Inclusion Criteria:
Body dysmorphic disorder: Inclusion:
- males or females
- ages 18-40
- meet Diagnostic and Statistical Manual-5 (DSM-5) criteria for Body Dysmorphic Disorder
- have a Body Dysmorphic Disorder version of the Yale-Brown Obsessive-Compulsive Disorder Scale (BDD-YBOCS) score of ≥20
- primary appearance concerns of the face or head area
- medication naïve or medication free for at least 8 weeks prior to enrollment
Inclusion Criteria:
Subclinical body dysmorphic disorder: Inclusion:
- males or females
- ages 18-40
- have a score on the Dysmorphic Concern Questionnaire of ≥8 \[1 standard deviation (STD) above population norms\] - primary appearance concerns of the face or head area
- medication naïve or medication free for at least 8 weeks prior to enrollment
Inclusion Criteria:
Healthy controls: Inclusion
- Healthy males and females from any racial or ethnic background - ages 18-40
- have a score on the Dysmorphic Concern Questionnaire of <8
Exclusion Criteria:
Body dysmorphic disorder: Exclusion
- concurrent major Axis I disorders including substance use disorders, aside from anxiety disorders or depressive disorders, as these comorbidities are very common and the sample would otherwise be non-representative; however BDD must be the primary diagnosis.
- lifetime: bipolar disorder or psychotic disorder.
- psychotropic medications, aside from a short half-life sedative/hypnotic for insomnia, or a short half-life benzodiazepine as needed for anxiety but not exceeding a frequency of 3 doses in one week and not to be taken on the days of the training or MRI scan
- current cognitive-behavioral therapy
Exclusion:
Subclinical body dysmorphic disorder: Exclusion
- meet full DSM-5 criteria for Body Dysmorphic Disorder
- current Axis I disorders including substance use disorders
- lifetime: bipolar disorder or psychotic disorder
- psychotropic medications, aside from a short half-life sedative/hypnotic for insomnia, or a short half-life benzodiazepine as needed for anxiety but not exceeding a frequency of 3 doses in one week and not to be taken on the days of the training or MRI scan
- current cognitive-behavioral therapy
Exclusion Criteria:
Healthy Controls: Exclusion
- Any current Axis I disorder
- lifetime: bipolar disorder or psychotic disorder
- Psychiatric medication
Exclusion Criteria:
All participants: Exclusion
- Neurological disorder
- Pregnancy
- Current major medical disorders that may affect cerebral metabolism such as diabetes or thyroid disorders - Current risk of suicide with a plan and intent
- Ferromagnetic metal implantations or devices (electronic implants or devices, infusion pumps, aneurysm clips, metal fragments or foreign bodies, metal prostheses, joints, rods or plates)
- Visual acuity worse than 20/35 for each eye as determined by Snellen close vision acuity chart (vision will be tested with corrective lenses if participant uses them).