A Comparison of the Efficacy of Acceptance and Commitment Therapy and Positive Psychotherapy on Body Image and Emotion Regulation Difficulties in Women with Body Dysmorphic Disorder: A Randomized Controlled Experimental Design with Three Groups

Abstract

Background: Body dysmorphic disorder becomes even more complicated by distorted body perception and difficulties in emotion regulation, which necessitate appropriate psychological therapies. Determining appropriate psychotherapy for these patients is still an important field with a significant research gap. Objectives: The purpose of this study was to evaluate and compare the efficacy of positive psychotherapy (PPT) and acceptance and commitment therapy (ACT) in treating women with body dysmorphic disorder. Methods: This study included a control group and was quasi-experimental. Sixty female participants with body dysmorphic disorder were randomly assigned to one of three groups (n = 60, 20 per group). To compare the groups in the study, the subjects were divided into three groups: The ACT (n = 20), PPT (n = 20), and control (n = 20). The participants comprised 60 patients with body dysmorphic disorder from the Rasta and Insight Psychotherapy Clinics, Iran Psychiatry Hospital, Arasteh Beauty Clinic, and Dr. Najmeh Ahmadi Beauty Clinic in Tehran, as well as via online announcements. There were eight sessions of PPT and eight sessions of ACT. Participants were assessed at three stages: Pre-test, post-test, and a three-month follow-up. Questionnaires on Body Image Test (BIT) and Difficulty in Emotion Regulation Scale (DERS) were utilized as outcome variables. Results: Compared to PPT and the control group, ACT was considerably more effective in improving body image and difficulties in emotion regulation in women with body dysmorphic disorder. Women with body dysmorphic disorder also reported improvements in body image and reductions in difficulties in emotion regulation after undergoing PPT. For body image, the between-subjects effect size was 0.40, and for difficulties in emotion regulation, it was 0.52. Conclusions: The findings suggest that, while the positive psychology approach can help women with body dysmorphic disorder, ACT is more effective in improving body image and difficulties in emotion regulation.