What is the Appearance Anxiety Questionnaire (AAQ)?

The AAQ is a clinical screening tool designed for aesthetic medicine settings. It measures appearance anxiety across 7 subscales (23 items) and screens for body dysmorphic disorder (BDD) features using 5 ALERT items. It helps clinicians identify patients who may need additional support or evaluation before aesthetic procedures.

How does the AAQ screen for Body Dysmorphic Disorder (BDD)?

The AAQ uses 5 ALERT items specifically designed to identify BDD features: Symptom Migration (concerns shifting between body areas), Insight Discrepancy (gap between perceived and objective appearance), Compulsive Research (excessive procedure research), Urgency (pressure for immediate treatment), and Perfectionism (unrealistic expectations). These items drive the traffic light triage recommendation.

What do the AAQ triage levels (Green, Amber, Red) mean?

Green indicates standard pathway with routine informed consent. Amber suggests extended discussion to explore expectations and ensure treatment goals are realistic - these patients may respond positively to treatment. Red indicates BDD features are present, meaning aesthetic treatment is unlikely to resolve underlying concerns, and psychological evaluation is recommended.

What are the 7 subscales measured by the AAQ?

The AAQ measures 7 clinical domains: (A) Preoccupation - time devoted to appearance concerns, (B) Social Threat - fear of negative evaluation, (C) Avoidance - avoiding situations due to appearance, (D) Safety Behaviours - camouflaging, checking, reassurance-seeking, (E) Mood Reactivity - emotional responses to appearance perceptions, (F) Self-Worth - appearance-contingent self-esteem, (G) Functional Impairment - impact on work, relationships, daily life.

Who should use the AAQ?

The AAQ is designed for cosmetic surgeons, plastic surgeons, dermatologists, aesthetic practitioners, and medical aesthetic clinics worldwide. It helps practitioners identify patients whose appearance concerns may not be addressed by aesthetic treatment and who may benefit from psychological support.

What percentage of aesthetic patients have BDD?

Research suggests that 7-15% of aesthetic patients may meet criteria for Body Dysmorphic Disorder. The AAQ helps differentiate between appearance anxiety that treatment can address and BDD patterns where treatment may not help.

Is patient data secure with the AAQ?

Yes. The AAQ platform is GDPR and HIPAA compliant. Patient data is encrypted, and research exports use k-anonymity protection (minimum group size of 5) ensuring individual responses cannot be traced back to specific patients or clinics.

Sample Report

AAQ Clinical Report Preview

This is an example of what your clinic will receive for each patient assessment.

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Back to About|Sample Patient: AAQ-DEMO-2024-AB

Clinical Report

AAQ-DEMO-2024-AB · Baseline Assessment

Extended Discussion Recommended

Some BDD indicators present. Extended consultation recommended to explore whether concerns are likely to be addressed by treatment or reflect underlying BDD features.

Reasons:

Moderate appearance anxiety (52.4%) - may respond to treatment
Single BDD indicator elevated (ALERT03) - explore further

Data Quality Assessment

Completion Time:4m 32s

Normal

Response Pattern:

Valid

Consistency:

Good

No quality concerns detected. Response patterns indicate engaged, thoughtful completion.

Appearance Anxiety Level

Overall level of appearance-related concerns

52.4%

moderate

49/92 raw score

BDD Feature Assessment

Presence of body dysmorphic disorder indicators

Some Indicators

1 of 5 ALERT items elevated

Important: Appearance anxiety level and BDD features are assessed separately. High appearance anxiety does not necessarily indicate BDD. Patients with elevated appearance anxiety but no BDD features may be appropriate candidates for aesthetic treatment. The BDD assessment (ALERT items) determines whether treatment is likely to address concerns.

Completed: 16 March 2026Instrument: AAQ-FULL

Appearance Anxiety Profile

Detailed breakdown of appearance concerns across seven clinical domains

Clinical Interpretation

Moderate appearance anxiety with some areas of concern. This patient shows elevated self-worth contingency on appearance and notable preoccupation with appearance concerns. Extended consultation is appropriate to explore motivations and ensure realistic expectations.

Subscale Profile

Index scores across the seven AAQ subscales (0-100%)

Preoccupation9/16

56%

Social Threat6/12

50%

Avoidance5/12

42%

Safety Behaviours11/20

55%

Mood Reactivity7/12

58%

Self-Worth8/12

67%

Functional Impairment3/8

38%

BDD Feature Assessment

Specific indicators that suggest body dysmorphic disorder - where aesthetic treatment is unlikely to resolve concerns

ALERT Items

Features associated with BDD that indicate treatment may not address underlying concerns

BDD Risk Indicators (ALERT Items)

1 elevated

ALERT01KEY

Symptom Migration

ALERT02

Insight Discrepancy

ALERT03

Compulsive Research

ALERT04

Urgency

ALERT05

Perfectionism

Scores of 3-4 are considered elevated. ALERT01 (Symptom Migration) is a key BDD indicator.

Recommendations

This assessment indicates elevated appearance anxiety that may respond positively to treatment.

Patients with elevated appearance anxiety (without BDD features) may be appropriate candidates who could benefit from aesthetic treatment when expectations are realistic.

Extended consultation to explore motivations and expectations
Document detailed discussion of realistic outcomes and limitations
Ensure patient goals are achievable with proposed treatment

Validation Notice: The Appearance Anxiety Questionnaire (AAQ) is currently undergoing psychometric validation. Population norms have not yet been established and current severity thresholds are provisional, based on clinical rationale pending normative data collection. Results are intended as a screening tool to support clinical decision-making and should be interpreted alongside professional clinical judgement. This instrument does not provide diagnosis and is not intended to replace comprehensive psychological assessment where indicated.

Assessment ID: sample-demo-001

Patient: AAQ-DEMO-2024-AB | Age: 35-44 | Sex: Female

Instrument: AAQ-FULL | Timepoint: Baseline Assessment

This report is generated for clinical decision support purposes. It should be interpreted by qualified professionals in the context of a comprehensive clinical assessment.

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