Body-related cognitions, affect and post-event processing in body dysmorphic disorder

Faculty/Professorship: Clinical Psychology and Psychotherapy  
Author(s): Kollei, Ines  ; Martin, Alexandra
Title of the Journal: Journal of behavior therapy and experimental psychiatry : the official organ of the Behavior Therapy and Research Society ; a journal of experimental psychopathology
ISSN: 0005-7916
Publisher Information: Amsterdam [u.a.] : Elsevier
Year of publication: 2014
Volume: 45
Issue: 1
Pages: 144-151
Language(s): English
DOI: 10.1016/j.jbtep.2013.09.005
Background and objectives: Cognitive behavioural models postulate that individuals with BDD engage in negative appearance-related appraisals and affect. External representations of one's appearance are thought to activate a specific mode of processing characterized by increased self-focused attention and an activation of negative appraisals and affect.
Methods: The present study used a think-aloud approach including an in vivo body exposure to examine body-related cognitions and affect in individuals with BDD (n = 30), as compared to individuals with major depression (n = 30) and healthy controls (n = 30). Participants were instructed to think aloud during baseline, exposure and follow-up trials.
Results: Individuals with BDD verbalized more body-related and more negative body-related cognitions during all trials and reported higher degrees of negative affect than both control groups. A weaker increase of positive body-related cognitions during exposure, a stronger increase of sadness and anger after exposure and higher levels of post-event processing, were specific processes in individuals with BDD.
Limitations: Individuals with major depression were not excluded from the BDD group. This is associated with a reduction of internal validity, as the two clinical groups are somewhat interwoven. Key findings need to be replicated.
Conclusion: The findings indicate that outcomes such as negative appearance-related cognitions and affect are specific to individuals with BDD. An external representation of one's appearance activates a specific mode of processing in BDD, manifesting itself in the absence of positive body-related cognitions, increased anger and sadness, and high levels of post-event processing. These specific processes may contribute toward maintenance of BDD psychopathology.
Keywords: Body dysmorphic disorder, Cognitions, Affect, Post-event processing, Body image
Type: Article
Year of publication: 20. August 2015