BDD-NET – Ein internetbasiertes Programm bei Körperunzufriedenheit zur niedrigschwelligen Behandlung der körperdysmorphen Störung für den deutschen Sprachraum

Hintergrund: Die Körperdysmorphe Störung (KDS) ist eine schwerwiegende psychische Störung, die mit starker Scham sowie Leidensdruck und Funktionseinschränkungen einhergeht. Kognitive Verhaltenstherapie stellt die aktuell wirksamste evidenzbasierte Behandlungsmethode dar. Aufgrund zahlreicher Behandlungsbarrieren kommen KDS-Betroffene jedoch selten in der psychotherapeutischen Behandlung an, weshalb niedrigschwelligen Behandlungsmethoden (z.B. aus dem Bereich E-Mental-Health) eine wichtige Rolle zukommen könnten. Erste internationale Studien weisen auf die Wirksamkeit von E-Mental-Health-Angeboten bei KDS hin. Material und Methoden: Dieser Beitrag gibt eine Übersicht zur bisherigen Umsetzung und Evidenz von E-Mental-Health-Angeboten für KDS und stellt die ins Deutsche übersetzte Version des BDD-NET-Programms, eines internetbasierten, manuali­sierten, therapeutenbegleiteten Interventionsprogramms, für die KDS vor, welches aus dem Englischen für den deutschen Sprachraum übersetzt und adaptiert wurde. Ergebnisse: BDD-NET umfasst acht Module, die binnen einer 12-wöchigen Behandlung online bearbeitet werden. Die Online-Plattform bietet für die Patienten die Möglichkeit, mit dem BDD-NET-Therapeuten mittels persönlicher Nachrichten zu kommunizieren. Sämtliche Materialien wurden aus dem Englischen übersetzt und vor allem in kultureller Hinsicht adaptiert. Schlussfolgerungen: BDD-NET könnte ein wichtiger Baustein in der Versorgung von KDS-Betroffenen sein. Die Evaluation steht für den deutschen Sprachraum noch aus. Auf Besonderheiten des Settings (z.B. Störungseinsicht als möglicher Behandlungsfokus) sowie praktische Implikationen wird eingegangen. Zudem werden Voraussetzungen und Rahmenbedingungen für eine perspektivische Dissemination diskutiert

Online supplements for "Interpretation bias across body dysmorphic, social anxiety and generalized anxiety disorder – a multi-level, diffusion model account"

This repository contains online supplementary material, additional analyses and data

Interpretation Bias Across Body Dysmorphic, Social Anxiety and Generalized Anxiety Disorder—A Multilevel, Diffusion Model Account

Dietel FA, Möllmann A, Bürkner P-C, Wilhelm S, Buhlmann U. Interpretation Bias Across Body Dysmorphic, Social Anxiety and Generalized Anxiety Disorder—A Multilevel, Diffusion Model Account. Cognitive Therapy and Research. 2021;45(4):715-729.**Background** Interpretation biases are suggested to be transdiagnostic phenomena, but have rarely been compared across different disorders and current concerns. **Methods** We investigated explicit, decision-based, and more implicit, reaction time-based interpretation bias in individuals with body dysmorphic disorder (BDD;N = 29), social anxiety disorder (SAD;N = 36), generalized anxiety disorder (GAD;N = 22), and non-clinical controls (NC;N = 32), using an adapted Word Sentence Association Paradigm (WSAP). **Results** Results indicated that interpretation bias occurred transdiagnostically, while content-specific bias patterns varied meaningfully across groups. BDD and SAD shared explicit and, more inconsistently, implicit interpretation biases for appearance-related and social situations. The GAD group exhibited an explicit and implicit negative interpretation bias for general situations, and an additional implicit lack of positive bias. Mechanistic Wiener diffusion model analyses revealed that interpretation bias patterns were mainly driven by speeded information uptake, potentially mirroring disorder-specific associative memory organization. **Conclusions** These findings have important implications for understanding interpretation biases as both etiological and treatment factors

Internet-based interpretation bias modification for body dissatisfaction

Objective Appearance-related interpretation bias is postulated to play a role in the maintenance of body dissatisfaction (BD), a risk factor for body dysmorphic disorder (BDD), and eating disorders (ED). Cognitive bias modification for interpretation (CBM-I) has been shown to reduce maladaptive interpretation bias and symptoms in various emotional disorders. This study investigated the acceptability and efficacy of an easily disseminable, web-based CBM-I program for BD. Methods Individuals with high BD (N = 318) were randomized to a multi-session CBM-I (Sentence Word Association Paradigm [SWAP] with feedback) vs. control (SWAP without feedback) versus waitlist condition. Interpretation bias, BD and associated symptoms were assessed at baseline and post-intervention. Symptoms were monitored up to 1-week and 4-week follow-up. We further investigated transference effects to stress reactivity, as predicted by cognitive-behavioral models, at post-intervention. Results Appearance-related CBM-I led to a differential pre-post increase in adaptive interpretation patterns, particularly for appearance-related and social situations (d = 0.65-1.18). Both CBM-I and control training reduced BD, BDD symptom severity, and depression. However, CBM-I (vs. control and waitlist) improved appearance-related quality of life (d = 0.51), self-esteem (d = 0.52), and maladaptive appearance-related beliefs (d = 0.47). State stress reactivity was overall reduced in the CBM-I condition (vs. waitlist). Intervention effects largely held stable up to follow-ups. Treatment satisfaction was comparable to other CBM-I studies, with low rates of adverse reactions. Discussion These findings support assumptions of cognitive-behavioral models for BD, BDD, and ED, and suggest that web-based CBM-I is an efficacious and acceptable intervention option.Peer reviewe

Internet-based Interpretation Bias Modification for body dissatisfaction: A three-armed randomized controlled trial

Objective: Appearance-related interpretation bias is postulated to play a role in the maintenance of body dissatisfaction, a risk factor for body dysmorphic disorder (BDD) and eating disorders (ED). Cognitive Bias Modification for Interpretation (CBM-I) has been shown to reduce interpretation bias and symptoms in emotional disorders. This study investigated the acceptability and efficacy of web-based, appearance-related CBM-I for body dissatisfaction in a three-armed randomized controlled trial. Methods: Participants with high body dissatisfaction (N = 318) were randomized to multi-session CBM-I (Sentence Word Association Paradigm, SWAP, with feedback) vs. control (SWAP without feedback) vs. waitlist condition. Body dissatisfaction, BDD symptoms, self-esteem, depression and quality of life were assessed at baseline and post-intervention. Symptoms were monitored up to one-week and four-week follow up. We further investigated video-based stress reactivity at post-intervention. Results: CBM-I led to a differential pre-post increase in adaptive interpretation patterns, particularly for appearance-related and social situations (d = 0.65-1.18). Both CBM-I and control training reduced body dissatisfaction, BDD symptom severity and depression. However, CBM-I (vs. control and waitlist) improved appearance-related quality of life (d = 0.51), self-esteem (d = 0.52), and maladaptive appearance-related beliefs (d = 0.47). State stress reactivity was overall reduced in the CBM-I group (vs. waitlist). Intervention effects largely held stable up to follow-up. Treatment satisfaction for appearance-related CBM-I was comparable to other CBM-I studies, with overall low rates of adverse reactions. Discussion: These findings support assumptions of cognitive-behavioral models for body dissatisfaction, BDD and ED, and suggest that CBM-I is an efficacious and acceptable intervention