Predicting response to a smartphone-based cognitive-behavioral therapy for body dysmorphic disorder.

Area of Science:

• Psychiatry
• Digital Health
• Behavioral Science

Background:

• Body dysmorphic disorder (BDD) is a severe, chronic mental health condition.
• Smartphone-based cognitive behavioral therapy (CBT) offers a scalable solution to BDD treatment barriers like cost and stigma.
• Understanding factors influencing smartphone CBT efficacy for BDD is crucial for optimizing its use.

Purpose of the Study:

• To analyze secondary data from a randomized trial of smartphone CBT for BDD.
• To identify predictors of treatment success in individuals using a 12-week, coach-guided BDD app.
• To explore demographic and psychological factors associated with improved BDD symptom severity, response, and remission.

Main Methods:

• Secondary data analysis of a randomized, waitlist-controlled trial involving 80 participants with BDD.
• Participants received a 12-week, coach-guided smartphone CBT app, either immediately or after a waitlist period.
• Outcomes included BDD severity (BDD-YBOCS) over time, treatment response, and remission rates.

Main Results:

• Immediate app access predicted better symptom improvement compared to delayed access.
• Positive outcomes were associated with specific gender identities and sexual minority status.
• Higher baseline treatment credibility and lower initial BDD severity predicted greater treatment response and remission.

Conclusions:

• Smartphone CBT may offer particular benefits for historically marginalized populations with BDD.
• Strategies to expedite treatment access and enhance patient confidence are important.
• Developing stratified care models can optimize the allocation and effectiveness of digital mental health interventions for BDD.