When The Mirror Is Wrong

Appearance Anxiety Inventory

The Appearance Anxiety Inventory (AAI) is a brief 10 item self-report scale that assesses the cognitive and behavioral aspects of BDD in particular. This scale was specifically developed by the original authors as both an outcome and process measure, since it can track changes in these processes and behaviors during treatment. Besides its global score, the AAI includes three subscales: threat monitoring, camouflaging, and avoidance. Each item is scored on a 4-point scale ranging from not at all (0) to much more than most people (3). A score equal or above 21 is considered high risk body image anxiety and/or Body Dysmorphic Disorder.

Dysmorphic Concern Questionnaire

The DCQ measures a person's degree of dysmorphic concern (i.e., the excessive preoccupation or concern with a perceived minor defect in one's physical appearance). This is a self-report measure with seven items, reporting on cognitive and behavioural aspects of dysmorphic concern. Each item is phrased with the question, "Have you ever…?" (e.g., "…been very concerned about some aspect of your physical appearance"). Each item is scored on a 4-point scale ranging from not at all (0) to much more than most people (3).

Patient Health Questionnaire - 9

: The PHQ-9 is a brief nine-item questionnaire used to screen for the severity of depression in adults. It's based on DSM-IV criteria for major depressive disorder and assesses symptoms like depressed mood, loss of interest, fatigue, and suicidal ideation. All items are rated on a four-point scale from not at all (0) to nearly every day (3).

Change in the Multidimensional Psychological Flexibility Inventory - 24

The MPFI-24 is a 24-item self-report scale for the assessment of psychological flexibility/inflexibility, comprised by 12 subscales, representing psychological flexibility (i.e., Acceptance, Present Moment Awareness, Self as Context, Defusion, Values, Committed Action) and psychological inflexibility (i.e., Experiential Avoidance, Lack of Contact with the Present Moment, Self as Content, Fusion, Lack of Contact with Values, Inaction). Items (e.g., "I opened myself to all of my feelings, the good and the bad") are answered on a 6-point Likert scale (ranging from 1 = 'never true' to 6 = 'always true') reporting to the previous 2 weeks. The scores of the 6 flexibility and 6 inflexibility subscales can be averaged to create a composite score representing global flexibility and inflexibility, respectively. Previous psychometric information indicates good to excellent internal consistency values.

Self-compassion Scale

The SCS is a 26-item self-report questionnaire that measures six components of self-compassion: self-kindness (five items); self-judgment (five items); common humanity (four items); isolation (four items); mindfulness (four items); and overidentification (four items). Mean scores on the six subscales can be averaged (after reverse-coding negative items) to create an overall self-compassion score. Items are rated on a 5-point Likert scale ranging from 1 (almost never) to 5 (almost always), with good psychometric properties.

Psychological Flexibility for Body Image

The Psy-Flex-BI assesses body image-related psychological flexibility. Just like the Psy-Flex, a general psychological flexibility measure, it includes all six skills assumed to comprise psychological flexibility according to ACT theory. This scale is a 6-item measure (e.g., I can look at hindering thoughts regarding my physical appearance from a distance without letting them control me.), and items are rated on a scale from 5 ("very often") to 1 ("very rarely"). The scale was developed under the current project and has presented great psychometric properties.

Emotion Recognition Task

The Emotion Recognition Task measures the ability to identify five basic emotions (happiness, sadness, anger, fear, disgust) in facial expressions along a continuum. A neutral condition was also included. For this study, brief videos (2s) depicting different facial expressions of real individuals were selected from the FACES database (Ebner et al., 2010). Each video is displayed on the screen, one at a time, and then the participant must select which emotion the face displayed from the 5 available options. The outcome measures for ERT cover percentage and number of correct or incorrect answers and overall response latencies. While completing this task, neuroimaging data will also be collected using fNIRS.

Emotional Stroop task

This task measures information processing for assessing emotions. The emotional Stroop task works by examining the response time of the participant to name colours of words presented to them. For this study, experimental stimuli were five 10-word lists developed in line with the following categories: (a) BDD-positive, (b) BDD-negative, (c) general positive, (d) general negative, and (e) neutral. Each word is displayed on the screen, one at a time, in a randomised colour (red, green, blue, and yellow) and the participant is asked to select the keyboard key corresponding to the word's colour, ignoring the word's meaning. The outcome measures for this task cover percentage and number of correct or incorrect answers, and overall response latencies. While completing this task, neuroimaging data will also be collected using fNIRS.