Neural Correlates of Own- and Other-Face Perception in Body Dysmorphic Disorder

The upside-down self: One's own face recognition is affected by inversion

One's own face is recognized more efficiently than any other face, although the neural mechanisms underlying this phenomenon remain poorly understood. Considering the extensive visual experience that we have with our own face, some authors have proposed that self-face recognition involves a more analytical perceptual strategy (i.e., based on face features) than other familiar faces, which are commonly processed holistically (i.e., as a whole). However, this hypothesis has not yet been tested with brain activity data. In the present study, we employed an inversion paradigm combined with event-related potential (ERP) recordings to investigate whether the self-face is processed more analytically. Sixteen healthy participants were asked to identify their own face and a familiar face regardless of its orientation, which could either be upright or inverted. ERP analysis revealed an enhanced amplitude and a delayed latency for the N170 component when faces were presented in an inverted orientation. Critically, both the self and a familiar face were equally vulnerable to the inversion effect, suggesting that the self-face is not processed more analytically than a familiar face. In addition, we replicated the recent finding that the attention-related P200 component is a specific neural index of self-face recognition. Overall, our results suggest that the advantage for self-face processing might be better explained by the engagement of self-related attentional mechanisms than by the use of a more analytical visuoperceptual strategy.

Is poor global processing a transdiagnostic feature of Body Dysmorphic Disorder and Anorexia Nervosa? A meta-analysis

Body dysmorphic disorder (BDD) and anorexia nervosa (AN) are characterised by body image disturbance. It has been suggested that poor global integration in visual processing may underlie distorted body image, but empirical studies have yielded mixed results. The current study involved two meta-analyses aimed at examining the extent to which poor global processing is evident in BDD and AN. Studies were identified through a systematic literature search up to October 2020. The BDD search yielded 16 studies and the AN search yielded 18 studies. Random-effect models demonstrated a small pooled effect size for BDD (g = -0.44, 95 % CI -0.70, -0.17, p < 0.001) and a moderate pooled effect size for AN (g = -0.63, 95 % CI -0.77, -0.49, p <  .001), with no evidence of significant publication bias for either. The results provide evidence that poor global processing is a transdiagnostic feature of both BDD and AN, although effects may be more pronounced in AN. Our findings highlight the possibility that interventions aimed at promoting global visual processing could prove beneficial in disorders characterised by distorted body image.

Role of Body Dysmorphic Disorder in Patients With Postparalytic Facial Synkinesis

OBJECTIVES/HYPOTHESIS

To evaluate the role of body dysmorphic disorder (BDD) in patients with postparalytic facial nerve syndrome with synkinesis (PFS).

STUDY DESIGN

A single-center retrospective cohort study.

METHODS

A total of 221 adults (74% women; median age: 44 years; median duration since onset of facial palsy: 1.6 years) were included. To diagnose BDD, the BDD Munich Module was used. Associations with House-Brackmann grading, Stennert index grading, Facial Clinimetric Evaluation (FaCE) survey, Facial Disability Index (FDI), general quality of life (SF-36), Beck Depression Inventory (BDI), and the Liebowitz Social Anxiety Scale (LSAS) was analyzed.

RESULTS

A total of 59 patients (27%) were classified as patients with BDD. Significant associations were found between the diagnosis of BDD and female gender and lower FDI, FaCE, and SF-36 scores and higher BDI and LSAS scores. Multivariate analysis revealed BDI, FaCE total score, and FaCE social function subscore as independent factors associated with BDD.

CONCLUSION

BDD was a relevant diagnosis in patients with PFS. A higher BDD level was associated with general and facial-specific quality of life and more psychosocial disabilities. Optimal treatment of PFS has to include these nonmotor dysfunctions.

LEVEL OF EVIDENCE

3 Laryngoscope, 131:E2518-E2524, 2021.