Cognitive-behavioral body image therapy for body dysmorphic disorder.

Body dysmorphic disorder (BDD) is a distressing body image disorder that involves excessive preoccupation with physical appearance in a normal appearing person. Prior case reports of behavior therapy were encouraging, but no controlled evaluation of behavior therapy or any other type of treatment had been conducted. In the present study, 54 BDD subjects were randomly assigned to cognitive behavior therapy or no treatment. Patients were treated in small groups for eight 2-hour sessions. Therapy involved modification of intrusive thoughts of body dissatisfaction and overvalued beliefs about physical appearance, exposure to avoided body image situations, and elimination of body checking. Body dysmorphic disorder symptoms were significantly decreased in therapy subjects and the disorder was eliminated in 82% of cases at posttreatment and 77% at follow-up. Overall psychological symptoms and self-esteem also improved in therapy subjects.

Assessment of body image in eating disorders with the body dysmorphic disorder examination.

The Body Dysmorphic Disorder Examination (BDDE) has several advantages for the assessment of body image in eating disorder patients. It measures distressing self-consciousness, preoccupation with appearance, overvalued ideas about the importance of appearance to one's self-worth, and body image avoidance and checking behaviors. The BDDE is relevant for any type of appearance complaint and is not limited to weight or body shape concerns. The BDDE measures the useful targets for body image therapy. In a sample of eating disorder patients, the Body Dysmorphic Disorder Exam had good internal consistency and was significantly correlated with other measures of body image. It added new information to the discrimination of women with eating disorders from clinical and nonclinical controls beyond that provided by other measures of body image.

Adolescent stress and coping: implications for psychopathology during adolescence.

Stressful experiences and efforts to cope with stress are central to understanding psychological distress and psychopathology during adolescence. Depressive phenomena during adolescence offer a particularly interesting opportunity for understanding the role of stress and coping processes in adolescent psychopathology. Research concerned with stress and coping during adolescence is reviewed, using depression as a key example of a consequence of stress and coping processes. Based on this research, it is hypothesized that exposure to and appraisals of interpersonal stress combine with aspects of biological development and the use of maladaptive coping strategies to account for the emergence of significant gender differences in depression and other forms of psychopathology during adolescence. Directions for future research in this area are highlighted.