In the Clinical Psychology and Psychotherapy Working Unit, we are interested in the development and maintenance of psychological disorders and their successful treatment with psychotherapeutic interventions. Our focus is on body dysmorphic disorder and other body image disorders as well as obsessive-compulsive disorders.

Our research questions include above all

  • Phenomenology
  • Etiological and maintaining factors
  • Development and evaluation of cognitive-behavioral treatment approaches
  • Stigma, treatment barriers, and help-seeking behavior
  • Application of internet-based and technology-based surveys and interventions

Current research

Phenomenology, Etiology and Maintenance

Numerous people are more or less dissatisfied with their appearance. Why do some of them develop body dysmorphic disorder? We study the development and causes of an excessive preoccupation with perceived physical flaws, for example the impact of emotional and cognitive factors (e.g. conviction, self-esteem) as well as behaviors (e.g. repeated mirror gazing).

  • Selected publications

    Kuck, N., Cafitz, L., Bürkner, P.-C., Hoppen, L., Wilhelm, S., & Buhlmann, U. (2021). Body dysmorphic disorder and self-esteem: A meta-analysis. BMC Psychiatry, 21(1), 310.

    Schulte, J., Dietel, F. A., Wilhelm, S., Nestler, S., & Buhlmann, U. (2021). Temporal dynamics of insight in body dysmorphic disorder: An ecological momentary assessment study. Journal of Abnormal Psychology, 130(4), 365–376.

    Möllmann, A., Hunger, A., Schulz, C., Wilhelm, S., & Buhlmann, U. (2020). Gazing rituals in body dysmorphic disorder. Journal of Behavior Therapy and Experimental Psychiatry, 68, 101522.

    Möllmann, A., Hunger, A., Dusend, C., van den Hout, M., & Buhlmann, U. (2019). Gazing at facial features increases dissociation and decreases attractiveness ratings in non-clinical females – A potential explanation for a common ritual in body dysmorphic disorder. PLOS ONE, 14(7), e0219791.

Cognitive Biases

A specific etiological factor in the development and maintenance of mental disorders are cognitive biases such as interpretation attentional biases. We investigate to what extent such cognitive biases exist in body image disorders and obsessive-compulsive disorders and whether they can be modified by training (so-called cognitive bias modification).

  • Selected publications

    Dietel, F. A., Möllmann, A., Bürkner, P.-C., Wilhelm, S., & Buhlmann, U. (2021). Interpretation Bias Across Body Dysmorphic, Social Anxiety and Generalized Anxiety Disorder—A Multilevel, Diffusion Model Account. Cognitive Therapy and Research, 45(4), 715–729.

    Dondzilo, L., Dietel, F. A., Buhlmann, U., & MacLeod, C. (2021). The role of biases in the judgement processing of (un)attractive faces in body dysmorphic symptomatology. Behaviour Research and Therapy, 144, 103919.

    Dietel, F. A., Zache, C., Bürkner, P.-C., Schulte, J., Möbius, M., Bischof, A., Wilhelm, S., & Buhlmann, U. (2020). Internet-based interpretation bias modification for body dissatisfaction: A three-armed randomized controlled trial. International Journal of Eating Disorders, 53(6), 972–986.

    Dusend, C., De Putter, L. M. S., Koster, E. H. W., Dietel, F. A., & Buhlmann, U. (2019). Does Modification of Implicit Associations Regarding Contamination Affect Approach Behavior and Attentional Bias? Cognitive Therapy and Research, 43(4), 693–704.

    Dietel, F. A., Möbius, M., Steinbach, L., Dusend, C., Wilhelm, S., & Buhlmann, U. (2018). Effects of induced appearance-related interpretation bias: A test of the cognitive-behavioral model of body dysmorphic disorder. Journal of Behavior Therapy and Experimental Psychiatry, 61, 180–187.

Intervention and prevention research in randomized controlled and naturalistic settings

To improve treatment for affected individuals, interventions and prevention approaches are being developed and evaluated in various projects.

In addition to our ongoing psychotherapeutic work in our special outpatient clinic for body dysmorphic disorder (, we are currently conducting, among other things, a study to evaluate the German version of BDD-NET, an internet-based cognitive behavioral therapy for body dysmorphic disorder. This program was developed by colleagues at the Karolinska Institute of Stockholm and has already been evaluated internationally. For more information on BDD-NET (only available in German):

  • Selected Publications

    Kuck, N., Dietel, F. A., Nohr, L., Vahrenhold, J., & Buhlmann, U. (2022). A smartphone app for the prevention and early intervention of body dysmorphic disorder: Development and evaluation of the content, usability, and aesthetics. Internet Interventions, 28, 100521.

    Meier, M., Jansen, K., Summers, B. J., Dreier, M. J., Farrell, N. R., & Buhlmann, U. (2022). Using Network Theory for Psychoeducation in Eating Disorders. Cognitive Therapy and Research, 46(1), 133–145.

    Hoppen, L. M., Kuck, N., Bürkner, P.-C., Karin, E., Wootton, B. M., & Buhlmann, U. (2021). Low intensity technology-delivered cognitive behavioral therapy for obsessive-compulsive disorder: A meta-analysis. BMC Psychiatry, 21(1), 322.

    Drüge, M., Buhlmann, U., Dietel, F. A., Hansmeier, J., Jäger, A., Dworakowski, O., Rück, C., Enander, J., & Watzke, B. (2021). BDD-NET – Ein internetbasiertes Programm bei Körperunzufriedenheit zur niedrigschwelligen Behandlung der körperdysmorphen Störung für den deutschen Sprachraum. Verhaltenstherapie, 1–10.

    Rupp, C., Gühne, D., Falke, C., Doebler, P., Andor, F., & Buhlmann, U. (2020). Comparing effects of detached mindfulness and cognitive restructuring in obsessive-compulsive disorder using ecological momentary assessment. Clinical Psychology & Psychotherapy, 27(2), 193–202.

    Rupp, C., Jürgens, C., Doebler, P., Andor, F., & Buhlmann, U. (2019). A randomized waitlist-controlled trial comparing detached mindfulness and cognitive restructuring in obsessive-compulsive disorder. PLOS ONE, 14(3), e0213895.

Stigma, treatment barriers and help-seeking behavior

Many people with mental disorders do not receive adequate treatment for their symptoms. We primarily investigate individual factors that influence help-seeking behavior of individuals with mental disorders, for example, understanding of the illness and stigma.

  • Selected publications

    Nohr, L., Ruiz, A. L., Ferrer, J. E. S., & Buhlmann, U. (2021). Mental health stigma and professional help-seeking attitudes a comparison between Cuba and Germany. PLOS ONE, 16(2), e0246501.

    Deres, A. T., Bürkner, P.-C., Klauke, B., & Buhlmann, U. (2020). The role of stigma during the course of inpatient psychotherapeutic treatment in a German sample. Clinical Psychology & Psychotherapy, 27(2), 239–248.

    Schulte, J., Schulz, C., Wilhelm, S., & Buhlmann, U. (2020). Treatment utilization and treatment barriers in individuals with body dysmorphic disorder. BMC Psychiatry, 20(1), 69.