Abstract. A survey of individuals was conducted on self-diagnosed vomit phobics compared to panic disorder and non-clinical controls. Vomit phobics were overwhelmingly female and had had symptoms for over 25 years. They were significantly more likely to fear themselves vomiting (in public and private situations) than fear others vomiting. The vomit phobics interpreted sensations of nausea as impending vomit and had a wide range of safety seeking and avoidance behaviours that were maintaining their fear. Although the vomit phobics reported feeling nauseous more often, there was no difference in their frequency of vomiting compared to the control group. The clinical implications of the study for therapy are discussed.
The results suggest that BDD patients have an unrealistic ideal or demand as to how they should look. BDD patients are more like depressed patients (rather than social phobics or bulimics), being more concerned with a failure to achieve their own aesthetic standard than with the perceived ideals of others.
Individuals with body dysmorphic disorder (BDD) are excessively preoccupied with an imagined or slight defect in appearance. Higher aesthetic sensitivity in facial proportions may explain why BDD patients are severely disturbed by a small defect in their appearance.Aesthetic sensitivity can be defined as an awareness and appreciation of beauty and harmony, with three components: i) perceptual (ability to differentiate variations in aesthetic proportions); ii) emotional (degree of emotion experienced when viewing beauty or ugliness); iii) evaluative (aesthetic standards, values and identity).Fifty BDD patients were compared with two non-clinical control groups; 50 art & design controls and 50 non-art controls. A facial photograph of the participant was manipulated using computer graphic techniques, to create a 9-image symmetry continuum. Presented with the continuum on a computer, participants selected and rated images representing their self-actual, self-ideal, idea of a perfect, most physically attractive, most pleasure and most disgust. Control symmetry continua examined the specificity of the disturbance.As predicted, BDD patients displayed increased accuracy in their self-actual estimation and greater sensitivity to aesthetic proportions. BDD patients were not distorted in their perceptual processing but appeared exclusively disturbed in their negative emotional/evaluative processing of their own face. However, BDD patients did not express a higher aesthetic standard of beauty compared to controls. A significant discrepancy between BDD patients' self-actual and self-ideal, resulting from an absent self-serving bias in their self-actual estimation, a bias notably exhibited by controls, may be the crucial determining factor and potential source of their disturbance. BDD patients also overvalued the importance of appearance and self-objectified. These aesthetic evaluations may interact with aesthetic perceptions and emotions to predispose them to and/or maintain the disorder.Investigating the role of personality/psychological factors, path analyses suggested that body shame mediates the relationship between aesthetic sensitivity and BDD symptomatology. Clinical implications are discussed.3
Onset of body dysmorphic disorder is usually gradual during adolescence, and an education in art and design may be a contributory factor to its development in some patients. An equally plausible explanation is that patients with body dysmorphic disorder tend to have an interest in aesthetics.
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