Cognitive Therapy for Body Dsymorphic Disorder: A Randomized Controlled Trial

• Applicants: Dr. Viktoria Ritter; Professor Dr. Ulrich Stangier
• Subject Area: Personality Psychology, Clinical and Medical Psychology, Methodology
• Term: Funded in 2015
• Project identifier: Deutsche Forschungsgemeinschaft (DFG) - Project number 287331963

The current project aims at investigating the efficacy of a manualized cognitive therapy for body dysmorphic disorder (BDD) in a randomized controlled trial. Cognitive therapy for BDD (CT-BDD) includes interventions that aim at modifying biased appearance-related cognitive and emotional processes such as attention, perception, mental imagery, memory, interpretation and dysfunctional behaviors (e.g., safety behaviors). CT-BDD utilizes interventions for BDD patients (Attentional Training, Perceptual Retraining with Mirror Feedback, Video Feedback, Imagery Rescripting, Behavioral Experiments and Cognitive Restructuring) and additional modules (e.g., Skin Picking, Surgery Seeking). Thirty-eight adults with a primary diagnosis of BDD will be randomized to 25 (+5) sessions of individual CT-BDD over 9 months or to a 3-month waitlist control group. Primary outcome measure is the Yale-Brown Obsessive-Compulsive Scale Modified for BDD (BDD-YBOCS). Secondary outcome measures are the Brown Assessment of Beliefs Scale (BABS), the Fragebogen körperdysmorpher Symptome (FKS), the Beck Depression Inventory-II (BDI-II), and the Brief Symptom Inventory (BSI). Outcome measures will be completed at pretreatment, every 3 months at intervention phase (resp. at 6- and 12-week during waitlist), at post treatment, and at 3- and 6-month follow-up. The Global Assessment of Functioning Scale (GAF) and the Questionnaire for Patient Satisfaction with Outpatient Psychological Services (Zam-PsyD) will also be administered. Treatment response is defined by a BDD-YBOCS reduction of higher or equal 30% from baseline. We hypothesize that manualized CT-BDD is more effective than the waitlist condition concerning improvements in BDD symptom severity and associated features (insight, depression and psychological functioning). We further hypothesize that treatment gains will be maintained at 3- and 6-month follow-up assessment. Finally, BDD symptom severity, BDD duration, comorbid mental disorders, delusional insight and satisfaction with treatment are expected to be significant predictors of treatment outcome. To date, no treatment study investigated the use and efficacy of cognitive therapy for BDD in a randomized controlled trial. The proposed project may contribute to integrate existing treatment approaches for BDD and may have potential benefits for patients with this severe disorder.

• DFG Programme: Research Grants