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.

Free Yourself from Panic Attacks

Free Yourself from Panic Attacks

With all the stresses and strains of modern living, panic attacks are become a common problem for many people. Panic attacks occur when the pressure we are living under starts to creep up and overwhelm us. Often it's a result of running on the treadmill of life and forgetting to watch the signs and symptoms of the effects of excessive stress on our bodies. Thankfully panic attacks are very treatable. Often it is just a matter of learning to recognize the symptoms and learn simple but effective techniques that help you release yourself from the crippling effects a panic attack can bring.

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