'Not just right' experiences and incompleteness in body dysmorphic disorder

Area of Science:

• Psychiatry
• Clinical Psychology
• Cognitive Science

Background:

• Body dysmorphic disorder (BDD) is a mental health condition characterized by obsessive preoccupation with perceived flaws in appearance.
• The subjective experience of 'not just right' (NJREs) and a sense of incompleteness (INC) are increasingly recognized as relevant to BDD.
• Understanding the specific role of NJREs and INC in BDD is crucial for developing targeted interventions.

Purpose of the Study:

• To investigate the relationship between NJREs, INC, and BDD symptomology across multiple studies.
• To determine if NJREs and INC are uniquely associated with BDD, independent of other comorbid conditions.
• To explore the impact of INC and NJREs on reactivity to BDD-relevant stimuli.

Main Methods:

• Four studies were conducted, employing clinical, unselected, and community samples.
• Methods included self-report questionnaires, in vivo tasks designed to elicit BDD concerns, and sensory-based NJRE tasks.
• Statistical analyses controlled for co-occurring symptoms of depression, anxiety, and obsessive-compulsive disorder (OCD).

Main Results:

• Individuals with BDD reported more severe NJREs than healthy controls, even after accounting for depression and anxiety.
• INC predicted heightened reactivity to in vivo tasks aimed at triggering BDD concerns.
• A positive correlation was found between INC and BDD symptom severity in a community sample.
• A BDD symptom group exhibited greater INC and reactivity to visual NJRE tasks compared to a low symptom group, controlling for comorbidities.

Conclusions:

• NJREs and INC are significantly associated with BDD, suggesting they are important transdiagnostic factors.
• These findings highlight the specific role of visual NJREs in BDD.
• Further research into INC and NJREs may inform novel therapeutic targets for BDD.