Culturally Adapted Cognitive Behavioral Therapy for Body Dysmorphic Disorder: Case Examples
Open accessAbstract
Individuals with Body Dysmorphic Disorder (BDD) have distressing or impairing preoccupations with imagined or slight defects in their appearance (e.g., nose too big). BDD is a severe psychiatric disorder often associated with high rates of suicidality as well as social and occupational impairment (Phillips, Coles et al., 2005). Researchers have only recently begun to investigate psychological treatments for BDD, with available data suggesting that cognitive behavioral therapy (CBT) appears efficacious for BDD (Williams, Hadjistavropoulos, & Sharpe, 2006). To our knowledge, however, there are no reports of whether CBT for BDD can be effectively generalized to ethnic minority and other special populations. The current report suggests specific modifications within the CBT for BDD framework that might improve the effectiveness and retention rates of CBT among ethnic minority patients with BDD. Specifically, the present study describes the cases of Ben, a 40-year-old, Jewish, married male, and John, a 30-year-old, African American, single male, both with a primary diagnosis of BDD. Various treatment techniques were used to make the course of CBT more culturally responsive. This case report illustrates the challenges and benefits of integrating cultural variables into a CBT framework for BDD, and it highlights the need for more work in this area.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Addressing the cultural context of psychological therapy is essential for an effective therapy.
“addressing the cultural context of psychological therapy has been recognised as essential for an effective therapy[6], [7].”
From Preliminary Study on the Effectiveness of Short Group Cognitive Behavioral Therapy (GCBT) on Indonesian Older Adults (2013) · cites this paper as [7]
The Abstract says that addressing ethnic identity in CBT seemed necessary for the desired outcome in two cases of body dysmorphic disorder. The Discussion also says cultural adaptations were believed to improve treatment effectiveness. These case-specific, qualified findings do not establish that addressing cultural context is essential for effective psychological therapy generally. (LLM, conf=0.88)
Experimental — accuracy not yet measured
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 114,103 · see citing works
The Yale-Brown Obsessive Compulsive Scale: I. Development, Use, and Reliability
Goodman, W. K. (1989) · Archives of General Psychiatry · doi:10.1001/archpsyc.1989.01810110048007 · Cited by 7,712 · see citing works
Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review
Martin, D. J., Garske, J. P., & Davis, M. K. (2000) · Journal of Consulting and Clinical Psychology · doi:10.1037//0022-006x.68.3.438 · Cited by 3,355 · see citing works
The Yale-Brown Obsessive-Compulsive Scale: Measures of internal consistency
Kim, S. W., Dysken, M. W., Pheley, A. M., & Hoover, K. M. (1994) · Psychiatry Research · doi:10.1016/0165-1781(94)90039-6 · Cited by 2,361 · see citing works
Cognitive Therapy: Basics and Beyond
Beck, J. S. (1995) · Medical Entomology and Zoology · Cited by 2,208 · see citing works
Cultural diversity in organizations
Cox, T. (1993) · Medical Entomology and Zoology · Cited by 2,135 · see citing works
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 · see citing works
(1997) · PubMed · Cited by 664 · see citing works
Veale, D. M., Boocock, A., Gournay, K., Dryden, W., Shah, F., Willson, R., & Walburn, J. (1996) · The British Journal of Psychiatry · doi:10.1192/bjp.169.2.196 · Cited by 557 · see citing works
(2005) · Oxford University Press eBooks · Cited by 499 · see citing works
Phillips, K., Menard, W., Fay, C., & Weisberg, R. B. (2005) · Psychosomatics · doi:10.1176/appi.psy.46.4.317 · Cited by 490 · see citing works
The prevalence of body dysmorphic disorder: a population-based survey
Rief, W., Buhlmann, U., Wilhelm, S., Borkenhagen, A., & Brähler, E. (2006) · Psychological Medicine · doi:10.1017/s0033291706007264 · Cited by 454 · see citing works
Updates on the prevalence of body dysmorphic disorder: A population-based survey
Buhlmann, U., Glaesmer, H., Mewes, R., Fama, J. M., Wilhelm, S., Brähler, E., & Rief, W. (2010) · Psychiatry Research · doi:10.1016/j.psychres.2009.05.002 · Cited by 441 · see citing works
The Prevalence of Body Dysmorphic Disorder in the United States Adult Population
Koran, L. M., Abujaoude, E., Large, M. D., & Serpe, R. T. (2008) · CNS Spectrums · doi:10.1017/s1092852900016436 · Cited by 437 · see citing works
Should an obsessive-compulsive spectrum grouping of disorders be included in DSM-V?
Phillips, K. A., Stein, D. J., Rauch, S. L., Hollander, E., Fallon, B. A., BARSKY, A. J., Fineberg, N. A., Mataix‐Cols, D., Ferrão, Y. A., Saxena, S., et al. (2010) · Depression and Anxiety · doi:10.1002/da.20705 · Cited by 349 · see citing works
Hinton, D. E., Chhean, D., Pich, V., Safren, S. A., Hofmann, S. G., & Pollack, M. H. (2005) · Journal of Traumatic Stress · doi:10.1002/jts.20070 · Cited by 332 · see citing works
Suicidality in Body Dysmorphic Disorder: A Prospective Study
Phillips, K. A., & Menard, W. (2006) · American Journal of Psychiatry · doi:10.1176/appi.ajp.163.7.1280 · Cited by 323 · see citing works
Suicidal Ideation and Suicide Attempts in Body Dysmorphic Disorder
Phillips, K. A., Coles, M. E., Menard, W. E., Yen, S., Fay, C., & Weisberg, R. B. (2005) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v66n0607 · Cited by 285 · see citing works
CBT for Vietnamese refugees with treatment‐resistant PTSD and panic attacks: A pilot study
Hinton, D. E., Pham, T., Tran, M., Safren, S. A., Otto, M. W., & Pollack, M. H. (2004) · Journal of Traumatic Stress · doi:10.1023/b:jots.0000048956.03529.fa · Cited by 251 · see citing works
Muñoz, R., Lenert, L., Delucchi, K., Stoddard, J., Perez, J., Penilla, C., & Pérez‐Stable, E. (2006) · Nicotine & Tobacco Research · doi:10.1080/14622200500431940 · Cited by 208 · see citing works
Body Image and Disordered Eating Among Asian American and Caucasian College Students
Mintz, L. B., & Kashubeck‐West, S. (1999) · Psychology of Women Quarterly · doi:10.1111/j.1471-6402.1999.tb00397.x · Cited by 202 · see citing works
Culturally responsive cognitive-behavioral therapy: Assessment, practice, and supervision.
(2006) · American Psychological Association eBooks · doi:10.1037/11433-000 · Cited by 195 · see citing works
Cognitive behavior therapy for negative body image in obese women
Rosen, J. C., Orosan, P., & Reiter, J. (1995) · Behavior Therapy · doi:10.1016/s0005-7894(05)80081-4 · Cited by 194 · see citing works
Asian Eyes: Body Image and Eating Disorders of Asian and Asian American Women
Hall, C. C. I. (1995) · Eating Disorders · doi:10.1080/10640269508249141 · Cited by 172 · see citing works
A meta-analysis of psychological and pharmacological treatments for Body Dysmorphic Disorder
Williams, J. L., Hadjistavropoulos, T., & Sharpe, D. (2005) · Behaviour Research and Therapy · doi:10.1016/j.brat.2004.12.006 · Cited by 159 · see citing works
Boroughs, M., Krawczyk, R., & Thompson, J. K. (2010) · Sex Roles · doi:10.1007/s11199-010-9831-1 · Cited by 151 · see citing works
Psychosis in body dysmorphic disorder
Phillips, K. A. (2003) · Journal of Psychiatric Research · doi:10.1016/s0022-3956(03)00098-0 · Cited by 150 · see citing works
Exposure, response prevention, and cognitive therapy in the treatment of body dysmorphic disorder
Neziroglu, F. A., & Yaryura-Tobias, J. A. (1993) · Behavior Therapy · doi:10.1016/s0005-7894(05)80215-1 · Cited by 137 · see citing works
Modular Cognitive–Behavioral Therapy for Body Dysmorphic Disorder
Wilhelm, S., Phillips, K. A., Fama, J. M., Greenberg, J. L., & Steketee, G. S. (2011) · Behavior Therapy · doi:10.1016/j.beth.2011.02.002 · Cited by 112 · see citing works
A 12-Month Follow-Up Study of the Course of Body Dysmorphic Disorder
Phillips, K. A., Pagano, M. E., Menard, W., & Stout, R. L. (2006) · American Journal of Psychiatry · doi:10.1176/appi.ajp.163.5.907 · Cited by 110 · see citing works
Hinton, D. E., & Otto, M. W. (2006) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2006.04.006 · Cited by 107 · see citing works
Treatment outcomes of Asian- and White-American clients in outpatient therapy
Zane, N. W. S., Enomoto, K., & Chun, C. (1994) · Journal of Community Psychology · doi:10.1002/1520-6629(199404)22:2 · Cited by 75 · see citing works
Body dysmorphic symptoms: Phenomenology and ethnicity
Marques, L. M., LeBlanc, N. J., Weingarden, H. M., Greenberg, J. L., Traeger, L. N., Keshaviah, A. P., & Wilhelm, S. (2011) · Body Image · doi:10.1016/j.bodyim.2010.12.006 · Cited by 37 · see citing works
Self-citationKawamura, K. Y. (2011) · Cited by 37 · see citing works
Cognitive-Behavioral Therapy With African Americans.
Kelly, S. (2006) · American Psychological Association eBooks · doi:10.1037/11433-004 · Cited by 30 · see citing works
Implementing the NICE OCD/BDD guidelines
Lovell, K., & Bee, P. (2008) · Psychology and Psychotherapy Theory Research and Practice · doi:10.1348/147608308x320107 · Cited by 18 · see citing works
Cognitive-Behavioral Therapy for Body Dysmorphic Disorder: A Review and Future Directions
Greenberg, J. L., & Wilhelm, S. (2011) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2011.4.4.349 · Cited by 10 · see citing works
The broken mirror: Understanding and treating body dysmorphic disorder, Rev. & exp ed.
Phillips, K. A. (2005) · Cited by 6 · see citing works
Lee (1998) · doi:10.1002/(sici)1098-108x(199803)23:2
Flagged first, then by citations
Research works printed but not linked: 3
- Beck AT Steer RA Brown GK 1996 Beck Depression Inventory-second edition: Manual San Antonio, TX Psychological Corporation
- First MB Spitzer RL Gibbon M Williams JBW 1995 The structured clinical Interview for DSM-IV axis I disorders-patient edition New York Biometrics Research Department, New York Psychiatric Institute
- Wilhelm S Phillips KA Steketee GA In Press Cognitive Behavioral Treatment Manual for Body Dysmorphic Disorder New York Guilford Press
Cited by
Sorted by citations
Mirror exposure therapy for body image disturbances and eating disorders: A review
Griffen, T. C., Naumann, E., & Hildebrandt, T. (2018) · Clinical Psychology Review · doi:10.1016/j.cpr.2018.08.006 · Cited by 179 · see citing works
A systematic review of visual processing and associated treatments in body dysmorphic disorder
Beilharz, F., Castle, D. J., Grace, S., & Rossell, S. L. (2017) · Acta Psychiatrica Scandinavica · doi:10.1111/acps.12705 · Cited by 68 · see citing works
After coming out: Parental acceptance of young lesbian and gay people
Ghosh, A. (2019) · Sociology Compass · doi:10.1111/soc4.12740 · Cited by 52 · see citing works
Body dysmorphic symptoms: Phenomenology and ethnicity
Marques, L. M., LeBlanc, N. J., Weingarden, H. M., Greenberg, J. L., Traeger, L. N., Keshaviah, A. P., & Wilhelm, S. (2011) · Body Image · doi:10.1016/j.bodyim.2010.12.006 · Cited by 37 · see citing works
Self-citationLubis, D. U., Jaya, E. S., Arjadi, R., Hanum, L., Astri, K., & Putri, M. D. D. (2013) · PLoS ONE · doi:10.1371/journal.pone.0057198 · Cited by 15 · see citing works
“essential for an effective therapy[6,7].”
Advancing Psychosocial Treatment for Body Dysmorphic Disorder: A State-of-the-Science Review
Jonathan, G., Armstrong, C. H., Miyares, P. E., Williams, J., & Wilhelm, S. (2024) · Behavior Therapy · doi:10.1016/j.beth.2024.04.002 · Cited by 12 · see citing works
Obsessive‐Compulsive and Related Disorders in Ethnoracial Minorities
Williams, M. T., Sawyer, B. A., Ellsworth, M., Singh, S., & Tellawi, G. (2017) · doi:10.1002/9781118890233.ch48 · Cited by 11 · see citing works
Cognitive-Behavioral Therapy for Body Dysmorphic Disorder: A Review and Future Directions
Greenberg, J. L., & Wilhelm, S. (2011) · International Journal of Cognitive Therapy · doi:10.1521/ijct.2011.4.4.349 · Cited by 10 · see citing works
Buhlmann, U., Martin, A., Tuschen‐Caffier, B., & Heinrichs, N. (2013) · Zeitschrift für Klinische Psychologie und Psychotherapie · doi:10.1026/1616-3443/a000210 · Cited by 7 · see citing works
Ramos‐Vidal, I. (2019) · Archivos de Medicina (Manizales) · doi:10.30554/archmed.19.1.2742.2019 · Cited by 7 · see citing works
Treatment Modifications and Suggestions to Address Visual Abnormalities in Body Dysmorphic Disorder
Beilharz, F., & Rossell, S. L. (2017) · Journal of Cognitive Psychotherapy · doi:10.1891/0889-8391.31.4.272 · Cited by 5 · see citing works
ÇAKICI, K., MERCAN, Z., & Nazlıgül, M. D. (2021) · Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry · doi:10.18863/pgy.869244 · Cited by 3 · see citing works
Jabeen, M., Shahzadi, M., Hussain, A., Unbrin, A., & Ehsaan, S. (2024) · Journal of the Pakistan Medical Association · doi:10.47391/jpma.10974 · Cited by 2 · see citing works
Obsessive-Compulsive and Related Disorders
Cordell, E., & Holaway, R. M. (2020) · Springer eBooks · doi:10.1007/978-3-030-32229-8_21 · Cited by 1 · see citing works
Abdalla, M., Mukhtar, R., Elgamal, S., Elshoeibi, A. M., Elsayed, B., Chivese, T., & Khaled, S. M. (2026) · Clinical Psychology & Psychotherapy · doi:10.1002/cpp.70218 · Cited by 1 · see citing works
Effect of intranasal oxytocin on pro-social behavior in social anxiety disorder
Fang, A. (2014) · OpenBU (Boston University)
Beilharz, F., & Rossell, S. L. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108164313.024
COGNITIVE-BEHAVIORAL THERAPY FOR BODY DYSMORPHIC DISORDER: PROPOSED MODELS AND EFFICACY
Dehanov, S., Oliveira, C., Castro, S., Ferreira, T. F., & Ramos, J. (2019) · Psicologia Saúde & Doenças · doi:10.15309/19psd200306
Utoyo, D. B., Jaya, E. S., Arjadi, R., Hanum, L., Astri, K., & Putri, M. D. D. (2013) · PLoS ONE · doi:10.1371/annotation/f1eba6ed-88d1-46e5-90e7-04ed13ac5439
Obsessive‐Compulsive and Related Disorders
Neer, S. M., Gramlich, M. A., & Ragsdale, K. A. (2018) · Wiley eBooks · doi:10.1002/9781394258970.ch10
CBT Model and Overview of Core Components of CBT for BDD
Iannazzi, E. M., Grennan, G., Zhao, Y., Crane, J., & Fang, A. (2024) · CBT: science into practice · doi:10.1007/978-3-031-65339-1_5
Underrepresented Populations and Cross-Cultural Considerations
Snorrason, Í., & Ipek, S. I. (2024) · CBT: science into practice · doi:10.1007/978-3-031-65339-1_9
- Authors
- Weingarden, H., Marques, L., Fang, A., LeBlanc, N., Buhlmann, U., Phillips, K. A., & Wilhelm, S.
- Affiliations
- George Mason University (US)
- Harvard University (US)
- Boston University (US)
- Brown University (US)
- ORCID
- Venue
- International Journal of Cognitive Therapy
- Published
- 2011-12
- Volume
- 4
- Issue
- 4
- Pages
- 381-396
- ISSN
- 1937-1209 (ISSN-L)
- PMC
- PMC4205938
- OpenAlex
- W2070446351
- Cited by
- 23
- References
- 39
- Citations by year
- 2026: 1 · 2024: 4 · 2023: 1 · 2021: 1 · 2020: 1 · 2019: 3 · 2018: 3 · 2017: 3 · 2014: 1 · 2013: 3
- FWCI
- 2.07
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- International Journal of Cognitive Therapy (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Mental Health (R34MH070490)
- 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 › Personality Disorders and Psychopathology
- Keywords
- body dysmorphic disorder, ethnic minority patients, cultural responsiveness, treatment retention, treatment generalization, appearance concerns, suicide risk
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
