مانیتورینگ واقعیت در بیماران مبتلا به اختلال بدریخت انگاری
|کد مقاله||سال انتشار||مقاله انگلیسی||ترجمه فارسی||تعداد کلمات|
|35581||2011||12 صفحه PDF||سفارش دهید||7112 کلمه|
Publisher : Elsevier - Science Direct (الزویر - ساینس دایرکت)
Journal : Behavior Therapy, Volume 42, Issue 3, September 2011, Pages 387–398
Patients with body dysmorphic disorder (BDD) typically have very poor insight into their disorder. Their conviction in their ugliness is often of delusional intensity. Reality monitoring is the ability to distinguish in memory between things that one has imagined and things that one has perceived. Deficits in reality monitoring have been associated with the development of other delusional beliefs. Therefore, in the present study we investigated whether individuals with BDD (n = 20) demonstrate impairments in reality monitoring relative to individuals with obsessive-compulsive disorder (OCD; n = 20) and healthy controls (n = 20). This hypothesized impairment might predispose people with BDD to confuse memories of how they imagine themselves to appear (i.e., ugly) with memories of how they actually appear (i.e., normal). All participants completed a memory task assessing reality-monitoring ability for verbal stimuli. The BDD patients did not exhibit a reality-monitoring deficit despite elevated levels of focal delusionality. The results suggest that impairments in reality monitoring do not contribute to the development or maintenance of appearance-related beliefs in BDD. Body dysmorphic disorder (BDD) is characterized by a preoccupation with imagined or very slight defects in physical appearance (American Psychiatric Association, 2000). The most frequent areas of concern are the skin, hair, and nose (Phillips, Menard, Fay, & Weisberg, 2005) although the focus of concern may be any body part. Individuals with BDD are often consumed by intrusive thoughts and images related to their appearance. In response to these concerns, they will often spend hours each day performing ritualistic behaviors to reduce their distress. Excessive grooming, mirror checking, repetitive touching, excessive application of makeup, and camouflaging one's appearance with clothing or jewelry are common rituals. The disorder may affect nearly 2% of the general population (Buhlmann et al., 2010, Koran et al., 2008 and Rief et al., 2006). It typically causes marked social, educational, and occupational impairment. For example, in a study of 200 individuals with BDD, 36% missed a week or more of work in the prior month and 11% dropped out of school because of BDD (Phillips et al., 2005). Perhaps most alarmingly, more than 25% reported at least one prior suicide attempt. Clearly, we need to deepen our understanding of the factors contributing to the development and maintenance of such a severe disorder. One striking feature of individuals with BDD is a lack of insight into their disorder. They often do not see themselves as suffering from a psychological problem requiring mental health care, but rather suffering from a defect in appearance remediable only by cosmetic procedures. For example, an examination of 129 patients with BDD revealed that 84% were classified as either delusional (n = 68) or having poor insight (n = 40) into their primary disorder-related belief ( Phillips, 2004). Similarly, in a larger study of 191 individuals with BDD, approximately one third of the sample (n = 68) was classified as delusional ( Phillips, Menard, Pagano, Fay, & Stout, 2006). The remaining participants, although not delusional, were characterized by poor insight into their primary disorder-related belief.