BDD Screening Questionnaire | Kinvara Private Hospital

1. Are you very worried about how you look and do you wish you could think about it less or not at all?*

2. What effect has your concern with your appearance had on your life?*

No effect at allMild effect, but my life is generally pretty normalModerate effect; there are things I have trouble doing or avoid because of my concernSevere effect; it has caused a lot of problems for meExtremely severe; it has completely ruined my life

3. How much distress does your concern with your appearance cause you? (e.g., feeling sad, anxious, panicky)*

NoneMild distress but generally manageableModerate and disturbing but still manageableSevere, very disturbing and not easy to manageExtreme, disabling distress

4. How hard is it for you to control your concern with your appearance and your appearance-related thoughts?*

Complete controlUsually able to control it with little difficultyModerate control; sometimes I can control itLittle control; I'm rarely able to control itNo control at all; I'm almost never able to control it

5. How much time per day on average do you spend thinking about your appearance concerns?*

6. Do you avoid certain situations or places because of your appearance concerns?*

7. How much does your concern with your appearance interfere with your ability to do things at work or school?*

No interferenceMild interference but my performance is generally goodModerate interference; some things are difficult to doSevere interference; a lot of things are difficult to doExtreme interference; I'm unable to work or study

8. How much does your concern with your appearance interfere with your social life and relationships?*

No interferenceMild interference but generally manageableModerate interference; it has caused some problemsSevere interference; it has caused a lot of problemsExtreme interference; I avoid all social activities

9. How much do you feel that other people are aware of your appearance concerns or judge you negatively because of how you look?*

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