توجه انتخابی به زشتی صورت تصورشده مختص به اختلال بدریخت انگاری است

Cognitive-behavioral models postulate that biases in selective attention are key factors contributing to susceptibility to and maintenance of body dysmorphic disorder (BDD). Visual attention in particular toward the imagined defect in appearance may be a crucial element. The present study therefore examined whether individuals with BDD showed increased visual attention to flaws in their own and in unfamiliar faces. Twenty individuals with BDD, 20 individuals with social phobia, and 20 mentally healthy individuals participated in an eye-tracking experiment. Participants were instructed to gaze at the photographs of 15 pictures of themselves and several unfamiliar faces. Only patients with BDD showed heightened selective visual attention to the imagined defect in their own face, as well to corresponding regions in other, unfamiliar faces. The results support the assumption that there is a specific attentional bias in BDD.

Body dysmorphic disorder (BDD) is characterized by preoccupation with perceived defects in one's appearance (American Psychiatric Association, 2000). Patients are distressed about abnormalities in their appearance that are either imaginary or constitute only minor physical anomalies (Phillips, 2005 and Veale and Neziroglu, 2010). Individuals with BDD exhibit fear and avoidance of situations in which they may be exposed to scrutiny and negative evaluation; they have recurrent, intrusive thoughts about their ugliness that are difficult to resist and prompt checking and grooming (Buhlmann, McNally, Wilhelm, & Florin, 2002). Many individuals with BDD also report low self-esteem (Buhlmann et al., 2008b and Phillips, 2005). Therefore, BDD shares some essential features with social anxiety disorder, among them fear and/or avoidance of social situations and low self-esteem. Accordingly, the most frequent comorbid disorders (lifetime) found in a study with 293 BDD patients were social phobia, major depression, obsessive–compulsive disorder, and substance use disorders (Gunstadt & Phillips, 2003). The common comorbidity of BDD and social phobia is also emphasized in current treatment manuals for BDD; for example, a range between 16% and 69% (Veale & Neziroglu, 2010). Kelly, Walters, and Phillips (2010) even suggested that social anxiety is a prominent characteristic of body dysmorphic disorder. These authors found that greater social anxiety in individuals with BDD was associated with poorer psychosocial functioning in cross-sectional and prospective analyses, particularly fear and avoidance of social situations (Kelly et al., 2010). They concluded that social anxiety may be a significant contributory factor to functional impairment in individuals with BDD. These results indicate a conceptual overlap between BDD and social phobia, which is also reflected in similarities of assumed information processing.