title: Body-related cognitions, affect and post-event processing in body dysmorphic disorder.
abstract: OBJECTIVE
  Cognitive behavioural models postulate that individuals with BDD engage in negative appearance-related appraisals and affect. External representations of one's appearance are thought to activate a specific mode of processing characterized by increased self-focused attention and an activation of negative appraisals and affect.
  
  
  METHODS
  The present study used a think-aloud approach including an in vivo body exposure to examine body-related cognitions and affect in individuals with BDD (n = 30), as compared to individuals with major depression (n = 30) and healthy controls (n = 30). Participants were instructed to think aloud during baseline, exposure and follow-up trials.
  
  
  RESULTS
  Individuals with BDD verbalized more body-related and more negative body-related cognitions during all trials and reported higher degrees of negative affect than both control groups. A weaker increase of positive body-related cognitions during exposure, a stronger increase of sadness and anger after exposure and higher levels of post-event processing, were specific processes in individuals with BDD.
  
  
  CONCLUSIONS
  Individuals with major depression were not excluded from the BDD group. This is associated with a reduction of internal validity, as the two clinical groups are somewhat interwoven. Key findings need to be replicated.
  
  
  CONCLUSIONS
  The findings indicate that outcomes such as negative appearance-related cognitions and affect are specific to individuals with BDD. An external representation of one's appearance activates a specific mode of processing in BDD, manifesting itself in the absence of positive body-related cognitions, increased anger and sadness, and high levels of post-event processing. These specific processes may contribute toward maintenance of BDD psychopathology.
authors.affiliation: Department of Psychosomatic Medicine and Psychotherapy, University Hospital of Erlangen, University of Erlangen-Nürnberg, Schwabachanlage 6, 91054 Erlangen, Germany. Electronic address: ines.kollei@uk-erlangen.de.
authors.forename: Ines
authors.initials: I
authors.lastname: Kollei
authors.forename: Alexandra
authors.initials: A
authors.lastname: Martin
mesh_terms: D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D057215:Body Dysmorphic Disorders / Q000150:complications* / Q000175:diagnosis / Q000523:psychology*; D001828:Body Image / Q000523:psychology*; D003071:Cognition / Q000502:physiology*; D003865:Major Depressive Disorder / Q000150:complications / Q000175:diagnosis / Q000523:psychology; D004644:Emotions / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012649:Self Concept; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Affect; Body dysmorphic disorder; Body exposure; Body image; Cognitions; Post-event processing