Interpretation bias across body dysmorphic, social anxiety and generalized anxiety disorder : a multilevel, diffusion model account

Interpretation biases are suggested to be transdiagnostic phenomena, but have rarely been compared across different disorders and current concerns. 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 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. These findings have important implications for understanding interpretation biases as both etiological and treatment factors.Projekt DEA

Body dysmorphic disorder and self-esteem : a meta-analysis

Body dysmorphic disorder (BDD) is associated with low self-esteem. The aim of this meta-analysis was to examine the strength of the cross-sectional relationship between BDD symptom severity and global self-esteem in individuals with BDD, mentally healthy controls, community or student samples, and cosmetic surgery patients. Moreover, the role of depressive symptom severity in this relationship and other moderating factors were investigated. A keyword-based literature search was performed to identify studies in which BDD symptoms and global self-esteem were assessed. Random effects meta-analysis of Fisher’s z-transformed correlations and partial correlations controlling for the influence of depressive symptom severity was conducted. In addition to meta-analysis of the observed effects, we corrected the individual correlations for variance restrictions to address varying ranges of BDD symptom severity across samples. Twenty-five studies with a total of 6278 participants were included. A moderately negative relationship between BDD symptom severity and global self-esteem was found (r = -.42, CI = [-.48, -.35] for uncorrected correlations, r = -.45, CI = [-.51, -.39] for artifact-corrected correlations). A meta-analysis of partial correlations revealed that depressive symptom severity could partly account for the aforementioned relationship (pr = -.20, CI = [-.25, -.15] for uncorrected partial correlations, pr = -.23, CI = [-.28, -.17] for artifact-corrected partial correlations). The sample type (e.g., individuals with BDD, mentally healthy controls, or community samples) and diagnosis of BDD appeared to moderate the relationship only before artifact correction of effect sizes, whereas all moderators were non-significant in the meta-analysis of artifact-corrected correlations. The findings demonstrate that low self-esteem is an important hallmark of BDD beyond the influence of depressive symptoms. It appears that negative evaluation in BDD is not limited to appearance but also extends to other domains of the self. Altogether, our findings emphasize the importance of addressing self-esteem and corresponding core beliefs in prevention and treatment of BDD.DEA

The effectiveness of cognitive behavioural therapy for social anxiety disorder in routine clinical practice

Numerous randomized controlled trials have shown cognitive behaviour therapy (CBT) to be effective in treating social anxiety disorder (SAD). Yet, less is known about the effectiveness of CBT for SAD conducted by psychotherapists in training in routine clinical practice. In this study, 231 patients with SAD were treated with CBT under routine conditions and were examined at pre‐ and post‐treatment as well as at 6 and 12 months follow‐up. We applied self‐reports to assess symptoms of SAD (defined as primary outcome), depression and psychological distress (defined as secondary outcome). We conducted both completer and intent‐to‐treat analyses and also assessed the reliability of change with the reliable change index. Results revealed significant reductions in symptoms of SAD between pre‐ and post‐assessments, with effect sizes ranging from d = 0.9 to 1.2. Depending on the SAD specific questionnaire applied, 47.8% to 73.5% of the sample showed a reliable positive change, whereas 1.9% to 3.8% showed a reliable negative change. Depressive symptoms and psychological distress also decreased significantly from pre‐ to post‐assessment, with large effect sizes. Significant treatment gains regarding both primary and secondary outcomes were further observed at 6 and 12 months follow‐up. The current findings based on a large sample of patients suggest that psychotherapists in CBT training working under routine conditions can effectively treat symptoms of SAD, depression and psychological distress.Projekt DEA

Study satisfaction among university students during the COVID-19 pandemic: longitudinal development and personal-contextual predictors

The COVID-19 pandemic challenges the well-being and academic success of many students. Yet, little is known about students’ study satisfaction during the COVID-19 pandemic, a multilayered construct which accounts for students’ subjective cognitive well-being and academic success. Besides, previous studies on study satisfaction are mostly cross-sectional and hardly consider the distinct subdimensions of this construct. Therefore, our main goal in this study was to shed light on the understudied development of the subdimensions of study satisfaction (i.e., satisfaction with study content, conditions of studying, and coping with study-related stress) in two semesters amid the COVID-19 pandemic. Additionally, we examined how particular personal (i.e., gender, age, GPA, intrinsic motivation, motivational cost, and academic procrastination) and contextual (i.e., loneliness) factors are related to these subdimensions. We conducted two panel studies with convenience and purposeful samples of university students in Germany (Nstudy1 = 837; Nstudy2 = 719). Participants responded online to questions on each of the subdimensions of study satisfaction at the beginning, middle, and end of each semester but responded to measures of personal and contextual factors only at the beginning of each semester. In both studies, manifest growth curve models indicated a decrease in all subdimensions of study satisfaction as the semester progressed. Generally, gender (male) and intrinsic motivation were positive predictors but age (younger students), motivational cost, and loneliness were negative predictors of different subdimensions of study satisfaction – particularly satisfaction with study content. Overall, motivational costs and loneliness were the most consistent predictors of all subdimensions of study satisfaction across both studies. Our findings provide support for the understanding that study satisfaction could diminish in the face of challenging situations such as in this pandemic. The present study also highlights certain personal and contextual factors that relate to study satisfaction and calls for intensive research into the multidimensional construct of study satisfaction

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

KDS-K / BDD-5 - Körperdysmorphe Störung Selbstberichtskriterien nach DSM-5

This project contains an English and a German version of BDD screening instruments according to DSM-5 criteria (one for adolescents and one for adults). Please see pdf files for citation

Body Dysmorphic Disorder: Treatment

Möllmann A, Buhlmann U. Body Dysmorphic Disorder: Treatment. In: Wenzel A, ed. The SAGE Encyclopedia of Abnormal and Clinical Psychology. Thousand Oaks, USA, CA : Sage; 2017