Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA.
Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA,
Psychother Psychosom. 2022;91(4):277-285. doi: 10.1159/000524628. Epub 2022 May 19.
Body dysmorphic disorder (BDD) is severe, chronic, and undertreated. Apps could substantially improve treatment access.
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.
A randomized waitlist-controlled trial was conducted. Adults (N = 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.
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]; p < 0.001, d = 1.44). App-based CBT was associated with greater improvements across all secondary measures, with medium to large effects.
Perspectives, supported by a bachelor's-level coach, is an efficacious, scalable treatment for adults with BDD.
躯体变形障碍（BDD）是一种严重、慢性且治疗不足的疾病。应用程序可以极大地改善治疗的可及性。
我们初步测试了基于教练支持的应用程序认知行为疗法（CBT）治疗 BDD 的可用性和疗效。Perspectives 应用程序涵盖了核心治疗内容：心理教育、认知重构、暴露与反应预防、正念、注意力再训练和复发预防。
进行了一项随机等待对照试验。患有原发性 BDD 的成年人（N=80）被分配到 Perspectives 或等待名单 12 周。教练通过应用内消息和电话促进参与并回答问题。盲法独立评估者在基线、治疗中期和治疗结束时评估 BDD 严重程度（改良耶鲁-布朗强迫量表用于 BDD；BDD-YBOCS）。次要结局包括 BDD 相关洞察力、抑郁、生活质量和功能。
应用程序的采用率和满意度很高。在意向治疗分析中，与等待名单相比，Perspectives 应用程序 CBT 在治疗结束时 BDD-YBOCS 严重程度显著降低（M [SD]：16.8 [7.5] 对 26.7 [6.2]；p < 0.001，d = 1.44）。应用程序 CBT 与所有次要测量指标的改善相关，具有中到大的效果。
在学士学位水平教练的支持下，Perspectives 是一种针对 BDD 成人患者的有效、可扩展的治疗方法。
