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THE BODYIMAGE QUESTIONNAIRE (BIQ): AN EXTENSION
MICHELE KOLECK, MARILOU BRUCHONSCHWEITZER, FLORENCE COUSSON
GÉLIE and BRUNO QUINTARD.
Department of Psychology, University of Bordeaux 2, France 1
Summary. The 19item BodyImage Questionnaire was administered to 1038 male and female French
subjects. Aprincipal component analysis of their responses yielded a first axis, interpreted as a general Body
Satisfaction dimension. Body Satisfaction was associated with sex, health and with current and future emotional
adjustment.
1
Département de Psychologie, Université de Bordeaux 2, 3 ter, Place de la Victoire, 33076 Bordeaux Cedex,
France.
2
A total of 137 male and female high school students were interviewed in 1987, and 300 words related to their body
image were elicited. These words were grouped into 13 large categories by a content analysis. Each category was
illustrated by one or two bipolar items, resulting in the 19item BodyImage Questionnaire (see Table 1).
3
The average testretest reliability coefficient of the 19 items was 0.67 for a 10day interval (89 male and female
students).
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patients had a more unfavourable body image than healthy subjects (male: p.001),
female: p..01). especially women. Furthermore, a favourable body image predicted a
better recovery of the hospitalized subjects, especially among female patients. The
productmoment correlations observed between FBI scores and the somatic outcome
(rated by the medical staff at the end of the hospitalization) were 0.22 for the 106 male
patients (p<0.05) and 0.43 for the 105 female patients (p<0.001).
The first purpose of this research was to replicate this first study with a new French
sample so as to verify the stability of the factorial structure of the BIQ obtained in 1987.
The second aim was to explore the relations between the body image dimensions and
different personality variables and attitude response scales. The third one was to confirm
the relations between a favourable body image and the adjustment to illness in different
groups of patients.
METHOD
The French version of the BIQ was administered to 1038 French subjects (358
males, 680 females) : 140 cancer patients (60 males, 80 females), 142 back pain patients
(77 males, 65 females), 437 students in psychology (45 males, 392 females) and 319
students in sport (176 males, 143 females)4. 99 of the 142 back pain patients (group A)
also answered the STAIY (Spielberger et al., 1983 ; BruchonSchweitzer et al., 1993),
the TAS20 (Bagby et al., 1994) and the CESD (Radlof, 1977) ; 430 among the 437
students in psychology (group B) also answered the E.P.I. form B (Eysenck et al., 1971)
and a Social Desirability Scale (Crowne and Marlowe, 1960) ; 75 of the 80 female cancer
patients (group C) also answered the STAIY. The 99 low back pain patients were
assessed one year later on StateAnxiety (STAI) and StateDepression (CESD). 59
female cancer patients were assessed two years later on StateAnxiety (STAIY) and the
survival duration without relapse (in months) was measured on the whole group.
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The scales were administered to the patients during an individual encounter. The students answered these scales in
groups of 20 to 25 persons.
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RESULTS
Construct validity :
A principal component analysis was performed on the answers of the 1038 French
subjects to the 19item BIQ. It yielded five axes (eigenvalue > 1) explaining 51.3% of the
total variance. The first one, accounting for 24,3% of the total variance, was interpreted as
a general Body Satisfaction factor (see Table 3). All of the 19 items had notable loadings
on this general axis (>0.30). The internal consistency of the Body Satisfaction scale on
the whole group was satisfactory ( = 0,82). The solutions obtained after varimax
rotations (4 and 5 axes) were unclear and the fourfactor structure observed in 1987 was
not replicated. So we only considered the general Body Satisfaction score (BS) in the
further analyses5.
Women reported significant lower scores of body satisfaction than men in the
whole population (p<0.0001) and in groups A, B, and D. Curiously, the male and female
cancer patients had the higher mean score of general Body Satisfaction (see Table 4).
Body Satisfaction was not associated with age in the whole population (r=0.03, N.S.) and
in each of the subgroups except in the group of male back pain patients (r=0.18, p<0.05).
Dicriminant validity :
Body Satisfaction was significantly linked to personality variables and to some
response attitude scales (see Table 5). Body Satisfaction was negatively correlated with
TraitAnxiety in group A (r=0.53, p<0.0001), group B (r=0.20, p<0.05) and group C (r=
0.39, p<0.0001), with StateAnxiety in group A (r=0.20, p<0.05), group B (r=0.39,
p<0.0001) and group C (r=0.43, p<0.0001), with depression in group A (r=0.50,
p<0.0001), with alexithymia in group A (r=0.30, p<0.01) and group B (r=0.28, p<0.01),
with Neuroticism in group B (r=0.36, p<0.0001). Body Satisfaction was positively
correlated with Extraversion in group B (r=+0.37, p<0.0001). Body satisfaction was not
associated with the Lie scale of EPI in groups A and B (r=0.12, N.S. ; r=0.08, N.S.). Its
5
The correlation between the original FBI score and this General Body Satisfaction score, calculated on the 1038
subjects, was 0.98 (p<0.0001).
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correlation with Social Desirability, calculated in group B, was moderately positive
(r=0.15, p<0.01). These results are close to those observed in 1987 with BIQ and EPI.
Predictive validity :
Body satisfaction was associated to a low score of StateDepression assessed one
year later in 90 patients of the group A and to a low score of StateAnxiety assessed two
years later in 59 women patients of the group C (see Table 5). The negative relation
observed between BS score and survival duration without relapse two years later in 75
women patients of the group C was unsignificant.
DISCUSSION
An unidimensional structure of the body image was confirmed in the present study.
The general Body Satisfaction factor (as the Favorable Body Image score in the first
study) appears as a general and stable component of the body image. This dimension is
probably very close to the body satisfaction as assessed by the B.C.S. (Body Cathexis
Scale) of Secord and Jourard (1953), which was associated with many adaptative
variables6. The general Body Satisfaction score will take the place of the FBI original
score in future.
As in the first study, the general Body Satisfaction score (FBI score in the first
study) is higher in male than in female subjects. The relative body insatisfaction of the
women may reflect their higher body concerns and worries, elicited by the particular
hardness of current standards of feminine beauty (BruchonSchweitzer, 1990). The high
mean BS scores of the cancer patients is amazing, considering the deleterious effects of
this disease and of the associated treatments on the patient’s body. The results concerning
the breast cancer patients belong to a larger study conducted by one of the authors of this
article (CoussonGélie, 2000). She observed some astonishing differences between breast
cancer patients and control subjects: higher Body Satisfaction, higher perceived social
6
In the Secord and Jourard study, men and women did not differ in their Body Cathexis mean scores but in their
variability. In the present study, the female subjects had a greater mean standard deviation on Body Satisfaction
score too. This result was interpreted by these authors in terms of a better body differenciation in women.
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support, and lower StateAnxiety (STAIY) in the first group. These counterintuitive
results may be attributed to the effects of specific defensive attitudes developed by cancer
patients (denial, emotional suppression), in order to cope with acute fear and distress
(Greer and Morris, 1979).
The Body Satisfaction was high in sport students and low in female back pain
patients. As in our first study, the body image is generally more favorable in healthy and
vigorous subjects, except in some groups using probably defensive attitudes to conceal
their distress (cancer patients and male back pain patients). These results support the
construct validity of the general Body Satisfaction.
The BS score varies directly with positive affectivity (extraversion) and inversely
with negative affectivity assessed in the same time (neuroticism) or later (anxiety,
depression). This result is in agreement with previous results (BruchonSchweitzer, 1987 ;
Secord and Jourard, 1953). A favorable body image goes along with and predicts
emotional adjustment. If the BS score is not affected by insincerity (Lie scale), it is
contaminated by social desirability which is a more subtle responseshift bias (but
unfortunately this correlation has been calculated in the student sample only) 7. In the
present study, BS is not associated with a good health issue (as it was the case in 1987),
but only with further emotional adjustment in cancer and low back pain patients.
Considering the prospective nature of the results gathered on patient subjects, we can
conclude that general Body Satisfaction plays a protective role when individuals have to
face a serious illness. But the links between BS and social desirability, and the pathways
between personality, body image, defensive attitudes and health issues have to be
explored with structural equation modeling in further studies conducted with patient
groups.
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In 1987, the body activity, one of the four components of Body Image, was the only factor to be linked with social
desirability. Social desirability as measured by Crowne and Marlowe scale comprises two components : self
deception and impression management (Paulhus, 1984). It would be interesting to know if SD (Social Desirability)
correlates with Body Satisfaction in cancer patients and if so, to know which one of the two components of SD links
more with BS (selfdeception, probably).
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TABLE 1
THE ENGLISH VERSION OF THE 19ITEM BODYIMAGE QUESTIONNAIRE8
1: very much, often ; 2: fairly, fairly often ; 3: in between, neither one ; 4: fairly, fairly often ; 5: very much, often
Cotation : In order to calculate the score of each subject :
add the answers to the favourable items : 1, 6, 7, 9, 10, 12, 14, 16 and 18. The score to each item varies from 1 to
5.
use the reverse scoring (5 to 1) to add the answers to the unfavourable items : 2, 3, 5, 8, 11, 13, 15, 17 and 19. The
score to each of these items varies from 5 to 1.
for the item 4, if the respondent is a man, « masculine » is the favourable answer ; so, use the 1, 2, 3, 4, 5 scoring.
If
the respondent is a woman, « feminine » is the favourable answer ; so, use the 5, 4, 3, 2, 1 scoring.
add the 19 answers : the total score varies from 19 to 95 ; a high score corresponding to Body Satisfaction.
8
These 19 items are not the original ones; they have been translated into English on purpose for this publication.
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TABLE 2
MEANS AND STANDARD DEVIATIONS OF THE FBI ORIGINAL SCORES IN 211
HOSPITALIZED PATIENTS AND 200 CONTROL SUBJECTS
Hospitalized subjects Control subjects
N 106 113
Male mean age 42.6 32.8
FBI mean score 10.09 11.72
S.D. 3.82 3.39
N 105 87
Female mean age 44.5 38.5
FBI mean score 8.54 10.47
S.D. 4.24 4.07
TABLE 3
LOADINGS OF THE 19 BIQ ITEMS ON THE FIRST AXIS (n = 1038).
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BIQ items axis 1
17. sad 0.68
3. source of displeasure 0.61
18. something to be looked at 0.61
12. something to be shown 0.60
2. physically unattractive 0.58
9. tender, loving 0.55
19. not energic 0.55
6. expressing daring 0.51
11. unexpressive 0.49
15. not sexy 0.49
8. something not to be touched 0.44
1. healthy 0.43
7. full 0.43
16. robust, resistant 0.42
13. nervous, worried 0.40
14. young 0.38
5. impure, dirty 0.38
4. masculine (men) / feminine (women) 0.34
10. expressing appeasing 0.32
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TABLE 4
MEANS AND STANDARD DEVIATIONS OF THE BS SCORE IN 142 BACK PAIN
PATIENTS (GROUP A), 437 STUDENTS IN PSYCHOLOGY (GROUP B), 140
CANCER PATIENTS (GROUP C) and 319 STUDENTS IN SPORT (GROUP D)
A B C D Total
n 77 45 60 176 318
Male mean age 42.4 24.6 49,7 19.9 26.9
FBI mean 77.18 73.42 78,33 77.66 76.25
score
S.D. 9.69 9.44 8,63 7.29 8.90
n 65 392 80 143 684
Female mean age 43.9 22.2 48.8 20.0 27.0
FBI mean 67.43 72.20 77.84 74.46 72.81
score
S.D. 11.74 8.95 9.37 5.36 9.09
n 142 437 80 319 1002
Total mean age 43.1 22.5 48.8 19.9 27.0
FBI mean 72.72 72.32 77.84 76.23 73.90
score
S.D. 11.70 8.99 9.37 6.70 9.16
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TABLE 5
PRODUCTMOMENT CORRELATIONS BETWEEN BS SCORE AND VARIOUS
CRITERION OF EMOTIONAL AND PHYSICAL ADJUSTMENT IN A GROUP OF 99
LOW BACK PAIN PATIENTS (A), 430 STUDENTS IN PSYCHOLOGY(B) AND 75
BREAST CANCER WOMEN (C)
General Body Satisfaction
A B C
TraitAnxiety (STAIY) 0.53*** 0.52*** 0.30**
StateAnxiety (STAIY) 0.20* 0.39*** 0.43***
StateDepression (CESD) 0.31**
Alexithymia (TAS20) 0.30** 0.28**
Nevroticism (EPI) 0.36***
Extraversion (EPI) 0.37***
L scale (EPI) 0.12 0,08
Social desirability (SDS) 0.15**
StateAnxiety (STAIY) 0.15 0.38**(1)
StateDepression (CESD) 0.23**
Survival duration without relapse 0.09(2)
*** : p<0.0001 ** : p<0.01 * : p<0.05
(1) (2)
N = 59 N = 75
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