Development and Pilot Testing of a Cognitive-Behavioral Therapy Digital Service for Body Dysmorphic Disorder

Behav Ther. 2020 Jan;51(1):15-26. doi: 10.1016/j.beth.2019.03.007. Epub 2019 Aug 7.

Abstract

Body dysmorphic disorder (BDD) has a severe presentation and chronic course when untreated. Although effective BDD treatments exist, most individuals do not have access to them. We therefore developed and pilot tested the first smartphone-delivered individual cognitive-behavioral therapy (CBT) treatment for adults with BDD. The digital service was developed via user-centered design, integrating input from engineering, design, and psychology experts, plus BDD patient consultants. We conducted a 12-week open pilot trial (N = 10) to describe preliminary results for feasibility, acceptability, and treatment outcome. Attrition rates (0%) and feedback on usability and satisfaction indicated that smartphone-based CBT for BDD may be feasible, acceptable, and satisfactory. Initial results suggest that smartphone-based CBT for BDD may hold promise for improving BDD symptom severity, BDD-related insight, functional impairment, and quality of life, as scores from baseline to posttreatment improved with large-to-very large effects; depression improved with a medium effect. Ninety percent of participants were responders at posttreatment and 3-month follow-up. Smartphone-based CBT for BDD may have strong potential as a standardized, low cost, and accessible treatment for this debilitating illness. A test of efficacy is merited as a next step, using a well-powered, randomized control trial design.

Trial registration: ClinicalTrials.gov NCT03221738.

Keywords: app; body dysmorphic disorder; cognitive-behavioral therapy; digital health; smartphone.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Body Dysmorphic Disorders / psychology*
  • Body Dysmorphic Disorders / therapy*
  • Cognitive Behavioral Therapy / methods
  • Cognitive Behavioral Therapy / trends*
  • Depression / psychology
  • Depression / therapy
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Pilot Projects
  • Quality of Life / psychology
  • Smartphone / trends*
  • Telemedicine / methods
  • Telemedicine / trends*
  • Treatment Outcome

Associated data

  • ClinicalTrials.gov/NCT03221738