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The Body Image Scale: A Simple and Valid Tool for Assessing Body Image Dissatisfaction in Inflammatory Bowel Disease

McDermott, Edel MB*,†; Moloney, Jenny BSc; Rafter, Niamh BComm*,†; Keegan, Denise RGN*,†; Byrne, Kathryn BSc*,†; Doherty, Glen A. PhD*,†; Cullen, Garret MD*,†; Malone, Kevin MD†,§; Mulcahy, Hugh E. MD*,†

doi: 10.1097/01.MIB.0000438246.68476.c4
Original Clinical Articles

Background: Body image refers to a persons' sense of their own physical appearance. This can be negatively influenced by a number of factors including disease states and treatments. Inflammatory bowel disease (IBD) carries a distinct psychosocial and a physical burden, but body image has not been formally assessed in patients with IBD, nor is there a validated body image questionnaire. Our aim was to assess and validate a body image questionnaire for patients with IBD.

Methods: Three hundred thirty-eight ambulatory patients (median age, 36; 174 male) completed a questionnaire that included the Hopwood body image scale adapted from the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Study Group. Data from another scale, the Cash Body Image Disturbance Questionnaire, were also collected in addition to demographic and clinical data.

Results: Factor analysis resulted in a single factor solution explaining 65% of the variance. Internal consistency of the body image scale was demonstrated with a Cronbach alpha of 0.93. Convergent validity was established with a correlation coefficient of 0.64 (P < 0.001) with the Cash Body Image Disturbance Questionnaire. Females (P < 0.001) and those who had undergone either stoma or nonstoma forming surgery experienced more body image dissatisfaction (P = 0.002), indicating predictive validity. Reliability was confirmed with a test–retest correlation of 0.82 (P < 0.001).

Conclusions: The modified body image scale is a valid tool for assessing body image in patients with IBD.

Article first published online 26 December 2013

*Department of Gastroenterology, St Vincent's University Hospital, Dublin, Ireland;

UCD School of Medicine and Medical Science, University College Dublin, Dublin, Ireland;

Department of Gastroenterology, St Luke's Hospital, Kilkenny, Ireland; and

§Department of Psychiatry, Psychotherapy and Mental Health Research, St Vincent's University Hospital, Dublin, Ireland.

Reprints: Hugh E. Mulcahy, MD, Department of Gastroenterology, St Vincent's University Hospital, Elm Park, Dublin 4, Ireland (e-mail:

The authors have no conflicts of interest to disclose.

Received September 21, 2013

Accepted November 1, 2013

© Crohn's & Colitis Foundation of America, Inc.
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