Hostname: page-component-848d4c4894-ndmmz Total loading time: 0 Render date: 2024-04-30T17:15:35.243Z Has data issue: false hasContentIssue false
  • English
  • Français

Cognitive Behaviour Therapy for Adolescents with Body Dysmorphic Disorder: A Case Series

Published online by Cambridge University Press:  12 April 2012

Georgina Krebs ,
Cynthia Turner ,
Isobel Heyman  and
David Mataix-Cols
Georgina Krebs*
Affiliation:
South London and Maudsley NHS Foundation Trust, UK
Cynthia Turner
Affiliation:
South London and Maudsley NHS Foundation Trust, and Institute of Psychiatry, London, UK
Isobel Heyman
Affiliation:
South London and Maudsley NHS Foundation Trust, and Institute of Psychiatry, London, UK
David Mataix-Cols
Affiliation:
South London and Maudsley NHS Foundation Trust, and Institute of Psychiatry, London, UK
*
Reprint requests to Georgina Krebs, South London and Maudsley NHS Foundation Trust, Michael Rutter Centre, Denmark Hill, London SE5 8AZ, UK. E-mail: georgina.krebs@slam.nhs.uk
Get access Rights & Permissions [Opens in a new window]

Abstract

Background: Body dysmorphic disorder (BDD) is relatively common in adolescents and can have serious negative consequences. However, the treatment of BDD in young people has received virtually no empirical attention to date, and the evidence-base for cognitive behaviour therapy (CBT) in this population is limited to a small number of single case reports. Aims: This study aimed to investigate treatment outcomes associated with CBT, primarily consisting of exposure and response prevention, in a group of young people with BDD. Method: Six adolescents with a diagnosis of BDD received a course of developmentally appropriate CBT for BDD with parental involvement. BDD and depressive symptoms were evaluated at pre-treatment, post-treatment and at 3- or 6-month follow-up, using the Yale-Brown Obsessive Compulsive Scale for BDD (BDD-YBOCS) and the Beck Depression Inventory-Youth, respectively. Results: Scores on the BDD-YBOCS indicated a 44% improvement in BDD symptoms at post-treatment and a 57% improvement at follow-up for the group. Considering response as a ≥30% reduction in BDD-YBOCS score, four of the six adolescents were classified as treatment responders. Improvements in depressive symptoms were observed among the treatment responders, but not the non-responders. Conclusions: These findings indicate the potential efficacy of CBT, including exposure and response prevention for adolescents with BDD, and highlight the need for further controlled trials.

Keywords

Cognitive behaviour therapyadolescentsyoung peoplecase reportchildhood anxiety
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 40 , Issue 4 , July 2012 , pp. 452 - 461
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Albertini, R. S. and Phillips, K. A. (1999). 33 cases of body dysmorphic disorder in children and adolescents. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 453–459.CrossRefGoogle Scholar
Aldea, M. A., Storch, E. A., Geffken, G. R. and Murphy, T. K. (2009). Intensive cognitive-behavioral therapy for adolescents with body dysmorphic disorder. Clinical Case Studies, 8, 113–121.CrossRefGoogle Scholar
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders (4th edn., Text rev.). Washington, DC: Author.Google Scholar
Beck, J. S., Beck, A. T. and Jolly, J. B. (2001). Beck Youth Inventories for Children and Adolescents. San Antonio, TX: The Psychological Corporation.Google Scholar
Beck, J. S., Beck, A. T., Jolly, J. B. and Steer, R. A. (2005). Beck Youth Inventories for Children and Adolescents (2nd edn.) San Antonio, TX: The Psychological Corporation.Google Scholar
Bienvenu, O. J., Samuels, J. F., Riddle, M. A., Hoehn-Saric, R., Liang, K.Y., Cullen, B. A., et al. . (2000). The relationship of obsessive-compulsive disorder to possible spectrum disorders: results from a family study. Biological Psychiatry, 48, 287–293.CrossRefGoogle ScholarPubMed
Braddock, L. E. (1982). Dysmorphophobia in adolescence: a case report. British Journal of Psychiatry, 140, 199–201.CrossRefGoogle ScholarPubMed
Geremia, G. and Neziroglu, F. (2001). Cognitive therapy in the treatment of body dysmorphic disorder. Clinical Psychology and Psychotherapy, 8, 243–251.CrossRefGoogle Scholar
Goodman, R., Ford, T., Richards, H., Gatward, R. and Meltzer, H. (2000). The Development and Well-Being Assessment: description and initial validation of an integrated assessment of child and adolescent psychopathology. The Journal of Child Psychology and Psychiatry, 5, 645–655.CrossRefGoogle Scholar
Greenberg, J.L., Markowitz, S., Petronko, M. R., Taylor, C. E., Wilhelm, S. and Wilson, G. T. (2010). Cognitive-behavioral therapy for adolescent body dysmorphic disorder. Cognitive and Behavioral Practice, 17, 248–258.CrossRefGoogle Scholar
Gunstad, J. and Phillips, K. A. (2003). Axis I comorbidity in body dysmorphic disorder. Comprehensive Psychiatry, 44, 270–276.CrossRefGoogle ScholarPubMed
Horowitz, K., Gorfinkle, K., Lewis, O. and Phillips, K. A. (2002). Body dysmorphic disorder in an adolescent girl. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 1503–1509.CrossRefGoogle Scholar
Koran, L. M., Ebujaoude, E., Large, M. D. and Serpe, R. T. (2008). The prevalence of body dysmorphic disorder in the United States adult population. CNS Spectrums, 13, 316–322.CrossRefGoogle ScholarPubMed
March, J. and Mulle, K. (1998). OCD in Children and Adolescents: a cognitive behavioural treatment manual. New York: Guilford Press.Google Scholar
Mayville, S., Katz, R. C., Gipson, M. T. and Cabral, K. (1999). Assessing the prevalence of body dysmorphic disorder in an ethnically diverse group of adolescents. Journal of Child and Family Studies, 8, 357–362.CrossRefGoogle Scholar
McKay, D., Todaro, J., Neziroglu, F., Campisi, T., Moritz, E. K. and Yaryura-Tobias, J. A. (1997). Body dysmorphic disorder: a preliminary evaluation of treatment and maintenance using exposure with response prevention. Behaviour Research and Therapy, 35, 67–70.CrossRefGoogle ScholarPubMed
Neziroglu, F., McKay, D., Todaro, J. and Yaryura-Tobias, J. A. (1996). Effect of cognitive behaviour therapy on persons with body dysmorphic disorder and comorbid axis II diagnosis. Behaviour Therapy, 27, 67–77.CrossRefGoogle Scholar
Phillips, K. A., Albertini, R.S. and Rasmussen, S.A. (2002). A randomized placebo-controlled trial of fluoxetine in body dysmorphic disorder. Archives of General Psychiatry, 59, 381–388.CrossRefGoogle ScholarPubMed
Phillips, K.A. and Diaz, S.F. (1997). Gender differences in body dysmorphic disorder. The Journal of Nervous and Mental Disease, 185, 570–577.CrossRefGoogle ScholarPubMed
Phillips, K. A., Didie, E. R. and Menard, W. (2007). Clinical features and correlates of major depressive disorder in individuals with body dysmorphic disorder. Journal of Affective Disorders, 97, 129–135.CrossRefGoogle ScholarPubMed
Phillips, K. A., Didie, E. R., Menard, W., Pagano, M. E., Fay, C. and Weisberg, R. B. (2006). Clinical features of body dysmorphic disorder in adolescents and adults. Psychiatry Research, 141, 305–314.CrossRefGoogle ScholarPubMed
Phillips, K. A., Hollander, E., Rasmussen, S. A., Aronowitz, B. R., DeCaria, C. and Goodman, W. K. (1997). A severity rating scale for body dysmorphic disorder: development, reliability, and validity of a modified version of the Yale-Brown Obsessive Compulsive Scale. Psychopharmacology Bulletin, 33, 17–22.Google ScholarPubMed
Rief, W., Bulhmann, U., Wilhelm, S., Borkenhagen, A. and Brahler, E. (2006). The prevalence of body dysmorphic disorder: a population-based survey. Psychological Medicine, 36, 877–885.CrossRefGoogle ScholarPubMed
Rosen, L. C., Reiter, J. and Orosan, P. (1995). Cognitive-behavioural body image therapy for body dysmorphic disorder. Journal of Consulting and Clinical Psychology, 63, 263–269.CrossRefGoogle Scholar
Sheehan, D.V., Lecrubier, Y., Sheehan, K.H., Amorim, P., Janavs, J., Weiller, E., et al. . (1998). The Mini-International Neuropsychiatric Interview (M.I.N.I.): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59, 22–33.Google ScholarPubMed
Sobanski, E. and Schmidt, M. H. (2000). Everybody looks at my pubic bone: a case report of an adolescent with body dysmorphic disorder. Acta Psychiatrica Scandinavia, 101, 80–82.CrossRefGoogle ScholarPubMed
Veale, D. (2004). Advances in a cognitive behavioural model of body dysmorphic disorder. Body Image, 1, 113–125.CrossRefGoogle Scholar
Veale, D., Gournay, K., Dryden, W., Boocock, A., Willson, R. and Walburn, J. (1996). Body dysmorphic disorder: a cognitive behaviour model and pilot randomized controlled trial. Behaviour Research and Therapy, 34, 717–729.CrossRefGoogle Scholar
Vogel, P. A., Stiles, T. C. and Götestam, K. G. (2004). Adding cognitive therapy elements to exposure therapy for obsessive compulsive disorder: a controlled study. Behavioural and Cognitive Psychotherapy, 32, 275–290.CrossRefGoogle Scholar
Wilhelm, S., Buhlmann, U., Cook, L. M., Greenberg, J. L. and Dimaite, R. (2010). A cognitive-behavioral treatment approach for body dysmorphic disorder. Cognitive and Behavioral Practice, 17, 241–247.CrossRefGoogle Scholar
Wilhelm, S., Otto, M. W., Lohr, B. and Deckersbach, T. (1999). Cognitive behaviour group therapy for body dysmorphic disorder: a case series. Behaviour Research and Therapy, 37, 71–75.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.