Exploring Potential Pathways Linking Childhood Maltreatment and Body Dysmorphic Disorder in Adolescents: A Cross-Sectional Study.

Abstract

While previous studies have highlighted a link between childhood maltreatment and body dysmorphic disorder (BDD), the psychological mechanisms underlying this association remain unclear-especially during adolescence. This cross-sectional study investigated cognitive, emotional, and behavioral mechanisms associated with BDD in adolescents with a history of childhood maltreatment. Participants included three groups: adolescents with BDD (n = 61), psychiatric controls (n = 68), and healthy controls (n = 70). All participants completed standardized clinical interviews, self-report questionnaires, and behavioral tasks assessing childhood maltreatment, social-cognitive processing, emotion regulation, and cognitive-behavioral control. Compared to psychiatric and healthy controls, adolescents with BDD reported a higher prevalence of emotional abuse and neglect, greater fear of negative evaluation, and more threat-related interpretive biases. They also showed elevated maladaptive schemas and emotion regulation difficulties, increased attention to appearance-related emotional stimuli, and reduced cognitive control and behavioral inhibition. Findings suggest that childhood maltreatment-particularly emotional abuse and neglect-may be associated with cognitive-affective and neurobehavioral vulnerabilities in adolescents with BDD. These results highlight potential targets for early identification and intervention strategies during this sensitive developmental stage.