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Executive function in body dysmorphic disorder

Published online by Cambridge University Press:  02 December 2009

J. Dunai
Affiliation:
School of Behavioural Science, Department of Psychology, University of Melbourne, Melbourne, Australia
I. Labuschagne
Affiliation:
MAP-RC, School of Psychology, Psychiatry and Psychological Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia
D. J. Castle
Affiliation:
School of Behavioural Science, Department of Psychology, University of Melbourne, Melbourne, Australia Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia Mental Health Research Institute of Victoria, Melbourne, Australia
M. Kyrios
Affiliation:
Department of Psychology, Swinburne University, Melbourne, Australia
S. L. Rossell*
Affiliation:
School of Behavioural Science, Department of Psychology, University of Melbourne, Melbourne, Australia MAP-RC, School of Psychology, Psychiatry and Psychological Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia Mental Health Research Institute of Victoria, Melbourne, Australia
*
*Address for correspondence: A/Professor S. L. Rossell, Cognitive Neuropsychiatry Laboratory, MAP-RC, School of Psychology, Psychiatry and Psychological Medicine, 1st Floor, Old Baker Building, The Alfred, Commercial Road, Melbourne, VIC3004, Australia. (Email: SRossell@SRossell.com)

Abstract

Background

Body dysmorphic disorder (BDD) is a poorly understood disorder that involves a preoccupation with imagined or minor bodily defects. Only a few studies of neuropsychological function have been conducted. Two previous studies have indicated executive dysfunction in BDD. The current study sought to further define these executive deficits.

Method

Fourteen DSM-IV BDD patients and 14 age- and sex-matched control participants took part. Because of the high incidence of co-morbidity in BDD, patients with co-morbid Axis I disorders were not excluded. Control participants had no history of psychiatric illness. All participants completed the following executive function (EF) tests: Spatial Span (SS), Spatial Working Memory (SWM) and the Stockings of Cambridge (SOC) task. They also completed the Pattern Recognition (PR) test, a test of visual memory (VM).

Results

BDD participants made significantly more between-search errors on the SWM task, an effect that increased with task difficulty. Between-search errors are an example of poor maintenance and manipulation of information. SOC results indicated slower subsequent thinking times (i.e. the time taken to plan) in BDD participants. There were no group differences in SS or PR scores. The severity of BDD, depressive or anxiety symptoms was not correlated with performance on any of the cognitive tasks.

Conclusions

The results of this study indicate that BDD patients have EF deficits in on-line manipulation, planning and organization of information. By contrast, spatial memory capacity, motor speed and visual memory were intact. Considered with evidence from lesion and neuroimaging studies, these results suggest frontal lobe dysfunction in BDD.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2009

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References

APA (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text revision (DSM-IV-TR). American Psychiatric Association: Washington, DC.Google Scholar
Beck, AT, Epstein, N, Brown, G, Steer, RA (1988). An inventory for measuring clinical anxiety: psychometric properties. Journal of Consulting and Clinical Psychology 56, 893897.Google Scholar
Beck, AT, Ward, C, Mendelson, M (1961). Beck Depression Inventory (BDI). Archives of General Psychiatry 4, 561571.Google Scholar
Brown, TA, DiNardo, PA, Barlow, DH (1994). The Anxiety Disorders Interview Schedule for DSM-IV. Greywind Publications Inc: New York.Google Scholar
Castle, DJ, Rossell, S (2006). An update on body dysmorphic disorder. Current Opinion in Psychiatry 19, 7478.Google Scholar
Castle, DJ, Rossell, S, Kyrios, M (2006). Body dysmorphic disorder. Psychiatric Clinics of North America 29, 521538.Google Scholar
Deckersbach, T, Otto, MW, Savage, CR, Baer, L, Jenike, MA (2000 a). The relationship between semantic organization and memory in obsessive-compulsive disorder. Psychotherapy and Psychosomatics 69, 101107.Google Scholar
Deckersbach, T, Savage, CR, Phillips, KA, Wilhelm, S, Buhlmann, U, Rauch, SL, Baer, L, Jenike, MA (2000 b). Characteristics of memory dysfunction in body dysmorphic disorder. Journal of the International Neuropsychological Society 6, 673681.Google Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JB (1996). Structured Clinical Interview for DSM-IV Axis I Disorders, Clinician Version (SCID-CV). American Psychiatric Press: Washington, DC.Google Scholar
Fray, P, Robbins, T, Sahakian, B (1996). Neuropsychiatric applications of CANTAB. International Journal of Geriatric Psychiatry 11, 329336.Google Scholar
Goodman, WK, Price, LH, Rasmussen, SA, Mazure, C, Fleischmann, RL, Hill, CL, Heninger, GR, Charney, DS (1989). The Yale–Brown Obsessive Compulsive Scale. I. Development, use, and reliability. Archives of General Psychiatry 46, 10061011.Google Scholar
Hanes, KR (1998). Neuropsychological performance in body dysmorphic disorder. Journal of the International Neuropsychological Society 4, 167171.Google Scholar
Maruff, P, Purcell, R, Pantelis, C (2002). Obsessive-compulsive disorder. In Cognitive Deficits in Brain Disorders (ed. Harrison, J. E. and Owen, A. M.). Martin Dunitz: London.Google Scholar
Nelson, HE (1982). National Adult Reading Test (NART): Test Manual. NFER-Nelson: Windsor, UK.Google Scholar
Owen, A, Downes, J, Sahakian, B, Polkey, C, Robbins, T (1990). Planning and spatial working memory following frontal lobe lesions in man. Neuropsychologia 28, 10211034.Google Scholar
Pantelis, C, Barnes, T, Nelson, H, Tanner, S, Weatherley, L, Owen, A, Robbins, T (1997). Frontal-striatal cognitive deficits in patients with chronic schizophrenia. Brain 120, 18231843.Google Scholar
Phillips, KA (2000). Quality of life for patients with body dysmorphic disorder. Journal of Nervous and Mental Disease 188, 170175.Google Scholar
Phillips, KA, Atala, K, Pope, H (1995). Diagnostic instruments for body dysmorphic disorder. In New Research Program and Abstracts. American Psychiatric Association 148th Annual Meeting, Miami, FL.Google Scholar
Phillips, KA, Hollander, E, Rasmussen, SA, Aronowitz, BR, DeCaria, C, Goodman, WK (1997). A severity rating scale for body dysmorphic disorder: development, reliability and validity of a modified version of the Yale-Brown Obsessive Compulsive Scale. Psychopharmacology Bulletin 33, 1722.Google Scholar
Purcell, R, Maruff, P, Kyrios, M, Pantelis, C (1998). Cognitive deficits in obsessive-compulsive disorder on tests of frontal-striatal function. Biological Psychiatry 43, 348357.Google Scholar
Saxena, S, Feusner, J (2006). Toward a neurobiology of body dysmorphic disorder. Primary Psychiatry 13, 4148.Google Scholar
Veale, D, Sahakian, B, Owen, A, Marks, I (1996). Specific cognitive deficits in tests sensitive to frontal lobe dysfunction in obsessive-compulsive disorder. Psychological Medicine 26, 12611269.Google Scholar