The present investigation was the first to evaluate cognitive therapy alone to treat body dysmorphic disorder (BDD). Four patients with BDD were treated with cognitive therapy based upon Beck's (1967) model. A single-subject multiple baseline design was used in which each subject served as his or her own control. Patients were randomly assigned to one of two conditions in which the duration of baseline and follow-up differed. Dependent measures included the Body Dysmorphic Disorder Examination, the Yale-Brown Obsessive Compulsive Scale for Body Dysmorphic Disorder, the Body Satisfaction Scale, the Beck Depression Inventory, the Beck Anxiety Inventory, and the Overvalued Ideas Scale. Three of the four patients reported statistically significant reductions in depression, anxiety, and dissatisfaction with their body parts. Two patients showed statistically significant decreases in body dysmorphic obsessions and compulsions. Two subjects reported statistically significant reductions in overvalued ideas. While the results show promise for the use of cognitive therapy in the treatment of BDD, further investigation is required. Further research is also recommended to directly compare exposure plus response prevention to cognitive restructuring and to evaluate their additive effect.
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