Clinical Psychology and Psychotherapy, Department of Psychology, Westfälische Wilhelms-Universität, Muenster, Germany.
Department of Computer Science, Aalto University, Espoo, Finland.
Int J Eat Disord. 2020 Jun;53(6):972-986. doi: 10.1002/eat.23280. Epub 2020 May 20.
Appearance-related interpretation bias is postulated to play a role in the maintenance of body dissatisfaction (BD), a risk factor for body dysmorphic disorder (BDD), and eating disorders (ED). Cognitive bias modification for interpretation (CBM-I) has been shown to reduce maladaptive interpretation bias and symptoms in various emotional disorders. This study investigated the acceptability and efficacy of an easily disseminable, web-based CBM-I program for BD.
Individuals with high BD (N = 318) were randomized to a multi-session CBM-I (Sentence Word Association Paradigm [SWAP] with feedback) vs. control (SWAP without feedback) versus waitlist condition. Interpretation bias, BD and associated symptoms were assessed at baseline and post-intervention. Symptoms were monitored up to 1-week and 4-week follow-up. We further investigated transference effects to stress reactivity, as predicted by cognitive-behavioral models, at post-intervention.
Appearance-related CBM-I led to a differential pre-post increase in adaptive interpretation patterns, particularly for appearance-related and social situations (d = 0.65-1.18). Both CBM-I and control training reduced BD, BDD symptom severity, and depression. However, CBM-I (vs. control and waitlist) improved appearance-related quality of life (d = 0.51), self-esteem (d = 0.52), and maladaptive appearance-related beliefs (d = 0.47). State stress reactivity was overall reduced in the CBM-I condition (vs. waitlist). Intervention effects largely held stable up to follow-ups. Treatment satisfaction was comparable to other CBM-I studies, with low rates of adverse reactions.
These findings support assumptions of cognitive-behavioral models for BD, BDD, and ED, and suggest that web-based CBM-I is an efficacious and acceptable intervention option.
与外貌相关的解释偏见被认为在外貌不满（BD）的维持中起作用，BD 是躯体变形障碍（BDD）和饮食障碍（ED）的一个风险因素。认知偏差修正解释（CBM-I）已被证明可减少各种情绪障碍中的适应不良的解释偏差和症状。本研究调查了一种易于传播的基于网络的 CBM-I 程序对 BD 的可接受性和疗效。
将高 BD 个体（N=318）随机分配到多疗程 CBM-I（句子词联想范式[SWAP]和反馈）与对照组（SWAP 无反馈）和等候名单条件。在基线和干预后评估解释偏差、BD 和相关症状。在 1 周和 4 周随访时监测症状。我们还根据认知行为模型预测，进一步调查干预后的转移效应到应激反应。
与外貌相关的 CBM-I 导致了与外貌相关和社交情境（d=0.65-1.18）的适应性解释模式的差异性前后增加。CBM-I 和对照组训练均降低了 BD、BDD 症状严重程度和抑郁。然而，CBM-I（与对照组和等候名单相比）改善了与外貌相关的生活质量（d=0.51）、自尊（d=0.52）和适应不良的外貌相关信念（d=0.47）。与等候名单相比，CBM-I 条件下的状态应激反应总体降低。干预效果在随访中基本保持稳定。治疗满意度与其他 CBM-I 研究相当，不良反应率较低。
这些发现支持了 BD、BDD 和 ED 的认知行为模型的假设，并表明基于网络的 CBM-I 是一种有效和可接受的干预选择。
