Evidence map›Paper›PMID 38031584›Full record

ArticleCognitive therapy and research2020

Mechanisms of Change in Cognitive Behavioral Therapy for Body Dysmorphic Disorder.

Angela Fang, Gail Steketee, Aparna Keshaviah, Elizabeth Didie, Katharine A Phillips, Sabine Wilhelm

Abstract read
In one paragraph

Article in Cognitive therapy and research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Body dysmorphic disorder: Diagnostic challenges and current management.JAAPA : official journal of the American Academy of Physician Assistants · 2026
    Review
  4. Article
  5. Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Angela FangDepartment of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Gail SteketeeSchool of Social Work, Boston University, Boston, MA, USA.
Aparna KeshaviahMathematica, Cambridge, MA, USA.
Elizabeth DidieButler Hospital and Alpert Medical School of Brown University, Providence, RI, USA.
Katharine A PhillipsButler Hospital and Alpert Medical School of Brown University, Providence, RI, USA.
Sabine WilhelmDepartment of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Simches Research Building, 185 Cambridge Street, Suite 2000, Boston, MA 02114, USA.

Funding

Treatment and Psychopathology of BDDK24MH063975 · NIMH · RHODE ISLAND HOSPITAL · PI PHILLIPS, KATHARINE ANNE · 2001 to 2011
$1.6M
Brain Correlates of Self-Focused Processing as a Biomarker of Treatment ResponseK23MH109593 · NIMH · UNIVERSITY OF WASHINGTON · PI FANG, ANGELA · 2016 to 2020
$888k
CBT Treatment Development for Body Dysmorphic DisorderR34MH070490 · NIMH · MASSACHUSETTS GENERAL HOSPITAL · PI WILHELM, SABINE · 2004 to 2006
$621k
NIMH NIH HHS K23 MH109593NIMH NIH HHS K24 MH063975NIMH NIH HHS R34 MH070490
6 · The paper itself

Abstract

Although cognitive-behavioral therapy (CBT) is highly efficacious for body dysmorphic disorder (BDD), not all patients benefit, and mechanisms underlying response remain unknown. In this first report of the mechanisms underlying improvement with CBT for BDD, we examined whether cognitive (maladaptive beliefs, perfectionism, schemas) and behavioral (checking, grooming, avoidance behaviors) changes mediate the effect of CBT on BDD symptom reduction. Forty-five participants with BDD who enrolled in a CBT for BDD treatment development study were included in two sets of analyses: (1) between-subject mediation of the effect of 12 weeks of CBT versus waitlist, and (2) within-subject mediation of longitudinal change in BDD symptom severity during 24 weeks of CBT. No significant mediators emerged in the between-subject analysis. Checking, grooming, avoidance behaviors, and maladaptive beliefs mediated within-subject improvements over time. Findings suggest that BDD symptom reduction occurs through the very mechanisms that have been hypothesized to maintain BDD in CBT models. Targeting certain cognitive (beliefs about appearance) and behavioral (checking, grooming, and avoidance behaviors) mechanisms in future treatment trials may enhance symptom improvement during CBT.

Indexed as

Body dysmorphic disorderBody imageCognitive-behavioral therapyMechanismsMediationPsychotherapyTreatment

Identifiers

PMID38031584
PMCPMC10686577

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.