My scales

My scales can all be downloaded from the KCL website and can be used without my permission so long as you cite it in any publication.

Scales on this page

Appearance Anxiety Inventory

The AAI is a 10 item self-report questionnaire assessing the frequency of cognitive processes (e.g., rumination, self-focused attention) and behaviours (e.g. social avoidance, appearance checking) seen in BDD.

Individuals respond to items on a 5-point Likert Scale (0= not all to 4= all the time) and a total score is obtained by summing all the items (maximum score is 40). Two factors were identified in a clinical sample (Avoidance subscale items 1, 3, 5, 7, 9, 10) and Threat Monitoring subscale (items 2, 4, 6, 8) (Veale et al, 2014). A reduction ≥40% on the AAI was the optimal cut-off for treatment response. An AAI score ≤13 was the optimal cut-off for full or partial remission (Fygare et al, 2020).

It can be used without my permission so long as you cite it in any publication.

Download the paper and scale from KCL

References

Veale, D, Eshkevari, E, Kanakam, N, Ellison, N, Costa, A, Werner, T. (2014). The Appearance Anxiety Inventory: Validation of a process measure in the treatment of body dysmorphic disorder. Behavioural and Cognitive Psychotherapy. 42: 605–616 http://dx.doi.org/10.1017/S1352465813000556

Flygare, O, Chen, L, Fernández de la Cruz, L, Enander, J, Mataix-Cols, D, Rück, C, Andersson, E (2020) Empirically defining treatment response and remission in body dysmorphic disorder using a short self-report instrument. Behavior Therapy, https://doi.org/10.1016/j.beth.2020.10.006

Cosmetic Procedure Screening Scale (COPS) or Body Image Questionnaire

The Cosmetic Procedure Screening Questionnaire (COPS) (or also called Body Image Questionnaire in non-cosmetic settings) is designed to screen for Body Dysmorphic Disorder and comprises 10 items. The first item defines the features and is not part of the total score. Items 2 to 10 are scored from 0 (least impaired) to 8 (most impaired).

The score is achieved by summing Q 2-10. Items 2, 3 and 5 are reversed (that is if the person circles “8” then this is a score of zero, circling “7” is scored as ‘1’ and so on). The total scores range from 0 to 72 with a higher score reflecting greater impairment and symptoms of BDD. Individuals who score 40 or more are likely to have a diagnosis of BDD. It has been adopted by IAPT as an outcome measure for treating BDD.

It can be used without my permission so long as you cite it in any publication.

Download the paper and scale from KCL

References

Veale, D, Ellison, N, Werner, T, Dodhia, R, Serfaty, M & Clarke, A. (2012) Development of a cosmetic procedure screening questionnaire (COPS) for Body Dysmorphic Disorder. Journal of Plastic Reconstructive and Aesthetic Surgery, 65:530-532. http://dx.doi.org/10.1016/j.bjps.2011.09.007

Penile Dysmorphic Disorder Screening Scale

Penile Dysmorphic Disorder is shorthand for men diagnosed with Body Dysmorphic Disorder (BDD), in whom the size or shape of the penis is their main, if not their exclusive, preoccupation causing significant shame or handicap. The Penile Dysmorphic Screening Questionnaire is therefore  designed to screen for BDD and comprises of 9 items. Items are scored from 0 (least impaired) to 8 (most impaired).  Items     are reversed (that is if the person circles “8” then this is a score of zero, circling “7” is scored as ‘1’ and so on). The total scores range from 0 to 72 with a higher score reflecting greater impairment and symptoms of BDD.

It can be used without my permission so long as you cite it in any publication.

Download the paper and scale from KCL

Reference

Veale, D, Miles, S, Read, J, Miles, S, Troglia, A, Phillips, R, Carmona, L, Fiorito, C, Wylie, K, Muir, G. (2015). Penile Dysmorphic Disorder: Development of a screening scale. Archives of Sexual Behavior, 44(8) 2311-2321. http://dx.doi.org/10.1007/s10508-015-0484-6

Beliefs about Penis Size

The BAPS is a 10-item self-report scale that measures beliefs about masculinity and shame about penis size. Two of the items measure internal self-evaluative beliefs, such as feeling abnormal (e.g., “I will never feel just right”). Three items describe a social cognitive component with predictions such as “Others will talk about my penis or laugh at it”. There are four items on anticipated consequences of a small penis size, such as having to avoid situations where they may be naked (e.g., “I will not be able to be naked in front of women”). Lastly, there are two items on extreme self-consciousness (e.g., “Others will be able to see the size or shape of my penis even when I have my trousers on”). The participant is asked to rate how strongly he agreed or disagrees with each statement, using a 5-point Likert scale from 0 (“Strongly disagree”) to 4 (“Strongly agree”). Total scores range from 0 to 40. A higher score therefore represents a greater level of insecurity and shame about penis size. Cronbach’s alpha for the scale was .95, indicating strong internal reliability.

It can be used without my permission so long as you cite it in any publication.

Download the paper and scale from KCL

References

Veale, D, Eshkevari, E, Read, J, Miles, S, Troglia, A, Phillips, R, Carmona, L, Fiorito, C, Wylie, K, Muir, G. (2014) Beliefs about penis size: validation of a scale for men ashamed about their penis size. Journal of Sexual Medicine, 11: 84-92. http://dx.doi.org/10.1111/jsm.12294

Cosmetic Procedure Screening for Labiaplasty

The Cosmetic Procedure Screening for Labiaplasty (COPS-L) is designed to screen for Body Dysmorphic Disorder and comprises of 9 items. Items are scored from 0 (least impaired) to 8 (most impaired).  Items 1, 2 and 4 are reversed (that is if the person  circles “8” then this is a score of zero, circling “7” is scored as ‘1’ and so on). The total scores range from 0 to 72 with a higher score reflecting greater impairment and symptoms of BDD. Individuals who score 45 or more are likely to have a diagnosis of BDD. We recommend that both the Genital Appearance Scale (GAS) by Bramwell and the COPS-L be routinely used for audit and outcome monitoring of interventions for women distressed by the appearance or function of their genitalia. The GAS has an advantage in assessing additional functional symptoms in such women. The COPS-L may be helpful in identifying women with BDD.

It can be used without my permission so long as you cite it in any publication.

Download the paper and scale from KCL

References

Veale, D, Eshkevari, E, Ellison, N, Cardozo, L, Robinson, D, & Kavouni, A. (2013). Validation of Genital Appearance Satisfaction Scale and COPS-L. Journal of Psychosomatic Obstetrics and Gynecology, 34(1): 46–52.http://dx.doi.org/10.3109/0167482X.2012.756865

Specific Phobia of Vomiting Inventory (SPOVI)

The Specific Phobia of Vomiting Inventory (SPOVI) is designed to measure the frequency of key cognitive processes and behaviours in emetophobia. It consists of 14 items. Responses are either “Not at all” = “0”, “A little” = 1, “Often” = 2, “A lot” = 3, or “All the time” = 4). The total score is calculated by adding all 14 items so that the range is 0 to 56. A diagnosis of emetophobia is likely with a score of 10 or above.

There are also two sub scales on the SPOVI. The avoidance subscale consists of 7 items (range 0-28). These have a shaded background on the questionnaire. The Threat Monitoring subscale is also 7 items (range 0-28). These do not have a shaded background. The subscales can help to know if you are mainly either avoiding or monitoring threats of vomiting.

It can be used without my permission so long as you cite it in any publication.

Download the paper and scale from KCL

References

Veale, D, Ellison, N, Boschen, M, Costa, A, Whelan, C, Muccio, F, Henry, K (2013). Development of an inventory to measure Specific Phobia of Vomiting (emetophobia). Cognitive Therapy and Research, 37:595-604 http://dx.doi.org/10.1007/s10608-012-9495-y

EmetQ

The Emetophobia Questionnaire (EmetQ-13) is a scale developed by Mark Boschen and I subsequently I helped to validate. It measures the severity of symptoms of emetophobia. The total score is calculated by adding all 13 items so that the range is range is from 13 to 65. A diagnosis of emetophobia is likely for a score above 22. The EmetQ can also be scored by adding three sub-scales (1) Items 1 to 6 which relate to avoidance of travel and places where there is no help available (2) Items 7 to relate to themes of dangerousness in exposure to vomit (3) Items 10 to 13 are related to avoidance of others who may vomit.

The EmetQ and SPOVI overlap slightly but measure slightly different constructs.

It can be used without Mark Boschen’s or my permission so long as you cite it in any publication.

Download the paper and scale from KCL

References

Boschen, M, Veale, D., Ellison, N., Reddell, T. (2013). The Emetophobia Questionnaire (EmetQ-13): Psychometric Validation of a Measure of Specific Phobia of Vomiting. Journal of Anxiety Disorders, 27(7): 670-677. http://dx.doi.org/10.1016/j.janxdis.2013.08.004

Therapeutic Environment Scales (TESS)

The Therapeutic Environment Scales (TESS) is designed to measure the occurrence of various processes in a therapeutic environment. It is theoretically driven with 9 subscales of inter-personal behaviour that may influence the environment. These consist of (a) positive reinforcement for acts of courage at the time they occurred, (b) extinction of unhelpful behaviours, (c) communication, honesty and genuineness, (d) feeling safe with others, (e) belongingness and shared responsibility to others, (f) compassion, (g) inconsistency in behaviour, (h) accommodation of unhelpful behaviours, (i) emotional expression. It has three main sections: Part 1 examines the respondent’s relationship with staff; Part 2 asks about their relationship with other members who are not staff; and Part 3 asks the respondent about their own actions within the community. Each section addresses the same processes and subscales, but from these different perspectives of the behaviour of clients, staff or one’s own behaviour. Processes that do not relate to interactions within the community are only assessed in Part 3 with four additional subscales that focus on one’s own behaviour (a) goal setting and tasks, (b) structured activity, (c) democracy and influence, (d) keeping to and questioning boundaries. This last subscale on “Boundaries” is less reliable on the Cronbach’s alpha and should be used with caution.

Responses on all items are given on a 7-point Likert scale from ‘Strongly disagree’ to ‘Strongly agree’ and refer to the past week.
The total for each subscale is averaged (i.e. divided by the number of items in the subscale).

Lastly there are a number of items that are reverse scored. These are
PART 1
B (3) “Staff reacted to my unhelpful behaviours in a way that upset me or made me feel uncared for “
D (1) “I was scared to express my needs to some staff”
D (4) “I felt some staff were rather bullying and intimidating”
F (6)  “I felt some staff did not have time for my problems”

PART 2
B (3) “Members reacted to my unhelpful behaviours in a way that upset me or made me feel uncared for “
D (1) “I was scared to express my needs to some members”
D (4) “I felt some members were rather bullying and intimidating”
F (6)  “I felt some members did not have time for my problems”

PART 3
K  (3) I reacted to the unhelpful behaviours of other members in a way that upset them
N (6) I did not have time for other members’ problems

The scale may be used freely but must be cited in a publication. Please do send me the results of your environment and with a short description of your environment (e.g population served, therapeutic modality, age range) and when it was taken so we may benchmark different types of environments. To ensure stability it is best to repeat the measures at least three times say 2 months apart.

It can be used without my permission so long as you cite it in any publication.

Download the paper and scale from KCL

References

Veale, D, Miles, S, Naismith, I, Gilbert, P. (2016). Development of a Compassion Focused and Contextual Behavioural Environment and validation of the Therapeutic Environment Scales (TESS).  BJPsych Bulletin, 40, 12-19. http://dx.doi.org/10.1192/pb.bp.114.048736

Exercise Dependence Questionnaire

The Exercise Dependence Questionnaire (EDQ) was designed to measure the severity of dependence on exercise. To calculate the total EDQ score, all items are summed (there are no reverse items). Total scores for each of the 8 factors can also be calculated.  The EDQ has not been validated against a clinical group to allow interpretation of the scores.

It can be used without my permission so long as you cite it in any publication.

Download the paper and scale from KCL

References

Ogden, J, Veale, D, Summers, Z (1997) Development and validation of the exercise dependence questionnaire. Addiction Research, 1997; 5: 343-356. http://dx.doi.org/10.3109/16066359709004348