About this trial

A core symptom of body dysmorphic disorder (BDD) is perceptual distortions for appearance, which contributes to poor insight and delusionality, limits engagement in treatment, and puts individuals at risk for relapse. Results from this study will provide a comprehensive mechanistic model of brain, behavioral, and emotional contributors to abnormal perceptual processing, as well as how malleable it is with visual modulation techniques. This will lay the groundwork for next-step translational perceptual retraining approaches.

Eligibility criteria

This trial accepts healthy volunteers

Qualifiers

males or females

ages 18-40

meet Diagnostic and Statistical Manual-5 (DSM-5) criteria for Body Dysmorphic Disorder

have a Body Dysmorphic Disorder version of the Yale-Brown Obsessive-Compulsive Disorder Scale (BDD-YBOCS) score of ≥20

Disqualifiers

concurrent major Axis I disorders including substance use disorders, aside from anxiety disorders or depressive disorders, as these comorbidities are very common and the sample would otherwise be non-representative; however BDD must be the primary diagnosis.

lifetime: bipolar disorder or psychotic disorder.

psychotropic medications, aside from a short half-life sedative/hypnotic for insomnia, or a short half-life benzodiazepine as needed for anxiety but not exceeding a frequency of 3 doses in one week and not to be taken on the days of the training or MRI scan

current cognitive-behavioral therapy

Trial design

Design model

Parallel

Treatments tested in this trial

attentional modulation
Behavioral
Attentional instructions when viewing faces will be given
perceptual modulation
Other intervention
Faces will be presented of varying durations
naturalistic viewing
Other intervention
Faces will be viewed without specific instructions

Treatment groups

146 Participants

are divided into 3 treatment groups

Group A: attention modulationExperimental treatment 1 intervention

Group B: perceptual modulationExperimental treatment 1 intervention

Group C: naturalistic viewingExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

Face inversion effect

In a force-choice recognition task, participants will view sets of upright target faces followed by 2 upright selection faces, and sets of inverted target faces followed by 2 inverted selection faces. Participants will be instructed to select one of the two faces that is the same as the target face, as quickly and as accurately as possible. The dependent variable is the difference in response times for upright vs. inverted faces.

Time frame

Baseline

2

Brain connectivity and activation in the dorsal and ventral visual stream

Investigators will obtain functional magnetic resonance imaging (fMRI) data while participants view photographs of one's face. After preprocessing and analysis investigators will be able to determine: a) baseline associations between brain activity and connectivity and global/ local processing (face inversion effect), and b) associations between changes in brain activity and connectivity with changes in global/local processing (face inversion effect)

Time frame

Baseline

3

Eye gaze behavior

Investigators will use eye-tracking for behavioral assessments related to viewing photos of one's face. The primary dependent variable will be mean fixation duration, defined as the mean time that eye gaze is limited to one area (using k-means clustering) across the total viewing duration. We will use an eye-tracker camera to collect data while individuals view photos of one's face. Each face will be 3.5 sec.

Time frame

Baseline

4

Emotional valence

Investigators will use automated facial emotional recognition software to calculate valence based on the activity of specific facial landmarks automatically read from video capture of participants while viewing one's own face. The data will be collected simultaneously with the eye-tracking data collection while viewing own faces. The dependent variable of emotional is calculated as the mean, across the entire face viewing, of the intensity of positive emotional expressions minus the intensity of the negative expression with the highest intensity.

Time frame

Baseline

Secondary outcomes

1

The body dysmorphic version of the Yale-Brown Obsessive-Compulsive Scale 0-48 values higher score= worse outcome

This is the most widely used scale to measure BDD symptom severity cross-sectionally, and as a measure of symptom change in treatment studies. It is a clinician-rated scale that consists of 12 items assessing appearance-related obsessions, compulsive behaviors, insight, and avoidance.

Time frame

Baseline

2

The Brown Assessment of Beliefs Scale 0-24 values higher score= worse outcome

This clinician-rated scale assesses insight and delusionality related to specific beliefs. It consists of six items that probe one's convictions about their beliefs, if others' agree with their beliefs, attempts to disprove their beliefs, and if their beliefs have psychological or psychiatric causes.

Time frame

Baseline

3

Body Image States Scale 1-9 values higher the score= better outcome

This scale consists of six items to assess domains of current body experiences

Time frame

Baseline

4

Change in the body dysmorphic version of the Yale-Brown Obsessive- Compulsive Scale 0-48 values higher score= worse outcome

This is the most widely used scale to measure BDD symptom severity cross-sectionally, and as a measure of symptom change in treatment studies. It is a clinician-rated scale that consists of 12 items assessing appearance-related obsessions, compulsive behaviors, insight, and avoidance.

Time frame

7-10 days after baseline

Perceptual Abnormalities and Their Malleability in BDD

About this trial

Eligibility criteria

Qualifiers

Disqualifiers

Trial design

Treatments tested in this trial

Treatment groups

Trial outcomes

Primary outcomes

Secondary outcomes

Other outcomes

Sponsors and contacts