Internet‐based interpretation bias modification for body dissatisfaction: A three‐armed randomized controlled trial.

Objective: Appearance‐related interpretation bias is postulated to play a role in the maintenance of body dissatisfaction (BD), a risk factor for body dysmorphic disorder (BDD), and eating disorders (ED). Cognitive bias modification for interpretation (CBM‐I) has been shown to reduce maladaptive interpretation bias and symptoms in various emotional disorders. This study investigated the acceptability and efficacy of an easily disseminable, web‐based CBM‐I program for BD. Methods: Individuals with high BD (N = 318) were randomized to a multi‐session CBM‐I (Sentence Word Association Paradigm [SWAP] with feedback) vs. control (SWAP without feedback) versus waitlist condition. Interpretation bias, BD and associated symptoms were assessed at baseline and post‐intervention. Symptoms were monitored up to 1‐week and 4‐week follow‐up. We further investigated transference effects to stress reactivity, as predicted by cognitive‐behavioral models, at post‐intervention. Results: Appearance‐related CBM‐I led to a differential pre–post increase in adaptive interpretation patterns, particularly for appearance‐related and social situations (d = 0.65–1.18). Both CBM‐I and control training reduced BD, BDD symptom severity, and depression. However, CBM‐I (vs. control and waitlist) improved appearance‐related quality of life (d = 0.51), self‐esteem (d = 0.52), and maladaptive appearance‐related beliefs (d = 0.47). State stress reactivity was overall reduced in the CBM‐I condition (vs. waitlist). Intervention effects largely held stable up to follow‐ups. Treatment satisfaction was comparable to other CBM‐I studies, with low rates of adverse reactions. Discussion These findings support assumptions of cognitive‐behavioral models for BD, BDD, and ED, and suggest that web‐based CBM‐I is an efficacious and acceptable intervention option. [ABSTRACT FROM AUTHOR]