Appearance Anxiety Inventory

What is the Appearance Anxiety Inventory?

The Appearance Anxiety Inventory (AAI) is a validated self-report anxiety inventory designed to assess appearance-related concerns and body image anxiety in both clinical and research contexts (Gumpert et. al., 2024). Developed as a process measure within behavioural and cognitive psychotherapy, the AAI specifically targets body dysmorphic symptoms and underlying cognitive processes, such as threat monitoring and appearance-based rejection sensitivity (Veale et. al., 2014).

Consisting of 10 items rated on a 5-point Likert scale, the AAI explores preoccupation with perceived flaws, avoidance behaviors, and the emotional distress tied to appearance anxiety. It is especially useful in identifying symptoms associated with body dysmorphic disorder (BDD) (Anxiety & Depression Association of America, 2021) and related disorders like young adolescents appearance anxiety. The tool demonstrates adequate convergent validity, and its psychometric properties have been supported through factor analysis and other psychometric evaluations.

Clinicians often use the AAI in clinical settings to support diagnosis, treatment planning, and outcome tracking within cognitive behaviour therapy (CBT) and cognitive psychotherapy. It helps assess the factor structure of an individual's distress, aiding in early identification and intervention for those experiencing body dysmorphic disorder BDD or similar concerns. While the AAI is highly effective, it should be used in conjunction with comprehensive clinical interviews and other diagnostic tools to gain a complete understanding of appearance-related concerns.

How does it work?

Our free Appearance Anxiety Inventory template lets you assess your client's level of appearance-related anxiety and worry. Here's how to proceed:

Step One: Obtain the questionnaire

Access the printable Appearance Anxiety Inventory using the link provided on this page. You can also access it through the Carepatron app or our extensive resources library.

Step Two: Discuss with your client

Explain the AAI with your client and how they can respond to the items. Be sure to address any queries they may have before proceeding.

Step Three: Client completes the questionnaire

Give your client ample time to complete the questionnaire. Encourage them to respond honestly, emphasizing that there are no right or wrong answers.

Step Four: Score the AAI

Refer to the scoring instructions provided in our Appearance Anxiety inventory template. Use this information to calculate a total score for your client, which will help you determine their level of appearance-related worry and anxiety.

Step Five: Discuss findings with your client

Discuss the results of your findings and provide relevant feedback. During this time, explain the appropriate interventions and strategies available to help them manage their appearance anxiety.

Scoring and interpretation

Scoring the Appearance Anxiety Inventory (AAI) involves summing the responses across all 10 items, each rated on a scale from 0 to 4. The total score ranges from 0 to 40 and reflects the severity of appearance-related anxiety. In addition to the total score, the AAI includes subscales that measure specific symptom domains, such as avoidance behaviors and threat monitoring (including checking and self-focused attention). These subscale scores can be calculated by summing the relevant items associated with each domain, providing further insight into the behavioral and cognitive components of the individual’s experience.

Interpretation is based on the following ranges: a score of 0–5 indicates low levels of appearance anxiety; 6–15 indicates moderately high levels; 16–25 reflects high levels; and 26–40 suggests very high or extreme levels of anxiety. A clinical cutoff score of 19 or higher is considered clinically significant and may indicate probable Body Dysmorphic Disorder (BDD) or a high risk for BDD. This threshold helps clinicians determine whether further diagnostic evaluation or treatment planning is warranted.

When should you use this template?

Our free printable Appearance Anxiety Inventory template is valuable for assessing your client's level of concern about their appearance. Furthermore, you can employ this questionnaire to:

Identify specific sources of distress or unease

The AAI can help you pinpoint specific areas where your client experiences chronic distress related to their appearance. By targeting these areas, you can offer tailored support and interventions to address their unique needs.

Evaluate the intensity of your client's concerns about their physical appearance

Using this template, you can quantify the intensity of your client's appearance anxiety and assess their progress over time. This way, you can accurately track their improvement and provide additional assistance.

Determine the cognitive impact of appearance anxiety

The Appearance Anxiety Inventory provides insights into your client's cognitive response to appearance-related concerns. By tracking progress over time, you can assist your client in making meaningful changes to their appearance anxiety and improving their coping mechanisms.

Address maladaptive thought patterns

This questionnaire helps clients identify underlying thought patterns that contribute to appearance anxiety. With this awareness, they can work towards challenging these negative thought patterns and adopting healthier perspectives.

Benefits of the free Appearance Anxiety Inventory

Here are some benefits of using our free Appearance Anxiety Inventory template:

It's fully digital and user-friendly

Our free template can be easily filled out online and is optimized for mobile devices. This allows clients to complete the questionnaire at their own pace without any added stress or pressure.

It's evidence-based

The Appearance Anxiety Inventory has undergone extensive testing and demonstrates high levels of reliability. This ensures consistent and accurate results across various studies.

It's quick to complete

The AAI is a concise assessment that can be completed in a matter of minutes. It provides a convenient way to evaluate appearance anxiety and gain valuable insights into your client's experiences.

It helps enhance self-awareness

By completing the AAI, clients can develop greater self-awareness regarding their concerns related to appearance. This self-awareness serves as a foundation for therapeutic interventions.

It aids in treatment planning

You can use the Appearance Anxiety Inventory template to inform treatment plans and evaluate progress. This helps you identify the best strategies for addressing your client's appearance anxiety and create a tailored approach to their care.

It fosters open communication

The AAI offers clients a comfortable and non-judgmental platform to express their thoughts and feelings about their body image. This facilitates open communication between you and your client, allowing for more meaningful progress in therapy sessions.

References

Anxiety & Depression Association of America. (2021). Body dysmorphic disorder (BDD) | Anxiety and Depression Association of America, ADAA. https://adaa.org/understanding-anxiety/body-dysmorphic-disorder

Gumpert, M., Rautio, D., Monzani, B., Jassi, A., Krebs, G., Fernández, L., Mataix-Cols, D., & Jansson-Fröjmark, M. (2024). Psychometric evaluation of the Appearance Anxiety Inventory in adolescents with body dysmorphic disorder. Cognitive Behaviour Therapy, 53(3), 1–13. https://doi.org/10.1080/16506073.2023.2299837

Veale, D., Eshkevari, E., Kanakam, N., Ellison, N., Costa, A., & 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. https://doi.org/10.1017/s1352465813000556