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1

Vashi, Neelam A., ed. Beauty and Body Dysmorphic Disorder. Cham: Springer International Publishing, 2015. http://dx.doi.org/10.1007/978-3-319-17867-7.

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Veale, David. Body dysmorphic disorder: A treatment manual. Chichester, West Sussex, UK: Wiley-Blackwell, 2010.

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Baughan, Racheal. Body dysmorphic disorder The Butterfly Girl. London: John Blake Publishing Ltd, 2008.

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4

Winograd, Arie M. Face to Face with Body Dysmorphic Disorder. New York, NY : Routledge, 2016.: Routledge, 2016. http://dx.doi.org/10.4324/9781315710082.

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5

Phillips, Katharine A. The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder. Oxford: Oxford University Press, USA, 2005.

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6

National Institute for Health and Clinical Excellence (Great Britain), British Psychological Society, and Royal College of Psychiatrists, eds. Obsessive-compulsive disorder: Core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder. Leicester: British Psychological Society, 2006.

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7

Sony, Khemlani-Petal, and Santos Melanie T, eds. Overcoming body dysmorphic disorder: A cognitive behavioral approach to reclaiming your life. Oakland, CA: New Harbinger Publications, 2012.

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8

Veale, David. Overcoming body image problems including body dysmorphic disorder: A self-help guide using cognitive behavioral techniques. New York: Basic Books, 2009.

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9

Neziroglu, Fugen, and David Veale. Body Dysmorphic Disorder. Wiley & Sons, Incorporated, John, 2010.

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10

Field, Rebecca. Body dysmorphic disorder. Edited by John Phillips and Sally Erskine. Oxford University Press, 2018. http://dx.doi.org/10.1093/med/9780198834281.003.0044.

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11

Feusner, Jamie D., and Danyale McCurdy-McKinnon. Body Dysmorphic Disorder. Edited by Christopher Pittenger. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190228163.003.0050.

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This chapter covers the latest studies addressing neurobiological and genetic/heritable factors that may contribute to body dysmorphic disorder (BDD). BDD affects approximately 2% of the population and involves perceived defects of appearance along with obsessive preoccupation and repetitive, compulsive-like behaviors. Studies of visual processing suggest that disturbances in visual perception and visuospatial information processing, characterized by heightened attention to detail and impairment in holistic and global assessment, contribute to the condition. Also reviewed are studies of brain circuitry in BDD, which implicate white matter and structural connectivity abnormalities as playing possible roles in the pathophysiology of BDD. Finally, this chapter reviews the evidence that the susceptibility for BDD may be partly heritable and that there may be shared genetic factors among the obsessive-compulsive and related disorders (of which BDD is a member) as a group.
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12

Phillips, Katharine A., ed. Body Dysmorphic Disorder. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.001.0001.

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Body dysmorphic disorder (BDD) is a devastating yet underrecognized illness. People with BDD are preoccupied with the belief that they look abnormal or ugly—when they actually do not. Their appearance preoccupations cause clinically significant distress or impairment in occupational, academic, social, or other areas of functioning. Psychosocial functioning and quality of life are typically markedly impaired, and rates of suicidality are very high. BDD is common, yet this disorder often goes undiagnosed and untreated. This book provides an up-to-date, comprehensive, and clinically focused overview of this intriguing, complex, and often severe disorder. The book contains nine sections: (1) patients, history, and classification; (2) phenomenology and epidemiology; (3) morbidity; (4) BDD in special populations; (5) assessment; (6) etiology and pathophysiology; (7) recommended treatments; (8) cosmetic treatment; and (9) BDD’s relationship to other disorders. Measures for assessing BDD are provided in the Appendix. Written by leading researchers and clinicians in the field, this book is for anyone who wants to better understand BDD, help patients overcome it, or conduct scientific research to advance knowledge. It is for mental health clinicians, primary care clinicians, and pediatricians, as well as surgeons, dermatologists, and others who provide cosmetic (aesthetic) treatment; cosmetic treatment is commonly received but virtually never alleviates BDD symptoms. This book is also for researchers and students who are interested in anxiety disorders, eating disorders, and obsessive-compulsive and related disorders. Although it is geared toward a professional audience, this book is also for anyone who is interested in or has been affected by BDD.
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13

Veale, David. Body Dysmorphic Disorder. Oxford University Press, 2008. http://dx.doi.org/10.1093/oxfordhb/9780195307030.013.0041.

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14

Body Dysmorphic Disorder. John Wiley and Sons Ltd, 2006.

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15

Castle, David, Roberta Honigman, and Michael Kyrios. Body Dysmorphic Disorder. Cambridge University Press, 2008.

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16

Neziroglu, Fugen, and Sony Khemlani-Patel. Body Dysmorphic Disorder. Hogrefe Publishing, 2021.

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17

Khemlani-Pater, Sony, and Fugen Neziroglu. Body Dysmorphic Disorder. Hogrefe Publishing, 2022.

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18

Neziroglu, Fugen, and Sony Khemlani-Patel. Body Dysmorphic Disorder. Hogrefe Publishing, 2022.

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19

Body Dysmorphic Disorder. John Wiley and Sons Ltd, 2006.

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20

Greenberg, Jennifer L., Katherine E. Limoncelli, and Sabine Wilhelm. Body Dysmorphic Disorder by Proxy. Edited by Katharine A. Phillips. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.003.0008.

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This chapter reviews the literature on body dysmorphic disorder (BDD) by proxy, outlines its clinical presentation using a case example, and describes the currently recommended treatment approach. BDD by proxy is a variant of BDD characterized by a preoccupation with perceived defects or flaws in another person’s appearance. Preoccupations commonly involve a loved one, such as a child or significant other, although any person can be the focus of concern. BDD by proxy is associated with high levels of psychosocial impairment, distress, and shame. Research on BDD by proxy and its treatment is extremely limited. Cognitive-behavioral therapy (CBT) is the gold-standard psychosocial intervention for patients with BDD; however, CBT for BDD does not focus on other persons of concern, nor does it address the interpersonal impairment specific to BDD by proxy. There is some preliminary support for the use of a modified CBT for BDD by proxy, which is described in this chapter.
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21

Gazzarrini, Denise, and Giulio Perugi. Gender and Body Dysmorphic Disorder. Edited by Katharine A. Phillips. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.003.0015.

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Body dysmorphic disorder (BDD) in females and males appears to have more similarities than differences; however, gender-related factors appear to influence some aspects of BDD’s clinical expression and prevalence. In epidemiologic studies, BDD is slightly more common in females than in males, but in clinical samples and samples of convenience, the gender ratio is more variable. Gender seems to influence some specific body parts of concern (e.g., men are more likely to be concerned about their genitals, women their breasts and legs). Women appear more likely than men to use certain camouflaging techniques and to pick their skin in response to skin concerns. Differences in comorbidity have also been reported, with substance use disorders more common in males and eating disorders more common in females. Men and women are equally likely to seek cosmetic treatment for BDD, which differs from the general population, but women are more likely to receive it. The possible influence of gender on treatment response deserves further research.
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22

Greenberg, Jennifer L., Anne Chosak, Angela Fang, and Sabine Wilhelm. Treatment of Body Dysmorphic Disorder. Edited by Gail Steketee. Oxford University Press, 2012. http://dx.doi.org/10.1093/oxfordhb/9780195376210.013.0089.

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Body dysmorphic disorder (BDD) is characterized by an excessive preoccupation with an imagined or slight defect in one’s appearance. BDD is a severe and common disorder associated with high levels of functional impairment and high rates of suicidality. Interventions, including cognitive-behavioral therapy and pharmacotherapy, are effective for BDD. This chapter outlines the cognitive-behavioral model and therapy of BDD. The chapter reviews pharmacotherapy of BDD, and discusses the role of combination therapy. The chapter also addresses ineffective approaches for the treatment of BDD, including the role of cosmetic procedures. Early recognition and intervention are critical, and limit its chronicity and subsequent morbidity.
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23

Neziroglu, Fugen, and David Veale. Body Dysmorphic Disorder: A Treatment Manual. Wiley & Sons, Limited, John, 2010.

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24

Neziroglu, Fugen, and David Veale. Body Dysmorphic Disorder: A Treatment Manual. Wiley & Sons, Incorporated, John, 2010.

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25

Neziroglu, Fugen, and David Veale. Body Dysmorphic Disorder: A Treatment Manual. Wiley & Sons, Incorporated, John, 2013.

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26

Hart, Ashley S., and Martha A. Niemiec. Comorbidity and Personality in Body Dysmorphic Disorder. Edited by Katharine A. Phillips. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.003.0011.

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Comorbidity is common in body dysmorphic disorder (BDD). Major depressive disorder, social anxiety disorder (social phobia), obsessive-compulsive disorder, and substance use disorders are the most frequently co-occurring Axis I conditions. Except for eating disorders (more common in women) and substance use disorders (more common in men), Axis I comorbidity rates in BDD appear similar across genders. Axis I comorbidity is associated with greater functional impairment and morbidity. Rates of comorbid personality disorders in BDD are high. Disorders from cluster C occur most frequently, with avoidant personality disorder the most common. Associated traits include low self-esteem and high levels of neuroticism, introversion, unassertiveness, social anxiety and inhibition, rejection sensitivity, and perfectionism. Research is needed on the relationship between BDD and psychiatric comorbidity, the causes and consequences of comorbidity in BDD, and the relationship between BDD and associated personality traits.
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27

Stein, Dan J. Evolutionary Psychiatry and Body Dysmorphic Disorder. Edited by Katharine A. Phillips. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.003.0019.

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Most work on the psychobiology of body dysmorphic disorder (BDD) has focused on “proximal” mechanisms: the possible cognitive-affective processes, neuronal circuitry, and genetic variants involved in underpinnings of this disorder. Evolutionary medicine has, however, emphasized that a comprehensive biologic approach to medical and psychiatric disorders should also address “distal” mechanisms. These are the adaptive processes that have underpinned phylogeny and ontogeny, and that are therefore relevant to a comprehensive understanding of biologic states and traits. Evolutionary accounts of disease have emphasized constructs such as co-evolution, constraints, defenses, mismatch, reproductive success, and tradeoffs. This chapter discusses how concepts from evolutionary theory may be useful in developing a more comprehensive model of BDD, and how this may in turn be useful for guiding aspects of clinical assessment and intervention.
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28

Neziroglu, Fugen, and Nicole Barile. Environmental Factors in Body Dysmorphic Disorder. Edited by Katharine A. Phillips. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.003.0021.

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Despite its prevalence, the etiology and pathogenesis of body dysmorphic disorder (BDD) has yet to be fully elucidated due to this disorder’s complexity. Research into causal and contributory factors has been limited, yet there is emerging evidence that environmental factors play an important role and, furthermore, that specific environmental factors may be characteristic of BDD and possibly contribute to the development and maintenance of the disorder. Sociocultural pressures to achieve physical perfection; factors such as teasing/bullying, abuse, and perceived childhood maltreatment; heighted aesthetic sensitivity; and possibly certain personality traits may all be important. Factors such as these, coupled with biologic factors that include genetic heritability and deficits in visual processing, may significantly contribute to both the development and maintenance of the disorder. More research is needed to understand the specific factors that lead to this disorder to better assist with the development of evidence-based psychological treatment.
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29

Body Dysmorphic Disorder. a Male Concern. GRIN Verlag GmbH, 2014.

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30

Salle, A. K. Inside Their Minds : (Body Dysmorphic Disorder). Independently Published, 2017.

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31

Gun, James. Understanding Body Dysmorphic Disorder in Adolescents. Indy Pub, 2023.

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32

Clarke, Alex, Rob Willson, and David Veale. Overcoming Body Image Problems Including Body Dysmorphic Disorder. Little, Brown Book Group Limited, 2012.

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33

Overcoming Body Image Problems Including Body Dysmorphic Disorder. Little, Brown Book Group Limited, 2009.

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34

Grant, Jon E., Eric W. Leppink, and Sarah A. Redden. The Relationship Between Body Dysmorphic Disorder and Eating Disorders. Edited by Katharine A. Phillips. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.003.0036.

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This chapter discusses research findings regarding body dysmorphic disorder (BDD) and eating disorders, and it provides guidelines for distinguishing between them. BDD and eating disorders show many similarities, including negative and distorted body image, decreased quality of life, compensatory behaviors such as dieting, and abnormalities in visual processing. Patients with BDD express specific concerns with different parts of their bodies and physical appearance; common examples are complexion, nose, breasts/genitals, and hair. In patients who have prominent concerns about weight and body fat and shape, however, the diagnosis of BDD can be complicated because such concerns can occur as a symptom of BDD but also overlap with those in eating disorders such as anorexia nervosa and bulimia nervosa. BDD and eating disorders are often comorbid, which is accompanied by notably higher rates of suicidality and psychiatric hospitalization than occur in patients with either disorder alone. BDD and eating disorders represent distinct pathologies, and it is important to distinguish between them, particularly given the increased risk of suicidality when the disorders are comorbid.
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35

Kelly, Megan M., and Katharine A. Phillips. Phenomenology and Epidemiology of Body Dysmorphic Disorder. Edited by Gail Steketee. Oxford University Press, 2012. http://dx.doi.org/10.1093/oxfordhb/9780195376210.013.0018.

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Body dysmorphic disorder (BDD) is an often severe DSM-IV disorder characterized by distressing or impairing preoccupations with imagined or slight defects in appearance. Individuals with BDD suffer from time-consuming obsessions about their bodily appearance and excessive repetitive behaviors (for example, mirror checking, excessive grooming, and skin picking). Functioning and quality of life are typically very poor, and suicidality rates appear markedly elevated. While prevalence data are still limited, they suggest that BDD affects 0.7% to 2.4% of the population; however, BDD typically goes unrecognized in clinical settings. In this chapter we discuss demographic and clinical features of BDD, prevalence, and morbidity. In addition, we discuss BDD’s relationship to obsessive compulsive disorder, hypochondriasis, and psychotic disorders.
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36

Understanding body dysmorphic disorder: An essential guide. New York: Oxford University Press, 2009.

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37

Jerome, Laurence. Body Dysmorphic Disorder over the Past Century. Edited by Katharine A. Phillips. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.003.0003.

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This chapter reviews the history of dysmorphophobia, the precursor of body dysmorphic disorder (BDD), in the world literature. The chapter also reviews the evolution of the more refined concept of BDD in recent years, its evolving definitions, and its current status as a distinct psychiatric illness. The first known clinical description of a syndrome describing patients who complain about their appearance as their primary concern dates back to Enrico Morselli’s seminal description in 1891. Morselli called this condition “dysmorphophobia,” a concern about imagined ugliness. Over the years, the nature of the excessive appearance concerns has been seen variously as a symptom of characterological disturbance, one manifestation of a continuum of obsessional disorders, or a discrete psychiatric illness. While many earlier descriptions of psychopathology have waned or disappeared, this intriguing and often severe disorder that involves a disorder of consciousness of the self has persisted into contemporary scientific literature.
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38

Hartmann, Andrea S., and Ulrike Buhlmann. Prevalence and Underrecognition of Body Dysmorphic Disorder. Edited by Katharine A. Phillips. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.003.0005.

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Large epidemiologic studies across Western countries that used DSM-IV and DSM-5 diagnostic criteria have found a point prevalence rate of body dysmorphic disorder (BDD) of 1.7% to 2.9%. The prevalence of BDD is higher in clinical samples. Gender ratios in epidemiologic studies show a slight preponderance of females, which is confirmed in most convenience and clinical samples. Prevalence rates appear to be highest in younger (adolescent) subsamples. Other demographic correlates include a lower likelihood of being in a committed relationship, less education, lower household income, and higher unemployment rates. Key clinical correlates from epidemiologic studies are greater depression, anxiety, and somatoform symptoms and more frequent suicidal ideation and suicide attempts. Reasons for the underrecognition of BDD include shame, fear of not being understood by the clinician, lack of readiness for treatment, skepticism about treatment or belief in the superiority of other forms of treatment (such as cosmetic treatment), and lack of financial coverage for treatment.
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39

Phillips, Katharine A. Body Dysmorphic Disorder in Children and Adolescents. Edited by Katharine A. Phillips. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.003.0014.

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Body dysmorphic disorder (BDD) usually has its onset during childhood or adolescence. Prevalence studies indicate that BDD is common in adolescents. BDD symptoms in children and adolescents appear largely similar to those in adults, although BDD may be somewhat more severe in youth. Youth with BDD typically have poor psychosocial functioning and mental health–related quality of life. BDD often causes academic underachievement, social avoidance, and other types of psychosocial impairment; it may lead to school refusal and dropping out of school. Suicidal ideation and attempts, physical aggression behavior that is attributable to BDD symptoms, and substance use disorders are common risk behaviors in youth with BDD. BDD can derail the developmental trajectory, which makes appropriate treatment especially important during childhood and adolescence. Youth in mental health settings and cosmetic treatment settings, as well as youth who express suicidal ideation or have attempted suicide, should be screened for BDD.
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40

Rasmussen, Jessica, Angelina F. Gómez, and Sabine Wilhelm. Cognitive-Behavioral Therapy for Body Dysmorphic Disorder. Edited by Katharine A. Phillips. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.003.0026.

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Cognitive-behavioral therapy (CBT) that is tailored to the unique clinical features of body dysmorphic disorder (BDD) is currently the psychosocial treatment of choice for BDD. Researchers have made great strides in understanding the cognitive-behavioral processes that contribute to the development and maintenance of BDD. CBT for BDD is based on this theoretical understanding and has been shown to be highly effective in reducing BDD symptom severity and associated symptoms. The key components of CBT include identifying and rationally disputing maladaptive appearance-related thoughts, and exposure with response prevention for feared and avoided situations. CBT for BDD also integrates educating the patient on the mental and behavioral processes involved in the BDD experience with mindfulness/perceptual retraining (e.g., techniques aimed at helping patients to view their appearance with a neutral, global, and aware perspective) to augment the therapeutic process. Advanced cognitive strategies are used to address negative core beliefs. Because BDD is typically characterized by poor or absent insight, motivational interviewing is often needed to overcome ambivalence towards treatment.
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41

Phillips, Katharine. Understanding Body Dysmorphic Disorder: An Essential Guide. Oxford University Press, 2008.

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42

Salle, A. K. Their Thoughts, Their Feelings : (Body Dysmorphic Disorder). Independently Published, 2017.

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43

Vashi, Neelam A. Beauty and Body Dysmorphic Disorder: A Clinician's Guide. Springer International Publishing AG, 2016.

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44

Beauty and Body Dysmorphic Disorder: A Clinician's Guide. Springer, 2015.

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45

Kelly, Megan M., and Mark Kent. The Relationship Between Body Dysmorphic Disorder and Social Anxiety Disorder. Edited by Katharine A. Phillips. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.003.0035.

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Body dysmorphic disorder (BDD) and social anxiety disorder (SAD) are highly comorbid disorders that share high levels of social anxiety, social avoidance, and rejection sensitivity. In addition, in emotional processing studies, patients with BDD and SAD both show a heightened sensitivity to hostility. However, BDD and SAD differ in many important ways, including key phenomenologic and clinical differences as well as treatment approaches. This chapter reviews similarities and differences between BDD and SAD across demographic, clinical, biologic, and other domains. Future research directions for work that may further elucidate the relationship between these two disorders are also discussed.
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46

The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder. Oxford University Press, USA, 1998.

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47

Phillips, Katharine A. Insight and Delusional Beliefs in Body Dysmorphic Disorder. Edited by Katharine A. Phillips. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.003.0009.

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This chapter discusses insight (“delusionality”) in body dysmorphic disorder (BDD). BDD beliefs span a broad range of insight, from good to absent insight (i.e., delusional beliefs). About 70% of patients have poor or absent insight. Early emerging clues suggest possible neurobiologic bases of poorer insight in BDD. BDD’s delusional form (characterized by the absence of insight) appears to be the same disorder as its nondelusional form rather than a separate psychotic disorder. Consistent with this, serotonin-reuptake inhibitor (SRI) monotherapy is efficacious for delusional BDD as well as nondelusional BDD. Neuroleptic (antipsychotic) monotherapy is not currently recommended for delusional BDD. Cognitive-behavioral therapy (CBT) appears efficacious for both delusional and nondelusional BDD, but research is needed to determine whether a somewhat modified approach may be helpful for delusional beliefs. Insight often improves with SRIs and CBT.
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48

Phillips, Katharine A. Suicidality and Aggressive Behavior in Body Dysmorphic Disorder. Edited by Katharine A. Phillips. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.003.0013.

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This chapter reviews suicidality and aggressive/violent behavior in body dysmorphic disorder (BDD) and presents clinical cases, which reflect the extreme suffering that BDD often causes. Suicidal ideation and suicide attempts are common in BDD. This has been found in both clinical and epidemiologic samples and in adults as well as youth. More severe BDD symptoms are independently associated with an increased risk of suicidal ideation and suicide attempts. Suicidality appears more common in BDD than in obsessive-compulsive disorder and other clinical samples with which BDD has been directly compared. Although data are limited, the rate of completed suicide appears markedly elevated; indeed, individuals with BDD have many risk factors for completed suicide. Physical aggression and violence are less well studied but appear to commonly occur as a consequence of BDD. Surgeons, dermatologists, and other clinicians who provide cosmetic treatment may be at particular risk. Additional studies designed to investigate these topics are urgently needed.
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49

Buhlmann, Ulrike, and Andrea S. Hartmann. Cognitive and Emotional Processing in Body Dysmorphic Disorder. Edited by Katharine A. Phillips. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.003.0022.

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According to current cognitive-behavioral models, body dysmorphic disorder (BDD) is characterized by a vicious cycle between maladaptive appearance-related thoughts and information-processing biases, as well as maladaptive behaviors and negative emotions such as feelings of shame, disgust, anxiety, and depression. This chapter provides an overview of findings on cognitive characteristics such as dysfunctional beliefs, information-processing biases for threat (e.g., selective attention, interpretation), and implicit associations (e.g., low self-esteem, strong physical attractiveness stereotype, and high importance of attractiveness). The chapter also reviews face recognition abnormalities and emotion recognition deficits and biases (e.g., misinterpreting neutral faces as angry) as well as facial discrimination ability. These studies suggest that BDD is associated with dysfunctional beliefs about one’s own appearance, information-processing biases, emotion recognition deficits and biases, and selective processing of appearance-related information. Future steps to stimulate more research and clinical implications are discussed.
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50

Greenberg, Jennifer L., Alexandra Sullivan, and Sabine Wilhelm. Treating Children and Adolescents with Body Dysmorphic Disorder. Edited by Katharine A. Phillips. Oxford University Press, 2017. http://dx.doi.org/10.1093/med/9780190254131.003.0028.

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Body dysmorphic disorder (BDD) is a common and severe disorder that typically has its onset during adolescence. Youth with BDD appear more severely ill than adults in terms of having poorer insight and a higher likelihood of having attempted suicide. Despite BDD’s severity and early onset, there is only limited research on its treatment in youth. Cognitive-behavioral therapy (CBT) and serotonin reuptake inhibitors (SRIs) are the first-line treatments for BDD in adults and appear to be effective for adolescents with BDD. This chapter provides an overview of the treatment of BDD in youth, including cognitive-behavioral and pharmacologic approaches, and an illustrative case example. The chapter also addresses cosmetic treatment for BDD in children and adolescents, which appear to be ineffective.
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