PURPOSE. To examine the validity of the nursing diagnosis body image disturbance and to specify its major and minor defining characteristics in Japanese culture. METHODS. A qualified sample of 149 RNs with an average of 10 years of clinical experience and knowledge of nursing diagnosis was given a questionnaire consisting of 21 defining characteristics from NANDA, 8 additional items from the literature, and 2 distracting characteristics. FINDINGS. Four major diagnostic content validation (DCV) scores of 0.75 and higher and 15 minor defining characteristics with DCV scores from 0.60 to 0.74 were identified. CONCLUSIONS. This study provides a foundation for further study of culturally appropriate defining characteristics for use in Japan.