In a recent post, we looked at some of the most common assessment instruments used in eating disorders treatment (see Treatment Notes dated 09-18-08). Today, let's examine some of the available instruments for assessing a elated area of concern - body image disturbance.
Studies show that body image disturbance is correlated with disordered eating (see Cash & Deagle, 1997). Indeed, body image disturbance is the most consistent predictor of eating disorders onset (Thompson, et al., 2005). Body image disturbance (or BID) is also notably one of the diagnostic criteria for both anorexia and bulimia. Thus, evaluation of BID is a necessary component for those who work to treat eating disorders.
As is the case with eating disorders assessment, a thorough evaluation of body image disturbance will include a diagnostic interview that assesses for (among other indicators) a history of teasing about weight and appearance, family history of eating disorders, body checking behavior and subjective body image dissatisfaction. However, in addition to a thorough interview, there are many fine measures that can assist in the assessment of body image disturbance.
Body image assessment instruments vary in type. There are self-report measures, paper-and-pencil inventories, as well as those use figure drawings to indicate a person's level of body image dissatisfaction (for an example of the latter, see my book 100 Questions and Answers about Anorexia Nervosa which includes sample figures from the Bidimensional Body Evaluation Scale for Women and the Bidimensional Body Evaluation Scale for Men).
Body image measures also vary in their focus, ranging from an evaluation of the cognitions related to body image disturbance, affect and/or behavior. Still other measures focus less on subjective dissatisfaction and concentrate instead on perceptual disturbances that may contribute to body image distortion.
Some of the most commonly used general assessment measures for eating disorders include subscales that address body image issues, including the Eating Disorder Examination and the Interview for Diagnosis of Eating Disorders (see Treatment Notes dated 09-18-08 for more about these measures). Other measures focus exclusively on evaluating for body image disturbance. A list of some of the most commonly used measures of body image disturbance can be found in the resource Assessment of Eating Disorders, by Mitchell & Peterson (2005).
A prolific researcher in the area of BID, psychologist Thomas Cash, has developed several useful inventories for use in clinical work. Cash makes these instruments available of his website (click here for information). In addition, Cash offers a number of self-help-based, self-report measures for patients in his resource The Body Image Workbook.
Sources: Cash, T. F., & Deagle, E. A. (1997). The nature and extent of body image disturbances in anorexia nervosa nd bulimia nervosa: A meta-analysis. International Journal of eating Disorders, 21, 2-19.
Thompson, J. K., Roehrig, M., Cafri, G., & Heinberg, L. J. (2005). Assessment of body Image disturbance. In Mitchell, J. E., & Peterson, C. B. (Eds.) Assessment of eating disorders. New York: The Guilford Press.
Mitchell, J. E., & Peterson, C. B. (Eds.) Assessment of eating disorders. New York: The Guilford Press.
Ryan, W. J., Sanftner, J. L., & Pierce, P. (2005, June). Validity and reliability of a new visual rating tool for assessing body image in women. Paper presented at the annual meeting of the American College of Sports Medicine, Nashville, Tennessee. Used with permission.