Development and Validation of the Iranian Body Image Scale (IBIS)

Background: Body dissatisfaction has been known as an important public health concern which can influence physical and psycho-social health of adolescents. Hence, health professionals need a valid and reliable tool to assess this problem and its related factors in youth. This study aims to develop and assess psychometric properties of an indigenous scale for evaluation of body image and to investigate its association with body weight status among Iranian adolescents.Methods: This study conducted on 857 adolescents who completed the Iranian body image scale (IBIS) and self-reported their body weight and height. Face, content and construct validity methods were used to assess validity of the IBIS. Exploratory factor analysis (EFA) was used to assess construct validity. Moreover, internal consistency of the scale was assessed by calculating Cronbach’s alpha coefficient (α), and test-retest reliability was examined using intra-class correlation coefficient (ICC). To compare the IBIS scores across sex and body weight status groups, the Mann–Whitney and Kruskal-Wallis tests were used, respectively.Results: Mean age and body mass index (BMI) of participants were 16.5±1.1 years and 22.4±4.5 kg/m2, respectively. The EFA showed a 10-factor construct which explained 57% of the variance. The Cronbach’s alpha coefficient for overall items of the scale was 0.896 and ranged from 0.42 to 0.92 for subscales. The test retest reliability result was acceptable for the IBIS (ICC= 0.805). The ICC values ranged from 0.753 to 0.990 for IBIS subscales. The IBIS total score was significantly higher in girls compared to boys (median (Q1-Q3): 32.2 (25.5-43.3) vs. 30.3(24.0-38.0); p<0.001). In girls, the IBIS total score was significantly lower in normal weight girls compared to their overweight (p=0.001), and obese (p=0.001) counterparts. This difference was not observed in boys. Conclusion: These findings support reliability and validity of the IBIS for assessment of body image in Iranian adolescents; this scale can be applied as an appropriate tool for assessment of body image in adolescents in related future studies. Current findings highlight considering body image as an important aspect of intervention programs targeting overweight and obesity in adolescents, specifically girls.

Association of Inventory to Measure and Assess imaGe Disturbance – Head and Neck Scores With Clinically Meaningful Body Image-Related Distress Among Head and Neck Cancer Survivors

Objective: The Inventory to Measure and Assess imaGe disturbance – Head and Neck (IMAGE-HN) is a validated patient-reported outcome measure of head and neck cancer-related body image-related distress (BID). However, the IMAGE-HN score corresponding to clinically relevant BID is unknown. The study objective is to determine the IMAGE-HN cutoff score that identifies head and neck cancer patients with clinically relevant BID.Methods: We conducted a cross-sectional study at six academic medical centers. Individuals ≥18 years old with a history of head and neck cancer treated with definitive intent were included. The primary outcome measure was the IMAGE-HN. A Receiver Operating Characteristic curve analysis was performed to identify the IMAGE-HN score that maximized sensitivity and specificity relative to a Body Image Scale score of ≥10 (which indicates clinically relevant BID in a general oncology population). To confirm the validity of the IMAGE-HN cutoff score, we compared the severity of depressive [Patient Health Questionnaire-9 (PHQ-9)] and anxiety symptoms [Generalized Anxiety Disorder-7 (GAD-7)], and quality of life [University of Washington-QOL (UW-QOL)] in patients with IMAGE-HN scores above and below the cutoff.Results: Of the 250 patients, 70.4% were male and the mean age was 62.3 years. An IMAGE-HN score of ≥22 was the optimal cutoff score relative to a Body Image Scale score of ≥10 and represents a clinically relevant level of head and neck cancer-related BID. Relative to those with an IMAGE-HN score of &lt;22, patients with IMAGE-HN scores of ≥22 had a clinically meaningful increase in symptoms of depression (mean PHQ-9 score difference = 5.8) and anxiety (mean GAD-7 score difference = 4.1) as well as worse physical (mean UW-QOL score difference = 18.9) and social-emotional QOL (mean UW-QOL score difference = 21.5). Using an IMAGE-HN cutoff score ≥22, 28% of patients had clinically relevant BID.Conclusion: An IMAGE-HN score of ≥22 identifies patients with clinically relevant head and neck cancer-related BID. This score may be used to detect patients who could benefit from strategies to manage their distress, select patients for studies evaluating interventions to manage head and neck cancer-related BID, and improve our understanding of the underlying epidemiology of the disorder.

Body image dissatisfaction in adolescent girls in puberty

The aim of this study was to analyze body image satisfaction among girls from different pubertal groups using two assessment instruments. The sample consisted of 82 adolescent girls, aged 11 to 14 years, divided into two groups: pre- and post-menarche. The Kakeshita’s Body Image Scale (BIS) and Body Shape Questionnaire (BSQ) were used to assess body image dissatisfaction. For comparisons of anthropometric variables between pubertal groups, Student's t-test was used for independent samples. Comparisons between BMI classifications, body image satisfaction and desire for body image change were performed using chi-square and binomial tests for both groups. For the comparison between the instruments, the Kappa coefficient (K) was calculated. The results showed that, for BIS, more than 81% of adolescents showed dissatisfaction, being higher among adolescents in post-menarche. For BSQ, the prevalence of body dissatisfaction was lower, but the results did not confirm those previously observed. In both instruments (BIS and BSQ), there were no differences between groups. However, the study indicated a tendency for post-menarche girls to show greater dissatisfaction in relation to pre-menarche adolescents, while the instruments used do not show agreement in the results.

The German version of the Body Image Scale: Validation among a sample of cancer survivors

Objective: To translate the cancer-specific Body Image Scale (BIS) into German and to validate the translated version by assessing its psychometric properties. Methods: The state-of-the-art translation of the BIS was tested in (i) a psychosocial cancer counselling center in Leipzig and (ii) oncological wards in Berlin, Germany. Composite reliability and factor structure were investigated using confirmatory factor analysis. Item response theory (IRT)-based analyses were performed. Convergent validity was assessed via correlation with another body image questionnaire (BAS) as well as psychological symptom burden (PHQ-9, GAD-2 and DT). Psychosocial and clinical group differences were assessed using t-tests. Results: 677 patients participated (response rate 78%). Composite reliability was 0.92 and the average variance extracted was above 50%. All items had a discriminating power above the established threshold of b = 0.5 and showed optimal discriminatory power at relatively high severity levels of body image disturbance (BID) (b = 0.89-2.06). Test information was highest in patients with moderate BID ( = 1.36). The BIS was negatively correlated with the BAS (r = -0.62, p &lt; 0.001) and positively with psychological symptom burden (e.g. PHQ-9: r = 0.49, p &lt; 0.001). Patients who were younger, female, had undergone chemotherapy and those who were distressed by fatigue, their appearance or sexual problems had significantly higher BID. Conclusions: The German version of the BIS is a valid tool to assess BID in patients with cancer. Normative data are needed to better interpret individual scores within the clinical context.

Alexithymia and Body Image in Saudi Arabian Females (University Students): Preliminary Data

<b><i>Introduction:</i></b> Alexithymia has been the focus of much recent research in relation to emotional regulation and eating problems amongst psychological disorders. It is dealing with difficulties in processing, expressing, and awareness of emotion. Body image has also been researched, especially amongst women, and its relation emotion. <b><i>Objective:</i></b> The aim of this exploratory study is to examine the presence of alexithymia and how this is related to body image amongst a group of female Saudi University students. <b><i>Methods:</i></b> 152 Arabic female students from a local University participated in the study. The Toronto Alexithymia Scale-20 (TAS-20 Arabic), the Therapeutic Alexithymia scale (PTA Scale) short scale, body image scale, and figure body image scale were all used in the study. <b><i>Results:</i></b> The results showed that there is significant correlation between TAS and body image scale. Further, results showed that body image scale is best predictor of alexithymia in regression analysis. <b><i>Discussion:</i></b> Alexithymia has not been studied in university students in KSA. We also explored its relationship to body image and found there is a significant correlation. Alexithymia is present and needs much research in this sample and beyond, in both clinical and non-clinical groups. <b><i>Conclusion:</i></b> This is the first study in an Arabic population to show the alexithymia is prevalent amongst this sample and it is significantly related to poor body image. Further studies are suggested to explore further psychological variables related to body image and eating problems, as well as on clinical samples is indicated.

Influence of Resilience and Social Support on Body Image of Patients in an Acute Stage Following Traffic Accidents

Purpose: The purpose of this study was to identify the relationships between resilience, social support, and body image in patients in an acute stage following traffic accidents and to investigate factors affecting body image.Methods: Data were collected from 86 patients at local hospitals from January 2019 to February 2020. To measure the variables, the body image scale, Conner-Davidson Resilience Scale, and Multidimensional Scale of Perceived Social Support were used. Data were analyzed using descriptive statistics, independent t-tests, analysis of variance, Pearson correlation coefficient, and multiple regression.Results: Mean age of participants was 43.40±14.75 and the proportion of men was 73.3%. The average score for resilience, social support, and body image were 65.16±16.89, 72.93±8.11, and 12.24±6.63, respectively. The highest item on the body image scale was “Are you dissatisfied with the appearance of your scar?”. There were differences in scores for body image according to gender, age, and living status. Resilience (r=-.68, p<.001) and social support (r=-.65, p<.001) were negatively correlated with body image. In the regression model, resilience (β=-.41), social support (β=-.30), and gender (β=.22) accounted for 57.6% of the variance in body image.Conclusion: Resilience and social support were identified in this study as significant factors protecting body image of patients during the acute stage following a traffic accident. It is recommended that psychosocial nursing interventions be conducted throughout the course of treatment.

IMPACT OF LAPAROSCOPIC COLORECTAL SURGERY ON BODY IMAGE

INTRODUCTION The aim of this study is to evaluate the impact of laparoscopic colorectal surgery (LCS) on body image using the validated Body Image Scale (BIS) as a parameter of surgical quality. MATERIAL AND METHODS We conducted an observational descriptive study. Patients who underwent scheduled LCS between June 2015 and December 2019 by a General Hospital Coloproctology Unit were included. RESULTS The sample included 180 patients, 115 men (63.9%) and 65 women (36.1%) with a median age of 67 years. Right hemicolectomies (31.7%) and sigmoidectomies (28.3%) were the main procedures performed. In most patients, a suprapubic (69.4%) or transverse (19.4%) incision was made. 21.9% suffered some type of postoperative complication (13.9% wound complication, 10.6% incisional hernia). The general result of the BIS questionnaire was satisfactory, with a median of 0 in the responses (no alteration of body image). We found that 46.2% of the women had some alteration in body image, compared to 28.7% of the men (p = 0.018) and low and ultra-low anterior resection were the surgeries that obtained worst scores, with 13,5% and 12,5% respectively of patients with a BIS score above 5 (p = 0.044). Patients with a stoma also obtained worst punctuation (25% above 5 vs 6,1%, p = 0.001). No statistically significant differences were found regarding type of incision, presence of complications and anxiety or depression. CONCLUSION Study results show, in general, good post-surgical body image after LCS. However, patients with stoma and women were more dissatisfied. Interestingly, there is no worse body image due to type of incision, so we recommend the least iatrogenic one.

Women's Body Image Distress Associated with Cervical Cancer

Background: Cervical cancer diagnosis and treatment can bring changes related to а woman's body image; which in turn can have a devastating on intimate relationships. Aim: The present study aimed to assess women's body image distress associated with cervical cancer. Methods; Design: A descriptive design was conducted. Setting: out-patient clinic in the oncology unit at Beni-Suef University hospital. Subjects: A purposive sample of 70 women. Tools: Data was collected through a structured interviewing questionnaire sheet, and body image scale. Results: The results of the study indicate that the majority (90%) of the studied women had body image distress. There is a statistically significant relationship between age and marriage age of women and their total body image scores. Conclusion: There is a statistical association between body image statuses amongst those women who were undergoing cervical cancer treatment concerning their socio-demographic characteristics. Recommendations: Implement an educational program to improve the self-body image for women with cervical cancer

Évaluation de l’image du corps chez des femmes traitées pour un cancer utérin

Introduction : À l’heure actuelle, le retentissement des cancers utérins, ainsi que leur traitement sur l’image du corps, demeure un sujet peu étudié en Tunisie et souvent négligé aussi bien par les praticiens, les malades et leurs partenaires. Méthodes : Il s’agit d’une étude transversale descriptive colligeant 100 patientes tunisiennes suivies à l’institut Salah- Azaïez pour un cancer de l’endomètre ou du col utérin confirmés histologiquement et non métastatiques, avec un recul supérieur à six mois. Nous avons utilisé l’échelle Body Image Scale (BIS) et Female Sexual Function Index (FSFI). Nous avons collecté les antécédents personnels et familiaux, et différentes données sociodémographiques des patientes. Résultats : Dans notre étude, 40 % des patientes ont des troubles de l’image du corps. La moyenne du score BIS était de 12,03 avec des extrêmes allant de 0 à 30 avec un écarttype de 7,88. En analyse univariée, l’absence du soutien familial, l’altération de la relation de couple et de la relation sexuelle, la mauvaise tolérance de la chirurgie et la curiethérapie utérovaginale étaient significativement associées à l’altération de l’image corporelle. En analyse multivariée, le bas niveau socio-économique était le facteur indépendant protecteur du trouble de l’image du corps, et la dysfonction sexuelle était le facteur indépendant prédicteur de ce trouble. Conclusions : Le manque de communication des patientes avec leur conjoint et avec l’équipe de soin constitue l’un des principaux obstacles lorsqu’il s’agit de reconnaître et de traiter ce problème. Des stratégies préventives visant à maintenir une image corporelle positive chez ces femmes devraient être entreprises.