Development and evaluation of an acceptance-facilitating intervention for an internet-based cognitive behavioral self-esteem training for adults with body dysmorphic symptoms

Abstract

BackgroundVarious barriers contribute to low treatment rates in Body Dysmorphic Disorder (BDD). While internet-based intervention is considered a low-threshold option and shows efficacy, studies report acceptance deficits. We first tested predictors of the Unified Theory of Acceptance and Use of Technology for acceptance and secondly evaluated an acceptance-facilitating intervention for an internet-based self-esteem training addressed to individuals with BDD symptoms. MethodWe randomly assigned 110 participants with distinct BDD symptoms to a 6-min animated whiteboard video (n = 50) or a waiting control group (n = 60) before offering them internet-based training. ResultsAcceptance was good before the intervention (87% with moderate/high scores). Performance expectancy, social influence and slightly effort expectancy predicted baseline acceptance (R2 = 0.70). The acceptance-facilitating intervention led to greater improvements of performance expectancy and facilitating conditions compared to the control group. Higher self-reported acceptance was associated with training uptake and higher adherence. DiscussionIn particular, performance expectancy, but also social influence seemed to be valid predictors of acceptance of web-based BDD treatment. The results suggest that a specifically designed, brief video improves acceptance-facilitating factors. Subject to review, the potential benefit of an acceptance-facilitating intervention may be to enhance treatment rates in BDD.