Lecture 9 Flashcards
1
Q
What is the ratio of BDD?
A
1:1 male to female
2
Q
What is the presentation of BDD?
A
- Similar in females and males
- Men tend to focus on muscles defects and bodybuilding
- Women are more likely to have co-morbid eating disorder
3
Q
What is the onset of BDD?
A
- 16 years (range: adolescence through 20s)
- High percentage of suicide attempts (21% - 27.5%)
- More impairment than depression, diabetes, heart attack
4
Q
What are some of the more prevalent actions of BDD?
A
- People keep it a secret.
- The statistics are so vast from study to study.
- Much higher in psychiatric population.
5
Q
What are some concerns of BDD?
A
-Suicidal behavior
- The text discusses one man who thought his skin was too loose, so he tried to
staple it with a staple gun - Another woman was preoccupied with her skin and her face shape. She filed her teeth to alter the appearance of her jawline.
- Another woman couldn’t afford liposuction, so she used a knife to cut her thighs open and squeeze out the fat.
- These are reactions to what they believe are horrible and disgusting features of their bodies…
6
Q
What are the assessments used for BDD?
A
- Clinical Interview
- Collateral Information
- Structured Assessments
7
Q
What are the treatments of BDD?
A
- Medication: block 5-HT reuptake (clomipramine, fluvoxamine)
- Psychological: ERP
- Therapy produces better and longer lasting outcomes compared to medication alone
8
Q
What is a cross cultural consideration of BDD?
A
- Japanese variant of social anxiety disorder.
- Patient believes they have horrendous breath or body odor, will embarrass themselves, have an odd apprearance > avoid social interaction
- Patients with BDD in the U.S> may be considered to have severe social anxiety in Japan and Korea
9
Q
What are the surgery statistics of BDD?
A
- 76.4% sought medical treatment
- Dermatology(45.2%)
- Plastic surgery (23.2%)
- People with BDD are often not satisfied with surgery
- 81% are dissatisfied
10
Q
What is Body Integrity Identity Disorder?
A
- Disorder in which the person does not identify with a part of their body, causing significant and obsessive emotional distress, and often a strong desire to amputate a healthy appendage, become paralyzed, or remove/disable whatever is bothering them.
- Some of these patients will mutilate themselves if requests from surgeons for an amputation or for the transection of their spinal cord is denied.
11
Q
What are some neurological underpinnings of BIID?
A
- Reduced cortical thickness in the areas of the parietal lobe and a reduced cortical surface areas of the somatosensory cortices and anterior insular cortex.
- Right-sided cortical abnormalities are associated with a strong desire for left-sided limbs for amputation.
12
Q
What are some of the the motivations for those with BIID?
A
- Restoring true identity as an amputee
- Feeling sexually attracted or aroused
- body sculpting/aesthetics
- feeling satisfied inside
13
Q
What is the treatment of BIID?
A
- Psychotherapy
- Medication – SSRI
- Fluoxetine
- Deep Brain Stimulation
- Elective Amputation…?
14
Q
What is Hoarding Disorder?
A
- The acquisition of, and failure to discard, a large number of possessions
- Living spaces so cluttered that they cannot be used as intended
- Significant distress or impairment due to clutter
15
Q
What is Hoarding?
A
- Excessively acquiring items that are not needed or for which there’s no space
- Persistent difficulty throwing out or parting with your things, regardless of actual value
- Feeling a need to save these items, and being upset by the thought of discarding them
- Building up of clutter to the point where rooms become unusable
- Having a tendency toward indecisiveness, perfectionism, avoidance, procrastination, and problems with planning and organizination.
