The Comparison of the Effectiveness of Cognitive Behavioral Therapy and Metacognitive Therapy on Depression, Suicide Ideation, and Masochistic Aggression in Individuals with Subclinical Symptoms of Body Dysmorphic Disorder

Background and Purpose: The most common comorbid disorder with body dysmorphic disorder (BDD) is depression. Masochistic aggression and suicide are the main concerns about individuals with BDD who suffer from depression and have impaired function. Present study aimed to compare the effectiveness of cognitive behavioral therapy (CBT) and metacognitive therapy (MCT) on depression, suicide ideation, and masochistic aggression among individuals with subclinical symptoms of BDD.  Method: This study was a quasi-experimental study with a control group pretest-posttest design. The sample included 51 girls with subclinical symptoms of BDD who had been selected with purposive sampling from a public secondary school in Tehran in the academic year 2018-2019. After being evaluated and giving the informed consent, the participants were randomly assigned to one of the two experimental groups of CBT and MCT or waiting list. The participants completed the Body Image Concern Inventory (Littleton, 2005), Beck Depression Inventory-II (Beck et al., 1996), Beck Scale for Suicide Ideation (Beck et al., 1979), and masochistic aggression subscale of Aggression Styles Inventory (Alavizadeh & et al., 2016) at the pre-test, post-test and 3 months follow-up stages. Data were analyzed by repeated-measures ANOVA in SPSS-26.  Results: Results showed that although CBT and MCT were effective in alleviating the symptoms of depression (p<0.01), suicide ideation (p<0.01) and masochistic aggression (P<0.05), CBT was more effective in decreasing depression (p<0.05). There was no significant difference between CBT and MCT in terms of their effect on suicide ideation and masochistic aggression (P<0.05). Conclusion: According to these findings, it can be concluded that CBT and MCT are effective in alleviating the mood-related symptoms in individuals with subclinical symptoms of BDD. Furthermore, the behavioral activation session can be the reason of the higher effectiveness of CBT.