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  • The Body Dysmorphic Disorder Program at Rhode Island Hospital

  • Causes and Treatment

  • Causes of Body Dysmorphic Disorder

    The cause of Body Dysmorphic Disorder is unknown, but it is likely that a combination of many factors causes BDD: a) genetic makeup and neurobiological factors and b) environmental factors, such as life events and our society's focus on appearance. 

    Recent scientific studies suggest that the following factors may be associated with BDD. But it's unlikely that any one of the following alone entirely explains why a person gets BDD:

    • Genetic factors
    • Abnormalities in visual processing, which involves overly focusing on details of both faces and non-face objects (such as houses), rather than seeing the "big picture" (that is, using holistic visual processing strategies)
    • Possible differences in brain structure between people with BDD and people who don't have BDD. Several studies that use brain imaging techniques have found this.
    • Greater activity in parts of the brain that are involved in obsessional preoccupation and fear (this was found in studies that used functional MRI)
    • Teasing and possibly maltreatment during childhood (however, it isn't known whether these events are really more common in people with BDD or are instead more upsetting and remembered more by people with BDD)
    • A tendency to interpret neutral facial expressions and scenarios as threatening
    • Personality traits like perfectionism, unassertiveness, emotional over-reactivity to rejection and criticism, and low self-esteem

    The above factors appear to be characteristic of many people with BDD, but the research studies were designed in such a way that they could not confirm that these factors actually make someone more likely to develop BDD or actually cause BDD. Much more scientific research is needed to confirm that the factors listed above are really characteristic of people with BDD and to identify the causes of BDD. Understanding what causes BDD may lead to the development of even more effective treatments and perhaps even prevent this serious mental illness from occurring.

    Recommended Treatments for Body Dysmorphic Disorder

    The good news is there are treatments that can improve BDD. BDD isn't vanity. It is a real medical disorder that often gets better with the right treatment. Read more about treaments for BDD.

    Certain medications called serotonin-reuptake inhibitors (also known as SRIs or SSRIs) are often very helpful for BDD. They are not habit-forming and are usually well tolerated. A certain type of therapy, called cognitive-behavioral therapy (CBT), is also often helpful for BDD. CBT needs to be tailored to BDD's unique symptoms. These two types of treatment often diminish preoccupations with appearance and compulsive behaviors such as mirror checking, alleviate emotional distress and suffering and improve depression in people with BDD. They also often help people with BDD feel better about how they look, function better and lead a happier and more productive life. 

    We Offer No Cost Study Treatment for Those Who Qualify

    We offer both therapy and medication study treatment for people who are within driving distance (about an hour) of Providence, RI, and who further qualify for our studies. Some of our studies are also offered in Boston, MA, in collaboration with researchers at Massachusetts General Hospital/Harvard Medical School.

    We are dedicated to doing research studies to increase understanding of BDD and to develop new and more effective treatments for BDD. Research provides extremely valuable information about BDD. It's the best way to better understand the disorder and how to overcome it. We regularly share our research findings with professionals and the public through media interviews, scientific journal publications and presentations around the world.

    We can do research and learn what treatments are effective only if people volunteer to participate in our studies. We are very grateful to everyone who participates! Their participation is an invaluable contribution toward our ultimate goal: to diminish suffering and improve quality of life for people with BDD.