What side effects are associated with this type of intervention?

Common treatments for Body Dysmorphic Disorder (BDD) include cognitive-behavioral therapy (CBT) and psychopharmacology. CBT, particularly when combined with mirror-based exposure techniques like mirror retraining and crooked mirror externalization therapy, can cause temporary emotional distress as patients confront their perceived defects. Psychopharmacological treatments, such as selective serotonin reuptake inhibitors (SSRIs), may lead to side effects like nausea, insomnia, and sexual dysfunction. Overall, while these treatments can be effective, they may also induce short-term discomfort and other side effects.

What prior FDA approvals exist?

Body Dysmorphic Disorder (BDD) is primarily treated with cognitive-behavioral therapy (CBT) and selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine and sertraline, which are FDA-approved for this condition. Mirror-based exposure therapy, which involves using mirrors to exaggerate perceived defects, is a novel approach being studied to enhance the benefits of CBT. While this specific method is not yet FDA-approved, it represents an innovative extension of existing therapeutic strategies for BDD.

What other types of research exist?

Promising novel alternatives to Mirror-Based Exposure Therapy for BDD patients include: 1) Virtual Reality Exposure Therapy (VRET), which uses immersive virtual environments to address body image concerns; 2) Augmented Reality (AR) applications that allow patients to visualize and modify their perceived defects in real-time; and 3) Mobile-based CBT applications that provide accessible, on-demand therapeutic interventions. These alternatives leverage technology to enhance traditional CBT methods and may offer more engaging and flexible treatment options.

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Behavioral Interventions for Body Dysmorphic Disorder (BDD Trial)

Phase 2

Waitlist Available

Led By Eda Gorbis, PhD, LMFT

Research Sponsored by Westwood Institute for Anxiety Disorders, Inc

Eligibility Criteria Checklist

Specific guidelines that determine who can or cannot participate in a clinical trial

Must have

Age 18-60

Be older than 18 years old

Must not have

No co-morbid psychiatric contraindications (psychosis, bipolar disorder, Tourette's or other tic disorder, panic disorder, PTSD, ADHD, anorexia nervosa, bulimia)

Primary diagnosis of OCD, depression, or substance abuse

Timeline

Screening 3 weeks

Treatment Varies

Follow Up day 1 and at 1 month

Awards & highlights

No Placebo-Only Group

Summary

This trial uses special mirror exercises to help people who worry excessively about their looks. The treatment helps them see their appearance more realistically and reduces their anxiety.

Who is the study for?

This trial is for adults aged 18-60 with Body Dysmorphic Disorder (BDD), as defined by the DSM-IV, who are English-speaking and have not changed their psychotropic medication recently. They must score above certain thresholds on BDD-specific assessments. People with primary OCD, depression, substance abuse issues or other psychiatric conditions like psychosis or bipolar disorder cannot join.

What is being tested?

The study compares two behavioral interventions for BDD: Mirror Retraining Method and Crooked Mirror Externalization Therapy. Participants will undergo three weeks of cognitive-behavioral therapy paired with one of these mirror-based techniques to see which is more effective at reducing BDD symptoms.

What are the potential side effects?

Since the interventions are behavioral therapies involving mirrors and do not involve drugs or medical procedures, there are no typical side effects like those seen in drug trials. However, participants may experience emotional discomfort during treatment.

Eligibility Criteria

Inclusion Criteria

You may be eligible if you check “Yes” for the criteria below

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I am between 18 and 60 years old.

Exclusion Criteria

You may be eligible for the trial if you check “No” for criteria below:

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I do not have any severe psychiatric conditions.

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I have been diagnosed with OCD, depression, or substance abuse.

Timeline

Screening ~ 3 weeks3 visits

Treatment ~ Varies

Follow Up ~ day 1 and at 1 month

Screening ~ 3 weeks

Treatment ~ Varies

Follow Up ~day 1 and at 1 month

This trial's timeline: 3 weeks for screening, Varies for treatment, and day 1 and at 1 month for reporting.

Treatment Details

Study Objectives

Study objectives can provide a clearer picture of what you can expect from a treatment.

Primary study objectives

Measure of change in the presence and severity of BDD before and after treatment

Secondary study objectives

Measure of change in the presence and type of BDD symptoms before and after treatment

Awards & Highlights

No Placebo-Only Group

All patients enrolled in this study will receive some form of active treatment.

Trial Design

2Treatment groups

Experimental Treatment

Active Control

Group I: Crooked Mirror Externalization TherapyExperimental Treatment1 Intervention

Of recent, the "crooked mirror" externalization therapy, developed by Dr. Eda Gorbis, has been put to use with much success (Gorbis 2004). This method involves the use of crooked or "fun house" mirrors made from highly reflective surfaces that can be bent in different directions, which distort and exaggerate the patient's perceived defects (Gorbis 2005). In turn, this process externalizes or reverses the patient's internalized distorted body image, and allows the patient to habituate to the reflection of the imagined defect that is even more distorted than the internalized image (Rosen et al. 1995).

Group II: Mirror Retraining MethodActive Control1 Intervention

In treating BDD, the cognitive-behavioral technique, "mirror retraining," uses ordinary and/or magnifying mirrors to amplify the supposed defect, which teaches patients to see their appearance in a more holistic way. Since BDD patients tend to only focus on their perceived flaws when looking in the mirror, and tend to think about their flaws in negative terms, in mirror retraining, patients learn how to change their negative evaluations of their appearance into more objective and nonjudgmental descriptions. Generally, this method is designed to intentionally exaggerate anxiety regarding appearance concerns through exposures with mirrors. However, using exclusively ordinary and/or magnifying mirrors does not address the internal distorted image that many patients with BDD experience (Rosen et al. 1995, Osman et al. 2004, Veale 2004).

0 / 3Eligibility criteria met

Research Highlights

Information in this section is not a recommendation. We encourage patients to speak with their healthcare team when evaluating any treatment decision.

Mechanism Of Action

Side Effect Profile

Prior Approvals

Other Research

Common treatments for Body Dysmorphic Disorder (BDD) include Cognitive-Behavioral Therapy (CBT) and mirror-based exposure therapies. CBT works by helping patients identify and change distorted thoughts and behaviors related to their perceived physical flaws. Mirror-based exposure therapies, such as mirror retraining and crooked mirror externalization, involve patients confronting their perceived defects in a controlled setting to reduce anxiety and distress. These therapies aim to desensitize patients to their appearance-related fears and improve their self-image, which is crucial for alleviating BDD symptoms and enhancing overall quality of life.