Introduction: Body dysmorphic disorder (BDD) is severe, chronic, and undertreated. Apps could substantially improve treatment access. Objective: 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. Methods: 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. Results: 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 #x3c; 0.001, d = 1.44). App-based CBT was associated with greater improvements across all secondary measures, with medium to large effects. Conclusions: Perspectives, supported by a bachelor’s-level coach, is an efficacious, scalable treatment for adults with BDD.
Psychother Psychosom

中文翻译：

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基于应用程序的认知行为疗法在教练支持下对身体变形障碍的疗效：初步随机对照临床试验


简介：身体变形障碍（BDD）是一种严重、慢性且治疗不足的疾病。应用程序可以大大改善治疗的可及性。目的：我们对教练支持的基于应用程序的 BDD 认知行为疗法 (CBT) 的可用性和功效进行初步测试。 Perspectives 应用程序涵盖核心治疗组成部分：心理教育、认知重建、接触预防反应、正念、注意力再训练和预防复发。方法：进行了一项随机等待名单对照试验。患有原发性 BDD 的成年人 ( N = 80) 被分配到 12 周的观察或候补名单中。教练通过应用内消息和电话来促进参与并回答问题。由盲法独立评估者在基线、治疗中期和治疗结束时测量 BDD 严重程度（针对 BDD 的耶鲁-布朗强迫症量表改良版；BDD-YBOCS）。次要结果包括 BDD 相关的洞察力、抑郁、生活质量和功能。结果：应用程序的使用率和满意度很高。在意向治疗分析中，与候补名单 (26.7 [6.2]) 相比，基于 Perspectives 应用程序的 CBT 与治疗结束时 BDD-YBOCS 严重程度显着降低相关 (M [SD]: 16.8 [7.5]) (26.7 [6.2]; p #x3c ；0.001， d = 1.44）。基于应用程序的 CBT 与所有次要措施的更大改进相关，具有中等到大的效果。结论：在学士级教练的支持下，观点对于成人 BDD 来说是一种有效、可扩展的治疗方法。
 心理医生