A 22-year-old female presents with significant distress about her appearance, spending approximately 4 hours daily examining perceived flaws in her facial features, particularly her nose and jawline. She avoids social situations, has missed multiple days of college, and uses heavy makeup to conceal what she describes as severe asymmetry that others tell her is not noticeable. She performs repetitive mirror-checking and seeks reassurance from friends about her appearance multiple times daily. Her BMI is 22 and she reports no dissatisfaction with her weight, no dietary restriction, no binge eating, no purging, and no desire to lose weight. She describes her self-worth as entirely dependent on whether her face looks acceptable. Which diagnostic consideration best accounts for this presentation?