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February 1, 2010
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Katherine Harmon is a freelance writer and contributing editor for Scientific American. Her book Octopus! will be published October 31 from Current/Penguin USA. Follow on Twitter @katherineharmon.
Despite living in a culture obsessed with physical flawlessness, most people in the U.S. have a relatively realistic perception of their own form and face—blemishes, bulges and all. About one to two percent of the population, however, suffers from a recognized psychological illness, known as body dysmorphic disorder (or BDD), which causes them to be preoccupied with physical defects that they think make them look repugnant. Such tendencies can lead some people to extreme and frequent plastic surgeries and even suicide.
A new study used brain scans to see how patients’ minds worked when looking at faces—both of others and themselves. The results, published online February 1 in Archives of General Psychiatry, show that people with BDD seem to get hung up on details and hint at a link with obsessive-compulsive disorder.
The new case-control study used functional magnetic-resonance imaging (fMRI) to study brain activity among 33 people (17 control subjects and 16 with BDD) as the subjects looked at photos of their face and that of a familiar celebrity. Previous research and clinical observation had found that people with BDD tend to "focus primarily on details of their appearance at the expense of global or configural aspects," the researchers wrote.
So following this lead, the researchers (led by Jamie Feusner, of the David Geffen School of Medicine at the University of California, Los Angeles) showed subjects standard photos as well as altered versions: one in which only the details remained and another in which only basic, blurred information remained.
Although the study was small, the researchers found a distinct difference between how the brains of the people with BDD and the control individuals reacted upon seeing the images. Analysis of the scans showed that "individuals with BDD have abnormal brain activation patterns when viewing their own face, showing hyperactivity in primary and secondary visual processing regions for [blurred] faces and hyperactivity in frontostriatal systems for [normal] faces," noted the researchers. This tendency to focus in on the details at the expense of an "ability to contextualize them configurally or holistically" might be at the root of the disorder and "suggests aberrant activity patterns for faces in general," the researchers wrote.
The severity of these effects appeared to correlate with the level of BBD symptoms in people who had the disorder.
These cognitive patterns, the scientists report, represent "preliminary evidence of a possible similarity in functional neuroanatomy between BDD and obsessive-compulsive disorder."
Image courtesy of iStockphoto/Opla
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Again, correlation does not establish causality. If defective brain physiology causes the disorder, why would it affect self-recognition differently from general facial recognition? It seems more likely that some underlying cause has affected the abnormal patterns of functional activation to produce the BDD symptoms. This could direct researches towards some effective methods of treatment of the symptoms produced, but not necessarily the root cause of the disorder.
Link to thisI don’t see anything in either this article or in the abstract of "Abnormalities of Visual Processing and Frontostriatal Systems in Body Dysmorphic Disorder" that says anything about causality.
In fact, I applaud Ms. Harmon for not making statements of causality that the authors of the study did not make. All too often, journalists will read of a mere association and create a headline that blares some unwarranted causal claim.
Link to thisbillsmith – You might be right. Perhaps I read too much into the following statement from the article:
‘This tendency to focus in on the details at the expense of an "ability to contextualize them configurally or holistically" might be at the root of the disorder and "suggests aberrant activity patterns for faces in general," the researchers wrote.’
I may have inappropriately generalized, as too often investigators attribute causation to the object of their investigations. I suggest that aberrant activity patterns in brain activity are most likely processing artifacts of the disorder.
Link to thisIn fact, since I am not a participant in the field but have, on occasion, observed its methods, I would speculate that this research could lead to development of medications to suppress hyperactivity of visual processing regions as an “effective treatment” for the disorder. While a profitable method of treatment development, the resulting products too often produce significant side effects and many times permanent disablement. I for one am against this type of “fast track” pharmaceutical product development. But then, none of that was explicitly stated in the article…
Link to thisI don’t understand how this is a discovery at all. BDD has always been a subset of OCD.
Link to this