Altering Visual Perception Abnormalities: A Marker for Body Image Concern

'Magic cosmetic fillers': Appearance-enhancement effects on self-face recognition

People naturally exhibit a self-serving bias which can be observed in their tendency to judge their own physical attractiveness more favourably than that of others. Despite this positive self-perception, minimally invasive cosmetic injectable procedures for facial rejuvenation and enhancement are becoming increasingly common. It remains unclear, however, whether recognizing an altered version of one's own face, enhanced cosmetically, correlates with a positive view of cosmetic surgery and excessive preoccupations about physical characteristics perceived as defects (body dysmorphic concerns). In this study, 30 healthy female participants, aged 18-24 years (Mage = 21.1 years, SD = 1.6), engaged in a face recognition task during which their faces were digitally morphed with that of gender-matched unfamiliar women who had undergone cosmetic enhancements, specifically lip and cheek fillers. The duration of exposure to these modified faces varied with short (500 msec) and long (2000 msec) viewing periods. Participants were asked to identify whether the digital morphs represented themselves or the other woman. Self-reports regarding acceptance of cosmetic surgery and dysmorphic concerns were collected. Participants PSE indicated a tendency towards self-bias under short presentation times, shifting towards the other as presentation times lengthened. Interestingly, this effect was associated with greater acceptance of cosmetic surgery and higher body dysmorphic concerns. This study underscores the importance of understanding how perceptions of others' physical appearances can influence self-recognition and attitudes towards cosmetic surgery, which may have both positive and potentially harmful implications.

Visual Perceptual Processing Abnormalities in Body Dysmorphic Disorder

Phenomenological observations of individuals with body dysmorphic disorder (BDD), coupled with evidence from neuropsychological, psychophysical, and neuroimaging studies, support a model of aberrant visual perception characterized by deficient global/holistic, enhanced detail/local processing, and selective visual-attentional biases. These features may contribute to the core symptomatology of distorted perception of their appearance, in addition to misinterpretation of others' facial expressions and poor insight regarding their misperceived appearance defects. Insights from visual processing studies can contribute to the development of novel interventions, such as perceptual retraining and non-invasive neuromodulation. However, much remains to be understood about visual perception in BDD. Future research should leverage brain imaging modalities with high temporal resolutions and employ study designs that induce conflicts in multisensory integration, thereby advancing our mechanistic understanding of distorted visual perception observed in BDD.

Neural and behavioral effects of modification of visual attention in body dysmorphic disorder

In individuals with body dysmorphic disorder (BDD), perceptual appearance distortions may be related to selective attention biases and aberrant visual scanning, contributing to imbalances in global vs. detailed visual processing. Treatments for the core symptom of perceptual distortions are underexplored in BDD; yet understanding their mechanistic effects on brain function is critical for rational treatment development. This study tested a behavioral strategy of visual-attention modification on visual system brain connectivity and eye behaviors. We acquired fMRI data in 37 unmedicated adults with BDD and 30 healthy controls. Participants viewed their faces naturalistically (naturalistic viewing), and holding their gaze on the image center (modulated viewing), monitored with an eye-tracking camera. We analyzed dynamic effective connectivity and visual fixation duration. Modulated viewing resulted in longer mean visual fixation duration compared to during naturalistic viewing, across groups. Further, modulated viewing resulted in stronger connectivity from occipital to parietal dorsal visual stream regions, also evident during the subsequent naturalistic viewing, compared with the initial naturalistic viewing, in BDD. Longer fixation duration was associated with a trend for stronger connectivity during modulated viewing. Those with more severe BDD symptoms had weaker dorsal visual stream connectivity during naturalistic viewing, and those with more negative appearance evaluations had weaker connectivity during modulated viewing. In sum, holding a constant gaze on a non-concerning area of one's face may confer increased communication in the occipital/parietal dorsal visual stream, facilitating global/holistic visual processing. This effect shows persistence during subsequent naturalistic viewing. Results have implications for perceptual retraining treatment designs.

A multilevel Bayesian meta-analysis of the body inversion effect: Evaluating controversies over headless and sexualized bodies

Face and body perception rely on specialized processing mechanisms to interpret social information efficiently. The body inversion effect (BIE), refers to an inversion effect for bodies, such that recognition of bodies is impaired by inversion. The BIE, like the face inversion effect (FIE), is particularly important because a disproportionate BIE relative to inversion effects for objects could be interpreted in much the same way as the disproportionate FIE has often been characterized; that is, as evidence of specialized, configural processing. However, research supporting the BIE is marked by methodological heterogeneity and mixed findings. Our multilevel Bayesian meta-analysis addresses inconsistencies in the literature by pooling data from numerous studies to estimate the magnitude of the BIE across various methodological and stimulus properties. We included 180 effect sizes from 41 empirical articles representing data from 2,274 participants. Overall, we found that the BIE was moderate-large in magnitude (Hedges' g = 0.75). Importantly, the inversion effect was larger for bodies than objects (b = 0.42); however, the inversion effect for faces was larger than for bodies (b = 0.34). We tested the role of discrimination dimension, stimulus type, face/head inclusion, stimulus sexualization, and sexualized stimulus sex as moderators of the BIE. We found that the BIE was moderated by discrimination dimension, stimulus type, stimulus sexualization, and sexualized stimulus sex. By synthesizing the existing literature, we provide a better theoretical understanding of how underlying visual processing mechanisms may differ for different types of social information (i.e., bodies vs. faces).

Associations of observer's gender, Body Mass Index and internalization of societal beauty ideals to visual body processing

We examined whether visual processing mechanisms of the body of conspecifics are different in women and men and whether these rely on westernised socio-cultural ideals and body image concerns. Twenty-four women and 24 men performed a visual discrimination task of upright or inverted images of female or male bodies and faces (Experiment 1) and objects (Experiment 2). In Experiment 1, both groups of women and men showed comparable abilities in the discrimination of upright and inverted bodies and faces. However, the gender of the human stimuli yielded different effects on participants' performance, so that female faces, and male bodies appeared to be processed less configurally than female bodies and male faces, respectively. Interestingly, the reduction of configural processing for male bodies was significantly predicted by participants' Body Mass Index (BMI) and their level of internalization of muscularity. Our findings suggest that configural visual processing of bodies and faces in women and men may be linked to a selective attention to detail needed for discriminating salient physical (perhaps sexual) cues of conspecifics. Importantly, BMI and muscularity internalization of beauty ideals may also play a crucial role in this mechanism.

Perceived match between own and observed models' bodies: influence of face, viewpoints, and body size

People are generally unable to accurately determine their own body measurements and to translate this knowledge to identifying a model/avatar that best represents their own body. This inability has not only been related to health problems (e.g. anorexia nervosa), but has important practical implications as well (e.g. online retail). Here we aimed to investigate the influence of three basic visual features—face presence, amount of viewpoints, and observed model size—on the perceived match between own and observed models’ bodies and on attitudes towards these models. Models were real-life models (Experiment 1) or avatar models based on participants’ own bodies (Experiment 2). Results in both experiments showed a strong effect of model size, irrespective of participants’ own body measurements. When models were randomly presented one by one, participants gave significantly higher ratings to smaller- compared to bigger-sized models. The reverse was true, however, when participants observed and compared models freely, suggesting that the mode of presentation affected participants’ judgments. Limited evidence was found for an effect of facial presence or amount of viewpoints. These results add evidence to research on visual features affecting the ability to match observed bodies with own body image, which has biological, clinical, and practical implications.

Evidence for altered configural body processing in women at risk of disorders characterized by body image disturbance

Two studies were conducted to assess appearance-related visual processing mechanisms in populations at risk of disorders characterized by body image disturbance. Using inverted stimuli, Experiment 1 assessed visual processing mechanisms associated with body, face, and house viewing in adolescents. Experiment 2 applied the same protocol to assess appearance-related configural processing in high- and low-risk adolescent women, and women recovering from disorders characterized by body image disturbance. Experiment 1 found evidence for typical configural face and body processing, although adolescent women reported higher levels of body image concern (BIC) and self-objectified to a greater extent than adolescent men. In Experiment 2, typical body inversion effects were seen in the low-risk group, whilst there was some evidence to suggest a disruption to the configural processing of body stimuli in high-risk adolescents and in women recovering from body image disorders. Women in recovery were also quicker to respond to all stimuli, whilst high-risk adolescents took longer to respond to bodies than to other stimuli. Configural face processing was intact in all groups, and effects did not directly relate to BIC or self-objectification. These findings have implications for future research looking to inform early interventions and treatment, suggesting that there could be a tendency to visually process individual body parts at the expense of the whole-body form in women at risk of developing body image disorders, as well as those in recovery.

Parameters of visual processing abnormalities in adults with body image concerns

Body dysmorphic disorder (BDD), at the extreme end of the body image concern (BIC) spectrum, is thought to be associated with a local (detail-focussed) visual processing bias. Given that the inversion of a stimulus disrupts holistic processing and demands detail-specific attention, this perceptual bias is characterised by superior processing of such inverted stimuli. This study examined the processing bias, via a body-inversion discrimination task, of 26 participants with non-clinical, high-BIC (Dysmophic Concern Questionnaire (DCQ) scores between 11–19) and 26 participants with low-BIC (DCQ scores between 0–4). This study also explored the impact of varying stimuli presentation durations and discrimination difficulties during the inversion task on visual processing. As hypothesised, compared to those with low-BIC, participants with high-BIC demonstrated superior accuracy when discriminating between images of inverted bodies, indicating a local processing bias. Also as hypothesised, this local processing bias selectively manifested only when stimuli were presented for longer durations and at higher discrimination difficulties, revealing the parameters of this, potentially conscious, processing tendency. Consistent with previous research, this study identified a local processing bias in those with high BIC, which may be a predisposing factor for developing BDD. In turn, identifying the parameters (stimulus exposure and stimulus complexity) in which the local bias manifests has implications for future interventions aiming to reverse this perceptual abnormality.

A translational neuroscience approach to body image disturbance and its remediation in anorexia nervosa

Deviant perception of the body is a fundamental component of anorexia nervosa. Here we offer a potential mechanistic explanation that involves perturbations within the visual system and the brain circuits that modulate perceptual organization. Based on the model proposed, we also suggest a mechanistic strategy for altering neuronal activity in the visual system to normalize perception of the body, and set out a strategy for empirically testing its clinical application.

A systematic review of visual processing and associated treatments in body dysmorphic disorder

OBJECTIVE

Recent advances in body dysmorphic disorder (BDD) have explored abnormal visual processing, yet it is unclear how this relates to treatment. The aim of this study was to summarize our current understanding of visual processing in BDD and review associated treatments.

METHOD

The literature was collected through PsycInfo and PubMed. Visual processing articles were included if written in English after 1970, had a specific BDD group compared to healthy controls and were not case studies. Due to the lack of research regarding treatments associated with visual processing, case studies were included.

RESULTS

A number of visual processing abnormalities are present in BDD, including face recognition, emotion identification, aesthetics, object recognition and gestalt processing. Differences to healthy controls include a dominance of detailed local processing over global processing and associated changes in brain activation in visual regions. Perceptual mirror retraining and some forms of self-exposure have demonstrated improved treatment outcomes, but have not been examined in isolation from broader treatments.

CONCLUSION

Despite these abnormalities in perception, particularly concerning face and emotion recognition, few BDD treatments attempt to specifically remediate this. The development of a novel visual training programme which addresses these widespread abnormalities may provide an effective treatment modality.

Face and Object Perception in Body Dysmorphic Disorder versus Obsessive-Compulsive Disorder: The Mooney Faces Task

OBJECTIVES

Body dysmorphic disorder (BDD) is characterized by repetitive behaviors and/or mental acts occurring in response to preoccupations with perceived defects or flaws in physical appearance. There are some similarities, but also important differences, between BDD and obsessive-compulsive disorder (OCD), not just in terms of core clinical symptoms, but possibly in the domain of perception. This study compared the nature and extent of perceptual anomalies in BDD versus OCD and health controls (HC), using a modified Mooney task.

METHODS

We included 21 BDD, 19 OCD, and 21 HC participants, who were age-, sex-, and IQ-matched. A set of 40 Mooney faces and 40 Mooney objects arranged in three configurations (i.e., upright, inverted, or scrambled) were presented under brief (i.e., 500 ms) free-viewing conditions. Participants were asked to decide whether each image represented a human face, an object, or neither in a forced-choice paradigm.

RESULTS

The BDD group showed significantly reduced face and object inversion effects relative to the other two groups. This was accounted for by BDD participants being significantly more accurate in identifying inverted Mooney faces and objects than the other participants.

CONCLUSIONS

These data were interpreted as reflecting an overreliance on independent components at the expense of holistic (configural) processing in BDD. (JINS, 2017, 23, 471-480).

Treatment Modifications and Suggestions to Address Visual Abnormalities in Body Dysmorphic Disorder

Recent psychophysical and neurocognitive findings implicate abnormal visual processing for a range of stimuli in body dysmorphic disorder (BDD); such abnormalities differentiate BDD from other mental health disorders. Current treatments most commonly involve cognitive behavior therapy with or without accompanying antidepressant medications. These are moderately successful yet appear to overlook the core phenomenological aspect of abnormal perception in BDD. The following text summarizes the current literature of perceptual abnormalities within BDD and how these findings may be applied and incorporated into treatment options. Possible modifications of cognitive behavioral therapy (CBT) based on the widespread visual abnormalities within BDD include making perceptual mirror retraining a compulsory component of therapy and implementing self-exposure tasks within exposure and response prevention. Alternative options such as a visual training program to remediate visual abnormalities across a range of visual stimuli are also explored, which may be included as an adjunctive treatment alongside CBT.