Millions of children are exposed to domestic violence. How children negotiate and make sense of living with domestic violence is still under-researched. This study sought to capture the dual-perspectives of school-aged children and their mothers, to develop a richer understanding of children's experiences of domestic violence, using a community-based sample. A qualitative research design was employed, with interpretative phenomenological analysis used to interpret the data. Five school-aged children and three of their mothers participated in the study. Two master themes are discussed from the analysis of the children's perspective: domestic violence through the eyes of children; and learning from children's experiences. Two master themes are discussed from the analysis of the mothers' perspective: reflecting on the child in the context of domestic violence; and learning from mothers: insights, support and services. The crucial importance of the mother-child relationship in shaping children's experience of domestic violence was illustrated in both the perspectives; a finding which may have important implications for the development of interventions. It was also evident that children as young as eight were able to powerfully articulate their experiences of domestic violence.

Objective: Body dysmorphic disorder (BDD) typically starts in adolescence, but evidence-based treatments are yet to be developed and formally evaluated in this age group. We designed an age-appropriate cognitive-behavioral therapy (CBT) protocol for adolescents with BDD and evaluated its acceptability and efficacy in a pilot randomized controlled trial.Method: Thirty adolescents aged 12-18 (mean=16.0,SD=1.7) with a primary diagnosis of BDD and their families were randomly assigned to 14 sessions of CBT delivered over four months or a control condition of equivalent duration, consisting of written psycho-education materials and weekly telephone monitoring. Blind evaluators assessed participants at baseline, mid-treatment, post-treatment, and at two-month follow-up. The primary outcome measure was the Yale-Brown Obsessive-Compulsive Scale Modified for BDD, adolescent version (mean baseline score=37.13,SD=4.98; range=24-43). Results:The CBT group showed a significantly greater improvement than the control group, both at post-treatment (time×group interaction coefficient [95%CI]=-11.26 [-17.22 to -5.31]; p=0.000) and at two-month follow-up (time×group interaction coefficient [95%CI]=-9.62 [-15.74 to -3.51]; p=0.002).Six (40%) participants in the CBT group and one (6.7%) in the control condition were classified as responders at both time points (χ 2 =4.658,p=.031). Improvements were also seen on secondary measures, including insight, depression, and quality of life at post-treatment. Both patients and their families deemed the treatment as highly acceptable. Conclusion:Developmentally tailored CBT is a promising intervention for young people with BDD, though there is significant room for improvement. Further clinical trials incorporating lessons learned in this pilot and comparing CBT and pharmacological therapies, as well as their combination, are warranted.

A high proportion of individuals with body dysmorphic disorder (BDD) undergo cosmetic treatments in an attempt to 'fix' perceived defect/s in their physical appearance. Despite the frequency with which such procedures are sought, few studies have prospectively examined the outcomes of cosmetic procedures in individuals with BDD. This article aims to critically review the literature and discuss the current debate that exists on outcomes of cosmetic treatment for individuals with BDD. An emerging literature suggests the majority of individuals with BDD have poor outcomes after cosmetic interventions; however, based on the current literature, it cannot be fully ruled out that certain individuals with mild BDD and localised appearance concerns may benefit from these interventions. Gaps in the current literature are highlighted, alongside recommendations for future research. Carefully conducted longitudinal studies with well-characterised patient populations are needed.

No abstract