Cognitive therapy in the treatment of body dysmorphic disorder

Abstract

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.

Perceived Ugliness: An Update on Treatment-Relevant Aspects of Body Dysmorphic Disorder

“…CBT generally begins with psychoeducation (eg, explaining the model of BDD) and is followed by cognitive and behavioral interventions. Cognitive interventions aim at identifying maladaptive beliefs such as, "As long as I have my hideous nose, I won't be able to be happy" to evaluate the accuracy of these beliefs and to help the patient develop more adequate beliefs [40]. Behavioral interventions typically consist of exposure and response prevention.…”

A smartphone app for the prevention and early intervention of body dysmorphic disorder: Development and evaluation of the content, usability, and aesthetics

“…Currently, there are only few studies investigating cognitive or metacognitive therapy without behavioral interventions for BDD in rather small samples. However, these studies suggest that (meta-)cognitive interventions are effective for BDD ( Geremia and Neziroglu, 2001 ; Rabiei et al, 2012 ; Taillon et al, 2013 ) as well as for obsessive-compulsive disorder (e.g., Wilhelm et al, 2009 ). Overall, cognitive interventions may be more accepted and less often refused than exposure and response prevention ( Wilhelm et al, 2009 ).…”