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Trial registered on ANZCTR


Registration number
ACTRN12618000274279
Ethics application status
Approved
Date submitted
16/02/2018
Date registered
22/02/2018
Date last updated
8/08/2019
Date data sharing statement initially provided
29/01/2019
Date results information initially provided
8/08/2019
Type of registration
Prospectively registered

Titles & IDs
Public title
A visual training program for body dysmorphic disorder: A novel intervention trial
Scientific title
A visual training program to remediate perceptual abnormalities in body dysmorphic disorder: A novel intervention trial
Secondary ID [1] 294075 0
None
Universal Trial Number (UTN)
Trial acronym
Linked study record

Health condition
Health condition(s) or problem(s) studied:
Body dysmorphic disorder 306632 0
Condition category
Condition code
Mental Health 305735 305735 0 0
Other mental health disorders

Intervention/exposure
Study type
Interventional
Description of intervention(s) / exposure
Visual training program for body dysmorphic disorder: A novel intervention trial
Up to 20 participants diagnosed with body dysmorphic disorder (BDD) will be recruited to participate in a visual training program. The visual training program will involve three phases presented in a bottom up sequence, consisting of 1) basic visual processing, 2) face specific visual processing, and 3) self-perception. Phases 1 and 2 will be administered using computer tasks from Posit Science (Brain HQ), and phase 3 involves 'perceptual mirror retraining' activities drawn from the Cognitive-Behavioral Therapy for Body Dysmorphic Disorder manual (Phillips, Wilhelm & Steketee, 2012).
Phase 1 will be delivered during weeks 1-4 using the Posit Science computer training module. This phase will be administered in a one-on-one face-to-face consultation between the therapist and participant, where the therapist will provide instructions and answer any questions. Adherence will be monitored using feedback from posit science.
Phase 2 will be delivered during weeks 5-8 using the Posit Science computer training module. This phase will be administered in a one-on-one face-to-face consultation between the therapist and participant, where the therapist will provide instructions and answer any questions. Adherence will be monitored using feedback from posit science.
Phase 3 will be delivered during weeks 9 and 10 using perceptual mirror retraining principles. This phase will be administered in a one-on-one face-to-face consultation between the therapist and participant, where the therapist will instruct, and guide the participant through the exercise and answer any questions.
This visual training program will be presented over a series of 10 weekly sessions, with each session running for one to two hours, resulting in a total of 16.8 hours in line with recommendations from Posit Science. Participants will complete a comprehensive pre- and post-assessment, including a range of self-report questionnaires, clinical interview measures, and a full eye-tracking battery. Between each phase, participants will also complete a brief assessment to track for any change throughout the program, including a brief symptom severity measure and eye tracking task. This program will be conducted by a provisional psychologist who has received specialised training in BDD in both clinical and research-specific contexts. The provisional psychologist will be blind to all assessment results. This training program will be administered face-to-face at Swinburne University of Technology, Melbourne, Australia.
Intervention code [1] 300344 0
Treatment: Other
Intervention code [2] 300345 0
Behaviour
Comparator / control treatment
No control group
Control group
Uncontrolled

Outcomes
Primary outcome [1] 304808 0
Change in 'Body dysmorphic disorder modification of the Yale Brown Obsessive Compulsive Scale' (BDD-YBOCS) scores
Timepoint [1] 304808 0
Baseline and at 7 days post completion of intervention
Primary outcome [2] 304809 0
Changes in patterns of eye movements will be assessed using an eye tracking device
Timepoint [2] 304809 0
Baseline and at 7 days post complintervention
Primary outcome [3] 304810 0
Change in diagnostic criteria met as qualified by the Mini International Neuropsychiatric Interview (MINI), including the Body Dysmorphic Disorder Module (BDDM)
Timepoint [3] 304810 0
Baseline and at 7 days post completion of intervention
Secondary outcome [1] 343262 0
Change in 'Dysmorphic concern questionnaire' (DCQ) scores
Timepoint [1] 343262 0
Baseline (prior to commencement of treatment), weeks 4, 8, 10, and 7 days post intervention
Secondary outcome [2] 343263 0
Change in the 'memory-guided' task assessed using an eye tracking machine. In this task, participants will be asked to fixate on a cross in the centre of the screen whilst another stimulus is presented in the periphery. The stimulus will disappear after a short period and then the participant will be required to look at (make a saccade towards) where they recall the stimulus in the periphery to have appeared. Performance on this task is assessed by inhibitory error rate and eye movement parameters.
Timepoint [2] 343263 0
Baseline (prior to commencement of treatment), weeks 4, 8, 10, and 7 days post intervention
Secondary outcome [3] 343264 0
Change in 'Depression Anxiety Stress Scales' (DASS-21) scores
Timepoint [3] 343264 0
Baseline and at 7 days post completion of the intervention
Secondary outcome [4] 343265 0
Change in 'Social Interaction Anxiety Scale' (SIAS) scores
Timepoint [4] 343265 0
Baseline and at 7 days post completion of the intervention
Secondary outcome [5] 343266 0
Change in 'Body Appreciate Scale' (BAS 2) scores
Timepoint [5] 343266 0
Baseline and at 7 days post completion of the intervention
Secondary outcome [6] 343267 0
Changes in 'Mirror gazing: cognition and affect rating scale' (MG-CARS) scores
Timepoint [6] 343267 0
Baseline and at 7 days post completion of the intervention
Secondary outcome [7] 343268 0
Changes in 'Assessment of Quality of Life' (AQoL) scores
Timepoint [7] 343268 0
Baseline and at 7 days post completion of the intervention

Eligibility
Key inclusion criteria
1. between the ages of 18 to 65 years old
2. have a primary diagnosis of BDD
3. have a preferred language of English
4. are available to attend 10 weekly treatment sessions at Swinburne University, Melbourne, Australia
Minimum age
18 Years
Maximum age
65 Years
Gender
Both males and females
Can healthy volunteers participate?
No
Key exclusion criteria
1. unable to provide informed consent
2. history of neurological or eye conditions
3. lifetime diagnosis of anorexia nervosa, bulimia nervosa, substance dependence disorder, or a psychotic disorder

Study design
Purpose of the study
Treatment
Allocation to intervention
Non-randomised trial
Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
Allocation is not concealed
Methods used to generate the sequence in which subjects will be randomised (sequence generation)
Not applicable
Masking / blinding
Open (masking not used)
Who is / are masked / blinded?



Intervention assignment
Single group
Other design features
Phase
Not Applicable
Type of endpoint(s)
Efficacy
Statistical methods / analysis
Due to the innovative and novel aspects of this visual training program to be used in BDD, a single-group open label trial will be conducted. As this will be an exploratory study of the effectiveness and feasibility of the visual training program, sample size calculations were not conducted.
Repeated measures analysis of variance (ANOVA) will be conducted to compare performance on the measures used within the change tracking assessments, including the brief eye tracking measure and the DCQ. This will assess the impact each phase has upon last, by examining the participants’ eye movements and symptom severity. A one-way analysis of variance will also be performed to compare results from the pre- and post-assessments (clinical interview, self-report questionnaires and battery of eye tracking tasks), to determine the overall impact of the 10-week visual training program.

Recruitment
Recruitment status
Completed
Date of first participant enrolment
Anticipated
Actual
Date of last participant enrolment
Anticipated
Actual
Date of last data collection
Anticipated
Actual
Sample size
Target
Accrual to date
Final
Recruitment in Australia
Recruitment state(s)
VIC
Recruitment postcode(s) [1] 21562 0
3122 - Hawthorn

Funding & Sponsors
Funding source category [1] 298704 0
Government body
Name [1] 298704 0
Australian Government Research Training Program Scholarship
Address [1] 298704 0
50 Marcus Clarke St, Canberra ACT 2601
Country [1] 298704 0
Australia
Primary sponsor type
University
Name
Swinburne University of Technology
Address
John St Hawthorn VIC 3122
Country
Australia
Secondary sponsor category [1] 297873 0
None
Name [1] 297873 0
Address [1] 297873 0
Country [1] 297873 0

Ethics approval
Ethics application status
Approved
Ethics committee name [1] 299653 0
Swinburne University Human Research Ethics Committee (SUHREC)
Ethics committee address [1] 299653 0
Research Ethics Office
Swinburne Research (H68)
Swinburne University of Technology
PO Box 218
Hawthorn VIC 3122
Ethics committee country [1] 299653 0
Australia
Date submitted for ethics approval [1] 299653 0
23/11/2017
Approval date [1] 299653 0
18/12/2017
Ethics approval number [1] 299653 0
SUHREC 2017/333

Summary
Brief summary
Body dysmorphic disorder is a characterised by perceived defects or flaws in appearance which are associated with distressing thoughts, repetitive or obsessive behaviours, and significant impairment in social and occupational functioning. A core feature of BDD involves abnormalities of visual processing, although this is predominantly ignored within psychological and psychiatric treatments. While current treatments such as cognitive behavioural therapy or antidepressant medications generally show moderate effectiveness in the short-term, those with BDD can have high relapse rates, perhaps as they can see ‘see’ their flaws or defects.
The current research is a single group pilot study to trial a visual training program designed to remediate visual abnormalities and reduce symptom severity of BDD. This pilot trial will be conducted at Swinburne University of Technology, Melbourne Australia, and will involve up to 20 participants diagnosed with BDD. These participants will complete pre- and post-assessments, and a 10-week visual training program encompassing three phases of: basic visual processing, face and emotion recognition, and self-perception. These training activities will include a combination of computer and therapist-administered tasks. Outcomes include a variety of clinical interview, self-report questionnaires, and a full eye tracking battery to assess overall clinical and visual performance across time. Analyses will compare participant’s overall symptom severity and eye movements across five timepoints using repeated measures ANOVAS. Qualitative data will also be collected to assess the feasibility and efficacy of the program using thematic analysis methods.
This pilot trial will be the first of its kind to translate the empirical findings of abnormalities in visual processing among those diagnosed with BDD, to an innovative treatment method across a range of visual processing levels. This trial will additionally assess the efficacy and feasibility of such a visual training program, paving the way for additional research including future randomised control trials.
Trial website
Trial related presentations / publications
Public notes

Contacts
Principal investigator
Name 81182 0
Prof Susan Rossell
Address 81182 0
ATC916, Centre for Mental Health, Swinburne University of Technology, John Street, Hawthorn VIC 3211
Country 81182 0
Australia
Phone 81182 0
+61 3 9214 8173
Fax 81182 0
Email 81182 0
srossell@swin.edu.au
Contact person for public queries
Name 81183 0
Ms Francesca Beilharz
Address 81183 0
400B, Centre for Mental Health, Swinburne University of Technology, John Street, Hawthorn VIC 3211
Country 81183 0
Australia
Phone 81183 0
+61 3 9214 5614
Fax 81183 0
Email 81183 0
fbeilharz@swin.edu.au
Contact person for scientific queries
Name 81184 0
Ms Francesca Beilharz
Address 81184 0
400B, Centre for Mental Health, Swinburne University of Technology, John Street, Hawthorn VIC 3211
Country 81184 0
Australia
Phone 81184 0
+61 3 9214 5614
Fax 81184 0
Email 81184 0
fbeilharz@swin.edu.au

Data sharing statement
Will individual participant data (IPD) for this trial be available (including data dictionaries)?
No
No/undecided IPD sharing reason/comment
Only group results will be available, as within the consent form
What supporting documents are/will be available?
Study protocol
How or where can supporting documents be obtained?
Type [1] 1199 0
Study protocol
Citation [1] 1199 0
Link [1] 1199 0
Email [1] 1199 0
Other [1] 1199 0
https://doi.org/10.1186/s40814-018-0384-3
Attachment [1] 1199 0
Summary results
Have study results been published in a peer-reviewed journal?
No
Other publications
Have study results been made publicly available in another format?
Results – basic reporting
Results – plain English summary