Appearance Anxiety

Inventory (AAI)
The Appearance Anxiety Inventory is a 10 question self-
report scale that measures the cognitive and behavioural
aspects of body image anxiety in general, and body
dysmorphic disorder (BDD) in particular. This scale is
useful as part of a diagnostic procedure for BDD as well
as symptom monitoring during treatment.

Validity and Reliability

The AAl was developed by Veale et al (2014). They
examined the psychometric properties in a clinical BDD
sample and non-clinical community sample in the UK. The
AAl was found to have good convergent validity, with
correlations of .55 with the clinician rated YBOCS-BDD
and .58 with the PHQ9. Internal consistency was high,
with a Cronbachs Alpha of .86. Two subscales were found
using factor analysis; Avoidance and Threat Monitoring.

The BDD validation sample (n = 13) had a median age of

28 and was 51.8% female. A subgroup of 12 participants

had a median AAl score of 26 at diagnosis and 10.50 after
CBT treatment.

The non-clinical community sample (n = 108) was used to

establish the normal levels of appearance anxiety among

relatively healthy individuals. The group had a median
age of 28.5 and 75.9% were female. The mean score was
15.45 (SD 8.68).
 Interpretation and Scoring
Scores consistent of a total raw score derived by summing
each item as well as two subscales.

Avoidance (items 1, 3, 4, 7,9 and 10)

-

Threat Monitoring (items 2,4, 6 and 8)

Two percentiles are presented to indicate how AAl scores

compare to a body dysmorphic disorder group anda
community sample. A BDD percentile of 50 indicates
average symptoms for someone with a BDD diagnosis
before treatment, while the community percentile
represents scores in comparison to a normal population.

Veale et al. (2014) did not define a cut-off score for BDD
diagnosis but Mastro et al. (2016) suggested a cutoff
score of 20 as being indicative of high risk of clinical
problems.

Developer:
Veale, D., Eshkevaria, E., Kanakama, N., Ellisona, N., Costa,
A, and Werner, T. (2014). The Appearance Anxiety
Inventory: Validation of a Process Measure in the
Treatment of Body Dysmorphic Disorder. Behavioural
and Cognitive Psychotherapy, 42, 605-616.

References:
Mastro, S., Zimmer-Gembeck, M. J., Webb, H. J., Farrell,
L.,&Waters,A. (2016). Young adolescents' appearance
anxiety and body dysmorphic symptoms: Social
problems, self-perceptions and comorbidities. Journal of
Obsessive-Compulsive and Related Disorders, 8, 50-55.
 NovoPsych

Appearance Anxiety Inventory (AAI)

Instructions:
Please check the box that best describes the way you
havefelt about your appearance or a
specific feature OVER THE PAST WEEK, INCLUDING TODAY.

Not at all A little Often A lot All the time

1 compare aspects of my 2
appearance to others
I check my appearance (e-g. in mirors,
2 |by touching with my fingers, or by taking 2 4
photos ot myseif)
3avoid situations or people because 2 4
of my appearance
brood about past events or reasons 2
to explain why I look the way I do 3 4

5THINK about how to camouflage or

ater my appearance 2

6 am focussed on how Ifeel I look,

rather than on my surroundings

, avoid reflective surfaces, photos, 0

or videos of mysel

adiscuss my appearance with others 2

orquestion them about it
9 try to camouftlage or alter aspects
of my appearance
try to prevert people from seeing aspects of my
10 perbculer
gyChunging my posure, avoding
bright lights

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