UNASSIGNED: To evaluate the effectiveness, cost-effectiveness and feasibility of internet-based Cognitive Behavioural Therapy (CBT) in the treatment of body dysmorphic disorder.
METHODS: The systematic review was conducted from August 19 to September 22, 2023, and comprised search on Cochrane Library, Embase, Google Scholar, PubMed, PsycINFO and Web of Science databases using specific key words for studies published in the English language from 2010 onwards. Grey literature and pertinent conference proceedings were also searched to include as many studies as possible that investigated internet-based cognitive behavioural therapy in the treatment of body dysmorphic disorder. Data extraction was done, and the selected studies were subjected to quality assessment, followed by a narrative synthesis of the findings.
RESULTS: Out of the 6,837 studies initially identified, 8(0.11%) were analysed in detail. Of the 8 studies, 4(50%) were RCTs, while 5(62.5%) had been conducted in Sweden. Therapist-guided internet-based cognitive behavioural therapy interventions consistently demonstrated efficacy with respect to reducing body dysmorphic disorder symptom severity, improving insight, and enhancing quality of life. Cost-effectiveness analyses highlighted the favourable economic aspect of internet-based cognitive behavioural therapy. Feasibility and acceptability were demonstrated by high participant engagement and satisfaction.
UNASSIGNED: Internet-based cognitive behavioural therapy showed promise in addressing the treatment gap in body dysmorphic disorder care, offering accessible, cost-effective and feasible interventions.

To understand the visual preponderance of perceived flaws in appearance in body dysmorphic disorder (BDD), the study of visual processing has been growing. Studies have focused on facial and other basic visual stimuli. The current literature does not provide evidence of consistent behavioural patterns, lacking an overarching body of work describing visual processing in BDD. This systematic review aims to characterise behavioural outcomes of visual processing anomalies and/or deficits in BDD. Articles were collected through online databases MEDLINE and PubMed, and were included if they comprised a clinical BDD group, and were published after 1990. Results indicate that individuals with BDD demonstrate deficits in emotional face processing, a possible overreliance on detail processing, aberrant eye-scanning behaviours, and a tendency to overvalue attractiveness. While findings consistently signal towards visual deficits in BDD, there is lack of clarity as to the type. This inconsistency may be attributed to heterogeneity within BDD samples and differences in experimental design (i.e., stimuli, tasks, conditions). There are difficulties distinguishing between BDD-associated deficits and those associated with OCD or eating disorders. A coherent framework, including sample characterisation and task design will seek to generate clear and consistent behavioural patterns to guide future treatments.

Body Dysmorphic Disorder (BDD) is a distressing psychological condition where an individual is preoccupied by a perceived issue with their appearance. Qualitative studies enable nuanced aspects of BDD phenomenology to be investigated. The current systematic review used thematic synthesis to integrate the findings from the extant qualitative studies. Searches were run on six databases to identify studies that had sought to describe the experience of individuals with BDD. PRISMA guidance was followed and ten articles were identified for inclusion. The quality of each article was appraised and thematic synthesis was conducted to generate novel and summative themes. Three superordinate themes were created: \'self-objectification and the view of self\'; \'control and protecting the self\'; and \'sociocultural influences and the impact of others in BDD\'. Shame and self-disgust emerged as key experiential elements of BDD. The findings of the review suggest that self-objectification theory and possibly models of self-compassion are theoretically relevant to understanding the experience of individuals presenting with BDD. Current interventions may benefit from consideration of these theoretical models when seeking to improve efficacy.

Available evidence demonstrates that individuals with body-image disturbance (BID) are prone to suffer from depression. This systematic review provides, to our knowledge, the first synthesis of the psychological mechanism of the association between BID and depression. We conducted a thorough search of online databases, including PubMed, Web of Science, and PsycINFO, for articles published up until February 2024. The final analysis comprised a total of 23 studies that focused on the mediating or moderating effects of psychological factors between depression and BID. This review identifies self-esteem and social support as both mediators and moderators of the relationship between BID and depression, while perceived stress acted only as a mediator. High self-esteem and strong social support as well as low levels of perceived stress may help individuals experience lower levels of BID, thereby contributing to a decreased likelihood of depression. Interventions aimed at increasing self-esteem, developing strong support, and decreasing perceived stress may hold promise to reduce the risk of depression in those with BID.

Body dysmorphic disorder (BDD) is a relatively common and highly impairing mental disorder that is strikingly underdiagnosed and undertreated in Child and Adolescent Mental Health Services (CAMHS). The only clinical guidelines for the management of BDD in youth were published nearly 20 years ago, when empirical knowledge was sparse. Fortunately, there has been a surge in research into BDD over the last 10 years, shedding important insights into the phenomenology, epidemiology, assessment and treatment of the disorder in young people. This review aimed to provide an overview of recent research developments of relevance to clinicians and healthcare policymakers. We summarise key findings regarding the epidemiology of BDD in youth, which indicate that the disorder usually develops during teenage years and affects approximately 2% of adolescents at any one point in time. We provide an overview of aetiological research, highlighting that BDD arises from an interplay between genetic and environmental influences. We then focus on screening and assessment strategies, arguing that these are crucial to promote detection and diagnosis of this under-recognised condition. Additionally, we summarise the recommended treatment approaches for BDD in youth, namely cognitive behaviour therapy with or without selective serotonin reuptake inhibitors. The review concludes by highlighting key knowledge gaps and priorities for future research including, but not limited to, better understanding aetiological factors, long-term consequences and treatment.

UNASSIGNED: Abnormal visual processing has been proposed as a mechanism underlying excessive focus on minor appearance flaws in body dysmorphic disorder (BDD). Existing BDD research has not differentiated the various stages of face processing (featural, first-order configural, holistic and second-order configural) that are required for higher-order processes such as emotion recognition. This study investigated a hierarchical visual processing model to examine the nature of abnormalities in face processing in BDD.
UNASSIGNED: Thirty BDD participants and 27 healthy controls completed the Navon task, a featural and configural face processing task and a facial emotion labelling task.
UNASSIGNED: BDD participants performed similarly to controls when processing global and local non-face stimuli on the Navon task, when detecting subtle changes in the features and spacing of a target face, and when labelling emotional faces. However, BDD participants displayed poorer performance when viewing inverted faces, indicating difficulties in configural processing.
UNASSIGNED: The findings only partially support prior work. However, synthesis of results with previous findings indicates that heterogenous task methodologies may contribute to inconsistent findings. Recommendations are provided regarding the task parameters that appear most sensitive to abnormalities in BDD.

BACKGROUND: We plan a scoping review aimed to synthesize what is known about the use of sensory-driven body illusion (BI) interventions for understanding and treating body image disturbance (BID) in people diagnosed with clinical eating disorders (EDs) and people with subclinical ED symptomatology. Our study will provide an outline of the current literature, identify gaps within the literature, and suggest novel directions for future research.
METHODS: The scoping review process will be guided by the methodological framework of Arksey and O\'Malley, subsequent recommendations by Levac et al., and the Preferred Reporting Items for Systematic Reviews and Meta-analysis Protocols Extension for Scoping Reviews guidelines. The following electronic databases will be systematically searched: MEDLINE (via PubMed), Web of Science, PsycINFO, and Scopus. Furthermore, to identify additional studies, we will use a search engine such as Google Scholar, and for grey literature, we will include Proquest for Dissertations and Theses. A search strategy has been identified and agreed upon by the research team in conjunction with a research librarian. Two researchers will screen the titles and abstracts independently and then assess the full text of the selected citations for the inclusion criteria. A third reviewer will be involved in cases of disagreement. Data will be extracted, collated, and charted to summarize all the relevant methods, outcomes, and key findings in the articles.
CONCLUSIONS: A better understanding of this topic will aid in the development and refinement of current treatments aimed at treating BID in people with EDs. Implications and recommendations for research, policy, and practice in the context of the ED community will be discussed.
BACKGROUND: https://osf.io/3bcm6/?view_only=83b2e8a2445d4266909992e3dfb51929.

This study aimed to review the findings on body image (BI) dissatisfaction and muscle dysmorphia (MD) in Brazilian RT practitioners and the differences in the assessment tools used. A critical review of studies with searches in PubMed, Brazilian Virtual Health Library, SciELO, PsycInfo, and SPORTDiscus databases was conducted. A total of 23 studies were included. Nine tools were used to assess BI dissatisfaction or MD: three questionnaires and six visual scales. The overall mean BI dissatisfaction was 56.5% (59.2% in men vs 57.3% in women). The mean MD was 42.4% (45.1% in women vs 38.5% in men). BI dissatisfaction and MD are related to women seeking slimness and men wanting to increase muscle mass. In conclusion, the frequency of BI was high in both sexes, and MD, when identified, was higher in women. The scales and questionnaires used differ significantly in depth and scope for the same purpose.

Body dysmorphic disorder (BDD) is characterised by a preoccupation with a perceived defect in appearance. This preoccupation results in the completion of repetitive/time consuming behaviours to reduce distress. While the disorder results in considerable distress and impairment, the prevalence of the disorder is largely unknown, as BDD has not been examined in large epidemiological studies. The aim of the current study was to provide an estimate of BDD prevalence in a variety of settings using a meta-analytic approach using only studies that have made a diagnosis using a structured diagnostic interview. Twenty-two studies met criteria (n = 7159) and the pooled point-prevalence estimate for BDD was 11.3% across all studies with high levels of heterogeneity (I2 = 95.81). The pooled point-prevalence estimate was 20.0% in cosmetic/dermatology settings, 7.4% in mental health settings, and 6.7% in \'other\' settings (including students and professional ballet dancers). The risk of bias assessment indicated questionable methodological quality in some of the included studies. While this study provides an important improvement on the existing literature there is a need to include BDD in epidemiological studies in order to have a more accurate understanding of the prevalence rate of this mental health condition in the community.

Prior reviews have shown that interventions targeting internalization of appearance standards are generally efficacious, though there is considerable heterogeneity in estimates across studies. This updated review of the literature evaluates whether efficacy estimates from RCTs systematically vary as a function of three related outcome measures (internalization, awareness, and perceived pressure regarding appearance standards).
Seven electronic databases were systematically searched from inception to February 8, 2023. The Cochrane Risk of Bias tool assessed each study\'s risk of bias. Studies included were randomized-controlled trials evaluating body image/eating disorder prevention or intervention programs targeting internalization as a focal point of treatment. Effect sizes were meta-analyzed and meta-regression analyses were conducted investigating the impact of outcome measure choice on study effect size at post-intervention and follow-up.
Thirty-seven studies (N = 4809 participants) were included. The meta-analytic findings as expected found interventions efficacious at reducing internalization post-intervention (d = -0.47, 95% CI [-0.60 to -0.34], k = 44), and at follow-up (d = -0.28, 95% CI [-0.39 to -0.17], k = 43), but also highly heterogenous (I2  = 52-67%). Operationalization of internalization moderated results at follow-up but not post-intervention timepoints, with awareness measures (compared with internalization measures) producing weaker effect sizes. Exploratory analyses found bigger effects when internalization was compared with all other measurement categories combined, suggesting possible issues with statistical power in main analyses.
Mixed present findings suggest need for further evaluation of measurement effects on efficacy, and possible caution in choice of outcome measure for internalization-based interventions.
This review provides some preliminary evidence that choice of survey measures used in randomized controlled trials can impact our judgments about whether a trial reduces the extent to which participants endorse unrealistic appearance standards. Accuracy in measurement of this efficacy of trials is crucial, given the role that internalized appearance standards play in onset and maintenance of eating disorders.
Las revisiones anteriores han demostrado que las intervenciones dirigidas a la internalización de los estándares de apariencia son generalmente eficaces, aunque existe una heterogeneidad considerable en las estimaciones entre los estudios. Esta revisión actualizada de la bibliografía evalúa si las estimaciones de eficacia de los ECA varían sistemáticamente en función de tres medidas de resultado relacionadas (internalización, conciencia y presión percibida con respecto a los estándares de apariencia). MÉTODO: Se realizaron búsquedas sistemáticas en siete bases de datos electrónicas desde su inicio hasta el 8 de febrero de 2023. La herramienta Cochrane Risk of Bias evaluó el riesgo de sesgo de cada estudio. Los estudios incluidos fueron ensayos controlados aleatorios (ECA) que evaluaron la prevención de la imagen corporal/trastornos alimentarios o programas de intervención dirigidos a la internalización como punto focal del tratamiento. Se metanalizaron los tamaños del efecto y se realizaron análisis de metarregresión que investigaron la repercusión de la elección de la medida de resultado sobre el tamaño del efecto del estudio después de la intervención y el seguimiento.
Se incluyeron treinta y siete estudios (N = 4 809 participantes). Los hallazgos metaanalíticos como era de esperarse encontraron intervenciones eficaces para reducir la internalización después de la intervención (d = -0,47, IC del 95% [-0,60 a -0,34], k = 44) y en el seguimiento (d = -0,28, IC del 95% [-0,39 a -0,17], k = 43), pero también altamente heterogéneas (I2 = 52-67%). La operacionalización de la internalización moderó los resultados en los puntos temporales de seguimiento pero no en posteriores a la intervención, y las medidas de sensibilización (en comparación con las medidas de internalización) produjeron tamaños del efecto más débiles. Los análisis exploratorios encontraron mayores efectos cuando la internalización se comparó con todas las demás categorías de medición combinadas, lo que sugiere posibles problemas con el poder estadístico en los análisis principales. DISCUSIÓN: Los hallazgos actuales mixtos sugieren la necesidad de una evaluación adicional de los efectos de la medición sobre la eficacia, y la posible precaución en la elección de la medida de resultado para las intervenciones basadas en la internalización.