None listed
Conditions
Brief summary
The primary purpose of the study is to investigate the efficacy of a pilot online 8-week cognitive behavioural therapy (CBT) program for adults with muscle dysmorphia. The outcome measures are: primary (changes in muscle dysmorphia symptoms) and secondary (changes in disordered eating, compulsive exercise, depressive symptoms, and psychological distress). There is no prior treatment research on muscle dysmorphia, but we expect participants to experience some benefit in symptoms over the course of the 8-week program.
Interventions
This intervention is a pilot online 8-week group cognitive behavioural therapy (CBT) program for adults with muscle dysmorphia living in Australia. To date, no treatment studies have been conducted in muscle dysmorphia.
The CBT program will be delivered online in a group format using Zoom with 8 90-minute weekly sessions. There is no control group for this pilot study, so it is a single-arm trial. We are aiming to recruit 8-14 participants who will be split across two treatment groups. Session
This intervention is a pilot online 8-week group cognitive behavioural therapy (CBT) program for adults with muscle dysmorphia living in Australia. To date, no treatment studies have been conducted in muscle dysmorphia. The CBT program will be delivered online in a group format using Zoom with 8 90-minute weekly sessions. There is no control group for this pilot study, so it is a single-arm trial. We are aiming to recruit 8-14 participants who will be split across two treatment groups. Session attendance checklists will be used to monitor adherence to the intervention. The initial template for the program came from the Individual Intensive Outpatient Program and Overcoming Binge Eating groups run by the Peter Beumont Eating Disorders Non-Admitted Service at RPA Hospital, which are 8- and 10-week, respectively, structured group programs for outpatients with an eating disorder. Both programs are standardised and have been running at RPA Hospital for at least the past decade. Both programs are grounded in principles of CBT and have been modified in this study for the treatment of muscle dysmorphia. The program will be facilitated by a PhD student and registered general psychologist. The study facilitator will receive weekly clinical supervision from a registered clinical psychologist throughout the 8-week program. A brief summary of the content to be covered in each weekly session is outlined below: 1 - Introduction • Group orientation • Introduction to CBT • Setting SMART goals • Introduction to CBT formulation of muscle dysmorphia 2 – Addressing strict dieting and establishing flexible eating • Dieting and restrictive eating • Calorie/protein tracking • Behavioural experiment to address food avoidance and/or challenge dietary rules 3 – Addressing compulsive exercise • Healthy vs. unhealthy exercise • Compulsive exercise • Exposure and response prevention to challenge compulsive exercise 4 – Developing alternate emotion regulation strategies • Mood intolerance • Developing alternate emotion regulation strategies to diet/exercise 5 – Building up marginalised areas of life • Overvaluation of weight/shape • Identifying overvalued/marginalised areas of life (pie chart exercise) • Overvaluation of control of weight/shape 6 – Addressing checking and avoidance behaviours • Body image • Checking behaviours and response prevention • Avoidance behaviours and graded exposure hierarchy 7 – Addressing feeling small/skinny and comparison making • Feeling small or skinny • Cognitive reappraisal of feeling small • Comparison making and associated biases • Behavioural experiment(s) to address comparison making 8 – Relapse prevention planning • Realistic expectations of recovery • Dealing with relapse and setbacks • Relapse prevention planning
Sponsors
The University of Sydney
Study design
Allocation
Non-randomised trial
Intervention model
Single group
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
• Age greater than or equal to 18 years. • Currently living in Australia. • Self-report that they think about not being big enough at least once per day (assessed on a pre-screening webpage). • Meet diagnostic criteria for MD (based on both DSM-5 and Pope et al., 1997 criteria) – assessed via a clinical diagnostic interview. • Receive a letter of medical clearance from their GP – includes blood test assessment. • Willingness to provide informed consent and attend the entire 8-week treatment program. • Access to a private space with sufficiently technology to engage in telehealth sessions (i.e., laptop or phone with video camera and stable internet connection).
Exclusion criteria
• Non-proficient English speaker. • Presence of significant medical instability (i.e., GP unable to provide a letter of medical clearance). • Active suicidality, or self-harm behaviours, or meeting clinical threshold for suicide risk – assessed via the clinical diagnostic interview and the Suicide Behaviors Questionnaire-Revised (SBQ-R) where a score greater than or equal to 7 indicates notable suicide risk in the general population. • Comorbid Major Depressive Disorder (MDD) – assessed via Patient Health Questionnaire-9 (PHQ-9) where a score greater than or equal to 10 indicates clinical depression that warrants treatment and could interfere with participation in the treatment program. • Prescribed a new psychotropic medication (e.g., SSRIs) in the past month or expects to be prescribed a new psychotropic medication at any point throughout the 8-week treatment program. • Currently involved in other active psychological treatment or plans to engage in other active psychological treatment over the course of the 8-week treatment program.
Outcome results
None listed