Wilhelm S, Weingarden H, Greenberg JL, Hoeppner SS, Snorrason I, Bernstein EE, McCoy TH, Harrison OT. Efficacy of App-Based Cognitive Behavioral Therapy for Body Dysmorphic Disorder with Coach Support: Initial Randomized Controlled Clinical Trial.
PSYCHOTHERAPY AND PSYCHOSOMATICS 2022;
91:277-285. [PMID:
35588706 PMCID:
PMC9394457 DOI:
10.1159/000524628]
[Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/30/2021] [Accepted: 04/10/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION
Body dysmorphic disorder (BDD) is severe, chronic, and undertreated. Apps could substantially improve treatment access.
OBJECTIVE
We provide an initial test of the usability and efficacy of coach-supported app-based cognitive behavioral therapy (CBT) for BDD. The Perspectives app covers core treatment components: psychoeducation, cognitive restructuring, exposure with response prevention, mindfulness, attention retraining, and relapse prevention.
METHODS
A randomized waitlist-controlled trial was conducted. Adults (N = 80) with primary BDD were assigned to 12 weeks of Perspectives or waitlist. Coaches promoted engagement and answered questions via in-app messaging and phone calls. BDD severity was measured at baseline, mid-treatment, and end of treatment by blinded independent evaluators (Yale-Brown Obsessive Compulsive Scale Modified for BDD; BDD-YBOCS). Secondary outcomes included BDD-related insight, depression, quality of life, and functioning.
RESULTS
App uptake and satisfaction were high. In intent-to-treat analyses, Perspectives app-based CBT was associated with significantly lower BDD-YBOCS severity at end of treatment (M [SD]: 16.8 [7.5]) compared to the waitlist (26.7 [6.2]; p < 0.001, d = 1.44). App-based CBT was associated with greater improvements across all secondary measures, with medium to large effects.
CONCLUSIONS
Perspectives, supported by a bachelor's-level coach, is an efficacious, scalable treatment for adults with BDD.
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