Indexed on: 16 Oct '14Published on: 16 Oct '14Published in: Clinical Psychology & Psychotherapy
Theoretical and empirical accounts highlight the link between shame and body image difficulties, and disordered eating behaviours. Specifically, body image shame seems to play a particularly important role in this association. The current study aimed at developing and validating a new measure of body image shame and its phenomenology, the Body Image Shame Scale (BISS). Distinct samples of women from the general and student populations were used to test the BISS factorial structure using principal component analysis (PCA) and confirmatory factor analysis (CFA), and to examine the psychometric properties of the BISS. Principal component analysis results indicated that the scale presents a two-factor structure assessing an externalized and an internalized dimension underlying body image shame, which explains a total of 62.41% of the variance. A confirmatory factor analysis further corroborated the adequacy of this structure, which revealed good global and local adjustment indices. The BISS also presented very good internal consistency, construct and discriminant validities and good test-retest reliability. The scale also showed good concurrent and divergent validities. Furthermore, the scale discriminates between women with higher or lower levels of disordered eating behaviours. Finally, a mediation analysis revealed that the BISS fully mediates the previously established association between external shame and eating psychopathology. The BISS is a psychometrically robust and short measure of body image shame and its external and internal dimensions. Copyright © 2014 John Wiley & Sons, Ltd. Key Practitioner Message The BISS is a brief and reliable self-report instrument of body image-related shame. The BISS assesses the phenomenology of body image shame considering an externalized dimension and an internalized dimension, which may have important clinical implications. The BISS presents very good internal consistency, construct and discriminant validities, test-retest reliability, concurrent and divergent validities, and accurately distinguishes between women with higher and normative levels of disordered eating behaviours. Body image shame, as assessed by the BISS, contributes to a better understanding of eating psychopathology with findings suggesting that the association between external shame and eating psychopathology fully depends on the extent to which one's body image becomes the source of shame, with the consequent activation of defensive attitudes and behaviours.