Dr. Ulrike Buhlmann

• Facial processing in body dysmorphic disorder

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  Individuals with body dysmorphic disorder (BDD) are characterized by imagined or slight defects in appearance, which lead to significant distress and interference in their everyday life. Several cognitive-behavioral models of BDD have recently been developed to explain BDD's unique symptoms (e.g., Wilhelm, 2006). According to Wilhelm's (2006) cognitive-behavioral model of BDD, everybody has some concerns about one's appearance. Individuals with BDD, however, over-focus on single aspects of their appearance while ignoring the entire face (the big picture) and are characterized by negative, self-defeating interpretations (e.g., or I have to look perfect), which leads to negative emotions and maladaptive behaviors such as avoidance behaviors or rituals. Wilhelm's (2006) model is supported from findings such as that individuals with BDD misinterpret ambiguous situations and others facial expressions in a negative way (Buhlmann et al., 2002, 2004, 2006). However, it is unclear whether they are characterized by a stronger acquisition and resistance to extinction of de novo skin conductance conditioned responses to critical emotional expressions as conditioned stimuli, i.e., stronger conditionability. This could explain why individuals with BDD are characterized by a strong fear of negative evaluation by others and why they are more sensitive to emotional expressions in social situations. Moreover, it is unclear whether emotion recognition deficits observed in BDD (Buhlmann et al., 2004, 2006) diminish through specific training interventions, which could have invaluable implications for cognitive-behavioral interventions such as mirror retraining. Thus, based on recent cognitive-behavioral models of BDD, the proposed project aims at investigating (1) whether individuals with BDD exhibit deficits in holistic face processing, (2) whether observed emotion recognition deficits in BDD can be normalized through specific training procedures, and (3) whether individuals with BDD exhibit a stronger acquisition and resistance to extinction of conditional stimuli such as critical faces.

• Facial processing in body dysmorphic disorder II

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  Body dysmorphic disorder (BDD) is characterized by a preoccupation with perceived defects in one s own appearance. According to cognitive-behavioral models of BDD, BDD sufferers overfocus on single (often facial) aspects of their appearance while ignoring the entire appearance (or face; the big picture ). They have self-defeating appearance beliefs and emotion recognition deficits, which lead to negative emotions and avoidance or rituals. While there is growing evidence supporting these models, research is still limited. The current results indicate that individuals with BDD, relative to healthy individuals, are more accurate in identifying subtle changes (particularly with respect to asymmetry and size) when being presented with a series of gradually morphed faces. This finding gives further rise to the question of building perceptual retraining into innovative cognitive-behavioral treatments for BDD. The current results also provide evidence that emotion recognition deficits can be normalized through a specific training, which is of potential relevance for the treatment of BDD. Further, individuals with BDD exhibit slower short-term and long-term extinction of de novo skin conductance conditioned responses to angry emotional expressions as conditioned stimuli. Whereas fear conditioning and extinction has been studied in anxiety disorders, to our knowledge, the current project is the first investigating these phenomena in BDD. Based on these promising results, the proposed project primarily aims at examining context modulation of memory of fear extinction in a 2-day conditioning paradigm (first aim). The second aim is to further investigate facial discrimination abilities including other people s face as well as one s own face. The third aim is to examine selective attention toward threatening faces. Individuals with social phobia and obsessive-compulsive disorder will be included as clinical control groups.

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