COGNITIVE-BEHAVIORAL THERAPY FOR BDD: WHAT’S THE EVIDENCE THAT CBT WORKS?

In the 1980s a few clinician-researchers (e.g., Isaac Marks in England) published papers in scientific journals that illustrated the effectiveness of CBT for several patients with BDD. These clinical reports spurred other researchers to conduct more scientifically rigorous studies of CBT. In these studies, larger numbers of patients were evaluated, and they were assessed with standard rating scales.
CBT is the only type of therapy that has been systematically studied in BDD. Available research studies indicate that CBT substantially improves BDD symptoms in a majority of people. Most of these studies, which are summarized in Table 17 below, used a combination of cognitive and behavioral techniques. Research hasn’t been published which teases apart which components of CBT are most effective. Nor have studies compared CBT to other forms of therapy, so it hasn’t been proven that CBT is more effective than other types of therapy. Nonetheless, clinical impressions suggest that this is probably the case. Studies have demonstrated that CBT is more effective than certain other therapies in disorders with similarities to BDD, such as OCD and social phobia.
The first two studies, which were “controlled” studies, are the most scientifically rigorous studies done so far. In these studies, patients who received CBT were compared to patients on a waiting list who received no treatment. The no treatment condition controls for changes in BDD that might occur simply with the passage of time or for other reasons. Another advantage of these two studies is that patients were randomly assigned to these two treatment conditions, which minimizes differences in the patients in each group that might affect treatment outcome. The other studies shown in the table were “case series,” in which a series of patients was treated with CBT (without comparison to another condition, such as a waiting list).
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COGNITIVE-BEHAVIORAL THERAPY FOR BDD: WHAT’S THE EVIDENCE THAT CBT WORKS?In the 1980s a few clinician-researchers (e.g., Isaac Marks in England) published papers in scientific journals that illustrated the effectiveness of CBT for several patients with BDD. These clinical reports spurred other researchers to conduct more scientifically rigorous studies of CBT. In these studies, larger numbers of patients were evaluated, and they were assessed with standard rating scales.CBT is the only type of therapy that has been systematically studied in BDD. Available research studies indicate that CBT substantially improves BDD symptoms in a majority of people. Most of these studies, which are summarized in Table 17 below, used a combination of cognitive and behavioral techniques. Research hasn’t been published which teases apart which components of CBT are most effective. Nor have studies compared CBT to other forms of therapy, so it hasn’t been proven that CBT is more effective than other types of therapy. Nonetheless, clinical impressions suggest that this is probably the case. Studies have demonstrated that CBT is more effective than certain other therapies in disorders with similarities to BDD, such as OCD and social phobia.The first two studies, which were “controlled” studies, are the most scientifically rigorous studies done so far. In these studies, patients who received CBT were compared to patients on a waiting list who received no treatment. The no treatment condition controls for changes in BDD that might occur simply with the passage of time or for other reasons. Another advantage of these two studies is that patients were randomly assigned to these two treatment conditions, which minimizes differences in the patients in each group that might affect treatment outcome. The other studies shown in the table were “case series,” in which a series of patients was treated with CBT (without comparison to another condition, such as a waiting list).*287\204\8*

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