Look at Yourself! – Perceptual Accuracy and Body Dysmorphic Disorder

We all have our flaws, but some of us are more keenly aware of them than others. Body dysmorphic disorder (BDD) affects about 1.7% of the population and is characterized by an enhanced awareness of one’s physical appearance, specifically the perceived negative aspects. Dissatisfaction with one’s appearance is not abnormal in itself, but in individuals suffering with BDD the distorted perception of oneself is extreme enough to impede their functioning in day to day life making it a candidate for a serious mental condition.

Researchers Lambrou, Veale and Wilson hypothesized that individuals suffering from BDD might be prone to making such negative judgements of their own appearance owing to a heightened sensitivity to aesthetics in general. This sensitivity might be evident in their choice of employment or education, in that they might be more prone to seek out a career in the creative and fine arts. Their study involved 150 participants divided into three groups, namely: 1) 50 BDD sufferers, 2) 50 students of arts and design, and 3) 50 non-art, non-BDD controls. Using an appreciation of symmetry as a measure of aesthetic sensitivity, Lambrou and her colleagues administered a combination of tests and experiments to the three groups. This would enable them to discern to what extent the BDD group differed from the art and design group in terms of each one’s aesthetic sensitivity.

In the experimental condition the groups were exposed to nine manipulated photographs of their own face. They were asked to select the images that gave them the most “pleasure,” which gave them the most ‘disgust’ as well as quantify the amount of pleasure and disgust felt in each case.

When it came to selecting the photographs of themselves that gave them the most pleasure, the results showed that the BDD group as well as the group of art and design students tended to choose the most symmetrical versions of their own face. There was a significant difference between the choices of these groups relative to those of the controls. Similarly, the BDD and art groups also picked a significantly less symmetrical version of themselves, compared to the controls, when selecting the image that filled them with the most disgust.

Between the BDD group and the art and design group, however, the differences were to be found in magnitude. Firstly, the BDD group was not as happy with the picture of their “ideal” self as the art and design group — the amount of pleasure they received from this image was significantly less than that felt by the art and design group. The situation was similarly negative in the second case where BDD participants expressed significantly greater amounts of disgust at their least favorite images of themselves than their art and design counterparts.

There was a third part to this experiment as well. In the final condition, from the nine pictures of themselves, the subjects were also asked to select the one they thought looked most like them. That is, participants had to choose the image that they felt most closely resembled their actual self. In this case the BDD group outshone both the other groups in displaying the most “perceptual accuracy.” This is to say their skill at being able to make out what they really looked like was significantly superior to both the other groups.

This final result may seem disheartening, as it looks like those of us who do not suffer from a body-image disorder are looking at rose-tinted reflections of ourselves. However, the explanation behind this perceptual accuracy in individuals with BDD may be explained with neuroscience.

Feusner and his colleagues have proven that people suffering from body image disorders do not process visual elements like the rest of the population. Their “distorted” perception applies not just to their own reflection but also to photographs of buildings, forms of art and so on. Feusner et al used an fMRI to observe the brain activity of 14 BDD patients in response to a series of photographs of houses and compared the results to those observed in a group of healthy controls. Specifically, the brain activity mapped for sufferers of BDD showed them to be less able to view a visual stimulus “holistically,” seeming instead to zoom in and focus on intricate details of the image, rather than taking it in in its entirety.

Furthermore, returning to the initial study by Lambrou et al, BDD sufferers are also noted to spend greater amounts of time examining their reflection in front of a mirror than their peers. Thus their enhanced perceptual accuracy might be the result of the more atomistic way in which they process of visual stimuli, or it might be due the greater familiarity they have with their own facial appearance. Most likely, it is a combination of both that is responsible for the unforgiving attention to give to every facet of their own reflection.


Lambrou C, Veale D, & Wilson G (2011). The role of aesthetic sensitivity in body dysmorphic disorder. Journal of abnormal psychology, 120 (2), 443-53 PMID: 21280932

Feusner JD, Hembacher E, Moller H, & Moody TD (2011). Abnormalities of object visual processing in body dysmorphic disorder. Psychological medicine, 1-13 PMID: 21557897

Radhika Takru, MA

Radhika Takru, MA, has a Bachelor's Degree with Honors in Psychology, a Postgraduate Degree in Media, and a Masters degree by research on online journalism and perceptions of authority.
See All Posts By The Author