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Virgili G, Neill E, Enticott P, Castle D, Rossell SL. A systematic review of visual processing in body dysmorphic disorder (BDD). Psychiatry Res 2024; 339:116013. [PMID: 38924902 DOI: 10.1016/j.psychres.2024.116013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Revised: 05/06/2024] [Accepted: 06/03/2024] [Indexed: 06/28/2024]
Abstract
To understand the visual preponderance of perceived flaws in appearance in body dysmorphic disorder (BDD), the study of visual processing has been growing. Studies have focused on facial and other basic visual stimuli. The current literature does not provide evidence of consistent behavioural patterns, lacking an overarching body of work describing visual processing in BDD. This systematic review aims to characterise behavioural outcomes of visual processing anomalies and/or deficits in BDD. Articles were collected through online databases MEDLINE and PubMed, and were included if they comprised a clinical BDD group, and were published after 1990. Results indicate that individuals with BDD demonstrate deficits in emotional face processing, a possible overreliance on detail processing, aberrant eye-scanning behaviours, and a tendency to overvalue attractiveness. While findings consistently signal towards visual deficits in BDD, there is lack of clarity as to the type. This inconsistency may be attributed to heterogeneity within BDD samples and differences in experimental design (i.e., stimuli, tasks, conditions). There are difficulties distinguishing between BDD-associated deficits and those associated with OCD or eating disorders. A coherent framework, including sample characterisation and task design will seek to generate clear and consistent behavioural patterns to guide future treatments.
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Affiliation(s)
- Gemma Virgili
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, VIC, Australia.
| | - Erica Neill
- Orygen, Centre for Youth Mental Health, University of Melbourne, Vic Australia
| | - Peter Enticott
- Cognitive Neuroscience Unit, Faculty of Health, Deakin University, Burwood, VIC, Australia
| | | | - Susan Lee Rossell
- Centre for Mental Health, Faculty of Health, Arts & Design, Swinburne University of Technology, Hawthorn, VIC, Australia
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Greenberg JL, Phillips KA, Hoeppner SS, Jacobson NC, Fang A, Wilhelm S. Mechanisms of cognitive behavioral therapy vs. supportive psychotherapy in body dysmorphic disorder: An exploratory mediation analysis. Behav Res Ther 2023; 161:104251. [PMID: 36640457 PMCID: PMC9892287 DOI: 10.1016/j.brat.2022.104251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Revised: 11/12/2022] [Accepted: 12/30/2022] [Indexed: 01/11/2023]
Abstract
Body dysmorphic disorder (BDD) is common, severe, and often chronic. Cognitive behavioral therapy (CBT) is the first-line psychosocial treatment for BDD, with well-established efficacy. However, some patients do not improve with CBT, and little is known about how CBT confers its effects. Neurocognitive processes have been implicated in the etiology and maintenance of BDD and are targeted by CBT-BDD treatment components. Yet, the malleability of these factors in BDD, and their potential role in mediating symptom improvement, are not well understood. Understanding how treatment works could help optimize treatment outcomes. In this secondary data analysis of a randomized clinical trial of CBT vs. supportive psychotherapy (SPT) in BDD (n = 120), we examined whether treatment-related changes in detail processing (Rey-Osterrieth Complex Figure test), maladaptive appearance beliefs (Appearance Schemas Inventory-Revised), and emotion recognition (Emotion Recognition Task) mediated treatment outcome. All constructs improved over time and were associated with symptom improvement. CBT was associated with greater improvements in maladaptive beliefs than SPT. None of the variables examined mediated symptom improvement. Findings suggest that with successful treatment, individuals with BDD demonstrate reduced neurocognitive deficits (detail processing, emotion recognition, maladaptive beliefs) and that CBT is more likely than SPT to improve maladaptive appearance beliefs. More work is needed to understand mechanisms of change and thus maximize treatment outcomes.
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Affiliation(s)
- Jennifer L Greenberg
- Massachusetts General Hospital and Harvard Medical School, 185 Cambridge Street, Suite 2000, Boston, MA, 02114, USA.
| | - Katharine A Phillips
- Rhode Island Hospital and Alpert Medical School of Brown University, 222 Richmond St, Providence, RI, 02903, USA; New York-Presbyterian Hospital and Weill Cornell Medical College, 315 East 62nd Street, New York, NY, 10065, USA.
| | - Susanne S Hoeppner
- Massachusetts General Hospital and Harvard Medical School, 185 Cambridge Street, Suite 2000, Boston, MA, 02114, USA.
| | - Nicholas C Jacobson
- Massachusetts General Hospital and Harvard Medical School, 185 Cambridge Street, Suite 2000, Boston, MA, 02114, USA; Geisel School of Medicine at Dartmouth College, 46 Centerra Parkway, EverGreen Center, Suite 315, Lebanon, NH, 03766, USA.
| | - Angela Fang
- Massachusetts General Hospital and Harvard Medical School, 185 Cambridge Street, Suite 2000, Boston, MA, 02114, USA; University of Washington, 3751 West Stevens Way NE, Seattle, WA, 98195, USA.
| | - Sabine Wilhelm
- Massachusetts General Hospital and Harvard Medical School, 185 Cambridge Street, Suite 2000, Boston, MA, 02114, USA.
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Uddin MN, Emran TB. Prevention of Progression and Remission in Public Health Sectors: Bangladesh Perspectives. ATLANTIS HIGHLIGHTS IN CHEMISTRY AND PHARMACEUTICAL SCIENCES 2023:131-150. [DOI: 10.2991/978-94-6463-130-2_15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Haywood D, Baughman FD, Mullan BA, Heslop KR. Neurocognitive Artificial Neural Network Models Are Superior to Linear Models at Accounting for Dimensional Psychopathology. Brain Sci 2022; 12:1060. [PMID: 36009123 PMCID: PMC9405994 DOI: 10.3390/brainsci12081060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 08/03/2022] [Accepted: 08/09/2022] [Indexed: 11/16/2022] Open
Abstract
In recent years, there has been debate about the optimal conceptualisation of psychopathology. Structural models of psychopathology have been developed to counter issues, including comorbidity and poor diagnostic stability prevalent within the traditional nosological approach. Regardless of the conceptualisation of psychological dysfunction, deficits in neurocognitive abilities have been claimed to be an aetiological feature of psychopathology. Explorations of the association between neurocognition and psychopathology have typically taken a linear approach, overlooking the potential interactive dynamics of neurocognitive abilities. Previously, we proposed a multidimensional hypothesis, where within-person interactions between neurocognitive domains are fundamental to understanding the role of neurocognition within psychopathology. In this study, we used previously collected psychopathology data for 400 participants on psychopathological symptoms, substance use, and performance on eight neurocognitive tasks and compared the predictive accuracy of linear models to artificial neural network models. The artificial neural network models were significantly more accurate than the traditional linear models at predicting actual (a) lower-level and (b) high-level dimensional psychopathology. These results provide support for the multidimensional hypothesis: that the study of non-linear interactions and compensatory neurocognitive profiles are integral to understanding the functional associations between neurocognition and of psychopathology.
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Affiliation(s)
- Darren Haywood
- St. Vincent’s Hospital Melbourne, Mental Health, Fitzroy, VIC 3065, Australia
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
- EnAble Institute, Curtin University, Bentley, WA 6102, Australia
| | - Frank D. Baughman
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
| | - Barbara A. Mullan
- School of Population Health, Curtin University, Bentley, WA 6102, Australia
- EnAble Institute, Curtin University, Bentley, WA 6102, Australia
| | - Karen R. Heslop
- Curtin School of Nursing, Curtin University, Bentley, WA 6102, Australia
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