Psychometric validation of the Japanese version of the Appearance Anxiety Inventory for body dysmorphic symptoms in Japanese populations

This study aimed to develop and validate the psychometric properties of the Japanese version of the Appearance Anxiety Inventory (J-AAI) and to explore the network structure of body dysmorphic symptoms. A total of 898 participants (457 individuals with self-reported psychiatric disorders and 441 individuals without self-reported psychiatric disorders) completed an online survey including the J-AAI and questionnaires assessing dysmorphic concerns, social anxiety, and depressive symptoms. Confirmatory factor analysis and exploratory graph analysis supported a one-factor model for individuals with and without self-reported psychiatric disorders. Reliability coefficients were high for individuals with and without self-reported psychiatric disorders ( α = .91; ω = .93; α = .90; ω = .91, respectively). Correlation analysis revealed a strong positive correlation between J-AAI scores and dysmorphic concerns, as well as moderate positive correlations with social anxiety and depressive symptoms. Network analysis identified “Camouflaging/altering appearance”, “Thinking about camouflaging/altering appearance”, and “Avoiding situations/people” as items with relatively higher centrality in the networks of body dysmorphic symptoms for individuals with and without self-reported psychiatric disorders. A network comparison test showed no significant between-group differences in global network structure and connectivity. These findings confirm the J-AAI’s high reliability and validity and suggest that the psychopathology of body dysmorphic symptoms may be consistent across individuals with and without self-reported psychiatric disorders. Additionally, “Camouflaging/altering appearance,” “Thinking about camouflaging/altering appearance,” and “Avoiding situations/people” may be important for understanding the interconnectedness of body dysmorphic symptoms and warrant further investigation in future longitudinal and intervention studies.