What is body dysmorphic disorder?
Individuals with body dysmorphic
disorder (formerly known as dysmorphophobia) are preoccupied with one or more
perceived defects or flaws in their physical appearance, which they believe
look ugly, unattractive, abnormal, or deformed. The perceived flaws are not
observable or appear only slight to other individuals.
Concerns range from looking
"unattractive" or "not right" to looking
"hideous" or "like a monster." Preoccupations can focus on
one or many body areas, most commonly the skin (e.g., perceived acne, scars,
lines, wrinkles, paleness), hair (e.g., "thinning" hair or
"excessive" body or facial hair), or nose (e.g., size or shape).
However, any body area can be the focus of concern (e.g., eyes, teeth, weight,
stomach, breasts, legs, face size or shape, lips, chin, eyebrows, genitals).
Some individuals are concerned
about perceived asymmetry of body areas. The preoccupations are intrusive,
unwanted, time-consuming (occurring, on average, 3-8 hours per day), and
usually difficult to resist or control.
Excessive repetitive behaviors or
mental acts (e.g., comparing) are performed in response to the preoccupation. The
individual feels driven to perform these behaviors, which are not pleasurable
and may increase anxiety and dysphoria.
They are typically time-consuming
and difficult to resist or control. Common behaviors are comparing one's
appearance with that of other individuals;
·
repeatedly checking perceived defects in mirrors or other
reflecting surfaces or examining them directly;
·
excessively grooming (e.g., combing, styling, shaving, plucking,
or pulling hair);
·
camouflaging (e.g., repeatedly applying makeup or covering
disliked areas with such things as a hat, clothing, makeup, or hair);
·
seeking reassurance about how the perceived flaws look;
·
touching disliked areas to check them;
·
excessively exercising or weight lifting;
·
and seeking cosmetic procedures.
Some individuals excessively tan
(e.g., to darken "pale" skin or diminish perceived acne), repeatedly
change their clothes (e.g., to camouflage perceived defects), or compulsively
shop (e.g., for beauty products).
Compulsive skin picking intended
to improve perceived skin defects is common and can cause skin damage,
infections, or ruptured blood vessels.