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Randomized Controlled Trial
. 2024 Jun 12:11:e55283.
doi: 10.2196/55283.

Web-Based Therapist-Guided Mindfulness-Based Cognitive Behavioral Therapy for Body Dysmorphic Disorder: Pilot Randomized Controlled Trial

Camrie Kerry  1 , Prabhdeep Mann  1 , Nazanin Babaei  2 , Joel Katz  3 , Meysam Pirbaglou  1 , Paul Ritvo  1
Affiliations
Randomized Controlled Trial

Web-Based Therapist-Guided Mindfulness-Based Cognitive Behavioral Therapy for Body Dysmorphic Disorder: Pilot Randomized Controlled Trial

Camrie Kerry et al. JMIR Ment Health. .

Abstract

Background: Internet-based cognitive behavioral therapy (CBT) and stand-alone mindfulness meditation interventions are gaining empirical support for a wide variety of mental health conditions. In this study, we test the efficacy of web-based therapist-guided mindfulness-based cognitive behavioral therapy (CBT-M) for body dysmorphic disorder (BDD), a psychiatric disorder characterized by preoccupations with perceived defects in appearance.

Objective: This study aims to determine whether CBT-M for BDD delivered on the web is feasible and acceptable and whether mindfulness meditation adds to CBT treatment effects for BDD.

Methods: In this 8-week, 2-arm, parallel pilot randomized controlled trial, n=28 adults (aged between 18 and 55 years) were randomly allocated to an experimental group (web-based therapist-guided CBT-M) or a control group (web-based therapist-guided CBT). Study retention, accrual, and intervention adherence were assessed, along with self-report measures for BDD, depression, anxiety, and pain intensity taken at baseline and postintervention.

Results: This study was feasible to implement and deemed acceptable by participants. After 8 weeks, significant improvements were found on all outcome measures for both treatment groups, and large between-group effect sizes favoring CBT-M were found for BDD symptom severity (d=-0.96), depression (d=-1.06), pain severity (d=-1.12), and pain interference (d=-1.28). However, linear mixed models demonstrated no significant differences between the groups over 8 weeks.

Conclusions: The results suggest that mindfulness meditation may add to beneficial web-based CBT treatment effects for BDD. An adequately powered randomized control trial of web-based CBT-M is warranted.

Trial registration: ClinicalTrials.gov NCT05402475, http://clinicaltrials.gov/ct2/show/NCT05402475.

Keywords: BDD; OCD; body dysmorphic disorder; cognitive behavior therapy; dysmorphophobia; eMental health; iCBT; internet-delivered cognitive behavior therapy; mindfulness; mindfulness-based cognitive therapy; obsessive-compulsive and related disorders; randomized controlled trial.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
CONSORT (Consolidated Standards of Reporting Trials) participant flow diagram. BDDQ: Body Dysmorphic Disorder Questionnaire; CBT: cognitive behavioral therapy; REML: restricted maximum likelihood.
Figure 2
Figure 2
Body Dysmorphic Disorder Symptom Scale (BDD-SS) change from baseline to postintervention. Error bars represent standard error. CBT: cognitive behavioral therapy.
See this image and copyright information in PMC

References

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