<p>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 (<i>n</i> = 61), psychiatric controls (<i>n</i> = 68), and healthy controls (<i>n</i> = 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.</p>