Seeing the Flaws? Visual Perception of Faces in Individuals Screening Positive for Body Dysmorphic Disorder - An Eye-Tracking Study

Sep 30, 2026

Body dysmorphic disorder (BDD) involves persistent preoccupation with perceived appearance flaws and is common among aesthetic surgery candidates, where it can undermine outcomes. This eye-tracking study examined whether people screening positive on the Body Dysmorphic Disorder Questionnaire (BDDQ) show different visual perception patterns for their own and model faces versus controls. A cross-sectional sample of 79 participants completed the BDDQ and evaluated standardized photographs while fixation data were recorded across facial regions of interest.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages14

Reading Time35 min

AccessFree to download

Introduction

Background on BDD and diagnostic criteria

Role of BDDQ screening

Eye-tracking rationale

Article Seeing the Flaws? Visual Perception of Faces in Individuals Screening Positive for Body Dysmorphic Disorder: An Eye-Tracking Study Łukasz Banaszek 1,2,†, Marta Wojtkiewicz 1,2,†, Monika Rudzi ´nska 1, Piotr Krysiak 1, Albert Stachura 1, *,Łukasz Mokros 3 and Wiktor Pascal 1,4 Academic Editor: Neelam Vashi Received: 22 November 2025 Revised: 21 December 2025 Accepted: 24 December 2025 Published: 28 December 2025 Copyright: © 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license. 1 Department of Methodology, Medical University of Warsaw, Banacha 1b Street, 02-097 Warsaw, Poland 2 Doctoral School, Medical University of Warsaw, 02-091 Warsaw, Poland 3 Department of Child and Adolescent Psychiatry, Medical University of Łód´z, 91-229 Łód´z, Poland 4 Private Practice, Sokolowska 9/31 Street, 01-142 Warsaw, Poland * Correspondence: [albert.stachura@wum.edu.pl](albert.stachura@wum.edu.pl)[ ](albert.stachura@wum.edu.pl)† These authors contributed equally to this work. Abstract Background: Body dysmorphic disorder (BDD) is a psychiatric condition characterized by a preoccupation with perceived appearance flaws. It is highly prevalent among aesthetic surgery candidates and can negatively impact surgical outcomes. The Body Dysmorphic Disorder Questionnaire (BDDQ) is used for BDD screening, but objective validation is limited. This study aimed to determine whether individuals screening positive for BDD exhibit different visual perception patterns of their own and model faces compared to controls, using eye-tracking technology. Methods: We conducted a cross-sectional study among 79 participants, including psychiatric patients and medical students. Participants completed the BDDQ and underwent eye-tracking while evaluating standardized photographs of models and their own faces. Gaze fixation patterns were recorded across pre-defined facial areas of interest. Perception and aesthetic assessment differences between the BDDQpositive and BDDQ-negative groups were studied. Results: Participants focused most frequently on the nose, eyes and eyebrows. Compared to model faces, more attention was directed toward their own chin and cheeks. However, BDDQ screening results did not significantly influence fixation patterns or eye-tracking metrics. Psychiatric patients, regardless of BDDQ status, exhibited more numerous and shorter fixations than students. All participants rated model faces as significantly more attractive (i.e., higher aesthetic rating) than their own, with the largest difference observed in the BDDQ-positive group. Conclusions: While individuals screening positive for BDD reported lower self-attractiveness, eye-tracking patterns did not differ significantly from those of healthy participants. These findings suggest that BDDQ remains a useful screening tool for subjective dissatisfaction but may not correspond to objective differences in facial visual processing. Keywords: body dysmorphic disorder; eye-tracking; auto-perception; facial features 1. Introduction Body dysmorphic disorder (BDD) is a mental health disorder wherein patients are excessively preoccupied with perceived flaws in their appearance and spend a significant amount of time daily ruminating on them [1] . To diagnose BDD in line with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), a patient must be concerned with a flaw, which is deemed non-existent or minor by others, engage in compulsive behaviours related to this and be significantly impaired in daily life, with these symptoms not better attributed to an eating disorder [2] . BDD is often comorbid with at least one other condition, such as social phobia, major depression, obsessive compulsive disorder and substance abuse [3,4] . Patients may pursue plastic surgery interventions to change their appearance

FAQs

What was the purpose of this eye-tracking study?

To determine whether individuals who screen positive for BDD show different visual perception patterns of their own and model faces compared with controls, using eye-tracking technology.

How were participants assessed in the study?

Participants completed the Body Dysmorphic Disorder Questionnaire (BDDQ) and then underwent eye-tracking while evaluating standardized photographs of both models and their own faces.

Did BDDQ screening status change eye-tracking fixation patterns?

BDDQ screening results did not significantly influence fixation patterns or eye-tracking metrics, despite some differences in reported self-attractiveness.

Sep 30, 2026

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