Two-year follow-up of behavioral treatment and maintenance for body dysmorphic disorder.
A short six-month upkeep plan after CBT halves relapse and keeps anxiety low two years out for adults with body dysmorphic disorder.
01Research in Context
What this study did
Zeiler (1999) tracked adults with body dysmorphic disorder for two years. After an intense course of behavioral therapy, half the group entered a six-month maintenance program. The rest received no extra care.
The team then compared relapse, anxiety, and depression at 24 months.
What they found
People who got the six-month program had fewer symptoms and less anxiety and depression two years later. Both groups kept the big gains they made in therapy, but the maintenance group held on better.
How this fits with other research
Bauman et al. (1996) saw the same 18-month hold for adults with fear of blushing, sweating, or trembling, yet they gave no extra sessions. Their gains stuck without a formal upkeep plan.
That looks like a clash, but the key is length. A et al. stopped checking at 18 months; D kept going to 24. The extra half-year is when slippage showed up, making the maintenance plan pay off.
Gershkovich et al. (2017) later moved the model online. Internet CBT for social anxiety still worked, and brief therapist texts only cut drop-out, not symptoms. The core lesson is the same: solid CBT plus some contact keeps adults with anxiety on track.
Why it matters
If you run CBT for adults with body image or other anxiety issues, plan a six-month taper with monthly check-ins. One booster session a month can spare you a full relapse hunt later.
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02At a glance
03Original abstract
Recent research has suggested that body dysmorphic disorder (BDD) is part of the obsessive-compulsive compulsive spectrum of disorders. As such, it has been hypothesized that these disorders respond in a similar manner to obsessive-compulsive disorder when behavioral interventions are used. A continuation of follow-up was conducted with a group of patients with BDD following treatment. Ten patients completed an intensive behavioral therapy program and either participated in a 6-month maintenance program or served as controls. At 12-, 18-, and 24-month follow-up assessments, patients participating in the maintenance program were more effective at managing limited symptom return and had significantly lower anxiety and depression. Both groups remained improved for acute symptomatology and behavioral avoidance. The results suggest that maintenance programs following behavioral treatment are effective in preventing symptom relapse and assist in patient self-management of lapses typically associated with BDD.
Behavior modification, 1999 · doi:10.1177/0145445599234006