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Karger Publishers, Psychotherapy and Psychosomatics, 4(91), p. 277-285, 2022

DOI: 10.1159/000524628

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Efficacy of App-Based Cognitive Behavioral Therapy for Body Dysmorphic Disorder with Coach Support: Initial Randomized Controlled Clinical Trial

This paper was not found in any repository, but could be made available legally by the author.
This paper was not found in any repository, but could be made available legally by the author.

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Abstract

<b><i>Introduction:</i></b> Body dysmorphic disorder (BDD) is severe, chronic, and undertreated. Apps could substantially improve treatment access. <b><i>Objective:</i></b> 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. <b><i>Methods:</i></b> A randomized waitlist-controlled trial was conducted. Adults (<i>N</i> = 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. <b><i>Results:</i></b> 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]; <i>p</i> &#x3c; 0.001, <i>d</i> = 1.44). App-based CBT was associated with greater improvements across all secondary measures, with medium to large effects. <b><i>Conclusions:</i></b> Perspectives, supported by a bachelor’s-level coach, is an efficacious, scalable treatment for adults with BDD.