Gazing rituals in body dysmorphic disorder

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.

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.

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 with regard to sample characteristics and experimental design are discussed.

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.