Seeing “changes" that aren’t there: Facial and object discrimination in body dysmorphic disorder

Cognitive–behavioral models of body dysmorphic disorder (BDD) suggest the disorder is characterized by several interpretive, attentional, and perceptual biases that contribute to its maintenance or even development. In addition, the role of aesthetic sensitivity has been discussed in BDD. However, previous research examining the ability to identify subtle changes in facial features and geometrical objects has produced mixed results. The purpose of the current study was to further evaluate facial and object discrimination among individuals with BDD (n = 35), individuals with a dermatological condition (n = 35), and mentally healthy control participants (n = 35) using a facial and object discrimination paradigm assessing the sensitivity for changes in symmetry, color, and size. Overall, the groups did not differ with respect to their performance in detecting actual changes in facial or object images. However, there was a significant group difference when they were presented with a series of unchanged facial but not object images: the BDD group rated identical facial images significantly more often as being changed, relative to individuals without BDD. The current results are discussed in light of the existing literature on facial and object discrimination in BDD.