Neziroglu BDD Presentation Part 2

  1. Function of Repetitive Behaviors
  • These behaviors reduce negative feelings of anxiety, shame and disgust
  • Neziroglu et al., 2008


  1. Psychopathology of Mirror Gazing
  • Motivation for Mirror Gazing:
  • Hope that I will look different
  • Need to camouflage self
  • Need to know exactly how I look
  • Compare with ideal or how I used to look
  • Mental cosmetic surgery
  • Feel worse if I resist


  1. Mirror Behaviors
  • Both BDD and healthy controls

o         Use make up

o         Comb/ style their hair

o         Pick spots, shave

  • Only BDD patients

o        Try to see something different

o        Compare reflection with an ideal image

o        Practice best position or pull face

o        May use specific order of mirrors


  1. Is mirror gazing similar to compulsive checking of OCD?
  • OCD patients aim to terminate compulsion when feel “comfortable” or “absolutely sure” (Richards & Salkovskis,1999 & Neziroglu, 1998)
  • Most BDD patients never feel comfortable – usually feel worse & finish mirror gazing when they have to.


  1. CBT Working Model
  2. Inappropriate Treatments for BDD
  • Cosmetic Surgery
  • D.I.Y – Do it Yourself Surgery
  • Psychodynamic Therapy


  1. Top 5 Surgical Procedures
  • Liposuction
  • Mammoplasty augmentation
  • Rhytidectomy (facelift)
  • Rhinoplasty (nose reconstruction)
  • Mammoplasty reduction


  1. Do It Yourself (D.I.Y)
  • Pinch and stapling skin(for rhytidectomy)
  • Filing down teeth to alter jawline
  • Superglue ears (for pinnaplasty)
  • Sandpaper to skin (dermabrasion)
  • Ex-sanguination to look paler
  • Cutting self to release fat (for liposuction)
  • (Veale, 2002)
  1. Surgery Outcome
  • Retrospective reports from 58 individuals with BDD
  • 82.6% BDD symptoms same or worse after cosmetic surgery
  • 24.3% BDD symptoms worsened after cosmetic surgery
  • 34.5% decrease in concern with body part
  • Phillips et al., 2001

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