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The Appearance Anxiety Inventory: Validation of a Process Measure in the Treatment of Body Dysmorphic Disorder

Published online by Cambridge University Press:  03 July 2013

David Veale ,
Ertimiss Eshkevari ,
Natalie Kanakam ,
Nell Ellison ,
Ana Costa  and
Tom Werner
David Veale*
Affiliation:
Institute of Psychiatry, King's College London and South London and Maudsley NHS Foundation Trust, UK
Ertimiss Eshkevari
Affiliation:
Institute of Psychiatry, King's College London and South London and Maudsley NHS Foundation Trust, UK
Natalie Kanakam
Affiliation:
Institute of Psychiatry, King's College London and South London and Maudsley NHS Foundation Trust, UK
Nell Ellison
Affiliation:
Institute of Psychiatry, King's College London and South London and Maudsley NHS Foundation Trust, UK
Ana Costa
Affiliation:
Institute of Psychiatry, King's College London and South London and Maudsley NHS Foundation Trust, UK
Tom Werner
Affiliation:
Institute of Psychiatry, King's College London and South London and Maudsley NHS Foundation Trust, UK
*
Reprint requests to David Veale, Centre for Anxiety Disorders, The Maudsley Hospital, 99 Denmark Hill, London SE5 8AZ, UK. E-mail: [email protected]
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Abstract

Background: At present there are no measures to identify the cognitive processes and behaviours that might mediate the outcome of treatment in people with Body Dysmorphic Disorder (BDD). Aims: To develop and validate a process measure that can be used to assess the progress of patients throughout therapy and in research for BDD. Method: The psychometric properties of the Appearance Anxiety Inventory (AAI) were explored in a clinical group of participants diagnosed with BDD (Study 1) and in a non-clinical community group with high appearance concerns (Study 2). Item characteristics, reliability, and factor structure were analysed. Convergent validity with measures of related symptoms was assessed. Results: The AAI was found to have good test-retest reliability and convergent validity in the measurement of appearance anxiety. It was also sensitive to change during treatment. The scale was found to have a two-factor structure in the clinical group, with one factor characterized by avoidance, and a second factor comprised of threat monitoring. However, in the community sample it appeared to have a one-factor structure. Conclusion: The results suggest that the AAI has the psychometric properties to determine whether changes in cognitive processes and behaviours can mediate the outcome following treatment in patients with BDD. This supports its potential usefulness in clinical and research settings.

Keywords

Body Dysmorphic Disorderquestionnaireassessment
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 42 , Issue 5 , September 2014 , pp. 605 - 616
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2013 

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References

Bjelland, I., Dahl, A. A., Haug, T. T. and Neckelmann, D. (2002). The validity of the Hospital Anxiety and Depression Scale: an updated literature review. Journal of Psychosomatic Research, 52, 69–77.CrossRefGoogle ScholarPubMed
Brown, T. A., Cash, T. F. and Mikulka, P. J. (1990). Attitudinal body-image assessment: factor analysis of the Body-Self Relations Questionnaire. Journal of Personality Assessment, 55, 135–144.CrossRefGoogle ScholarPubMed
Cash, T. F. and Fleming, E. C. (2002). The impact of body-image experiences: development of the Body Image Quality of Life Inventory. International Journal of Eating Disorders, 31, 455–460.CrossRefGoogle ScholarPubMed
Cash, T. F., Phillips, K. A., Santos, M. T. and Hrabosky, J. I. (2004). Measuring “negative body image”: validation of the Body Image Disturbance Questionnaire in a non-clinical population. Body Image, 1, 363–372.CrossRefGoogle Scholar
Eisen, J. L., Phillips, K. A., Baer, L., Beer, D. A., Atala, K. D. and Rasmussen, S. A. (1998). The Brown Assessment of Beliefs Scale: reliability and validity. American Journal of Psychiatry, 155, 102–108.CrossRefGoogle ScholarPubMed
Harvey, A., Watkins, E., Mansell, W. and Shafran, R. (2004). Cognitive Behavioural Processes across Psychological Disorders: a trans-diagnostic approach to research and treatment. Oxford: University Press CrossRefGoogle Scholar
Hayes, S. C., Villate, M., Levin, M. and Hildebrant, M. (2011). Open, aware, and active: contextual approaches as an emerging trend in the behavioral and cognitive therapies. Annual Review of Clinical Psychology, 7, 141–168.CrossRefGoogle ScholarPubMed
Hofman, S. G. (2008). Common misconceptions about cognitive mediation of treatment change: a commentary to Longmore and Worrell, 2007 . Clinical Psychology Review, 28, 67–70.CrossRefGoogle Scholar
Horn, J. (1965). A rationale and test for the number of factors in factor analysis. Psychometrika, 30, 179–185.CrossRefGoogle ScholarPubMed
Hrabosky, J. I., Cash, T. F., Veale, D., Neziroglu, F., Soll, E. A., Garner, D. M., et al. (2009). Multidimensional body image comparisons among patients with eating disorders, body dysmorphic disorder, and clinical controls: a multisite study. Body Image, 6, 155–163.CrossRefGoogle ScholarPubMed
Kraemer, H. C., Wilson, G. T., Fairburn, C. G. and Agras, W. S. (2002). Mediators and moderators of treatment effects in randomized clinical trials. Archives of General Psychiatry, 59, 877–883. doi: 10.1001/archpsyc.59.10.877 CrossRefGoogle ScholarPubMed
Kroenke, K. and Spitzer, R. L. (2002). The PHQ-9: a new depression diagnostic and severity measure. Psychiatric Annals, 32, 509–515.CrossRefGoogle Scholar
Longmore, R. J. and Worrell, M. (2007). Do we need to challenge thoughts in cognitive behavior therapy? Clinical Psychology Review, 27, 173–187.CrossRefGoogle ScholarPubMed
Lorenzo-Seva, U. and Ferrando, P. J. (2006). FACTOR: a computer programme to fit the exploratory factor analysis model. Behavioral Research Methods, Instruments and Computers, 38, 88–91.CrossRefGoogle ScholarPubMed
Mancuso, S. G., Knoesen, N. P. and Castle, D. J. (2010). The Dysmorphic Concern Questionnaire: a screening measure for body dysmorphic disorder. The Australian and New Zealand Journal of Psychiatry, 44, 535–542.Google ScholarPubMed
Mardia, K. V. (1970). Measures of multivariate skewness and kurtosis with applications. Biometrika, 57, 519–530.CrossRefGoogle Scholar
Neziroglu, F., Khemlani-Parel, S. and Veale, D. (2008). Social learning theory and cognitive behavioural models of body dysmorphic disorder. Body Image, 5, 28–38.CrossRefGoogle ScholarPubMed
Phillips, K. A., Hollander, E., Rasmussen, S. A., Aronowitz, B. R., DeCaria, C. and Goodman, W. K. (1997). A severity rating scale for body dysmorphic disorder: development, reliability, and validity of a modified version of the Yale-Brown Obsessive Compulsive Scale. Psychopharmacology Bulletin, 33, 17–22.Google ScholarPubMed
Rosen, J. C., Reiter, J. and Orosan, P. (1995). Cognitive-behavioral body image therapy for body dysmorphic disorder [published erratum appears in Journal of Consulting and Clinical Psychology, 1995 Jun; 63, 437]. Journal of Consulting and Clinical Psychology, 63, 263–269.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Kroenke, K., Williams, J. B. W. and Lowe, B. (2006). A brief measure for assessing generalized anxiety disorder: the GAD-7. Archives of Internal Medicine, 166, 1092–1097. doi:10.1001/archinte.166.10.1092 CrossRefGoogle ScholarPubMed
Veale, D. (2004). Advances in a cognitive behavioural model of body dysmorphic disorder. Body Image, 1, 113–125.CrossRefGoogle Scholar
Veale, D., Gournay, K., Dryden, W., Boocock, A., Shah, F., Willson, R., et al. (1996). Body Dysmorphic Disorder: a cognitive behavioural model and a pilot randomised controlled trial. Behaviour, Research and Therapy, 34, 717–729 CrossRefGoogle Scholar
Veale, D., Ellison, N., Werner, T. G., Dodhia, R., Serafty, M. and Clarke, A. (2011). Development of a cosmetic procedure screening questionnaire (COPS) for body dysmorphic disorder. Journal of Plastic, Reconstructive and Aesthetic Surgery, 65, 530–532. doi:10.1016/j.bjps.2011.09.007 CrossRefGoogle ScholarPubMed
Veale, D. and Neziroglu, F. (2010). Body Dysmorphic Disorder: a treatment manual. Chichester: John Wiley and Sons.CrossRefGoogle Scholar
Wilson, P. and Cooper, C. (2008). Finding the magic number. The Psychologist, 21, 866–867.Google Scholar
Worrell, M. and Longmore, R. J. (2008). Challenging Hofmann's negative thoughts: a rebuttal. Clinical Psychology Review, 28, 71–74.CrossRefGoogle ScholarPubMed
Zigmond, A. and Snaith, R. P. (1983). The Hospital Depression and Anxiety Scale. Acta Psychiatrica Scandinavica, 67, 361–370.CrossRefGoogle Scholar
Zwick, W. R. and Velicer, W. F. (1986). Comparison of five rules for determining the number of components to retain. Psychological Bulletin, 99, 432–442.CrossRefGoogle Scholar
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