Visual Brain Glitch Causes Distorted
Self-Image, UCLA Research Finds
December 4, 2007
Although they look normal, people suffering from body dysmorphic disorder (BDD)
perceive themselves as ugly and disfigured. New imaging research reveals that
the brains of people with BDD look normal, but function abnormally when
processing visual details. Reported in the December edition of the Archives
of General Psychiatry, the UCLA findings are the first to demonstrate a
biological reason for patients' distorted body image.
"Our discovery suggests that the BDD brain's hardware is fine, but there's
a glitch in the operating software that prevents patients from seeing themselves
as others do," explained Dr. Jamie Feusner, principal investigator and
assistant professor of psychiatry at UCLA's Semel Institute. "Now that
we've identified a possible physical cause, down the road we may be able to
pinpoint ways that patients' brains can be retrained to perceive faces more
accurately."
Individuals with BDD fixate on an imagined flaw in appearance or a slight
physical abnormality. To fix their "problem," they tend to pursue
plastic surgery -- sometimes repeatedly. They often feel ashamed, depressed and
anxious, increasing their risk of suicide.
Affecting an estimated two percent of the population, BDD tends to run in
families and is especially common in persons with obsessive-compulsive disorder
(OCD). Thirty percent of people with BDD suffer from eating disorders, which are
also linked to a distorted self-image.
Feusner was curious whether BDD patients' brains interfered with the
interpretation of visual input, and if so, whether this glitch occurred when
looking at faces other than their own.
"We hoped that asking patients to focus on others' faces would allow them
to be less emotionally engaged during the experiment," he said.
For the first time, functional magnetic resonance imaging (fMRI) was used to
reveal how the patients' brains processed visual input. The UCLA team outfitted
12 BDD patients with special goggles that enabled them to view digital photos of
various faces as they underwent a brain scan.
Each volunteer viewed three types of images. The first type was an untouched
photo. The second type was a photo altered to eliminate facial details that
appear frequently, such as freckles, wrinkles and scars. This "low
frequency" technique blurred the final image.
The third type of image essentially subtracted the blurred second image from the
untouched photo. This "high frequency" technique resulted in a finely
detailed line drawing.
Feusner's team compared the BDD patients' responses to 12 control subjects
matched by age, gender, education and handedness. What the scientists observed
surprised them.
"We saw a clear difference in how the right and left sides of the brain
worked in people with BDD versus those without the disorder," noted Feusner.
BDD patients more often used their brain's left side -- the analytic side
attuned to complex detail -- even when processing the less intricate,
low-frequency images. In contrast, the left sides of the control subjects'
brains activated only to interpret the more detailed high-frequency information.
Their brains processed the untouched and low-frequency images on the right side,
which is geared toward seeing things in their entirety.
"We don't know why BDD patients analyze all faces as if they are high
frequency," said Feusner. "The findings suggest that BDD brains are
programmed to extract details -- or fill them in where they don't exist. It's
possible they are thinking of their own face even when they are looking at
others."
Feusner also recently discovered that the more severe the BDD patient's
symptoms, the more strongly the brain's left side activates during visual
processing. He is currently studying how BDD patients process their own faces in
order to explore how emotional arousal may influence visual processing.
"All of these findings indicate that BDD has a biological link and can no
longer be attributed solely to our society's focus on appearance," he
concluded.
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Article adapted by Medical News Today from original press release.
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A psychiatrist specializing in obsessive-compulsive disorders, Feusner leads
UCLA's BDD program, which uses medications and cognitive behavioral therapy to
improve patients' symptoms and functioning. To learn more about the program or
his research studies, go to http://www.npi.ucla.edu/bdd/index.php.
The study was supported by the Saban Family Foundation, the Neysa Jane BDD Fund
and National Institute of Mental Health. Feusner's coauthors included Dr. Susan
Bookheimer, Dr. Alexander Bystritsky and Jennifer Townsend, all of UCLA's Semel
Institute.
Source: Elaine Schmidt
University of California
- Los Angeles
Medical News Today: http://www.medicalnewstoday.com
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