The purpose of this study is to develop a cognitive behavioral therapy (CBT) treatment manual to treat symptoms of body dysmorphic disorder (BDD).

Study hypothesis: CBT, when given as advised in the newly developed treatment manual, will reduce symptoms of BDD.

BDD is a disease that involves preoccupation with imagined or minor physical flaws. The condition often begins in adolescence and, if left untreated, can cause significant social, emotional, and occupational distress. Within the last decade, BDD has received increased attention, and various modes of treatment have been utilized and evaluated. CBT has been found to be a more effective form of treatment than other types of psychotherapy. This study will create a new CBT treatment manual and evaluate ways to increase patient participation in manual-based CBT. The utility of this manual for different populations will also be evaluated, and adherence and competence measures to assess CBT delivery will be developed.

This study will last 14 to 18 weeks. Participants will be randomly assigned to receive 18 to 22 sessions of individual, manual-based CBT. The CBT sessions will occur twice weekly for the first 4 weeks, then weekly thereafter. During the sessions, participants will receive education about BDD and CBT, engage in activities that help them confront their BDD, learn new ways of thinking about body image, and learn relapse prevention techniques. Self-report scales will be used to assess participants.

Ages Eligible for Study:  18 Years and above,  Genders Eligible for Study:  Both

Criteria

Inclusion Criteria:

• DSM-IV diagnosis of BDD for at least 6 months prior to study entry
• Score higher than 23 on BDD Yale-Brown Obsessive Compulsive Scale
• Live within driving distance of Boston, MA or Providence, RI

Exclusion Criteria:

• Any psychiatric diagnoses other than BDD
• Alcohol abuse or dependence within 3 months prior to study entry
• Suicidal or homicidal
• Psychotropic medication within 2 months prior to study entry