title: Cognitive dysfunction in body dysmorphic disorder: new implications for nosological systems and neurobiological models.
abstract: Introduction Body dysmorphic disorder (BDD) is a debilitating disorder, characterized by obsessions and compulsions relating specifically to perceived appearance, and which has been newly classified within the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) Obsessive-Compulsive and Related Disorders grouping. Until now, little research has been conducted into the cognitive profile of this disorder.
  
  
  METHODS
  Participants with BDD (n=12) and participants without BDD (n=16) were tested using a computerized neurocognitive battery investigating attentional set-shifting (Intra/Extra Dimensional Set Shift Task), decision-making (Cambridge Gamble Task), motor response-inhibition (Stop-Signal Reaction Time Task), and affective processing (Affective Go-No Go Task). The groups were matched for age, IQ, and education.
  
  
  RESULTS
  In comparison to controls, patients with BDD showed significantly impaired attentional set-shifting, abnormal decision-making, impaired response inhibition, and greater omission and commission errors on the emotional processing task.
  
  
  CONCLUSIONS
  Despite the modest sample size, our results showed that individuals with BDD performed poorly compared to healthy controls on tests of cognitive flexibility, reward and motor impulsivity, and affective processing. Results from separate studies in OCD patients suggest similar cognitive dysfunction. Therefore, these findings are consistent with the reclassification of BDD alongside OCD. These data also hint at additional areas of decision-making abnormalities that might contribute specifically to the psychopathology of BDD.
authors.affiliation: 1Highly Specialized OCD Service,Hertfordshire, Partnership University National Health Service Foundation Trust,Welwyn Garden City,UK.
authors.forename: Kiri
authors.initials: K
authors.lastname: Jefferies-Sewell
authors.affiliation: 3Department of Psychiatry,School of Clinical Medicine,University of Cambridge,Cambridge,UK.
authors.forename: Samuel R
authors.initials: SR
authors.lastname: Chamberlain
authors.affiliation: 1Highly Specialized OCD Service,Hertfordshire, Partnership University National Health Service Foundation Trust,Welwyn Garden City,UK.
authors.forename: Naomi A
authors.initials: NA
authors.lastname: Fineberg
authors.affiliation: 2Department of Psychology,School of Life and Medical Sciences,University of Hertfordshire,Hatfield,UK.
authors.forename: Keith R
authors.initials: KR
authors.lastname: Laws
mesh_terms: D000328:Adult; D001288:Attention; D057215:Body Dysmorphic Disorders / Q000523:psychology*; D016022:Case-Control Studies; D060825:Cognitive Dysfunction / Q000523:psychology*; D003657:Decision Making; D005260:Female; D006801:Humans; D007266:Inhibition, Psychological; D008297:Male; D008875:Middle Aged; D008959:Models, Neurological; D008960:Models, Psychological; D009446:Neurobiology; D009483:Neuropsychological Tests; D011930:Reaction Time; D055815:Young Adult
keywords: Affective processing; body dysmorphic disorder; cognitive deficits; cognitive inflexibility; neurobiological; obsessive compulsive disorder; response inhibition