2009年7月29日水曜日

Body dysmorphic disorder ( & Anorexia nervosa ↓ ) symptoms fit Michael's character 身体醜形障害(日本語)


From Wikipedia, the free encyclopedia (below)
This is clearly a mental disorder where you have been wrongly wired and you can't see what others see.
Basically BDD is about 'imagined' ugliness. Most people who have it are somehow related to the creative arts.
Michael Jackson is a known sufferer with all the known symptoms.
Avoidance of mirrors, self-hate, imagined ugliness that needs to be corrected with plastic surgery, massive usage of beauty-products and etc.

Too ugly for love part 1

Too ugly for love part 2


Body dysmorphic disorder (BDD) (previously known as Dysmorphophobia and sometimes referred to as Body dysmorphia or Dysmorphic syndrome) is a psychological disorder in which the affected person is excessively concerned and preoccupied by a perceived defect in his or her physical features.
The sufferer may complain of several specific features or a single feature, or a vague feature or general appearance, causing psychological distress that impairs occupational and/or social functioning, sometimes to the point of severe depression, severe anxiety, development of other anxiety disorders, social withdrawal or complete social isolation, and more. It is estimated that 1–2% of the world's population meet all the diagnostic criteria for BDD.
The exact cause or causes of BDD differ from person to person, however but most clinicians believe it could be a combination of biological, psychological and environmental factors from their past or present. Abuse can also be a contributing factor.
Onset of symptoms generally occurs in adolescence or early adulthood, where most personal criticism of one's own appearance usually begins. Although cases of BDD onset in children and older adults is not unknown. BDD is often misunderstood to affect mostly women, but research shows that it affects men and women equally.
The disorder is linked to significantly diminished quality of life and co-morbid major depressive disorder and social phobia. With a completed-suicide rate more than double than that of major depression, and a suicidal ideation rate of around 80%, BDD is considered a major risk factor for suicide.
A person with the disorder may be treated with psychotherapy, medication, or both. Research has shown cognitive behavioural therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs) to be effective in treating BDD. BDD is a chronic illness and symptoms are likely to persist, or worsen, if left untreated.


The Diagnostic and Statistical Manual of Mental Disorders defines body dysmorphic disorder as a preoccupation with an imagined or minor defect in appearance which causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. The individual's symptoms must not be better accounted for by another disorder; for example weight concern is usually more accurately attributed to an eating disorder.
The disorder generally is diagnosed in those who are extremely critical of their mirror image, physique or self-image even though there may be no noticeable disfigurement or defect. The three most common areas that those suffering from BDD will feel critical of have to do with the face: the hair, the skin, and the nose. Outside opinion will typically disagree, and may protest that there even is a defect. The defect exists in the eyes of the beholder, and one with BDD really does feel as if they see something there that is defective.
People with BDD say that they wish that they could change or improve some aspect of their physical appearance even though they are generally of normal or even highly attractive appearance. Body dysmorphic disorder causes sufferers to believe that they are so unspeakably hideous that they are unable to interact with others or function normally for fear of ridicule and humiliation about their appearance. This can cause those with this disorder to begin to seclude themselves or have trouble in social situations. They can become secretive and reluctant to seek help because they fear that others will think them vain or because they feel too embarrassed. It has been suggested that fewer men seek help for the disorder than women.
Ironically, BDD is often misunderstood as a vanity-driven obsession, whereas it is quite the opposite; people with BDD do not believe themselves to be beautiful and getting more beautiful with each surgery, but instead feel that their perceived "defect" is irrevocably ugly. People with BDD may compulsively look at themselves in the mirror or, conversely, cover up and avoid mirrors. They may typically think about their appearance for at least one hour a day (and usually more), and in severe cases may drop all social contact and responsibilities as they become a recluse.
A German study has shown that 1–2% of the population meet all the diagnostic criteria of BDD, with a larger percentage showing milder symptoms of the disorder (Psychological Medicine, vol 36, p 877). Chronically low self-esteem is characteristic of those with BDD, because the one's assessment of one's value is so closely linked with one's perception of one's appearance.
BDD is diagnosed equally in men and women, and causes chronic social anxiety for its sufferers.
Phillips & Menard (2006) found the completed-suicide rate in patients with BDD to be 45 times higher than that of the general United States population. This rate is more than double that of those with clinical depression and three times as high as that of those with bipolar disorder. Suicidal ideation is also found in around 80% of people with BDD. There has also been a suggested link between undiagnosed BDD and a higher than average suicide rate among people who have undergone cosmetic surgery.


In 1886, BDD was first documented by the researcher Morselli, who called the condition simply "Dysmorphophobia". BDD was first truly recognized by the American Psychiatric Association in 1987, and in 1997, BDD was first recorded and formally recognized as a disorder in the DSM.
In his practice, Freud eventually had a patient who would today be diagnosed with the disorder: Russian aristocrat Sergei Pankejeff, nicknamed "The Wolf Man" by Freud himself in order to protect Pankejeff's identity, had a preoccupation with his nose to an extent that greatly limited his functioning.


According to the DSM IV, to be diagnosed with BDD, a person must fulfill the following criteria:
"Preoccupation with an imagined defect in appearance. If a slight physical anomaly is present,
the person's concern is markedly excessive."
"The preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning."
"The preoccupation is not better accounted for by another mental disorder (e.g., dissatisfaction with body shape and size in Anorexia Nervosa)."
In most cases, BDD is under-diagnosed. In a study of 17 patients with BDD, BDD was noted in only five patient charts, and none of the patients received an official diagnosis of BDD despite the fact that it was present. BDD is often under-diagnosed because the disorder was only recently included in DSM IV, therefore clinician knowledge of the disorder, particularly among general practitioners, is not widespread. Also, BDD is often associated with shame and secrecy, therefore patients often fail to reveal their appearance concerns for fear of appearing vain or superficial.
BDD is also often misdiagnosed because its symptoms can mimic that of major depressive disorder or social phobia. and so the root of the individual's problems remain unresolved. Many individuals with BDD also do not possess knowledge or insight into Body Dysmorphic Disorder and so regard their problem as one of a physical nature rather than psychiatric, therefore individuals may seek cosmetic treatment rather than mental health treatment.


Studies show that BDD is common in not only nonclinical settings, but clinical settings, as well. A study was done of 200 people with DSM-IV Body Dysmorphic Disorder. These people were of age 12 or older and were available to be interviewed in person. They were obtained from mental health professionals, advertisements, the subject's friends and relatives, and non-psychiatric physicians. Out of the subjects, 53 were receiving medication, 33 were receiving psychological psychotherapy, and 48 were receiving both medication and psychotherapy.
The severity of BDD was assessed using the Yale–Brown Obsessive Compulsive Scale modified for BDD, and symptoms were assessed using the Body Dysmorphic Disorder Examination. Both tests were designed specifically to assess BDD. Results showed that BDD occurs in 0.7–1.1% of community samples and 2–13% of nonclinical samples. 13% of psychiatric inpatients had BDD. Studies also found that some of the patients initially diagnosed with OCD had BDD, as well. 53 patients with OCD and 53 patients with BDD were compared in a study. Clinical features, comorbidity, family history, and demographic features were compared between the two groups. Nine of the 62 subjects (14.5%) of those with OCD also had BDD.


There is a high degree of comorbidity with other psychiatric disorders, often resulting in misdiagnoses by clinicians. Research suggests that around 76% of people with BDD will experience major depressive disorder at some point in their lives, significantly higher than the 10–20% expected in the general population. Around 37% of people with BDD will also experience social phobia and around 32% experience obsessive–compulsive disorder. The most common personality disorders found in individuals with BDD are avoidant personality disorder and dependent personality disorder which conforms to the introverted, shy and neurotic traits usually found in individuals with the disorder.
Eating disorders, such as Anorexia nervosa and Bulimia nervosa, are also sometimes found in people with BDD, usually women, as are trichotillomania, dermatillomania, and sub-type disorders Olfactory Reference Syndrome and muscle dysmorphia.


There are many common symptoms and behaviors associated with BDD. Often these symptoms and behaviours are determined by the nature of the BDD sufferer's perceived defect, for example, use of cosmetics is most common in those with a perceived skin defect, therefore many BDD sufferers will only display a few common symptoms and behaviors.


Common symptoms of BDD include:
Obsessive thoughts about perceived appearance defect.
Obsessive and compulsive behaviors related to perceived appearance defect (see section below).
Major depressive disorder symptoms.
Delusional thoughts and beliefs related to perceived appearance defect.
Social and family withdrawal, social phobia, loneliness and self-imposed social isolation.
Suicidal ideation.
Anxiety; possible panic attacks.
Chronic low self-esteem.
Feeling self-conscious in social environments; thinking that others notice and mock their perceived defect.
Strong feelings of shame.
Avoidant personality: avoiding leaving the home, or only leaving the home at certain times, for example, at night.
Dependant personality: dependence on others, such as a partner, friend or family.
Inability to work or an inability to focus at work due to preoccupation with appearance.
Decreased academic performance (problems maintaining grades, problems with school/college attendance).
Problems initiating and maintaining relationships (both intimate relationships and friendships).
Alcohol and/or drug abuse (often an attempt to self-medicate).
Repetitive behaviour such as constantly applying make up and often applying it quite heavily.
Seeing slightly varying image of self upon each instance of observal in mirror/reflective surface.
Note: Modification of the body in anyway is a way to change one's appearance. There are many ways to modify the body that do not include surgery/cosmetic surgery. Please take note if any body modification seems compulsive, repetitive, or focused on one area or upon "defects" that person perceives are there.


Common compulsive behaviors associated with BDD include:
Compulsive mirror checking, glancing in reflective doors, windows and other reflective surfaces.
Alternatively, an inability to look at one's own reflection or photographs of oneself; often the removal of mirrors from the home.
Attempting to camouflage imagined defect: for example, using cosmetic camouflage, wearing baggy clothing, maintaining specific body posture or wearing hats.
Excessive grooming behaviors: skin-picking, combing hair, plucking eyebrows, shaving, etc.
Compulsive skin-touching, especially to measure or feel the perceived defect.
Becoming hostile toward people for no known reason, especially those of the opposite sex
Reassurance-seeking from loved ones.
Excessive dieting / exercise, or work on outside appearance.
Self harm
Comparing appearance/body-parts with that of others, or obsessive viewing of favorite celebrities or models whom the person suffering from BDD wishes to resemble.
Use of distraction techniques: an attempt to divert attention away from the person's perceived defect, e.g. wearing extravagant clothing or excessive jewelry.
Compulsive information seeking: reading books, newspaper articles and websites which relates to the person's perceived defect, e.g. hair loss or dieting and exercise.
Obsession with plastic surgery or dermatology procedures, with little satisfactory results for the patient.
In extreme cases, patients have attempted to perform plastic surgery on themselves,
including liposuction and various implants with disastrous results. Patients have even tried to remove undesired features with a knife or other such tool when the center of the concern is on a point, such as a mole or other such feature in the skin. This can be deadly.
Excessive enema use.
source: The Broken Mirror, Katharine A Philips, Oxford University Press, 2005 ed


In research carried out by Dr. Katharine Philips, involving over 500 patients, the percentage of patients concerned with the most common locations were as follows;
Skin (73%)
Hair (56%)
Nose (37%)
Weight (22%)
Abdomen (22%)
Breasts/chest/nipples (21%)
Eyes (20%)
Thighs (20%)
Teeth (20%)
Legs (overall) (18%)
Body build/bone structure (16%)
facial features (general) (14%)
Face size/shape (12%)
Lips (12%)
Buttocks (12%)
Chin (11%)
Eyebrows (11%)
Hips (11%)
Ears (9%)
Arms/wrists (9%)
Waist (9%)
Genitals (8%)
Cheeks/cheekbones (8%)
Calves (8%)
Height (7%)
Head size/shape (6%)
Forehead (6%)
Feet (6%)
Hands (6%)
Jaw (6%)
Mouth (6%)
Back (6%)
Fingers (5%)
Neck (5%)
Shoulders (3%)
Knees (3%)
Toes (3%)
Ankles (2%)
Facial muscles (1%)
source: The Broken Mirror, Katharine A Philips, Oxford University Press, 2005 ed, p56
People with BDD often have more than one area of concern.


BDD usually develops in adolescence, a time when people are generally most sensitive about their appearance. However, many patients suffer for years before seeking help. An absolute cause of body dysmorphic disorder is unknown. However, research shows that a number of factors may be involved and that they can occur in combination.
Some of the theories regarding the cause of BDD are summarized below:
[edit]Biological/genetic
Chemical imbalance in the brain: An insufficient level of serotonin, one of the brain's neurotransmitters involved in mood and pain, may contribute to body dysmorphic disorder. Although such an imbalance in the brain is unexplained, it may be hereditary.
Serotonin is thought to have a role in regulating anxiety, though it is also thought to be involved in such processes as sleep and memory function. This neurotransmitter travels from one nerve cell to the next via synapses. In order to send chemical messages, serotonin must bind to the receptor sites located on the neighboring nerve cell. It is hypothesized that BDD sufferers may have blocked or damaged receptor sites that prevent serotonin from functioning to its full potential. This theory is supported by the fact that many BDD patients respond positively to selective serotonin reuptake inhibitors (SSRIs) – a class of antidepressant medications that allow for more serotonin to be readily available to other nerve cells. There are cases, however, of patient's BDD symptoms worsening from SSRI use. Imbalance of other neurotransmitters, such as Dopamine and Gamma-aminobutyric acid, have also been proposed as contributory factors in the development of BBD.
Genetic predisposition:
It has been suggested that certain genes may make an individual more predisposed to developing BDD. This theory is supported by the fact that approximately 20% of people with BDD have at least one first-degree relative, such as a parent, child or sibling, who also has the disorder. It is not clear, however, whether this is genetic or due to environmental factors (i.e. learned traits rather than inherited genes). Twin studies suggest that the majority, if not all, psychiatric disorders are influenced, at least to some extent, by genetics and neurobiology, although no such studies have been conducted specifically for BDD.
Brain regions:
A further biological-based hypothesis for the development of BDD is possible abnormalities in certain brain regions. Magnetic resonance imaging (MRI)-based studies found that individuals with BDD may have abnormalities in brain regions, similar to those found in OCD.
Visual processing:
While some believe that BDD is caused by an individual's distorted perception of his or her actual appearance, others have hypothesized that people with BDD actually have a problem processing visual information. This theory is supported by the fact individuals who are treated with SSRI's often report that their defect has gone—that they no longer see it. However, this may be due to a change in the individual's perception, rather than a change in the visual processing itself.
Obsessive–compulsive disorder.
BDD often occurs with OCD, where the patient uncontrollably practices ritual behaviors that may literally take over his or her life. A history of, or genetic predisposition to obsessive–compulsive disorder may make people more susceptible to BDD.
Generalized anxiety disorder.
Body dysmorphic disorder may co-exist with generalized anxiety disorder. This condition involves excessive worrying that disrupts the patient's daily life, often causing exaggerated or unrealistic anxiety about life circumstances, such as a perceived flaw or defect in appearance, as in BDD.


Teasing or criticism:
It has been suggested that teasing or criticism regarding appearance could play a contributory role in the onset of BDD. While it's unlikely that teasing causes BDD, since the majority of individuals are teased at some point in their life, it may act as a trigger in individuals who are genetically or environmentally predisposed; likewise, extreme levels of childhood abuse, bullying and even psychological torture, are often rationalized and dismissed as "teasing," sometimes leading to traumatic stress in vulnerable persons. Around 60% of people with BDD report frequent or chronic childhood teasing.

Parenting style:
Similarly to teasing, parenting style may contribute to BBD onset, for example, parents of individuals who place excessive emphasis on aesthetic appearance (i.e. that aesthetic appearance is the most important thing in life) or no emphasis at all may act as a trigger in those genetically predisposed.
Other life experiences:
Many other life experiences may also act as triggers to BDD onset, for example, neglect, physical and/or sexual trauma, insecurity and rejection.


Media:
It has been theorised that media pressures may contribute to BBD onset, for example glamour models and the implied necessity of aesthetic beauty. BDD, however, occurs in all parts of the world, including isolated areas where access to media mediums is limited or non-existent. Media pressures are therefore an unlikely cause of BDD, however they could act as a trigger in those already genetically predisposed or could worsen existing BDD symptoms.
[edit]Personality
Certain personality traits may make someone more susceptible to developing BDD. Personality traits which have been proposed as contributing factors include:
Perfectionism
Introversion / shyness
Neuroticism
Sensitivity to rejection or criticism
Unassertiveness
Avoidant personality
Schizoid personality
Since personality traits among people with BDD vary greatly, it is unlikely that these are the direct cause of BDD. However, like psychological and environmental factors, they may act as triggers in individuals.


BDD can be anywhere from slightly to severely debilitating. It can make normal employment or family life impossible. Those who are in regular employment or who have family responsibilities would almost certainly find life more productive and satisfying if they did not have the symptoms. The partners and family of sufferers of BDD may also become involved and suffer greatly, sometimes losing their loved one to suicide.
Studies have shown a positive correlation between BDD symptoms and poor quality of life. An indicator of just how seriously this disorder can affect a human being is the fact that the quality of life for individuals with BDD has also been shown to be poorer than those found in major depressive disorder, dysthymia, obsessive–compulsive disorder, social phobia, panic disorder, premenstrual dysphoric disorder and Post traumatic stress disorder.
Because BDD onset typically occurs in adolescence, an individual's academic/social performance may be significantly affected. Depending on the severity of symptoms, an individual may experience great difficulty maintaining grades and attendance or, in severe cases, an individual may drop out of school and therefore not reach the academic level they are capable of. The vast majority of people with BBD (90%) say that their disorder impacts on their academic/occupational functioning, while 99% say that their disorder impacts on their social functioning.
Despite a strong desire for relationships with other people, many BDD sufferers will instead choose to be lonely rather than risk being rejected or humiliated about their appearance by getting involved with people. Many people with BDD also have coexisting social phobia and/or avoidant personality disorder, making the sufferer's ability to establish relationships even more difficult.
Sufferers of BDD may often find themselves getting almost 'stuck' in moping around. That is to say that sufferers, with such a type of depression, can in some cases appear to take a long time to get everything done. However, this is not actually the case, as it is simply that the BDD sufferers will often just sit or lie down for prolonged periods of time, without being able to actually motivate themselves until it becomes completely necessary to get back up. This can often cause little to get done by sufferers, and they can have little self motivation with anything, including relationships with other people. However, contrary to this, when the action is relevant to the person's image, it is more common for the sufferer to exhibit a fanatic and extreme approach, applying attention fully to the tasks at hand and at self-grooming/modification.


Many individuals with BDD have repeatedly sought treatment from dermatologists or cosmetic surgeons with little satisfaction before finally accepting psychiatric or psychological help. Plastic surgery on those patients can lead to manifest psychosis, suicide or never ending requests for more surgery. Treatment can improve the outcome of the illness for most people. Other patients may function reasonably well for a time and then relapse, while others may remain chronically ill. Research on outcome without therapy is not known but it is thought the symptoms persist unless treated.


Studies have found that Cognitive Behavior Therapy (CBT) has proven effective. In a study of 54 patients with BDD who were randomly assigned to Cognitive Behavior Therapy or no treatment, BDD symptoms decreased significantly in those patients undergoing CBT. BDD was eliminated in 82% of cases at post treatment and 77% at follow-up.
(8) Due to low levels of serotonin in the brain, another commonly used treatment is SSRI drugs (Selective Serotonin Reuptake Inhibitor). 74 subjects were enrolled in a placebo-controlled study group to evaluate the efficiency of Fluoxetine hydrochloride (Prozac), a SSRI drug. Patients were randomized to receive 12-weeks of double-blind treatment with fluoxetine or the placebo. At the end of 12 weeks, 53% of patients responded to the fluoxetine.
Body Dysmorphic Disorder is a chronic disorder that if left untreated can worsen with time. Without treatment, BDD could last a lifetime. In many cases, as illustrated in The Broken Mirror by Katharine Phillips, the social and professional lives of many patients disintegrates because they are so preoccupied with their appearance.

身体醜形障害(しんたいしゅうけいしょうがい、Body Dysmorphic Disorder:BDD)とは、自分の身体や美醜に極度にこだわる症状である。実際よりも低い自己の身体的なイメージが原因である。一種の心気症や強迫性障害とされる。重度の場合は統合失調症ともなる。俗に醜形恐怖また醜貌恐怖といわれる。また非常に強い強迫観念から強迫性障害と深い関連性があり、強迫スペクトラム障害にある。その強い強迫観念から身体醜形障害はうつ病も併発する割合もかなり高いとされる。また欧米では身体醜形障害(BDD)と独立だった専門分野として治療されているようだが、本国日本での治療分野では身体醜形障害はまだ独立だって居らず、強迫性障害や統合失調症の前駆症状と診断されているケースが多いようである。当然、強迫スペクトラム障害の伏線上にある純粋な身体醜形障害としての診断もある。

概要
「醜形恐怖」という言葉が19世紀にこの病気について初めて発表したイタリア人医師の名付けた原語を日本語訳したものとして作られ、長らくこの用語が日本では一般的であったが、近年患者が顔だけではなく身体全体を気にしだしたため「身体醜形障害」と呼ばれることも多くなった。近年、アメリカで研究が進んでいる。1995年に発表されたアメリカの調査によると、有病率は1%であるとされているが、患者は自身の身体醜形障害を医師にも言わない傾向が多いため、実際にはより多数の患者がいるのではないかと推測されている。
日本では1990年頃(特に後半)から多くなりだした。この内2割は引きこもりのような状況になるとされる[要出典]。整形をする人も多いが、実際には思い込みに過ぎないため、満足な結果が得られることは少なく、結果的に逆に顔を崩してしまうことさえある。
この障害を持つ場合には、1日に何時間も自身の肉体的な欠陥について考えるようになり、極端に社会から孤立してしまうとされる。その結果として、学校を退学したり、仕事を辞めたりすることがある。また友人を作らなくなったり、離婚をしたりし、最終的には自殺をするに至ることもあるとされる[要出典]。
男性の場合、第二次性徴によって男らしく変化した部分を嫌い、幼児期のままの自分でいたいと思う傾向が強いとされる。また、女性の場合は、母親や姉妹など周囲の身体に対する優劣を意識する傾向が強いとされる。顔自体に限っていえば男性に多いが、身体全体に亘る場合は女性に多いとされる[要出典]。
醜形障害者の割合に男女比の差はあまりないとされるが、とらわれる箇所は男女個々様々で体全体にいたる(頭蓋骨(頭)の大きさ、体型、肌、髪、爪、目、鼻、耳、口、歯並び、顎、体毛、性器、身長、体重など)。
醜形障害者はかなり偏ったボディーイメージを持っている(極端な体重(低体重・モデル体重など)へのこだわりなど)。そういった意味では摂食障害とも関連性はある。もっとも体重だけではなく、一度鏡で見た顔や容姿にいたるイメージへも確固たる真のイメージを持ち難いともされる。それゆえ、何度も鏡を確認するものと思われる。
身体醜形障害の状態があまりにも長く続く場合は、持続性妄想性障害(統合失調症など)にも関連する。その際診断の結果、統合失調症とされる場合も少なくない。それ故、精神科などの比較的大きな医療機関を訪れた際に、対人恐怖や身体醜形障害と診断されることは少なく、強迫性障害や統合失調症となるケースが多い。
醜形障害者の日常生活における困難は、鏡などの反射物(鏡、ガラス、水面、なべのふた、スプーン、ペットボトル、食器類など)に映る顔全体の影形やその姿であり、その対象物を何十分、何時間という単位で目で確認し続けるという強迫性障害でいう強迫確認または強迫行動によって支配される苦しみや苦痛である。また外出した際は他人の視線(顔や容姿全体、こだわっている箇所)を意識しすぎて、ショーウィンドーのガラスや車のガラス、バックミラーなどに自分の顔や容姿を映し様々な角度から自分のこだわっている箇所を確認し続けるという行動をとる。その姿が自分の思っていた顔や容姿とのイメージと合致した場合は、気分が高揚し安心感を持ち、かけ離れていた場合は酷く落ち込み、目的だった事柄や場所に行けず冷や汗を掻いて引き返してくることもある。また外出時は自分の顔・容姿のこだわっている箇所を他人と必死に比べようともする。
また反射物に限らず、写真や映像(カメラやビデオ)に撮られることも嫌い、その自身が映った写真や映像から目を背けたり映りたがらない。写真や映像に写った自身の顔・姿のイメージが自己のイメージと合致すれば上記の様な心理状態になり、違った場合は気落ち落胆しうつになったり、写真の場合は破り捨てることも見受けられる。その結果、履歴書などに載せる証明写真を撮るのに支障を来たす場合がある。
また、醜形障害者は鏡やガラスなどに映った自分を見続ける確認行動がある裏側、必死に鏡やガラスなどの反射対象物を避け、なるべくこだわっている箇所を映らない、映さない、確認しないなどといった極端な反面も持ち合わせていることが多い。なぜ、その両面を持ち合わせているのかは具体的には分からないが、強迫性障害で言う強迫確認の負のループに自身の大事な時間を費やされたくない、その確認しているさまを他人に見られるのが恥ずかしい、奇妙な行為だと思われるのが怖い、またその確認でこだわっている箇所を見てしまったための落ち込みの不安で、恐怖と絶望の渦に陥りたくないという心理的要因が働くのではないかと思われる[要出典]。そしてこの二つの局面を持ち合わせている者もいれば、そうでない者もいるようである[要出典]。
醜形障害者は妄想的に確信を抱いたとらわれのパターンと、元々(生まれつき)の細かい欠陥(例えば、髪の毛が柔らかく細く頭髪が元々薄い傾向や、成人して止ってしまった身長などに対する変えられようのない事実)にとらわれてしまうパターンとがある。後者は投薬治療では中々改善しない場合が多く、10年近く症状で悩まされる場合も多い。いずれにしても、細かい顔や体に対する欠陥や妄想的とらわれが身体醜形障害の特徴である。
自分の容姿にとらわれるあまり、家族にまでそのとらわれ箇所の確認を要求する(どのように思い、感じるか)家族巻き込み型もこの病の典型である。その結果、家族のいい回答が得られずに(正しい返答がない、もしくは家族として思い合ってか言葉に表しにくいため)家庭内暴力にまで至るケースもある。
またこれら反射物による恐怖を発端とする忌避行為により、日常生活に多大なる影響を与える。特に就労に関してこの問題は大きい。例を挙げれば、反射するモニターを使用する光沢液晶やCRTの仕事を忌避したり、サイドミラーを恐れ運転免許が取れなかったり等致命的な支障を就労においてきたす。自分の顔への恐怖は、裏返せば他者の視線への恐怖であり、面を向かってのデスクワークや会議、及び面談等もまともに正対して視線を合わすことさえ困難を極める。結果的に、能力的にできる職種であっても、醜形恐怖が先行するあまり、自ら職業の選択を狭め、最悪何も仕事を選べないという状況になり得る。プライベートにおいてもそのような状態では恋愛はおろか友人関係を築くのも著しい困難を生じる。
原因としては、先天的なこだわりやすい性格や完全志向、強迫神経症に通じる確認行為等の素因も軽視できない一方で、人とのコミュニケーションを上手く取れない自己の内面の脆さを違う形で、つまり外見の劣等へ形を置き換える事で、無意識的にバランスを取っている側面もある。醜形恐怖の人達に、コミュニケーションスキル不足や対人恐怖を含む社会不安症を併発しやすいのもその影響が考えられる。自己へ自己へと意識が集中しすぎ自身で、完璧なこうであれねば、という枠組みを形成してしまうのが根底にある。外界(他人)への意識を拡大させると共に、自分への美醜のこだわりより先に対人スキルを含む内面精神に対する誤った認識の確認、再生、充実が結果的にこれらの強迫観念を解決させる一助になりえる。
マスメディアにおける時代の美醜の価値観も関連する。
容姿だけではなく、社会的に非常に強いコンプレックスを抱く者もある。
自尊心も極端に低い傾向にある。
長期による深刻な悩みの末、自己同一性に欠ける問題もある。
身体表現性障害と大まかに括れる事が出来る。
しばしば、ノイローゼ的になりパニック発作を起こす場合もある。
強迫性障害からの視点では脳内伝達物質のセロトニンの異常と、眼窩皮質という箇所の異常だともいわれる。
身体醜形障害は自己愛とも深い関連があり、自己愛性人格障害にも少なからず関連性がある。
森田療法や暴露反応妨害法なとが有効とされている。
身体醜形障害の自己対処法として、とらわれている箇所を鏡で重視するのではなく、鏡で見てとらわれている箇所から容姿全体へと視点をなぞり移すようにして行き、最後に容姿全体へと視点そのものを変えて行くと良いとされている。
醜形恐怖症は自己臭恐怖症とも深い因果関係があり、しばしば両方を併発する。根底には他者に受け入れられたい迷惑をかけたくないという考えがある。
醜形恐怖は精神病というより元来持つ性格から発している部分が大きい、その際たるものが「完璧主義」である。醜形恐怖が難治といわれるのは、先天的あるいは、長年積み重なった性格・気質によるためでもある。
最近のプチ整形を筆頭として美容整形の浸透が醜形恐怖を更に根深い問題とさせている。
身体醜形障害の治療は心療内科、クリニック、精神科などを受診した場合は向精神薬の(商品名)「一般名」(アナフラニール)「塩酸クロミプラミン」(三環形抗うつ剤)や(デプロメール)・「フルボキサミン」(別名:ルボックス)・(パキシル)「パロキセチン」・(ジェイ・ゾロフト)「セルトラリン」などのSSRI、また抗不安薬(マイナートランキライザー)である(レキソタン)「ブロマゼパム」や、眠りが浅い場合は(ロヒプノール)「フルニトラゼパム」などの睡眠導入剤が処方が主流である。また比較的症状が重い場合は抗精神病薬(メジャートランキライザー)である、(セレネース)(ハロペリドール)・(ルーラン)(非定型抗精神病薬/ペロスピロン)・(セロクエル)「非定型抗精神病薬/クエチアピン」・(エビリファイ)「非定型抗精神病薬/アリピプラゾール」・(リスパダール)「非定型抗精神病薬/リスペリドン」などが処方として挙げられる。

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  1. When not given the right anorexia treatment, anorexia may result to anemia and low white blood count which are necessary in fighting off infections.

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