Sabine Wilhelm, Ph.D., is a Professor at Harvard Medical School (HMS), Donovan-Chien Family Professor in the Field of Psychology at Harvard Medical School, Chief of Psychology at Massachusetts General Hospital (MGH), Director of the Center for Obsessive Compulsive and Related Disorders (CORD) at MGH, and Director of the Center for Digital Mental Health in Psychiatry at MGH. Dr. Wilhelm is recognized as a leading researcher in obsessive-compulsive and related disorders (OCRD). Her recent research focuses on using cutting-edge technology to improve and personalize mental health care for a range of mental health concerns. She is currently working on the development and testing of smartphone-based treatments for OCD, depression, and body dysmorphic disorder. Her ultimate goal is to use technology-based interventions to enhance global access to high-quality mental health interventions. Dr. Wilhelm has published 342 papers and chapters, as well as nine books. She has also given around 300 talks on these subjects, locally, nationally, and internationally. Dr. Wilhelm has mentored more than 50 junior investigators in the field. She has been the principal investigator of numerous NIMH-and foundation funded clinical research grants investigating medication, cognitive-behavioral therapy, digital services, and other treatments for a range of psychiatric disorders in children and adults.Dr. Wilhelm is the Chair of the Scientific Advisory Board of the International OCD Foundation. She serves on the Scientific Council for the Anxiety and Depression Association of America and the Tourette Syndrome Association Behavioral Science Consortium. She is the past president of the Association for Behavioral and Cognitive Therapies (ABCT) and was an Associate Editor for the journals Depression and Anxiety and Behavior Therapy. Dr. Wilhelm currently serves on seven editorial boards. She was the Scientific Program Chair of the World Congress of Behavioral and Cognitive Therapies held in Boston in June 2010. Additionally, Dr. Wilhelm is a fellow of the Association for Psychological Science. Dr. Wilhelm received many awards for her work, including the distinguished Aaron T. Beck Award from the Academy of Cognitive Therapy. She was also awarded the Peter K. Ranney Innovation Award from the World Medical Innovation Forum and she is the recipient of the 2023 NAMI Scientific Research Award.
The Journal of nervous and mental disease, Jan 17, 2016
Body dysmorphic disorder (BDD) and obsessive compulsive disorder (OCD) are associated with elevat... more Body dysmorphic disorder (BDD) and obsessive compulsive disorder (OCD) are associated with elevated depression, suicidality, functional impairment, and days housebound, yet little research has identified risk factors for these outcomes. Using path analysis, the present study examined anxiety and shame as risk factors for these outcomes across Internet-recruited self-report groups (BDD [n = 114], OCD [n = 114], and healthy control [HC; n = 133]). Paths from anxiety and shame to outcomes were similar and mostly significant across BDD and OCD, compared to non-significant paths for HCs, with one exception: the path from shame to depression was significant in the BDD group (b = 0.32) but non-significant in the OCD group (b = 0.07). Findings underscore similarities in BDD and OCD, supporting their reclassification into the same Obsessive Compulsive Related Disorders category. Results emphasize the importance of targeting shame, in addition to anxiety, in treatments for BDD and OCD.
Background Preliminary research suggests that a mindfulness-based treatment approach may be benef... more Background Preliminary research suggests that a mindfulness-based treatment approach may be beneficial for adults with tic disorders. In the present study, we report on the feasibility, acceptability, safety, and symptomatic effect of a novel online mindfulness-based group intervention for adults with Tourette syndrome or persistent tic disorder. Data from this study will directly inform the conduct of a funded randomized controlled trial comparing the efficacy of this intervention to another active psychological intervention. Methods One cohort of adults with Tourette syndrome participated in an 8-week online mindfulness-based group intervention. Measures of feasibility, acceptability, and safety were administered throughout and at posttreatment. Self-reported measures of mindfulness and clinician-rated measures of tic severity and impairment were administered at baseline and posttreatment. Results Data on refusal, dropout rate, attendance, participant satisfaction, and safety sugg...
Background Although effective treatments are available, most individuals with body dysmorphic dis... more Background Although effective treatments are available, most individuals with body dysmorphic disorder (BDD) do not receive an appropriate diagnosis or treatment. We aimed to examine treatment utilization and barriers to treatment, and to identify associated socio-demographic and clinical characteristics. Methods German individuals completed an online self-report survey of appearance concerns. A sample of N = 429 individuals met criteria for BDD. We examined the frequency of treatment utilization and barriers, analyzed comparisons between treated and untreated individuals and assessed the relationships of socio-demographic and clinical features with mental health treatment utilization and treatment barriers, respectively. Results Only 15.2% of the individuals with BDD had been diagnosed with BDD, and lifetime rates of mental health treatment were low (39.9%). Individuals endorsed multiple barriers to mental health treatment, especially shame, low perceived need and a preference for ...
Current approaches to psychiatric assessment are resource-intensive, requiring time-consuming eva... more Current approaches to psychiatric assessment are resource-intensive, requiring time-consuming evaluation by a trained clinician. Development of digital biomarkers holds promise for enabling scalable, time-sensitive, and cost-effective assessment of both psychiatric diagnosis and symptom change. The present study aimed to identify robust digital biomarkers of diagnostic status and changes in symptom severity over ~2 weeks, through re-analysis of public-use actigraphy data collected in patients with major depressive or bipolar disorder and healthy controls. Results suggest that participants’ diagnostic group status (i.e., mood disorder, control) can be predicted with a high degree of accuracy (predicted correctly 89% of the time, kappa = 0.773), using features extracted from actigraphy data alone. Results also suggest that actigraphy data can be used to predict symptom change across ~2 weeks (r = 0.782, p = 1.04e-05). Through inclusion of digital biomarkers in our statistical model, w...
ObjectivesCognitive–behavioural therapy (CBT) has been shown to be an effective treatment for bod... more ObjectivesCognitive–behavioural therapy (CBT) has been shown to be an effective treatment for body dysmorphic disorder (BDD), but access to treatment around the world is limited. One way to increase access is to administer CBT remotely via the internet. This study represents the first effort to remotely deliver a therapist-supported, internet-based CBT treatment with no restrictions on enrolment based on geographical location, and it aims to assess whether this treatment can be delivered safely across international borders, with outcomes comparable to previous BDD-NET trials.DesignUncontrolled clinical trial.ParticipantsPatients (n=32) in nine different countries were recruited primarily through internet advertisements.InterventionBDD-NET is a 12-week treatment, consisting of eight treatment modules previously shown to be effective in a Swedish version.SettingTherapists based at a single, secondary care centre in Sweden provided active guidance and feedback throughout the treatment ...
Journal of child and adolescent psychopharmacology, 2018
The study examined clinical correlates of quality of life (QoL), impact of treatment on QoL, and ... more The study examined clinical correlates of quality of life (QoL), impact of treatment on QoL, and predictors of QoL change among children with obsessive-compulsive disorder (OCD). One hundred forty-two children with primary OCD who were enrolled as part of a larger clinical trial participated. Children were administered a structured diagnostic interview, as well as clinician-administered measures of OCD and depression symptom severity. Children and parents completed reports of QoL, as well as measures of impairment and internalizing and externalizing symptoms. Youth received 10 sessions of family-based cognitive-behavioral therapy (CBT). At baseline, QoL was inversely related to obsessive-compulsive symptom severity, impairment, externalizing and internalizing symptoms, and severity of depression symptoms according to children and parents. After CBT, QoL improved according to parent ratings, but not child ratings. None of the predictors examined were associated with changes in QoL sc...
Journal of the American Academy of Child and Adolescent Psychiatry, 2018
Insight in obsessive-compulsive disorder (OCD) refers to patients' recognition that their obs... more Insight in obsessive-compulsive disorder (OCD) refers to patients' recognition that their obsessions and compulsions are symptoms rather than necessary or natural thoughts and behaviors. It has been estimated that 20% to 45% of youth with OCD exhibit poor or absent insight. Identified correlates of poor insight include younger age, increased OCD severity, impairment, and family accommodation; lower intellectual and adaptive functioning; and greater depressive symptoms. Poorer insight has also been associated with reduced response across treatment groups (ie, selective serotonin reuptake inhibitor [SSRI], cognitive behavioral therapy [CBT], combined SSRI plus CBT, or pill placebo)..
To examine the internal consistency and distribution of the Yale Global Tic Severity Scale (YGTSS... more To examine the internal consistency and distribution of the Yale Global Tic Severity Scale (YGTSS) scores to inform modification of the measure. This cross-sectional study included 617 participants with a tic disorder (516 children and 101 adults), who completed an age-appropriate diagnostic interview and the YGTSS to evaluate tic symptom severity. The distributions of scores on YGTSS dimensions were evaluated for normality and skewness. For dimensions that were skewed across motor and phonic tics, a modified Delphi consensus process was used to revise selected anchor points. Children and adults had similar clinical characteristics, including tic symptom severity. All participants were examined together. Strong internal consistency was identified for the YGTSS Motor Tic score (α = 0.80), YGTSS Phonic Tic score (α = 0.87), and YGTSS Total Tic score (α = 0.82). The YGTSS Total Tic and Impairment scores exhibited relatively normal distributions. Several subscales and individual item sc...
ABSTRACT Body Dysmorphic Disorder (BDD) is a mental disorder characterized by a preoccupation wit... more ABSTRACT Body Dysmorphic Disorder (BDD) is a mental disorder characterized by a preoccupation with an imagined or slight defect in appearance (eg, shape or size of the nose) that the BDD sufferer perceives as hideous and repulsive. If the individual has a slight physical defect, the concern has to be markedly excessive. Moreover, the preoccupation must cause significant distress or impairment in social or occupational functioning. The concern in appearance also is not better accounted for by another mental disorder (e.g., anorexia nervosa). Research has shown that patients with BDD exhibited significantly poorer performance in both verbal and nonverbal memory tasks, mediated by deficits in organizational strategies. People with BDD believe that appearance is important and that other people notice their imagined or slight flaw in appearance. This may lead to feelings of shame and low self-esteem. Various theorists have incorporated the research on information-processing biases and maladaptive beliefs and attitudes into cognitive-behavior models of BDD's development and maintenance. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
We investigated motor inhibition abilities in trichotillomania (TTM) and obsessive-compulsive dis... more We investigated motor inhibition abilities in trichotillomania (TTM) and obsessive-compulsive disorder (OCD), two disorders characterized by repetitive, intentionally performed behaviors. Performance in a GoNogo experiment of 25 TTM and 21 OCD participants was compared to the performance of 26 HC participants. In contrast to OCD and HC participants, TTM participants tended to perform either 'fast and inaccurate' (indicating poor motor inhibition) or 'slow and accurate'. TTM participants with poor motor inhibition reported a significantly earlier age of TTM onset than those TTM participants who performed well. There was no evidence for motor inhibition deficits in OCD. Based on our data, a subgroup of TTM sufferers seems to be characterized by motor inhibition deficits.
Patients with obsessive‐compulsive disorder (OCD) (N = 36) and healthy controls (N = 24) particip... more Patients with obsessive‐compulsive disorder (OCD) (N = 36) and healthy controls (N = 24) participated in an autobiographical memory experiment in which they were asked to retrieve specific personal memories in response to cue words having either positive (e.g. happy) or negative (e.g. anxiety) valence. Compared to control participants, OCD patients had difficulty retrieving specific memories and showed longer retrieval latencies. However, these overgenerality effects were not a function of OCD per se, but were related to a co‐morbid diagnosis of major depression. The difficulty in retrieving specific autobiographical memories exhibited by OCD patients might reflect excessive cognitive capacity consumption due to preoccupation with intrusive thoughts typical of major depression.
The Journal of nervous and mental disease, Jan 17, 2016
Body dysmorphic disorder (BDD) and obsessive compulsive disorder (OCD) are associated with elevat... more Body dysmorphic disorder (BDD) and obsessive compulsive disorder (OCD) are associated with elevated depression, suicidality, functional impairment, and days housebound, yet little research has identified risk factors for these outcomes. Using path analysis, the present study examined anxiety and shame as risk factors for these outcomes across Internet-recruited self-report groups (BDD [n = 114], OCD [n = 114], and healthy control [HC; n = 133]). Paths from anxiety and shame to outcomes were similar and mostly significant across BDD and OCD, compared to non-significant paths for HCs, with one exception: the path from shame to depression was significant in the BDD group (b = 0.32) but non-significant in the OCD group (b = 0.07). Findings underscore similarities in BDD and OCD, supporting their reclassification into the same Obsessive Compulsive Related Disorders category. Results emphasize the importance of targeting shame, in addition to anxiety, in treatments for BDD and OCD.
Background Preliminary research suggests that a mindfulness-based treatment approach may be benef... more Background Preliminary research suggests that a mindfulness-based treatment approach may be beneficial for adults with tic disorders. In the present study, we report on the feasibility, acceptability, safety, and symptomatic effect of a novel online mindfulness-based group intervention for adults with Tourette syndrome or persistent tic disorder. Data from this study will directly inform the conduct of a funded randomized controlled trial comparing the efficacy of this intervention to another active psychological intervention. Methods One cohort of adults with Tourette syndrome participated in an 8-week online mindfulness-based group intervention. Measures of feasibility, acceptability, and safety were administered throughout and at posttreatment. Self-reported measures of mindfulness and clinician-rated measures of tic severity and impairment were administered at baseline and posttreatment. Results Data on refusal, dropout rate, attendance, participant satisfaction, and safety sugg...
Background Although effective treatments are available, most individuals with body dysmorphic dis... more Background Although effective treatments are available, most individuals with body dysmorphic disorder (BDD) do not receive an appropriate diagnosis or treatment. We aimed to examine treatment utilization and barriers to treatment, and to identify associated socio-demographic and clinical characteristics. Methods German individuals completed an online self-report survey of appearance concerns. A sample of N = 429 individuals met criteria for BDD. We examined the frequency of treatment utilization and barriers, analyzed comparisons between treated and untreated individuals and assessed the relationships of socio-demographic and clinical features with mental health treatment utilization and treatment barriers, respectively. Results Only 15.2% of the individuals with BDD had been diagnosed with BDD, and lifetime rates of mental health treatment were low (39.9%). Individuals endorsed multiple barriers to mental health treatment, especially shame, low perceived need and a preference for ...
Current approaches to psychiatric assessment are resource-intensive, requiring time-consuming eva... more Current approaches to psychiatric assessment are resource-intensive, requiring time-consuming evaluation by a trained clinician. Development of digital biomarkers holds promise for enabling scalable, time-sensitive, and cost-effective assessment of both psychiatric diagnosis and symptom change. The present study aimed to identify robust digital biomarkers of diagnostic status and changes in symptom severity over ~2 weeks, through re-analysis of public-use actigraphy data collected in patients with major depressive or bipolar disorder and healthy controls. Results suggest that participants’ diagnostic group status (i.e., mood disorder, control) can be predicted with a high degree of accuracy (predicted correctly 89% of the time, kappa = 0.773), using features extracted from actigraphy data alone. Results also suggest that actigraphy data can be used to predict symptom change across ~2 weeks (r = 0.782, p = 1.04e-05). Through inclusion of digital biomarkers in our statistical model, w...
ObjectivesCognitive–behavioural therapy (CBT) has been shown to be an effective treatment for bod... more ObjectivesCognitive–behavioural therapy (CBT) has been shown to be an effective treatment for body dysmorphic disorder (BDD), but access to treatment around the world is limited. One way to increase access is to administer CBT remotely via the internet. This study represents the first effort to remotely deliver a therapist-supported, internet-based CBT treatment with no restrictions on enrolment based on geographical location, and it aims to assess whether this treatment can be delivered safely across international borders, with outcomes comparable to previous BDD-NET trials.DesignUncontrolled clinical trial.ParticipantsPatients (n=32) in nine different countries were recruited primarily through internet advertisements.InterventionBDD-NET is a 12-week treatment, consisting of eight treatment modules previously shown to be effective in a Swedish version.SettingTherapists based at a single, secondary care centre in Sweden provided active guidance and feedback throughout the treatment ...
Journal of child and adolescent psychopharmacology, 2018
The study examined clinical correlates of quality of life (QoL), impact of treatment on QoL, and ... more The study examined clinical correlates of quality of life (QoL), impact of treatment on QoL, and predictors of QoL change among children with obsessive-compulsive disorder (OCD). One hundred forty-two children with primary OCD who were enrolled as part of a larger clinical trial participated. Children were administered a structured diagnostic interview, as well as clinician-administered measures of OCD and depression symptom severity. Children and parents completed reports of QoL, as well as measures of impairment and internalizing and externalizing symptoms. Youth received 10 sessions of family-based cognitive-behavioral therapy (CBT). At baseline, QoL was inversely related to obsessive-compulsive symptom severity, impairment, externalizing and internalizing symptoms, and severity of depression symptoms according to children and parents. After CBT, QoL improved according to parent ratings, but not child ratings. None of the predictors examined were associated with changes in QoL sc...
Journal of the American Academy of Child and Adolescent Psychiatry, 2018
Insight in obsessive-compulsive disorder (OCD) refers to patients' recognition that their obs... more Insight in obsessive-compulsive disorder (OCD) refers to patients' recognition that their obsessions and compulsions are symptoms rather than necessary or natural thoughts and behaviors. It has been estimated that 20% to 45% of youth with OCD exhibit poor or absent insight. Identified correlates of poor insight include younger age, increased OCD severity, impairment, and family accommodation; lower intellectual and adaptive functioning; and greater depressive symptoms. Poorer insight has also been associated with reduced response across treatment groups (ie, selective serotonin reuptake inhibitor [SSRI], cognitive behavioral therapy [CBT], combined SSRI plus CBT, or pill placebo)..
To examine the internal consistency and distribution of the Yale Global Tic Severity Scale (YGTSS... more To examine the internal consistency and distribution of the Yale Global Tic Severity Scale (YGTSS) scores to inform modification of the measure. This cross-sectional study included 617 participants with a tic disorder (516 children and 101 adults), who completed an age-appropriate diagnostic interview and the YGTSS to evaluate tic symptom severity. The distributions of scores on YGTSS dimensions were evaluated for normality and skewness. For dimensions that were skewed across motor and phonic tics, a modified Delphi consensus process was used to revise selected anchor points. Children and adults had similar clinical characteristics, including tic symptom severity. All participants were examined together. Strong internal consistency was identified for the YGTSS Motor Tic score (α = 0.80), YGTSS Phonic Tic score (α = 0.87), and YGTSS Total Tic score (α = 0.82). The YGTSS Total Tic and Impairment scores exhibited relatively normal distributions. Several subscales and individual item sc...
ABSTRACT Body Dysmorphic Disorder (BDD) is a mental disorder characterized by a preoccupation wit... more ABSTRACT Body Dysmorphic Disorder (BDD) is a mental disorder characterized by a preoccupation with an imagined or slight defect in appearance (eg, shape or size of the nose) that the BDD sufferer perceives as hideous and repulsive. If the individual has a slight physical defect, the concern has to be markedly excessive. Moreover, the preoccupation must cause significant distress or impairment in social or occupational functioning. The concern in appearance also is not better accounted for by another mental disorder (e.g., anorexia nervosa). Research has shown that patients with BDD exhibited significantly poorer performance in both verbal and nonverbal memory tasks, mediated by deficits in organizational strategies. People with BDD believe that appearance is important and that other people notice their imagined or slight flaw in appearance. This may lead to feelings of shame and low self-esteem. Various theorists have incorporated the research on information-processing biases and maladaptive beliefs and attitudes into cognitive-behavior models of BDD's development and maintenance. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
We investigated motor inhibition abilities in trichotillomania (TTM) and obsessive-compulsive dis... more We investigated motor inhibition abilities in trichotillomania (TTM) and obsessive-compulsive disorder (OCD), two disorders characterized by repetitive, intentionally performed behaviors. Performance in a GoNogo experiment of 25 TTM and 21 OCD participants was compared to the performance of 26 HC participants. In contrast to OCD and HC participants, TTM participants tended to perform either 'fast and inaccurate' (indicating poor motor inhibition) or 'slow and accurate'. TTM participants with poor motor inhibition reported a significantly earlier age of TTM onset than those TTM participants who performed well. There was no evidence for motor inhibition deficits in OCD. Based on our data, a subgroup of TTM sufferers seems to be characterized by motor inhibition deficits.
Patients with obsessive‐compulsive disorder (OCD) (N = 36) and healthy controls (N = 24) particip... more Patients with obsessive‐compulsive disorder (OCD) (N = 36) and healthy controls (N = 24) participated in an autobiographical memory experiment in which they were asked to retrieve specific personal memories in response to cue words having either positive (e.g. happy) or negative (e.g. anxiety) valence. Compared to control participants, OCD patients had difficulty retrieving specific memories and showed longer retrieval latencies. However, these overgenerality effects were not a function of OCD per se, but were related to a co‐morbid diagnosis of major depression. The difficulty in retrieving specific autobiographical memories exhibited by OCD patients might reflect excessive cognitive capacity consumption due to preoccupation with intrusive thoughts typical of major depression.
Uploads
Papers by Sabine Wilhelm