Gazing rituals in body dysmorphic disorder

Anne Möllmann; Antje Hunger; Claudia Schulz; Sabine Wilhelm; Ulrike Buhlmann

doi:10.1016/j.jbtep.2019.101522

Gazing rituals in body dysmorphic disorder

J Behav Ther Exp Psychiatry. 2020 Sep:68:101522. doi: 10.1016/j.jbtep.2019.101522. Epub 2019 Nov 4.

Authors

Anne Möllmann¹, Antje Hunger², Claudia Schulz³, Sabine Wilhelm⁴, Ulrike Buhlmann⁵

Affiliations

¹ Institute of Psychology, Westfälische Wilhelms-Universität Münster, Münster, Germany; Institute of Psychology, University of Bremen, Bremen, Germany.
² Faculty of Social Sciences and Cultural Studies, University of Applied Sciences Düsseldorf, Düsseldorf, Germany.
³ Institute of Psychology, Westfälische Wilhelms-Universität Münster, Münster, Germany; AMEOS Klinikum Osnabrück, Osnabrück, Germany.
⁴ Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
⁵ Institute of Psychology, Westfälische Wilhelms-Universität Münster, Münster, Germany. Electronic address: ulrike.buhlmann@wwu.de.

PMID: 31877406
DOI: 10.1016/j.jbtep.2019.101522

Abstract

Background and objectives: Gazing rituals and selective attention to perceived flaws during gazing are considered as maintaining factors in cognitive-behavioral models for body dysmorphic disorder (BDD). This study investigated different durations of BDD-like gazing at different facial stimuli (an unfamiliar face, the participant's own face, and the participant's own reflection in the mirror) with regard to effects on dissociation, attractiveness evaluations and perceptual uncertainty. The aim of this study was to examine the hypothesized causal effects of gazing rituals on appearance preoccupation.

Methods: We asked 115 females to complete a face gazing paradigm with three different facial stimuli and, depending on the condition, different gazing durations. We also examined the influence of BDD symptom severity on the reactions to different facial stimuli.

Results: Five minutes of gazing significantly increased dissociation. Participants rated the attractiveness of self-relevant stimuli, especially the own photographed face, below average and lower than the unfamiliar face.

Limitations: Limitations with regard to sample characteristics and experimental design are discussed.

Conclusions: Our findings support cognitive-behavioral models for BDD and indicate that therapists may extend therapeutic interventions like mirror retraining by specific perceptual retraining with photographs of the patients.

Keywords: Attractiveness; Body dysmorphic disorder; Body image; Dissociation; Gazing rituals; Perceptual distortion.

MeSH terms

Beauty
Body Dysmorphic Disorders / psychology*
Body Image / psychology*
Ceremonial Behavior*
Dissociative Disorders / psychology
Face*
Female
Fixation, Ocular*
Humans
Judgment
Young Adult