ORIGINAL ARTICLE
Effectiveness of acceptance and commitment therapy in improving interpersonal problems, quality of life, and worry in patients with body dysmorphic disorder
 
More details
Hide details
1
Ma, Clinical Psychology, Islamic Azad University, Rasht branch, Rasht, Iran
Online publish date: 2018-07-15
Publish date: 2018-12-28
 
Electron J Gen Med 2019;16(1):em105
KEYWORDS
ABSTRACT
Background:
Body dysmorphic disorder (BDD) is a relatively common yet understudied disorder of perceived flaws in one’s appearance.

Aims:
To evaluate the effectiveness of acceptance and commitment therapy (ACT) in improving interpersonal problems, quality of life, and worry in patients with BDD.

Methods:
This was a single-case research with multiple baseline design. Six eligible cases were recruited from among the clients of a cosmetic center in Tehran city during 2015–16. Yale-Brown Obsessive Compulsive Scale modified for Body Dysmorphic Disorder, the Inventory of Interpersonal Problems, WHOQOL-BREF, and the Penn State Worry Questionnaire were used for data collection. The intervention included 8 weekly sessions of acceptance and commitment therapy. Data were collected before intervention, after 4th session, after intervention, and 3-month follow-up. Descriptive statistics was used for data analysis by using SPSS 22.

Results:
Mean score for interpersonal problems decreased from 65 at pre-intervention to 39 at 3-month follow-up, and that for worry decreased from 59 to 33. All domains of quality of life increased at 3-month follow-up compared with pre-intervention: physical domain increased from 41 to 75, psychological domain from 36 to 72, social domain from 32 to 75, and environment domain from 41 to 73.

 
REFERENCES (36)
1.
American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders, 5th, DSM-5, 2013.
 
2.
Sadock BJ, Sadock VA. Kaplan and Sadock’s Synopsis of Psychiatry: Behavioral Sciences/Clinical Psychiatry. 2011.
 
3.
Otto UV, Wilhelm S, Chohen LS, et al. Prevalence of body dysmorphic disorder in a community sample of women. Am J Psychiatry. 2001;158-206;1-3.
 
4.
Erica L. The relationship between body dysmorphic disorder and depression, self-esteem, somatization and obsessive compulsive disorder. J Clin Psychology. 2011;15-26.
 
5.
Sarwer DB, Crerand CE. Body image and cosmetic medical treatments. Body Image. 2004;1(1):99-111. https://doi.org/10.1016/S1740-....
 
6.
Fath N, Azadfallah P, Rasolzadeh S, et al. Validity and reliability inventory of interpersonal problems. Jur clin psychol. 2013;5(3). [Persian].
 
7.
Simanowitz V, Pearce P. Personality and development. Uk:MC Grow-Hill. 2003.
 
8.
Sayad S, Zargar Y, Besaknejad S. Efficacy cognitive behavioral therapy on body dysmorphic disorder in daughter student. Res Behavior. 2010;8-34.
 
9.
Basaknejad S, Ghafari M. Relation between body dysmorphic concern and psychological disorders in Students of university, Journal of Behavior Science Research Center. 2007;1(2):179-87. [Persian].
 
10.
Rafiee M. The relationship between quality of life and job satisfaction of faculty at Sharif University. Journal of Research and Planning in Higher Education. 2003;48:72-80. [Persian].
 
11.
Cuhandaoglu F. Self-esteem and quality of life in adolescents with body dysmorphic disorder in Turkey. (Dissertation). Ankara: Hacettepe uni. 2006.
 
12.
Albertiny MM, Malters C, Philips KA. Psychological and quality of life in adolescent with body dysmorphic disorder behavior. Psychiatry Res. 2010;4(2):53-143.
 
13.
Hazlett-Stevens H. Psychological approaches to generalized anxiety disorder: A clinician’s guide to assessment and treatment. New York: Springer Verlag. 2008. https://doi.org/10.1007/978-0-....
 
14.
Hong RY. Worry and rumination: Differential associations with anxious and depressive symptoms and coping behavior. Behavior Research and Therapy. 2007;45(4):227-290. https://doi.org/10.1016/j.brat....
 
15.
Hughes ME, Alloy LB, Cogswell A. Repetitive thought in psychopathology: The relation of rumination and worry to depression and anxiety symptoms. J Cogn Psychother. 2008;22(3):271-289. https://doi.org/10.1891/0889-8....
 
16.
Veal D. Cosmetic rhinoplasty in body dysmorphic disorder. Br J Plast Sur. 2003;56(6):546-551. https://doi.org/10.1016/S0007-....
 
17.
Hayes SC, Strosahl K, Wilson KG. Acceptance and commitment therapy. An experimental approach to behavior Change. New York: Guillford press. 1999.
 
18.
Hayes SC, Luoma JB, Bond FW, et al. Acceptance and Commitment therapy: model, processed and outcomes. Behav Res Therapy. 2006;44(1):1-25. https://doi.org/10.1016/j.brat....
 
19.
Hayes SC, Strosahal KD. A practical Guide to Acceptance and commitment Therapy. New York: springer science and Business media Inc. 2010.
 
20.
Blakledge JT, Hayes SC. Emotion regulation in acceptance and commitment therapy. J Clin Psychol. 2001;57(2):243-255. https://doi.org/10.1002/1097-4...<243::AID-JCLP9>3.0.CO;2-X.
 
21.
Habibollahi A, Soltanizadeh M. Efficacy acceptance and commitment therapy on body evaluation in girl adolescents with body dysmorphic disorder. J Mazandaran Uni Medsci. 2016;25(134):278-290. [Persian].
 
22.
Linde J, Ruck C, Bjureberg J, et al. Acceptance-Based Exposure Therapy for body dysmorphic disorder: A pilot study. Behav Ther. 2015;46(4):423-431. https://doi.org/10.1016/j.beth....
 
23.
Forman EM, Butrun ML, Hoffman KL, et al. An open trial of an acceptance-based behavioral treatment for weight loss. Cogn Behav Pract. 2009;16(2):223- 235. https://doi.org/10.1016/j.cbpr....
 
24.
Phillips KA, Hollander E, Rasmussen SA, et al. Severity rating scale for body dysmorphic disorder: development, reliability and validity of a modified version of the Yale-Brown obsessive compulsive scale. Psychopharmacol Bull. 1997;33(1):17-22.
 
25.
Rabiee M, Khoramdel K, Kalantari M, et al. Factor structure, validity and reliability of the modified yale-brown obsessive compulsive scale for body dysmorphic disorder in students. Psychiatry Clin Psychol. 2010;15(4):343-350 [ Persian].
 
26.
Barkham M, Hardy GE, Startup M. The IIP-32: A short version of the inventory of interpersonal problems. Br J Clin Psychol. 1996;35(1):21-35. https://doi.org/10.1111/j.2044....
 
27.
Dehshiri GH, Golzari M, Borjali A, et al. Psychometric properties of the Farsi version of the Penn state worry questionnair in student. Jur Clin Psychol. 2009;1(4).
 
28.
Skevington SM, Lotfy M, O’Connell KA. WHOQOL Group. The world Health organization’s WHOQOL–BREF quality of life assessment: psychometric properties and results of the WHOQOL Group. Qual Life Res. 2004;13:299-310. https://doi.org/10.1023/B:QURE....
 
29.
WHOQOL Group. Development of the world health organization WHOQOL-BREF quality of life assessment. Psychol Med. 1998;28:551-558. https://doi.org/10.1017/S00332....
 
30.
Vowles K, Sorrell JT. Life with chronic pain: An acceptance-based approach therapist guide and patient work book. 2007.
 
31.
Codd RT, Twohig MP, Crosby JM, et al. Treatment of three anxiety disorder cases with acceptance and commitment therapy in a private practice. J Cogn Psychother. 2011;25(3):203-17. https://doi.org/10.1891/0889-8....
 
32.
Rajabi, GR, Imani M, Khojastehmehr R, et al. Review performance-based acceptance and commitment therapy based on an integrated behavioral marital therapy and marital concerns women have martial turmoil and generalized anxiety disorder. Research and behavioral Sciences. 2013;11(6): 600-619.
 
33.
Kahel KG, Winter L, Schweiger U. The third wave of cognitive behavioural therapies: what is new and what is effective? Curr Opin Psychiatry. 2012;25(6):522-528. https://doi.org/10.1097/YCO.0b....
 
34.
Mohabbat-Bahar S, Maleki-Rizi F, Akbari ME, et al. The effectiveness of group psychotherapy based on acceptance and commitment on quality of life in women with breast cancer. Thought & Behavior in clinical psychology. 2015;9(34):17-26.
 
35.
Hayes SC. Acceptance and commitment therapy, relation frame theory, and the third wave of behavioral and cognitive therapies. Behav Ther. 2004;35(4):639-665. https://doi.org/10.1016/S0005-....
 
36.
Hayes SC, Lillis J. Acceptance and commitment therapy (theories of psychotherapy). USA: American psychological Association. 2012.
 
eISSN:2516-3507