Overview
The AAI is a measure of appearance anxiety exploring cognitive processes (e.g., rumination, self-focused attention) of body image anxiety, and behavioural responses (e.g., avoidance) in Body Dysmorphic Disorder (BDD). Although designed for clinical application it is also used as a measure of appearance anxiety and body image in people without BDD.Scoring & Interpretation
The AAI is a 10-item measure including three subscales. Threat monitoring (Items 1,2,4,6,8) measures the degree of appearance vigilance. Camouflaging (Items 5, 9) measures the tendancy to hide or disguise appearance concerns. Avoidance (Items 3,7,10) measure the extent to which individuals avoid situaltions or activities due to appearance concerns. Items are scored on a five point scale from 0 (Not at all) to 4 (All the time). Higher scores indicate higher levels of vigilance, camouflaging and avoidance. Subscale and total scores can be calculated. The AAI items have a five point Likert scale ranging from 0 (not at all) to 4 (All the time). Total scores are the sum of all items with scores ranging from 0-40). Change scores are 7 and above and scores of 19 and above indicate BDD.Psychometric Properties
Internal Consistency
Cronbach Alpha = .86 in the clinical sample and .91 in the community sample (Veale at al., 2014) McDonalds Omega = .83 (Gumpert et al., 2024).
Test-Retest Reliability
The AAI had good test–retest reliability after 1 week in the community sample with an intra-class correlation of .87 (p <.001). Veale et al., 2014).
Factor Structure
The original development work (Veale et al 2014) identified two factors: Avoidance (items 1, 3, 5, 7, 9, 10) and Threat Monitoring (items 2, 4, 6, 8) in a clinical sample. More recent work (Gumpert et al 2024) also in a clinical sample, identified three factors : Camoufflaging (Items 5, 9), Threat Monitoring (Items 1,2,4,6,8), Avoidance (Items 3,7,10).
Validity
Convergent validity with the Yale Brown Obsessive Compulsive Scale modified for BDD (YBOCS-BDD: .55) and The Patient Health Questionnaire (PHQ9: .58: Veale et al., 2014).
Convergent validity with the Yale-Brown Obsessive-Compulsive Scale modified for Body Dysmorphic Disorder for Adolescents (BDD-YBOCS-A; rs = .42) and the Clinical Global Impression-Severity Scale (rs = .32: Gumpert et al., 2024).
Measurement Invariance
Access
Free to download - must be citedhttps://www.veale.co.uk/scales/