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

Abstract

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 < 0.001) and positively with psychological symptom burden (e.g. PHQ-9: r = 0.49, p < 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.