Body Dysmorphic Disorder and Mirror Gazing - Research Paper Example

BODY DYSMORPHIC DISORDER AND MIRROR GAZING Lecturer’s Introduction Body Dysmorphic disorder (BDD) is a mental illness where the individual experiences symptoms similar to those of a medical illness but are unexplainable by actual physical evidence. The person is preoccupied with an imagined physical defect that others often cannot see, often referred to as “imagined ugliness.” The patient spends most of their time examining their defect in reflecting surfaces such as a mirror that causes a sense of loss of proportion. The individual’s body evaluation is expected to decrease after a mirror exposure. Patients concern relates to one or more parts of the body that they believe are dysmorphic but are not visible to other people in areas like the nose, skin and the eyes. Other more covered body parts where patient’s pre- occupations may be focused include parts such as body muscles or the genitals (Bjornsson, Didie, & Phillips, 2010). The condition has equal prevalence to both male and females with the patients spending up to 3 to 8 hours in a day thinking about their physical defects, examining themselves in mirrors or other reflecting surfaces while trying to hide or in trying to change the pre-occupied so called deformity. The disorder is thus chronic, time-consuming although the patients level of functioning ought to vary across each individual (Grant & Phillips, 2005). The patient may function normally while others become isolated, may even develop a secondary depression or may even commit suicide. It still remains unclear of what maintains or causes the condition, but it has been suggested that cognitive, behavioral and affective factors are the maintaining factors of the disease. The paper examines articles and studies that deal with body dysmorphic disorder and mirror gazing and summarizes the findings. Empirical articles that deal with body dysmorphic and mirror gazing Cognitive models of behavior of the Body Dysmorphic Disorder have suggested that a mirror can act as a trigger to individuals with the condition to lead to a specific mode of processing in their cognition characterized by increased focused attention of the deformity and associated distress. A study was carried out with the aim of investigating associated factor by exposing 25 individuals with BDD and 25 others without to a mirror in a controlled setting. Another goal of the study was to find out and ascertain the role of mirror duration gazing in the maintenance of self-consciousness and distress by manipulating the length of participants gazing from short to long periods. From the study finding, they demonstrated that not only participants with BDD but also those who were not suffering from the condition experienced increased stress as well as self-focused attention upon mirror exposure (Windheim, Veale, & Anson, 2011). However, individuals with Body Dysmorphic Disorder unlike normal individuals who do not experience the disorder are bound to experience more stress when gazing at the mirror for a lengthy period as opposed to a shorter period. From the study results, it is therefore correct to conclude that, individuals suffering from BDD, exposing them to a mirror regardless of the duration of mirror exposure act serves as an immediate trigger for abnormal mode of processing as well as well as associated distress. Thus, Body Dysmorphic Disorder development can be associated from past excessive mirror gazing behaviors. It is unsurprising that many individuals have concerns regarding their physical appearance. However, in body dysmorphic disorder, the relevant concerns are so pronounced that they are associated with intense distress as well as interference with the quality of life. A study was conducted to determine strategic and automatic measures as predictors of mirror gazing among persons with Body Dysmorphic Disorder symptoms. The aim for the study was to test cognitive behavioral models of Body Dysmorphic Disorder in an effort of examining the relationships correlates of mirror gazing and cognitive biases. The study investigated both relatively strategic and automatic measures of cognitive biases among 32 participants (Clerkin & Teachman, 2009). From the study results, anxiety and avoidance were associated with mirror gazing among the individuals who had a Body Dysmorphic Disorder. The interpretation that were tied to appearance uniquely illustrated a self-reported desire to avoidance, while the evaluations of strategic appearance uniquely illustrated peak anxiety that was associated with mirror gazing as well as automatic appearance associations that was uniquely predicted behavioral avoidance. These study results provide considerable support for cognitive models of Body Dysmorphic Disorder while suggesting dissociation between strategic automatic and automatic measures. Patients suffering from BDD are bound to spend many hours in front of the mirror. However, little is known about factors that make such kind of behavior and the psychopathology. A study was done to find out the behaviors and beliefs leading to the trend. The study examined two types of groups for comparison that involved 55 body dysmorphic disorder patients and 55 control individuals. A self-reported questionnaire was used in collecting the responses. From the study results, the BDD patient were driven to continue with the mirror gazing behavior with the hope that they will look different. They have a strong desire to know how they look and belief that they will get and feel even worse if they resist the gazing behavior. BDD patients show the concern and practice so that they can show the best face in the public. They will go to a further extent of using mental cosmetic surgery in changing their body image as compared to the controls. After mirror gazing, the BDD patients felt worse and were more likely to utilize different ambiguous surfaces for their reflection such as CDs or Cutlery. A conclusion from the study is that mirror gazing in BDD patients entails a series of complex safety behaviors and like the obsessive-compulsive disorder, it does not comply with a simple model of anxiety reduction (Veale & Riley, 2001). Body dysmorphic disorder and self-esteem Most of the people have something that they do not like about their appearance but although individuals feel fret about their imperfections, such problems in appearances do not interfere with our daily lives. For individuals who have body dysmorphic disorder (BDD) they concentrate on their flaws for hours each day. Body dysmorphic disorder people lack the ability to control their negative thoughts and will not believe what people tell them about themselves that they are looking good (Phillips, Pinto, & Jain, 2004). Thus, the self- esteem of such individuals is very low. As a result of the lowered self-esteem, such individuals avoid disclosure in the public and will opt to stay indoors most of their time. The thoughts of such individuals lead to severe emotional distress interfering with their daily functioning in life. Because of the lowered self-esteem individuals miss school most of the times, they even miss work, isolate themselves even from friends and family members because they live in fear that other people will notice their flaws (Phillips et al., 2004). As a the person may even opt to undergo plastic surgery in a measure of collecting the perceived imperfections though even after the surgery they never find satisfaction with the results. Empirical articles dealing with body dysmorphic and self-esteem Studies have indicated that that a poor body image is associated with poor self-esteem among individuals. Persons with body dysmorphic disorder have a lowered self-esteem thus they have a poor perception to their body image. However, few investigations have been conducted examining the self-esteem among the BDD patients. A study was conducted to examine the self-esteem of Body Dysmorphic Disorder patients, and 93 patients were examined in relation to self-esteem changes with pharmacotherapy. The study involved a placebo and a controlled trial. All the participants taking place in the study filled measures and questionnaires for the research study. From the study results, the mean RSES score for the BDD patients was 1.5 SD units that were lower than the control group (Phillips et al., 2004). Poor self-esteem was associated with BDD and depression. However, although lowered self-esteem with BDD as well as delusionality from the research study, the relationship of BDD severity and self-esteem was largely mediated by major symptoms of depression. Medication was administered to reduce the depressive symptoms i.e. fluoxetine, and it reduced the depressive states significantly. However from the study it was very difficult to determine whether poor self –esteem predisposes the condition or whether it results as a consequence of the disorder. The preoccupation to a slight defect among BDD individuals causes significant distress among the individuals casing lowering of the self-esteem among those affected. In line depression and lowered stress among the patients, a study was conducted assessing the gender differences in BDD among the population with relation to their perceived self-esteem levels. The study was carried out among students in a university where the participants filled out self-reported questionnaires assessing them on the condition. From the study results, 156 students took part in the study 57.1 percent being female students. From the responses gave 78.8 percent of the students reported dissatisfaction with themselves in some aspect of their appearance. Out of those who were dissatisfied 5.8 percent of the met the DSM-IV criteria for BDD and reported high levels of dissatisfaction with their life’s with lowered self-esteem (Taqui et al., 2008). From the study, the male to female ratio for DBB was determined to be 1:7. Among the body foci creating dissatisfaction among the participants were head hair, being fat, skin color, nose and other deformities. Biby conducted a study to determine the relationship between DBB, self-esteem, obsessive compulsive disorder, depression and somatization. The participants for the study included 83 females and 25 male participants. The participants had to be screened for eating disorders with the use of the DSM-IV scale and upon screening only 78 females, and 24 males were left. From the study results, lower body esteem scores of the participants was associated with lower levels of their self-esteem and the individuals had higher levels of somatization, depressive and obsessive-compulsive tendencies. Thus, DBB patients suffer from lowered self-esteem (Biby, 1998). Conclusion Body Dysmorphic disorder (BDD) is a mental illness where the individual experiences symptoms of medical illness. The person is preoccupied with an imagined physical defect that others often cannot see referred to as “imagined ugliness.” The patient spends most of their time examining their defect in reflecting surfaces i.e. a mirror that causes a sense of loss of proportion and lowered self-esteem and body image. For individuals suffering from BDD, exposing them to a mirror regardless of the duration of mirror exposure serves as an immediate trigger for abnormal mode of processing as well as well as associated distress. Mirror gazing in BDD patients entails a series of complex safety behaviors and like the obsessive-compulsive disorder, it does not follow a simple model of anxiety reduction. Poor body image is associated with poor self-esteem among individuals. Persons with body dysmorphic disorder have a lowered self-esteem thus they have a poor perception to their body image. References Biby, E. L. (1998). The relationship between body dysmorphic disorder and depression, self-esteem, somatization, and obsessive-compulsive disorder. Journal of Clinical Psychology, 54, 489–499. Bjornsson, A. S., Didie, E. R., & Phillips, K. A. Body dysmorphic disorder. , 12 Dialogues in clinical neuroscience 221–232 (2010). Clerkin, E. M., & Teachman, B. A. (2009). Automatic and strategic measures as predictors of mirror gazing among individuals with body dysmorphic disorder symptoms. The Journal of Nervous and Mental Disease, 197, 589–598. doi:10.1097/NMD.0b013e3181b05d7f Grant, J. E., & Phillips, K. A. (2005). Recognizing and treating body dysmorphic disorder. Annals of Clinical Psychiatry. doi:10.1080/10401230500295313 Phillips, K. A., Pinto, A., & Jain, S. (2004). Self-esteem in body dysmorphic disorder. Body Image, 1, 385–390. doi:10.1016/j.bodyim.2004.07.001 Taqui, A. M., Shaikh, M., Gowani, S. A., Shahid, F., Khan, A., Tayyeb, S. M., … Naqvi, H. A. (2008). Body Dysmorphic Disorder: gender differences and prevalence in a Pakistani medical student population. BMC Psychiatry, 8, 20. doi:10.1186/1471-244X-8-20 Veale, D., & Riley, S. (2001). Mirror, mirror on the wall, who is the ugliest of them all? The psychopathology of mirror gazing in body dysmorphic disorder. Behaviour Research and Therapy, 39, 1381–1393. doi:10.1016/S0005-7967(00)00102-9 Windheim, K., Veale, D., & Anson, M. (2011). Mirror gazing in body dysmorphic disorder and healthy controls: Effects of duration of gazing. Behaviour Research and Therapy, 49, 555–564. doi:10.1016/j.brat.2011.05.003 Read More