Cognitive-Behavioral Therapy for Pediatric Body Dysmorphic Disorder

Inclusion Criteria: * Diagnosis of DSM-IV BDD or its delusional variant, which must be present currently and for at least 6 months prior to study entry * Total score of at least 24 on the 12-item BDD-YBOCS, adolescent version, which includes a score of at least 2 on item 1 (1-3 hours/day of preoccupation with the perceived defect) * Score of at least moderate on the Clinical Global Impressions of Severity (CGI-Severity) * Score of \< 60 on the Child Global Assessment Scale (C-GAS) * Ability to communicate meaningfully with the investigators and competent to provide written assent; both parental informed consent and adolescent assent must be obtained Exclusion Criteria: * Alcohol or substance abuse or dependence within the past 3 months, bipolar disorder, psychosis, organic mental disorder, development disorder, body image concerns accounted for primarily by an eating disorder or weight concerns. If subjects have another comorbid diagnosis, the BDD has to be the primary concern. * Recent (within the past 6 months) suicide attempt, or suicidal ideation as indicated by a K-SADS score of 4 or higher that is active or warrants consideration of hospitalization * Need for inpatient or partial hospital treatment * Current psychotherapy and failure to benefit from ten or more sessions of previous CBT treatment * Participants can be receiving psychotropic medication, but they must be on a stable dose for 2 months prior to the study baseline assessment and maintain this dosage throughout the course of the study