A Pilot Randomized Controlled Trial of Cognitive-Behavioral Therapy for Adolescents With Body Dysmorphic Disorder

Mataix-Cols, David, Fernandez De La Cruz, Lorena, Isomura, Kayoko, Anson, Martin, Turner, Cynthia, Monzani, Benedetta, Cadman, Jacinda, Bowyer, Laura, Heyman, Isobel, Veale, David and Krebs, Georgina (2015) A Pilot Randomized Controlled Trial of Cognitive-Behavioral Therapy for Adolescents With Body Dysmorphic Disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 54 11: 895-904. doi:10.1016/j.jaac.2015.08.011

Attached Files (Some files may be inaccessible until you login with your UQ eSpace credentials)
Name Description MIMEType Size Downloads

Author Mataix-Cols, David
Fernandez De La Cruz, Lorena
Isomura, Kayoko
Anson, Martin
Turner, Cynthia
Monzani, Benedetta
Cadman, Jacinda
Bowyer, Laura
Heyman, Isobel
Veale, David
Krebs, Georgina
Title A Pilot Randomized Controlled Trial of Cognitive-Behavioral Therapy for Adolescents With Body Dysmorphic Disorder
Journal name Journal of the American Academy of Child and Adolescent Psychiatry   Check publisher's open access policy
ISSN 1527-5418
0890-8567
Publication date 2015-11-01
Year available 2015
Sub-type Article (original research)
DOI 10.1016/j.jaac.2015.08.011
Open Access Status Not yet assessed
Volume 54
Issue 11
Start page 895
End page 904
Total pages 10
Place of publication Amsterdam, Netherlands
Publisher Elsevier
Collection year 2016
Language eng
Formatted abstract
Objective

Body dysmorphic disorder (BDD) typically starts in adolescence, but evidence-based treatments are yet to be developed and formally evaluated in this age group. We designed an age-appropriate cognitive-behavioral therapy (CBT) protocol for adolescents with BDD and evaluated its acceptability and efficacy in a pilot randomized controlled trial.

Method

Thirty adolescents aged 12-18 (mean=16.0,SD=1.7) with a primary diagnosis of BDD and their families were randomly assigned to 14 sessions of CBT delivered over four months or a control condition of equivalent duration, consisting of written psycho-education materials and weekly telephone monitoring. Blind evaluators assessed participants at baseline, mid-treatment, post-treatment, and at two-month follow-up. The primary outcome measure was the Yale-Brown Obsessive-Compulsive Scale Modified for BDD, adolescent version (mean baseline score=37.13,SD=4.98; range=24–43).

Results

The CBT group showed a significantly greater improvement than the control group, both at post-treatment (time×group interaction coefficient [95%CI]=-11.26 [-17.22 to -5.31]; p=0.000) and at two-month follow-up (time×group interaction coefficient [95%CI]=-9.62 [-15.74 to -3.51]; p=0.002). Six (40%) participants in the CBT group and one (6.7%) in the control condition were classified as responders at both time points (χ2=4.658,p=.031). Improvements were also seen on secondary measures, including insight, depression, and quality of life at post-treatment. Both patients and their families deemed the treatment as highly acceptable.

Conclusion

Developmentally tailored CBT is a promising intervention for young people with BDD, though there is significant room for improvement. Further clinical trials incorporating lessons learned in this pilot and comparing CBT and pharmacological therapies, as well as their combination, are warranted.
Keyword Body dysmorphic disorder
Children
Adolescents
Cognitive-behavioral therapy
Randomized controlled trial
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2016 Collection
School of Psychology Publications
 
Versions
Version Filter Type
Citation counts: TR Web of Science Citation Count  Cited 3 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 4 times in Scopus Article | Citations
Google Scholar Search Google Scholar
Created: Tue, 03 Nov 2015, 02:27:16 EST by System User on behalf of Scholarly Communication and Digitisation Service