Cognitive-Behavioral Therapy for Body Dysmorphic Disorder: A Comparative Investigation

Khemlani-Patel, Sony; Neziroglu, Fugen; Mancusi, Lauren

doi:10.1521/ijct.2011.4.4.363

Cited by 18 publications

(11 citation statements)

References 57 publications

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“…This may explain why behavioural interventions have demonstrated equal degrees of efficacy relative to cognitive‐behavioural packages (e.g., see Khemlani‐Patel, Neziroglu, & Mancusi, ), as it is only through exposure techniques that the individual learns to tolerate short‐term distress in exchange for long‐term benefits. Thus, techniques such as habit reversal training have been suggested for targeting BDD behaviours that are carried out by individuals at a non‐conscious level, while “perceptual training” and “mirror retraining” have been highlighted as key treatments in therapy packages (Phillips, ; Veale & Neziroglu, ), as both involve replacing existing behaviours with alternative activities.…”

Section: Discussionmentioning

confidence: 99%

Repetitive, Safe, and Automatic: The Experience of Appearance‐Related Behaviours in Body Dysmorphic Disorder

Oakes

Collison

Milne-Home

2017

Australian Psychologist

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Objective: Body dysmorphic disorder (BDD) entails a preoccupation with a perceived appearance defect, which causes distress and/or functional impairment. The individual must also perform repetitive behaviours in response to these concerns (e.g., mirror checking, excessive grooming). Prior research has focused primarily on preoccupation, and behaviours have rarely been examined. As such, there is limited insight regarding how these activities are perceived by the sufferer. This study therefore examined how individuals with BDD experience these behaviours. Method: Eight individuals diagnosed with BDD completed a 60-min, semi-structured interview. Inductive thematic analysis was employed to investigate semantic themes within the data. Results: Three themes emerged: "Routine and repetitive", "Safety through control," and "Natural and automatic." These findings portray a complex experience of distressing activities that may also provide comfort and safety, in time coming to embodying what "normal" constitutes for the individual. Conclusions: The experience of BDD behaviour is complex. Camouflaging and using make-up provided a sense of relief and/or reassurance, whereas other behaviours were reported as distressing and likely to promote further concerns. Ironically, participants were seemingly dissatisfied with these symptoms, while also drawing comfort and a sense of identify from them. This inconsistent pattern of reward and punishment supports existing conceptual models of BDD, and may explain why these symptoms are so difficult to manage and/or change (i.e., via negative reinforcement). It also suggests that different types or categories of behaviour may exist for BDD (e.g., checking vs fixing behaviours), reflecting different functions and/or underlying motivations among individuals.What is already known on this topic 1 Appearance-related behaviours are a common clinical feature of body dysmorphic disorder (BDD) and a newly added symptom in DSM-5 nosology. 2 BDD behaviours are thought to be distressing and cause functional impairment (American Psychiatric Association, 2013). 3 The only previous qualitative study on BDD reported on the experience of BDD, but did not explore its behavioural symptoms in detail.What this paper adds 1 Some BDD behaviours are negatively reinforcing (e.g., camouflaging), while others are positively punishing (e.g., mirror checking). 2 The lived experience of BDD behaviour is multi-faceted. These activities may provide reassurance and a sense of identity, but they are also distressing and cause significant functional impairment. 3 BDD behaviour is complex and may not follow the anxietyreduction mechanisms seen in obsessive-compulsive disorder. This finding is consistent with existing literature, and conceptual models of BDD should reflect this. When treating, BDD clinicians should recognise the complex relationship an individual may have with their behaviours and the notable reluctance participants reported about giving them up.Body dysmorphic disorder (BDD) is a debilitating psychiatric ...

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Section: Discussionmentioning

confidence: 99%

Repetitive, Safe, and Automatic: The Experience of Appearance‐Related Behaviours in Body Dysmorphic Disorder

Oakes

Collison

Milne-Home

2017

Australian Psychologist

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“…However, a number of studies indicate that exposure and response prevention (ERP) in itself is effective for treating BDD (Campisi, 1995;Gomez-Perez, Marks, & Gutierrez-Fisac, 1994;McKay et al, 1997). Furthermore, a small randomized controlled trial conducted by Khemlani-Patel, Neziroglu, and Mancusi (2011) indicated that ERP was equally effective alone as when combined with cognitive therapy, suggesting that ERP is a core component of BDD treatment.…”

Section: Acceptance-based Exposure Therapy For Bddmentioning

confidence: 99%

Acceptance-Based Exposure Therapy for Body Dysmorphic Disorder: A Pilot Study

et al. 2015

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“…Khemlani-Patel et al41 compared 10 patients randomly assigned to ERP or CBT in order to evaluate whether addition of cognitive strategies improves the treatment response in BDD patients. Both intervention conditions were conducted three times a week for a total of 24 sessions in 8 weeks.…”

Section: Resultsmentioning

confidence: 99%

Cognitive-behavioral therapy for body dysmorphic disorder: a review of its efficacy

Prazeres

Nascimento

Fontenelle³

2013

NDT

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The aim of this study was to review the efficacy of different methods of cognitive and/or behavioral therapies used to treat body dysmorphic disorder. We evaluated all case series, open studies, controlled trials, and meta-analyses of cognitive and/or behavioral treatment approaches to body dysmorphic disorder published up to July 2012, identified through a search in the PubMed/Medline, PsycINFO, ISI Web of Knowledge, and Scopus databases. Our findings indicate that individual and group cognitive behavioral therapies are superior to waiting list for the treatment of body dysmorphic disorder. While the efficacy of cognitive therapy is supported by one controlled trial, utility of behavioral therapy is suggested by one open study and one controlled relapse prevention follow-up study. There is a pressing need to conduct head-to-head studies, with appropriate, active, control treatment groups, in order to examine further the efficacy of cognitive and/or behavioral therapies for body dysmorphic disorder.

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Cognitive-Behavioral Therapy for Body Dysmorphic Disorder: A Comparative Investigation

Cited by 18 publications

References 57 publications

Repetitive, Safe, and Automatic: The Experience of Appearance‐Related Behaviours in Body Dysmorphic Disorder

Repetitive, Safe, and Automatic: The Experience of Appearance‐Related Behaviours in Body Dysmorphic Disorder

Acceptance-Based Exposure Therapy for Body Dysmorphic Disorder: A Pilot Study

Cognitive-behavioral therapy for body dysmorphic disorder: a review of its efficacy

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