The 19-item Body Image Concern Inventory (BICI; Littleton et al., 2005) is a brief self-report measure of dysmorphic appearance concern that assesses preoccupation with perceived appearance defect(s), checking, camouflaging, and reassurance seeking behavior related to one’s appearance defect(s), and social avoidance due to appearance concerns. The BICI can be administered online or in-person to adolescents and adults and is free to use in any setting. This chapter first discusses the development of the BICI and then provides evidence of its psychometrics. More specifically, the BICI has been found to either have a two-factor or three-factor correlated structure, depending on the nation/language in which it is administered. Internal consistency reliability, test-retest reliability, convergent, discriminant, and criterion validity support the use of the BICI. Additionally, the BICI has been found to have good to excellent sensitivity and reasonable to excellent specificity in classifying clinical versus subclinical levels of dysmorphic symptoms and/or disordered eating. Next, this chapter provides the BICI items in their entirety, instructions for administering the BICI to participants, the item response scale, and the scoring procedure. Information about an abbreviated version of the BICI and known translations are provided. Logistics of use, such as permissions, copyright, and contact information, are provided for readers.

The 28-item Body Exposure during Sexual Activities Questionnaire (BESAQ; Cash et al., 2004) assesses respondents’ anxious attentional focus on and avoidance of exposing their body during sexual relations. The BESAQ can be administered online or in-person to sexually active adolescents or adults and items are averaged to obtain a total score. It is free to use. This chapter first discusses the development of the BESAQ and then provides evidence of its psychometrics. More specifically, internal consistency reliability, test-retest reliability, and construct validity support the use of the BESAQ. Next, this chapter provides all BESAQ items, instructions for administering the BESAQ to participants, the item response scale, and the scoring procedure. An 18-item abbreviated form is discussed. Known translations are provided. Logistics of use, such as permissions, copyright, and contact information, are provided for readers.

The 18-item Social Media Appearance Preoccupation Scale (SMAPS) has three subscales that measure social comparison (6 items), self-presentation (7 items), and general activity (5 items) related to appearance when engaging in visual online content, especially using social media. The subscales can form a total score or be used to focus on one or more of the three subscales of online appearance preoccupation, which allows for a shorter measure. The SMAPS was designed with five issues in mind: 1) image sharing activity, 2) investment and self-presentation, 3) social comparison, 4) active versus passive social media use, and 5) negative responses to social media. The SMAPS can be administered online or in-person and has been included in research with adolescents and young adults. The SMAPS is free to use. This chapter begins with a discussion of the development of the SMAPS from item generation to psychometric analyses, which is followed by sections with psychometric information, including the factor structure and invariance, and evidence of reliability and validity. Additional sections cover administration and scoring, the response scale, the items in their entirety, instructions for administration and scoring, and permissions, copyright and contact information are provided.

The 10-item Appearance Anxiety Inventory (AAI; Veale et al., 2013) assesses cognitive processes and behaviours characteristic of body dysmorphic disorder (BDD). The AAI is derived from a theoretical model of BDD that defines appearance anxiety as a person’s responses to their perceived flaws and shame about their appearance (e.g., appearance-focused attention, comparison, rumination, checking, and avoidance). The AAI can be administered online or in-person to adolescents and adults and is free to use. This chapter first discusses the development of the AAI and then provides evidence of its psychometrics. Findings from exploratory and confirmatory factor analysis support a 2-factor structure (appearance avoidance, threat monitoring), yet a single factor accounted for most of the scale’s variance and therefore the AAI is calculated as a single appearance anxiety score. Internal consistency reliability, test-retest reliability, convergent validity, and sensitivity to change as a result of therapy support the use of the AAI. Next, this chapter provides the AAI items in their entirety, instructions for administering the AAI to participants, item response scale, and scoring procedure. Links to known translations are provided. Logistics of use, such as permissions, copyright, and contact information, are provided for readers.

Sociocultural theories of body image propose that different societies have different conceptions of the ideal body shape. Within contemporary Westernized cultures, advertisements, the Internet, and social media networks promote particular assumptions about what constitutes the ‘ideal’ body, and thus exert a strong social pressure to achieve such a body shape. Individuals go to great lengths to achieve and maintain a body image that corresponds to these archetypes of ‘beauty’, which are reinforced as having a superior social value. Such social ideals of beauty are often entirely unrealistic, and can result in body dissatisfaction, appearance anxiety, body image disorder, low self-esteem, and depressive symptoms. Attempts to attain the ideal body can lead to excessive behaviours, such as compulsive exercising, the use of image- and performance-enhancing drugs (IPEDs), and eating disorders. This chapter focuses on excessive exercising and the use of IPEDs, and how these behaviours relate to distress about body image.

Exercise addiction (AE), which can be defined as engaging in excessive and problematic physical exercise, is still not officially included in the psychiatric nosography, although this disorder can be identified as linked to addictive behaviours. Many different etiopathogenetic hypotheses have been proposed to account for the epidemiological distribution of EA in the general population. However, a clear phenomenological concept of the disorder and shared diagnostic tools are still lacking. It is frequently comorbid with eating disorders and body dysmorphic disorder, which can both trigger EA and develop secondary to it. In recent times it has been proposed that the lockdowns and other restrictions which were imposed during the COVID-19 pandemic could have been possible risk factors for the development or worsening of EA, as physical exercise was widely recommended as a strategy for coping with these restrictions. The initial evidence about the emergence of EA during the COVID-19 pandemic is presented.