The processing of the self as an aesthetic object: Development of a new measure for understanding body dysmorphic disorder

A theoretical model for understanding body dysmorphic disorder is the processing of the self as an aesthetic object (SAO), which includes the experience of a negative imagery in relation to how one looks and the experience of shame. Our aim was to psychometrically evaluate a new questionnaire, the SAO, to explore this concept. In Study 1, 80 participants with BDD and 102 with body dissatisfaction completed the SAO, the Appearance Anxiety Inventory (AAI), and the Cosmetic Procedures Screening (COPS) questionnaires. Exploratory factor analyses (EFA) were conducted, and convergent validity was assessed through correlation with the AAI and COPS. In Study 2, a confirmatory factor analysis (CFA) of the SAO was conducted on another clinical sample (N = 77) of participants with BDD who completed questionnaires prior to attending assessment and treatment at a specialist outpatient clinic. Convergent validity and internal consistency were re-assessed. EFA in the BDD group in Study 1 suggested a single factor structure on the basis of 11 of the original 12 items. CFA of a one-factor structure of the 11-item SAO found a reasonable fit, with some unacceptable fit indices. Convergent validity was demonstrated through moderate and significant correlation of the SAO with the AAI and the COPS. Internal consistency of the SAO was good (Cronbach's alpha range: .89-.94). In conclusion, we explored the processing of the self as an aesthetic object through a new questionnaire, and findings support its reliability and validity with a single factor. Several treatment implications are discussed.