Maaya Kobayashi

Abstract 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.

Body dysmorphic disorder (BDD) is a psychiatric disorder characterized by a preoccupation with nonexistent or slight flaws in one’s physical appearance. This study outlined the epidemiology, comorbidity, psychopathology, and efficacy of cognitive behavioral therapy (CBT) for BDD. According to meta-analytic studies, the prevalence of BDD is 20.0% in patients undergoing cosmetic surgery or dermatology, 7.4% in psychiatric patients, 1.9% in adults, and 3.3% in university students. BDD also has a high rate of comorbidity with major depressive disorder, social anxiety disorder, and alcohol use disorder. CBT for BDD includes psychoeducation, exposure therapy, and response prevention, and its efficacy in the treatment of BDD has been reported in randomized controlled trials. Future challenges include elucidating the psychopathology of BDD in Japanese individuals and developing CBT tailored to the Japanese population.

Background This study developed the Japanese version of the Auckland Individualism and Collectivism Scale (J-AICS), examined its reliability and validity, and explored the associations between its factors (compete, unique, responsibility, advice, and harmony) along with variables related to mental health in the Japanese population. Methods We recruited 476 Japanese participants from the general population. Participants completed the J-AICS along with questionnaires pertaining to culture and mental health. Results Confirmatory factor analysis indicated the correlated five-factor model showed a good fit to the data. The Cronbach’s α and McDonald’s ω coefficients were high for the individualism, collectivism, compete, unique, and advice factors, but low for the responsibility and harmony factors. Convergent validity was supported by significant relationships between culture-related variables. A one-way analysis of variance revealed the low individualism/collectivism cluster had higher loneliness and lower satisfaction with life than the high individualism and collectivism clusters. The multiple regression analyses showed that the responsibility factor was significantly and negatively associated with mental health concerning anxiety and depressive symptoms, loneliness, and satisfaction with life. In addition, the harmony factor was significantly and positively associated with the mental health. Conclusion These findings demonstrate sufficient validity of the J-AICS; however, reliability was insufficient for responsibility and harmony. Further, responsibility was positively associated with mental health and harmony was negatively associated with mental health.