Although BDD's aetiology and pathophysiology are unknown, they are probably multifactorial, with neurobiological, psychological, and sociocultural sources. (4> Family history data, while limited, indicate that BDD occurs in about 10 per cent of first-degree family members. In some cases, stressors, or even a benign comment about appearance, can trigger the disorder's onset.

Available treatment data and several clues,(4) while providing only indirect evidence about aetiology, suggest a role for serotonin. Several case reports noted worsening of BDD symptoms with serotonin antagonists. Neuroimaging studies have not been published, but two neuropsychological studies of BDD found impaired executive function, which in turn implicates frontostriatal dysfunction. It has been hypothesized that BDD may involve dysfunction of the orbitofrontal system or the orbitofrontal-amygdalar axis, perhaps similar to obsessive-compulsive disorder. Studies of this hypothesis are needed, as are studies that investigate the temporal and occipital lobes, which process facial images and (along with the parietal lobes) are involved in neurological disorders involving disturbed body image.

In a study that used the Parental Bonding Instrument, parental care scores of BDD subjects were lower than published norms. It is unclear whether this finding reflects patients' perceptions of care or actual care received. It seems plausible that frequent teasing about one's appearance would be a risk factor for BDD, but potential risk factors such as this have not been studied.

Eliminating Stress and Anxiety From Your Life

Eliminating Stress and Anxiety From Your Life

It seems like you hear it all the time from nearly every one you know I'm SO stressed out!? Pressures abound in this world today. Those pressures cause stress and anxiety, and often we are ill-equipped to deal with those stressors that trigger anxiety and other feelings that can make us sick. Literally, sick.

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