11 - Body dysmorphic disorder

Summary

This chapter intends to alert clinicians to the presence of body dysmorphic disorder (BDD) and offers some useful tools for the detection, assessment, and treatment of BDD. Body dysmorphic disorder appears to be a relatively common disorder that usually begins in late childhood or early adolescence and has a chronic course if left untreated. The etiology and maintenance of BDD involve an interaction of cognitive, affective, behavioral, biological, and sociocultural factors. BDD patients who engage in anxiety-provoking situations will often use rituals or safety behaviors to cope with the anxiety-provoking event. Pharmacotherapy with serotonin reuptake inhibitors (SRIs) and cognitive-behavioral therapy (CBT) are considered the first-line treatments for BDD. Level of delusionality may affect treatment process or outcome in CBT for BDD. Motivation for change and ambivalence about treatment and treatment goals can also present a challenge to treatment.