@2024 Afarand., IRAN

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ISSN: 2383-3483    Journal of Police Medicine 2019;8(1):13-19

Background
Body dysmorphic disorder (BDD) is one of the unknown disorders which is resistant to treatment.
Previous Studies
… [1]. The prevalence of BDD is 1.9% in adults, 2.2% in adolescents, 3.3% in students, 7.4% in hospitalized adult patients, 7.7% in hospitalized adolescent patients, and 8.8% in outpatient services for adults. The prevalence of BDD is 13.2% in cosmetic surgeries, 20.1% in rhinocentric surgeries, 5.2% in orthodontic/cosmetic dentistry procedures, 11.3% in outpatient dermatology, and 11.1% in acne skin clinics. In most cases, the prevalence of BDD is higher among women than men [2, 3]. … [4]. According to the latest categorization, it is suggested that the BDD and some related disorders be separately classified into obsessive-compulsive disorder class. The obsessive-compulsive class includes many psychiatric disorders, but according to the Sulkowski et al. [5] and DSM-V classification, obsessive-compulsive disorder, hoarding obsession, body dysmorphic disorder, trichotillomania, and pathological skin picking symptoms are the most important disorders. … [6, 7]. Common treatments and models are currently used to determine BDD, including the Cognitive Behavior Therapy (CBT) and new therapies such as metacognitive therapy [8]. … [9-14].
Aim(s)
The present study was conducted with the aim of preparing and investigating the effect of behavioral-cognitive-metacognitive intervention on BDD symptoms.
Research type
The present study is a single case report [13].
Research society, place and time
In this study 3 outpatient military personnel with BDD were studied in one of the counseling centers of Isfahan during the 2012 to 2013.
Sampling method and number
The patients aged 15 to 50 with at least a high school diploma and were selected based on DSM-IV-TR criteria and the proposed changes for the DSM-5 with the consent to participate.
Used devices&materials
The demographic questionnaire and the modified Yale-Brown Obsessive Compulsive Scale were used as research tools to evaluate BDD. The patient's characteristics in terms of age, gender, marital status, number of family members, educational level, parents’ educational level, previous referral to a psychiatrist or psychologist due to psychological problems and a history of drug use, and duration of the disease were assessed by the researcher-made demographic questionnaire. The Yale-Brown Obsessive Compulsive Scale for modified for BDD (YBOCS-BDD) [9]: it is a 12-item self-measurement scale measuring the severity of the symptoms of BDD. It is characterized by two-factor model (i.e. obsessions and compulsions) and two additional questions on insight and avoidance. The questions are scored on a Likert scale from totally disagree to totally agree. Phillips et al. [15] reported an appropriate reliability and re-test for this questionnaire. Its test-retest reliability was appropriate for the one-week period (r=0.88). Cronbach's alpha coefficient for the internal consistency was obtained 0.8, indicating the high internal consistency of this scale. BDD-YBOCS had a positive correlation with the Global Assessment of Functioning (GAF) scores of the DSM (r=0.51). Diagnostic validity was appropriate in comparison with the Brief Psychiatric Rating Scale (BPRS) (r=0.19) [15]. In Iran, Rabiei et al. [16] reported an appropriate validity and reliability for the Persian version of BDD-YBOCS. To observe ethical considerations, the participants were informed that they are participating in a research aiming at assessing a new therapeutic model for obsessive-compulsive symptoms. They were assured that their information is completely confidential and they are completely allowed not to participate or refuse to participate at any stage of the study. For each patient, 12 training sessions were held. The obtained results were assessed in different stages of the study and were presented separately as a figure.
Findings by Text
BDD was decreased through the training sessions and the follow-up (Fig. 1).
Main comparison to the similar studies
… [17-23]. The results of this study are consistent with the results of some other studies [5, 7, 13] in the relationship between cognitive components and BDD. The results of this study also were consistent with the results of studies by Rabaie et al. [8] and Cooper and Osman [24] in the relationship between meta-cognitive components and BDD. The cognitive model is based on the fact that the cognitive factor itself can cause disorders. It has been shown that this view can be partly incorrect, since negative cognitions can not lead to disorders and they can be observed in general public, which was first found by Rachman et al. and some other researchers [9, 11]. … [25, 26]. Wells and King [27] believe that attempts to control and eliminate negative thoughts do not reduce negative thoughts and shocks, but it can lead to failure to control thoughts and it sometimes can even increase negative thoughts.
Suggestions
It is suggested that the developed intervention be tested quantitatively and qualitatively in the controlled experimental studies on patients with BDD and, if possible, be compared with interventions in different samples.
Limitations
Using the single case report was one of the limitations of this study.
Conclusions
Behavioral-cognitive-metacognitive intervention affects severity of BDD symptoms and reduces the severity of the disease.
Acknowledgments
The authors are thankful from all who participated in this research and all who helped us with this research.
Conflict of interest
None declared.
Ethical Permissions
All participants were informed about the research objectives and procedure, and the written informed consent to participate in a behavioral-cognitive-metacognitive intervention sessions was obtained.
Funding Sources
This research has been conducted without the financial support received by any specific institution.

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