Investigating a Therapist-Guided Internet-Based Cognitive Behavioral Therapy for Body Dysmorphic Disorder Among Adolescents
A recent clinical trial exploring an internet-based Cognitive Behavioral Therapy (iCBT) program specifically tailored for adolescents and young adults with Body Dysmorphic Disorder (BDD) has yielded promising insights. Registering under the German Clinical Trials Register (DRKS00022055) before data collection commenced on June 8, 2020, the study adhered to the established CONSORT 2010 guidelines for reporting parallel group randomized trials. A detailed study protocol was published, elaborating on the methodology and anticipated outcomes of this innovative intervention.
Participant Selection Criteria
The trial targeted German-speaking participants aged 15 to 21 diagnosed with BDD per the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5). This inclusive recruitment allowed for comorbid diagnoses while setting exclusion parameters for individuals with substance abuse issues, bipolar disorder, psychotic episodes, suicidal tendencies, current psychotherapeutic engagement, recent changes in medication, or cognitive limitations that could hinder engagement in the intervention.
Recruitment and Data Collection
Recruitment spanned from July 2020 to September 2022 across Germany, Austria, and Switzerland, utilizing various platforms including social media and university email lists. Participants self-enrolled in the study and were not compensated for their involvement. Following initial screenings for eligibility via an online platform, selected candidates underwent comprehensive diagnostic interviews conducted by trained psychologists using secure video conferencing tools.
Randomization split participants into two intervention groups: one receiving the iCBT and the other an active control condition based on supportive online therapy. The latter was structured to facilitate therapist interaction while minimizing potential biases around awareness of treatment conditions. Both groups underwent a series of assessments at various points during the study to gauge treatment efficacy and symptom severity.
Intervention Details
The iCBT, named ImaginYouth, consisted of 12 structured sessions employing core CBT principles adapted for younger patients. These sessions included psychoeducation, cognitive restructuring, and relapse prevention strategies, each supplemented by assignments to reinforce skills in real-world scenarios. Participants were encouraged to progress through sessions at their own pace, although a weekly schedule was deemed ideal. Communication with the therapists was maintained through an integrated messaging function.
In comparison, the supportive online therapy involved psychoeducational content similar to the first iCBT module but lacked interactive exercises aimed at personalizing the therapeutic experience. This control condition emphasized therapeutic support without innovative interventions designed to address specific BDD symptoms.
Safety Protocols and Outcome Measures
Safety measures included obtaining emergency contact details and continuous monitoring for suicidal ideation throughout the intervention, ensuring participant welfare was prioritized. Various assessment tools such as the Yale-Brown Obsessive-Compulsive Scale Modified for BDD (BDD-YBOCS) and the Patient Health Questionnaire (PHQ-9) facilitated a rigorous evaluation of treatment outcomes.
Statistical Analysis
Data analysis proceeded with sophisticated statistical methodologies, including linear mixed models and ANOVA, to assess intervention impact and manage missing data appropriately. The trial concluded on September 30, 2023, marking an important step in understanding the efficacy of digital health interventions for mental health challenges faced by adolescents.
Overall, this study represents a significant advancement in addressing the complexities of BDD in youth through innovative technological solutions, reflecting growing trends in online mental health care applications. As mental health researchers and practitioners continue to explore these strategies, the outcomes of this trial will provide valuable insights into the future of therapeutic modalities for adolescent populations diagnosed with BDD and potentially other psychological conditions.
