Facial Attractiveness Ratings and Perfectionism in Body Dysmorphic Disorder and Obsessive-compulsive Disorder

Individuals with body dysmorphic disorder (BDD) suffer from a preoccupation about imagined or slight appearance flaws. We evaluated facial physical attractiveness ratings and perfectionistic thinking among individuals with BDD (n=19), individuals with obsessive-compulsive disorder (OCD; n=21), and mentally healthy control participants (n=21). We presented participants with photographs displaying faces varying in facial attractiveness (attractive, average, unattractive) and asked them to rate them in terms of their physical attractiveness. We further examined how the participants evaluated their own physical attractiveness, relative to independent evaluators (IEs). As predicted, BDD participants perceived their own attractiveness as significantly lower than did the IEs, and they rated photographs from the category "Attractive" as significantly more attractive than did the other groups. Furthermore, both clinical groups were characterized by more perfectionistic thinking than controls. These findings mostly support cognitive-behavioral models of BDD that suggest that individuals with BDD exhibit perfectionistic thinking and maladaptive attractiveness beliefs.