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Background Identity disruption and internalised shame may be important factors in explaining possible psychological mechanisms that underlie body dysmorphic disorder (BDD). These factors have also been linked to obsessive-compulsive disorder (OCD), a condition closely related to BDD. However, these factors have not been specifically examined in BDD, nor contrasted between BDD and OCD. Methods We compared identity functioning and internalised shame among 26 BDD, 22 OCD and 26 healthy control participants, and examined clinical correlates in both disorders. Results Findings demonstrated increased identity disruption and internalised shame in BDD and OCD relative to controls, and increased internalised shame in BDD relative to OCD. In both disorders, shame and identity disruption was correlated with suicidal ideation, depression, stress, and anxiety. In BDD only, increased identity disruption correlated with poorer insight, and increased internalised shame correlated with more severe BDD symptoms and poorer illness insight. Conclusions These data suggest that internalised shame may have important and specific relevance to BDD, and more general relevance to OCD. Moreover, identity disruption may represent an area meriting further research attention in both BDD and OCD. Clinical implications include the potential benefits of addressing internalised shame and identity problems in the treatment of both disorders.

Evidence now suggests executive dysfunction in Body Dysmorphic Disorder (BDD) which may be related to Obsessive-Compulsive Disorder (OCD). However, neurocognitive performance in the two disorders has rarely been compared. This study compared 14 BDD participants on neurocognitive tasks taken from the Cambridge Automated Neuropsychological Test Automated Battery (CANTAB) with previously published data from 23 OCD participants (Purcell, Maruff, Kyrios, & Pantelis, 1998). Effect sizes from three executive function tests (Spatial Span, Spatial Working Memory and Stockings of Cambridge), and one visual memory task (Pattern Recognition) were compared for group differences using difference and equivalence testing. Equivalence testing was used to determine whether BDD and OCD effects sizes were equivalent, non-equivalent or equivocal. Results indicated an equivocal pattern for Spatial Span, Spatial Working Memory, Pattern Recognition and most Stockings of Cambridge measures. However, results for Stockings of Cambridge accuracy measure indicated a non-equivalent pattern, with BDD but not OCD participants performing significantly worse than controls. Results suggest a number of similarities in neurocognitive function in BDD and OCD, although it was not possible to establish statistical equivalence on most study measures. The findings raise the possibility of more severe planning deficits in BDD compared to OCD.