Veale D, Riley S
Department of Psychiatry and Behavioural Sciences, Royal Free and University College School of Medicine, University of London, UK.
Behav Res Ther. 2001 Dec;39(12):1381-93. doi: 10.1016/s0005-7967(00)00102-9.
Patients with Body Dysmorphic Disorder (BDD) may spend many hours in front of a mirror but little is known about the psychopathology or the factors that maintain the behaviour. A self-report mirror gazing questionnaire was used to elicit beliefs and behaviours in front of a mirror. Two groups were compared, which consisted of 55 controls and 52 BDD patients.
Prior to gazing, BDD patients are driven by the hope that they will look different; the desire to know exactly how they look; a belief that they will feel worse if they resist gazing and the desire to camouflage themselves. They were more likely to focus their attention on an internal impression or feeling (rather than their external reflection in the mirror) and on specific parts of their appearance. They were also more likely to practise showing the best face to pull in public or to use "mental cosmetic surgery" to change their body image than controls. BDD patients invariably felt worse after mirror gazing and were more likely to use ambiguous surfaces such as the backs of CDs or cutlery for a reflection.
Mirror gazing in BDD consists of a series of complex safety behaviours. It does not follow a simple model of anxiety reduction that occurs in the compulsive checking of obsessive-compulsive disorder. The implications for treatment are discussed.
身体变形障碍（BDD）患者可能会在镜子前花费数小时，但对于维持这种行为的精神病理学或因素却知之甚少。使用一份自我报告的照镜子问卷来引出在镜子前的信念和行为。比较了两组，一组由55名对照者组成，另一组由52名BDD患者组成。
在照镜子之前，BDD患者受以下因素驱使：希望自己看起来有所不同；渴望确切知道自己的样子；相信如果抗拒照镜子会感觉更糟；以及伪装自己的欲望。他们更有可能将注意力集中在内心的印象或感觉（而非镜子中的外在影像）以及自己外貌的特定部位上。与对照者相比，他们也更有可能在公共场合练习展现最佳面容或使用“心理整容手术”来改变自己的身体形象。BDD患者照镜子后总是感觉更糟，并且更有可能使用诸如CD背面或餐具等模糊表面来映照自己。
BDD患者照镜子包含一系列复杂的安全行为。它并不遵循强迫症强迫检查中出现的简单焦虑减轻模式。文中讨论了其对治疗的启示。
