Dataset Information

Visual training program for body dysmorphic disorder: protocol for a novel intervention pilot and feasibility trial.

ABSTRACT:

Background

Body dysmorphic disorder (BDD) is a characterised by perceived defects or flaws in appearance which are associated with distressing thoughts, repetitive or obsessive behaviours, and significant impairment in social and occupational functioning. A core feature of BDD involves abnormalities of visual processing, although this is not typically a focus of psychological and psychiatric treatments. While current treatments generally show moderate effectiveness in the short-term, those with BDD can have high relapse rates, as they still 'see' their flaws or defects. The current research trials a visual training program designed to remediate visual abnormalities and reduce symptom severity of BDD.

Methods

This is a single-group open-label pilot study assessing the feasibility and potential efficacy of a 10-week visual training program. This pilot trial will be conducted at Swinburne University of Technology, Melbourne, Australia, and will recruit up to 20 participants diagnosed with BDD. These participants will complete pre- and post-assessments and a 10-week visual training program encompassing three phases of basic visual processing, face and emotion recognition, and self-perception. The primary outcomes focus on feasibility and acceptability of the intervention, with secondary outcomes exploring clinical outcomes related to symptom severity, quality of life and eye movements.

Discussion

This pilot trial will translate the empirical findings of abnormalities in visual processing among those diagnosed with BDD, to an innovative treatment method across a range of visual processing levels. This trial will assess the feasibility and potential efficacy of such a visual training program, paving the way for further research including a future definitive randomised control trial.

Trial registration

Australian New Zealand Clinical Trial Registry, ACTRN 12618000274279, Registered 22nd February 2018.

SUBMITTER: Beilharz F

PROVIDER: S-EPMC6302469 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

ACCESS DATA

Publications

Visual training program for body dysmorphic disorder: protocol for a novel intervention pilot and feasibility trial.

Beilharz Francesca F Castle David J DJ Phillipou Andrea A Rossell Susan L SL

Pilot and feasibility studies 20181221

<h4>Background</h4>Body dysmorphic disorder (BDD) is a characterised by perceived defects or flaws in appearance which are associated with distressing thoughts, repetitive or obsessive behaviours, and significant impairment in social and occupational functioning. A core feature of BDD involves abnormalities of visual processing, although this is not typically a focus of psychological and psychiatric treatments. While current treatments generally show moderate effectiveness in the short-term, tho ...[more]

PMID: 30598835

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Project description:BACKGROUND:Body dysmorphic disorder (BDD) is a prevalent and disabling preoccupation with a slight or imagined defect in appearance. Trials have investigated the use of serotonin reuptake inhibitors (SRIs) and cognitive behaviour therapy (CBT) for BDD. OBJECTIVES:To assess the efficacy of pharmacotherapy, psychotherapy or a combination of both treatment modalities for body dysmorphic disorder. SEARCH STRATEGY:We searched the Cochrane Depression, Anxiety and Neurosis Trial Register (December 2007), the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 4, 2007), MEDLINE (January 1966 to December 2007), and PsycINFO (1967 to December 2007). Ongoing and unpublished trials were located through searching the metaRegister of Controlled Trials, the CRISP and WHO ICTRP search portals (databases searched in December 2007), and through contacting key researchers and pharmaceutical companies. Additional studies were located through study reference lists. SELECTION CRITERIA:Randomised controlled trials (RCTs) of patients meeting DSM or ICD diagnostic criteria for BDD, in which the trials compare pharmacotherapy, psychotherapy or multi-modal treatment groups with active or non-active control groups. Short or long-term trials were eligible. DATA COLLECTION AND ANALYSIS:Two review authors independently assessed RCTs for inclusion in the review, collated trial data, and assessed trial quality. Investigators were contacted to obtain missing data. Summary effect sizes for dichotomous and continuous outcomes were calculated using a random effects model and heterogeneity was assessed. MAIN RESULTS:Two pharmacotherapy and three psychotherapy trials were eligible for inclusion in the review, with data from four short-term RCTs (169 participants) available for analysis. Response data from a single placebo-controlled trial of fluoxetine suggested overall superiority of medication relative to placebo (relative risk (RR) 3.07, 95% CI 1.4 to 6.72, n = 67). Symptom severity was also significantly reduced in the RCTs of fluoxetine and clomipramine (relative to desipramine), as well as in the two CBT trials (WMD -44.96, 95% CI -54.43 to -35.49, n = 73). A low relapse rate (4/22) was demonstrated in one trial of CBT. AUTHORS' CONCLUSIONS:Results from the small number of available RCTs suggest that SRIs and CBT may be useful in treating patients with BDD. The findings of these studies need to be replicated. In addition, future controlled studies in other samples, such as adolescents, and using other selective SRIs, as well as a range of psychological therapy approaches and modalities (alone and in combination), are essential in supplementing the sparse data currently available.

Project description:ObjectiveBody dysmorphic disorder (BDD) is associated with low self-esteem. The aim of this meta-analysis was to examine the strength of the cross-sectional relationship between BDD symptom severity and global self-esteem in individuals with BDD, mentally healthy controls, community or student samples, and cosmetic surgery patients. Moreover, the role of depressive symptom severity in this relationship and other moderating factors were investigated.MethodsA keyword-based literature search was performed to identify studies in which BDD symptoms and global self-esteem were assessed. Random effects meta-analysis of Fisher's z-transformed correlations and partial correlations controlling for the influence of depressive symptom severity was conducted. In addition to meta-analysis of the observed effects, we corrected the individual correlations for variance restrictions to address varying ranges of BDD symptom severity across samples.ResultsTwenty-five studies with a total of 6278 participants were included. A moderately negative relationship between BDD symptom severity and global self-esteem was found (r = -.42, CI = [-.48, -.35] for uncorrected correlations, r = -.45, CI = [-.51, -.39] for artifact-corrected correlations). A meta-analysis of partial correlations revealed that depressive symptom severity could partly account for the aforementioned relationship (pr = -.20, CI = [-.25, -.15] for uncorrected partial correlations, pr = -.23, CI = [-.28, -.17] for artifact-corrected partial correlations). The sample type (e.g., individuals with BDD, mentally healthy controls, or community samples) and diagnosis of BDD appeared to moderate the relationship only before artifact correction of effect sizes, whereas all moderators were non-significant in the meta-analysis of artifact-corrected correlations.ConclusionsThe findings demonstrate that low self-esteem is an important hallmark of BDD beyond the influence of depressive symptoms. It appears that negative evaluation in BDD is not limited to appearance but also extends to other domains of the self. Altogether, our findings emphasize the importance of addressing self-esteem and corresponding core beliefs in prevention and treatment of BDD.

Dataset Information

Visual training program for body dysmorphic disorder: protocol for a novel intervention pilot and feasibility trial.

Background

Methods

Discussion

Trial registration

Publications

Visual training program for body dysmorphic disorder: protocol for a novel intervention pilot and feasibility trial.

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