Acceptance and Compassion-Based Therapy Targeting Shame in Body Dysmorphic Disorder: A Multiple Baseline Study

Area of Science:

• Psychiatry
• Clinical Psychology
• Behavioral Therapy

Background:

• Shame is a core feature of body dysmorphic disorder (BDD), contributing to significant psychosocial distress.
• Existing interventions for BDD often lack specific strategies to address shame.
• Acceptance and Commitment Therapy (ACT) and self-compassion interventions show potential for managing shame in various clinical conditions.

Purpose of the Study:

• To develop and evaluate a novel acceptance and compassion-based intervention, ACT with Compassion (ACTwC), tailored for individuals with BDD.
• To specifically target and reduce shame experienced by individuals with BDD.
• To assess the efficacy and maintenance of ACTwC in a clinical sample.

Main Methods:

• A randomized nonconcurrent multiple baseline design was employed.
• The study involved five adult outpatients diagnosed with BDD receiving a 12-session ACTwC intervention.
• Daily ratings were used to track BDD behaviors, self-criticism, and body shame, with follow-up assessments at 6 months.

Main Results:

• Four out of five participants showed significant reductions in BDD behaviors and self-criticism post-treatment.
• Three participants experienced decreased body shame compared to baseline.
• Improvements in general shame, BDD symptoms, depressive symptoms, and quality of life were maintained at 6-month follow-up for responders.

Conclusions:

• ACTwC appears to be a promising treatment for reducing shame and core symptoms in individuals with BDD.
• The intervention demonstrated reliable long-term improvements in psychological flexibility and self-compassion among treatment responders.
• High participant satisfaction and credibility suggest ACTwC warrants further investigation in larger trials.