This systematic review and meta-analysis examined the evidence supporting the association between body dysmorphic disorder (BDD) symptomology and four types of cognitive processing abnormalities: local processing, selective attention, interpretive biases, and memory deficits. Twenty-three studies met inclusion requirements that examined differences in performance on cognitive tasks between BDD and control groups across the four categories. Multilevel modelling was used to calculate an overall effect size for each cognitive category. BDD and control groups differed significantly on measures of selective attention (g = 0.60, 95% CI = 0.26: 0.93), interpretive biases (g = 0.30, 95% CI = . 07: 0.54), and memory deficits (g=.56, 95% CI = 0.26: 0.87). Differences between the BDD and control groups on measures of local processing did not reach significance. These findings support the hypothesis that people with BDD may selectively attend to perceived threats or to disorder-related stimuli, misinterpret ambiguous stimuli as threatening, overvalue the importance of attractiveness, and have inaccurate coding and recall for facial or bodily stimuli. Recommendations for future research of these specific cognitive deficits in BDD include introducing the use of Modified Dot Probe Paradigms and new treatment targets that can be used as adjuncts to current treatment modalities.
Perfectionism is an important transdiagnostic risk factor for several psychopathologies. As such, treatments targeting perfectionism have gained increased attention over recent years. While perfectionism is postulated to be an important underlying mechanism for dysmorphic concern, no research has explored the benefits of targeting perfectionism to reduce dysmorphic concern. The current study evaluated the use of internet-delivered cognitive behavioural therapy for perfectionism (ICBT-P) with thirty-one participants (28 women) with high levels of dysmorphic concern to examine the impact on perfectionism, dysmorphic concern, body image disturbance, negative affect, and a dot-probe task assessing selective attention to appearance-based stimuli. Using a case series design, observations were collected at baseline, at the end of a four-week pre-treatment phase, after the eight-week ICBT-P, and one-month post-treatment. Intent-to-treat analyses showed significant improvement from baseline to end-of-treatment and follow-up on most of the variables, with a large effect size decrease in dysmorphic concern, and decreased vigilance for the BDD-body, BDD-positive, and BDD-negative words. The results of this study support the use of ICBT-P as an efficacious treatment worthy of further examination in populations who experience high levels of dysmorphic concern.
Objective
There is a paucity of research investigating the underlying aetiological mechanisms contributing to dysmorphic concern. In the present study, we used a multidimensional measure of perfectionism and a dot‐probe task, borrowed from the dysmorphic concern and body dysmorphic disorder literature, to assess associations between subtypes of perfectionism (i.e., concerns and strivings), selective attention towards target word stimuli (i.e., DC‐body, DC‐negative, and DC‐positive words), and dysmorphic concern. This was the first study to simultaneously examine these predictors and to investigate specific underlying selective attention mechanisms using probes and stimuli relevant to dysmorphic concern. Informed by current theories, we hypothesised that perfectionistic concerns and/or strivings and attention bias to target stimuli would be significantly associated with dysmorphic concern.
Method
Fifty‐seven students recruited from an Australian university completed the dot‐probe task and self‐report measures for perfectionism and dysmorphic concern.
Results
Doubts about actions (perfectionistic concerns), or a perfectionistic need to check details, and attention bias towards the DC‐positive words (e.g., pretty, attractive, chiselled) predicted dysmorphic concern in men and women. Perfectionism predicted most of the variance.
Conclusions
Perfectionism and selective attention predicted dysmorphic concern, which may serve to inform the development of future dot‐probe paradigms and early intervention programs targeting at‐risk populations endorsing clinically significant dysmorphic concerns.
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