Body Dysmorphic Disorder 243
Specify if:
With muscle dysmorphia:  The individual is preoccupied with the idea that his or her
body build is too small or insufficiently muscular. This specifier is used even if the indi-
vidual is preoccupied with other body areas, which is often the case. 
Specify if: 
Indicate degree of insight regarding body dysmorphic disorder beliefs (e.g., “I look ugly” or
“I look deformed”).
With good or fair insight:  The individual recognizes that the body dysmorphic disor-
der beliefs are definitely or probably not true or that they may or may not be true.
With poor insight:  The individual thinks that the body dysmorphic disorder beliefs are
probably true.
With absent insight/delusional beliefs:  The individual is completely convinced that
the body dysmorphic disorder beliefs are true.
Diagnostic Features 
Individuals with body dysmorphic disorder (formerly known as dysmorphophobia ) are pre-
occupied with one or more perceived defects or flaws in their physical appearance, which
they believe look ugly, unattractive, abnormal , or deformed (Criterion A). The perceived
flaws are not observable or appear only slig ht to other individuals. Concerns range from
looking “unattractive” or “not  right” to looking “hideous” or “like a monster.” Preoccu-
pations can focus on one or many body are as, most commonly the skin (e.g., perceived
acne, scars, lines, wrinkles, paleness), hair (e.g., “thinning” hair or “e xcessive” body or fa-
cial hair), or nose (e.g., size or shape). Howe ver, any body area can be the focus of concern