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Cognitive dysfunction in body dysmorphic disorder: new implications for nosological systems and neurobiological models.

Accepted version
Peer-reviewed

Type

Article

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Authors

Jefferies-Sewell, Kiri 
Chamberlain, Samuel R 
Fineberg, Naomi A 
Laws, Keith R 

Abstract

UNLABELLED: Introduction Body dysmorphic disorder (BDD) is a debilitating disorder, characterized by obsessions and compulsions relating specifically to perceived appearance, and which has been newly classified within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Obsessive-Compulsive and Related Disorders grouping. Until now, little research has been conducted into the cognitive profile of this disorder. METHODS: Participants with BDD (n=12) and participants without BDD (n=16) were tested using a computerized neurocognitive battery investigating attentional set-shifting (Intra/Extra Dimensional Set Shift Task), decision-making (Cambridge Gamble Task), motor response-inhibition (Stop-Signal Reaction Time Task), and affective processing (Affective Go-No Go Task). The groups were matched for age, IQ, and education. RESULTS: In comparison to controls, patients with BDD showed significantly impaired attentional set-shifting, abnormal decision-making, impaired response inhibition, and greater omission and commission errors on the emotional processing task. CONCLUSION: Despite the modest sample size, our results showed that individuals with BDD performed poorly compared to healthy controls on tests of cognitive flexibility, reward and motor impulsivity, and affective processing. Results from separate studies in OCD patients suggest similar cognitive dysfunction. Therefore, these findings are consistent with the reclassification of BDD alongside OCD. These data also hint at additional areas of decision-making abnormalities that might contribute specifically to the psychopathology of BDD.

Description

Keywords

Affective processing, body dysmorphic disorder, cognitive deficits, cognitive inflexibility, neurobiological, obsessive compulsive disorder, response inhibition, Adult, Attention, Body Dysmorphic Disorders, Case-Control Studies, Cognitive Dysfunction, Decision Making, Female, Humans, Inhibition, Psychological, Male, Middle Aged, Models, Neurological, Models, Psychological, Neurobiology, Neuropsychological Tests, Reaction Time, Young Adult

Journal Title

CNS Spectr

Conference Name

Journal ISSN

1092-8529
2165-6509

Volume Title

22

Publisher

Cambridge University Press (CUP)
Sponsorship
Academy of Medical Sciences (unknown)
Wellcome Trust (110049/Z/15/Z)
Academy of Medical Sciences