Spontaneously occurring images and early memories in people with body dysmorphic disorder.

A semi-structured interview assessing the presence and characteristics of spontaneous appearance-related images was designed and administered. A total of 18 patients with body dysmorphic disorder (BDD) and 18 normal controls took part. The BDD patients were found to have spontaneously occurring appearance-related images that were significantly more negative, recurrent, and viewed from an observer perspective than control participants. These images were more vivid and detailed and typically involved visual and organic (internal body) sensations. The study also found that BDD images were linked to early stressful memories, and that images were more likely than verbal thoughts to be linked to these memories. Implications for theory and clinical practice are discussed.