Body Dysmorphic Disorder (BDD) is a psychological disorder in which people suffer from a distorted self body image.

In this Simpson’s episode the topic of appearance anxiety is being discussed in a accessible way, showing that the topic has reached a high level of public awareness.

There are a number of similar scales to measure appearance anxiety. The AAI scale (Veale et al., 2014) has been validated with people suffering from the BDD.

In the paper it says that the frequency 5-point Likert scale "ranging from 0 for not at all to 4 for all the time." In this PsyToolkit implementation, the intermediate steps have been named as well (it is unclear if they did this in the original study). The choices between not at all and all the time are rarely, sometimes, and often. Of course, you can change this.
In the paper, they did not seem to randomize the order of the items, but you could, if you wish, by adding the line o: random to the scale question item (labeled aai).

The score on the scale runs from 0 to 40.

In the paper, they compared people with BDD (n=139) and a sample of people with a high level of concern about body image (n=108). The median score in the BDD group was 27.0 and in the community sample of people with body image concerns was 13.0.

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The paper says that this inventory can be used by researchers and clinicians: "The AAI can be used as a tool for treatment planning and outcome measurement." (Veale et al., 2014, p.615)


This is a very simple scale in which the scores are summed. None are reverse scored.

The survey code for PsyToolkit

Copy and paste this code to your PsyToolkit account if you want to use the scale in your own online research project
scale: frequency
- {score=0} Not at all
- {score=1} Rarely
- {score=2} Sometimes
- {score=3} Often
- {score=4} All the time

l: aai
q: Please answer how often each of the following applies to you
t: scale frequency
o: width 50%
- I check my appearance (e.g. in mirrors, by touching with my fingers or by taking photos of myself)
- I compare aspects of my appearance to others
- I avoid situations or people because of my appearance
- I think about how to camouflage or alter my appearance
- I avoid reflective surfaces, photos or videos of myself
- I try to camouflage or alter aspects of my appearance
- I brood about past events or reasons to explain why I look the way I do
- I am focused on how I feel I look rather than on my surroundings
- I discuss my appearance with others or question them about it
- I try to prevent people from seeing aspects of my appearance within particular situations (e.g. by changing my posture, avoiding bright lights)

l: score_aai
t: set
- sum $aai

l: feedback
t: radio
q: Your score on the AAI (ranging from 0-40) is {$score_aai}<br>
In the study validating this scale, the group with Body Dismorphic Disorder had a median score of 27.0<br>
The community sample of people with a high level of body level concerns a median score of 13.0.
- Okay, I got it.


  • 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. Link to publisher