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Efficacy of Cognitive Behaviour Therapy versus Anxiety Management for Body Dysmorphic Disorder: A Randomised Controlled Trial
Open accessAbstract
Background: The evidence base for the efficacy of cognitive behaviour therapy (CBT) for treating body dysmorphic disorder (BDD) is weak. Aims: To determine whether CBT is more effective than anxiety management (AM) in an outpatient setting. Method: This was a single-blind stratified parallel-group randomised controlled trial. The primary endpoint was at 12 weeks, and the Yale-Brown Obsessive Compulsive Scale for BDD (BDD-YBOCS) was the primary outcome measure. Secondary measures for BDD included the Brown Assessment of Beliefs Scale (BABS), the Appearance Anxiety Inventory (AAI) and the Body Image Quality of Life Inventory (BIQLI). The outcome measures were collected at baseline and week 12. The CBT group, unlike the AM group, had 4 further weekly sessions that were analysed for their added value. Both groups then completed measures at their 1-month follow-up. Forty-six participants with a DSM-IV diagnosis of BDD, including those with delusional BDD, were randomly allocated to either CBT or AM. Results: At 12 weeks, CBT was found to be significantly superior to AM on the BDD-YBOCS [β = -7.19; SE (β) = 2.61; p < 0.01; 95% CI = -12.31 to -2.07; d = 0.99] as well as the secondary outcome measures of the BABS, AAI and BIQLI. Further benefits occurred by week 16 within the CBT group. There were no differences in outcome for those with delusional BDD or depression. Conclusions: CBT is an effective intervention for people with BDD even with delusional beliefs or depression and is more effective than AM over 12 weeks.
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“A kognitív viselkedésterápia hatékony intervenciónak bizonyul (Veale, Anson, Miles, Pieta, Costa és Ellison, 2014; Harrison, Fernández de la Cruz, Enander, Radua és Mataix-Cols, 2016)”
From A testdiszmorfiás zavar pszichológiai vonatkozásai (2023) · cites this paper as Veale, Anson, Miles, Pieta, Costa és Ellison, 2014
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“For example, some patients may require a higher number of sessions.”
From Cognitive-behavioral therapy for body dysmorphic disorder: A systematic review and meta-analysis of randomized controlled trials (2016) · cites this paper as Veale et al., 2014
In the citing paper
“We conservatively considered that only one study to date (Veale et al., 2014) employed a truly credible control treatment.”
From Cognitive-behavioral therapy for body dysmorphic disorder: A systematic review and meta-analysis of randomized controlled trials (2016) · cites this paper as Veale et al., 2014
In the citing paper
“There is some uncontrolled trial data to suggest that adding additional sessions (beyond the standard 8-14 sessions employed in previous trials) may lead to further improvement in BDD symptoms (Veale et al., 2014; Wilhelm et al., 2014).”
From Cognitive-behavioral therapy for body dysmorphic disorder: A systematic review and meta-analysis of randomized controlled trials (2016) · cites this paper as Veale et al., 2014
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Cites
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Devilly, G. J., & Borkovec, T. D. (2000) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/s0005-7916(00)00012-4 · Cited by 2,295
The Brown assessment of beliefs scale: Reliability and validity
Eisen, J. L., Phillips, K. A., Baer, L., Beer, D. A., Atala, K. D., & Rasmussen, S. A. (1998) · American Journal of Psychiatry · doi:10.1176/ajp.155.1.102 · Cited by 705
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Veale, D., Gledhill, L. J., Christodoulou, P., & Hodsoll, J. (2016) · Body Image · doi:10.1016/j.bodyim.2016.07.003 · Cited by 431
Self-citationHarrison, A., Fernández de la Cruz, L., Enander, J., Radua, J., & Mataix-Cols, D. (2016) · Clinical Psychology Review · doi:10.1016/j.cpr.2016.05.007 · Cited by 215
Veale, D., Miles, S., Bramley, S., Muir, G., & Hodsoll, J. (2015) · BJU International · doi:10.1111/bju.13010 · Cited by 213
Self-citationThe classification of obsessive-compulsive and related disorders in the ICD-11
Stein, D. J., Kogan, C. S., Atmaca, M., Fineberg, N. A., Fontenelle, L. F., Grant, J. E., Matsunaga, H., Reddy, Y. C. J., Simpson, H. B., Thomsen, P. H., et al. (2016) · Journal of Affective Disorders · doi:10.1016/j.jad.2015.10.061 · Cited by 204
Self-citationFineberg, N. A., Apergis-Schoute, A. M., Vaghi, M. M. S., Banca, P., Gillan, C. M., Voon, V., Chamberlain, S. R., Cinosi, E., Reid, J. E., Shahper, S., et al. (2017) · The International Journal of Neuropsychopharmacology · doi:10.1093/ijnp/pyx088 · Cited by 195
Metadata
- Authors
- Veale, D., Anson, M., Miles, S., Pieta, M., Costa, A., & Ellison, N.
- Affiliations
- King's College London (GB)
- Venue
- Psychotherapy and Psychosomatics
- Publisher
- S. Karger AG
- Published
- 2014
- Volume
- 83
- Issue
- 6
- Pages
- 341-353
- ISSN
- 0033-3190 (ISSN-L)
- 1423-0348
- OpenAlex
- W2166071618
- Cited by
- 179
- References
- 42
- Citations by year
- 2026: 10 · 2025: 8 · 2024: 22 · 2023: 15 · 2022: 11 · 2021: 9 · 2020: 9 · 2019: 15 · 2018: 10 · 2017: 15 · 2016: 15 · 2015: 34 · 2014: 6
- FWCI
- 27.54
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Psychotherapy and Psychosomatics (publishedVersion)
- PubMed (publishedVersion)
- Create (Canterbury Christ Church University) (acceptedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Funders
- South London and Maudsley NHS Foundation Trust
- United Kingdom Clinical Research Collaboration
- National Institute for Health and Care Research
- King's College London
- Topics
- Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Keywords
- body dysmorphic disorder, cognitive behavioral therapy, anxiety reduction, treatment efficacy, appearance anxiety, body image, obsessive-compulsive symptoms, depression, outpatient care
- MeSH terms
- Adult, Anxiety, Female, Humans, Male, Psychiatric Status Rating Scales, Quality of Life, Relaxation Therapy, Cognitive Behavioral Therapy, Single-Blind Method, Treatment Outcome, Young Adult, Body Dysmorphic Disorders
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