due to embarrassment or fear of being judged about the perceived flaw.

Causes and Risk Factors

The exact cause of Body Image Disturbance is unknown, but it is believed to result from a combination of genetic, biological, environmental, and psychological factors. Risk factors may include:

• A history of teasing or bullying related to appearance.
• Exposure to societal or media ideals of beauty.
• Certain personality traits, such as perfectionism.
• Co-occurring mental health disorders, such as depression or anxiety disorders.

Diagnosis

Diagnosis of BID involves a comprehensive clinical interview that assesses the individual's concerns about appearance, the impact of these concerns on functioning, and the presence of repetitive behaviors or mental acts related to the appearance concerns. The DSM-5 criteria for Body Dysmorphic Disorder provide a framework for diagnosis.

Treatment

Treatment for Body Image Disturbance typically involves a combination of psychotherapy and medication. Cognitive-behavioral therapy (CBT) is the most evidence-based type of psychotherapy for BID, focusing on identifying and challenging negative thoughts about body image and reducing avoidance behaviors. In some cases, medications such as selective serotonin reuptake inhibitors (SSRIs) may be prescribed to help reduce obsessive thoughts and compulsive behaviors.

Prognosis

With appropriate treatment, individuals with Body Image Disturbance can experience significant improvement in symptoms and functioning. However, the condition can be chronic, and ongoing treatment may be necessary to maintain gains and prevent relapse.

See Also

• Eating Disorders
• Obsessive-Compulsive Disorder (OCD)
• Self-esteem
• Mental Health