# Neural mechanisms of perceptual abnormalities and their malleability in body dysmorphic disorder.

> **NIH NIH R01** · UNIVERSITY OF CALIFORNIA LOS ANGELES · 2020 · $757,798

## Abstract

PROJECT SUMMARY
Individuals with body dysmorphic disorder (BDD) misperceive specific aspects of their appearance to be
conspicuously flawed or defective, despite these being unnoticeable or appearing miniscule to others. With
convictions of disfigurement and ugliness, they typically have poor insight or delusional beliefs, obsessive
thoughts and compulsive behaviors, anxiety, and depression. These result in significant difficulties in
functioning, depression, suicide attempts (25%), and psychiatric hospitalization (50%). Despite this, relatively
few studies of the neurobiology, and few treatment studies, have been conducted. This underscores a critical
need for research to identify novel targets for intervention based on a comprehensive understanding of the
pathophysiological mechanisms. Neuropsychological, behavioral, and neurobiological research by our group
and others have uncovered mechanisms that may contribute to perceptual distortions, including prominent
abnormalities in visual processing systems. These have contributed to a model of diminished global/holistic
processing and enhanced local/detailed processing, attributed to “bottom-up” and “top-down” disturbances in
perception. Using psychophysical experiments and novel visual modulation techniques, we have probed the
brain’s visual systems responsible for global and local processing and found early evidence that they may be
modifiable in BDD. These techniques include a “top-down” attentional modulation and a “bottom-up” perceptual
modulation strategy. Abnormal eye gaze and emotional arousal when viewing faces may further contribute to
abnormal perception. Whether these brain and behavior abnormalities are directly linked to abnormal
perception remains to be understood. Accordingly, this study will determine a) if abnormalities in neural
activation and connectivity in BDD when viewing one’s appearance are directly associated with abnormalities
in perceptual functioning; and b) if changes in neural activation and connectivity from these visual modulation
strategies are linked to changes in perceptual functioning, thus representing potential biomarkers. We will also
determine how attentional systems, eye gaze behaviors and emotional arousal interact with brain functioning in
visual systems, and with global and local perceptual functioning. We will enroll 80 participants with BDD, 40
with subclinical BDD, and 40 healthy controls who will undergo functional magnetic resonance imaging while
viewing photographs of their, and others’, faces. We will obtain measures of global and local visual processing,
emotional arousal while viewing their face, and eye gaze behaviors using eye tracking. To understand the
malleability of global/local perception, and the neural mechanisms of these changes, we will determine whether
repeated visual modulation using top-down and bottom-up strategies results in alterations of perceptual
functioning and brain activity/connectivity, and relationships between them. Re...

## Key facts

- **NIH application ID:** 10051358
- **Project number:** 1R01MH121520-01A1
- **Recipient organization:** UNIVERSITY OF CALIFORNIA LOS ANGELES
- **Principal Investigator:** Jamie Feusner
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $757,798
- **Award type:** 1
- **Project period:** 2020-07-23 → 2021-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10051358

## Citation

> US National Institutes of Health, RePORTER application 10051358, Neural mechanisms of perceptual abnormalities and their malleability in body dysmorphic disorder. (1R01MH121520-01A1). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10051358. Licensed CC0.

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