Reliability and Validity of the Turkish BIQ-C and AAI for Assessing Body Dysmorphic Disorder Symptoms

Abstract

This study aimed to translate the Body Image Questionnaire–Child and Adolescent Version (BIQ-C) and the Appearance Anxiety Inventory (AAI) into Turkish and evaluate their psychometric properties in adolescents and young adults. A total of 192 participants aged 11–20 years were recruited from child and adolescent psychiatry and dermatology clinics. After a forward–backward translation procedure, participants completed the BIQ-C, AAI, Yale-Brown Obsessive-Compulsive Scale modified for BDD (BDD-YBOCS), Rosenberg Self-Esteem Scale, and PedsQL.

Exploratory factor analysis supported a three-factor structure for the BIQ-C and a unidimensional structure for the AAI. Confirmatory factor analysis indicated a good fit for the BIQ-C (CFI = 0.975, RMSEA = 0.038) and an acceptable fit for the AAI (CFI = 0.918, RMSEA = 0.102). Internal consistency was acceptable for the BIQ-C (α = 0.75) and good for the AAI (α = 0.88). Test–retest reliability was moderate for the BIQ-C (r = 0.59) but low for the AAI (r = 0.36). Both measures correlated positively with each other and BDD-YBOCS, and negatively with quality-of-life, supporting validity.

Findings suggest that the Turkish BIQ-C and AAI are reliable tools for assessing body image concerns and BDD symptoms, though the AAI may be more sensitive to symptom fluctuations.

Plain Language Summary

People with body dysmorphic disorder (BDD) worry too much about small or imagined flaws in their looks. Researchers in Türkiye require scientifically validated tools in the Turkish language to effectively identify and treat this condition. This research concentrated on the translation and evaluation of two international surveys: the Body Image Questionnaire (Child and Adolescent Version) and the Appearance Anxiety Inventory. We tested these Turkish versions on 192 young people (ages 11 to 20) who were going to dermatology or psychiatry clinics. We used statistical tests to make sure the surveys were correct by checking if the questions made sense together and if the results stayed the same over time. We also looked at how these surveys' scores compared to other well-known ways to measure quality of life and self-esteem. Both surveys accurately assess the symptoms they were intended to monitor. As anticipated, participants exhibiting elevated appearance anxiety also indicated diminished self-esteem and a reduced quality of life, thereby validating that the surveys are assessing genuine challenges encountered in reality. The Body Image Questionnaire remained stable over time. The Appearance Anxiety Inventory exhibited greater variability between assessments, indicating its potential efficacy in detecting daily fluctuations in an individual's anxiety levels. This study gives Turkish healthcare providers two new tools that they can trust. These surveys will help doctors and counselors better understand how teenagers and young adults feel about their bodies, which will help them get better help and treatment.

Keywords

body dysmorphic disorders psychometrics adolescent surveys questionnaires

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