Recent studies suggest that Body Dysmorphic Disorder (BDD) may share some key similarities with Social Anxiety Disorder (SAD), including diagnostic features, prevalence, and treatment overlap. A new study of Body Dysmorphic Disorder among adults with SAD revealed that treatment for SAD can also reduce symptoms of BDD. But what do these findings mean for the future of treatment for anxiety disorders?

What Is Body Dysmorphic Disorder?

Body Dysmorphic Disorder is a body image disorder characterized by a strong preoccupation with a minor or imagined defect in physical appearance. Unlike everyday concerns about appearance, people with BDD experience significant distress or impairment in social, occupational, and other important areas of functioning. For example, someone suffering from BDD may extensively avoid reflective surfaces, seek an excessive amount of cosmetic surgery, or avoid social situations in order to prevent being seen by others.

How Are BDD And SAD Related?

Approximately 12% of individuals with SAD also have co-occurring BDD and 12-68% of individuals with BDD also have co-occurring SAD. Both of these disorders are a consequence of an over-emphasized view of the self as a social object, a hyper-attention to social threat cues, and external environmental cues like facial expressions.

SAD and BDD are not the only anxiety disorders that co-occur. More than half of people suffering from one anxiety disorder experience symptoms of two or more separate anxiety disorders.

More On The Study

The researchers examined 85 adult patients who were undergoing cognitive behavioral therapy (CBT) treatment for SAD in an outpatient clinic specializing in anxiety disorders. Out of the original 85 participants, only 27 experienced significant BDD symptoms and were counted towards the final sample. Each of the 27 participants completed a Social Anxiety questionnaire and a Body Dysmorphic questionnaire before and after receiving CBT treatment.

Previous research has shown that CBT treatment for BDD relieves symptoms of SAD. Similarly, the results from this investigation found that there was a significant improvement of BBD symptoms after CBT treatment targeted for SAD.

People reported a decrease in checking and comparing themselves to others, concern over their weight and shape, avoiding and hiding, seeking cosmetic surgery, and their beliefs about appearance. These findings suggest that treating one specific disorder can also simultaneously relieve symptoms of another disorder without directly treating the other disorder.

Future Projections

Although researchers cannot yet identify the exact mechanism by which symptoms of BDD improve after treatment for SAD, these findings have exciting implications for understanding the cognitive mechanisms for these disorders, and revolutionizing future treatment options for patients. The co-occurrence and treatment of SAD and BDD may lead to findings in diagnosis and treatment overlap in other anxiety disorders as well.

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Emily K. White. Ph.D.
Carol S. Lee, Ph.D.
Christian Hahn, M.Sc.
Rockwell Parker, Ph.D.
Sigal Sharf, MS


Date of original publication:

Updated: June 30, 2017