The role of aesthetic sensitivity in body dysmorphic disorder.

Abstract

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

Incompleteness, aesthetic sensitivity, and the obsessive-compulsive need for symmetry

“…Veale, Ennis, and Lambrou (2002) found that compared to individuals with other psychiatric diagnoses, those with BDD were five times more likely to have aesthetic interests and skills, evidenced by an education or occupation in art and design. In a quasi-experimental study in which symmetry of images was manipulated, Lambrou, Veale, and Wilson (2011) found further evidence of enhanced aestheticality in BDD, in the form of perceptual acuity for symmetry in face and non-face stimuli, similar to a comparison group of individuals with an arts and design background. These authors allude to the possibility that heightened aestheticality may extend to the more general OC need for symmetry, and also, importantly, that incompleteness may be the bridge between them (Veale & Lambrou, 2002, p. 430).…”

Scar satisfaction and body image in thyroidectomy patients: prospective study in a tertiary referral centre

“…26 No assessment of aesthetic sensitivity has yet been conducted in patients undergoing thyroid surgery. Anecdotally, the authors have encountered patients with high aesthetic standards perceiving their scars negatively, even disproportionately so, particularly in the context of robotic-assisted thyroidectomy.…”

Cosmetic Clitoridectomy in a 33-Year-Old Woman

“…This case was characterized by the extreme ordinariness of her background and lack of any psychiatric disorder or significant psychopathology. This may, therefore, be an example of some individuals being more aesthetically sensitive (Lambrou, Veale, & Willson, 2011;Veale et al, 1996) and just having an aversion to the appearance of normal genitalia. It may be better to accept our lack of understanding for such procedures than suggest an unknown learning history or an unconscious motivation for her desire.…”