Validation of the Body Concealment Scale for Scleroderma (BCSS): Replication in the Scleroderma Patient-centered Intervention Network (SPIN) Cohort

Lisa R Jewett; Linda Kwakkenbos; Marie-Eve Carrier; Vanessa L Malcarne; Diana Harcourt; Nichola Rumsey; Maureen D Mayes; Shervin Assassi; Annett Körner; Rina S Fox; Shadi Gholizadeh; Sarah D Mills; Catherine Fortune; Alexandra Portales; Brett D Thombs; SPIN Investigators

doi:10.1016/j.bodyim.2016.11.007

Validation of the Body Concealment Scale for Scleroderma (BCSS): Replication in the Scleroderma Patient-centered Intervention Network (SPIN) Cohort

Body Image. 2017 Mar:20:99-106. doi: 10.1016/j.bodyim.2016.11.007. Epub 2017 Jan 6.

Authors

Collaborators

SPIN Investigators:
Murray Baron¹⁰, Susan J Bartlett¹⁰, Dan Furst¹¹, Karen Gottesman¹², Frank van den Hoogen¹³, Luc Mouthon¹⁴, Warren R Nielson¹⁵, Serge Poiraudeau¹⁴, Robert Riggs¹⁶, Maureen Sauve¹⁷, Fredrick Wigley¹⁸, Isabelle Boutron¹⁹, Angela Costa Maia²⁰, Ghassan El-Baalbaki²¹, Carolyn Ells¹⁰, Cornelia van den Ende²², Kim Fligelstone²³, Catherine Fortune¹⁷, Tracy Frech²⁴, Dominique Godard²⁵, Daphna Harel²⁶, Marie Hudson¹⁰, Ann Impens²⁷, Yeona Jang¹⁰, Sindhu R Johnson²⁸, Ann Tyrell Kennedy²⁹, Dinesh Khanna³⁰, Maggie Larche³¹, Catarina Leite²⁰, Carlo Marra³², Karen Nielsen¹⁷, Janet L Poole³³, Janet Pope³⁴, Tatiana Sofia Rodriguez Reyna³⁵, Anne A Schouffoer³⁶, Russell J Steele³⁷, Maria E Suarez-Almazor³⁸, Joep Welling³⁹, Durhane Wong-Rieger⁴⁰, Alexandra Albert⁴¹, Guylaine Arsenault⁴², Lyne Bissonnette⁴², Gilles Boire⁴², Alessandra Bruns⁴², Patricia Carreira⁴³, Lorinda Chung⁴⁴, Pierre Dagenais⁴², Christopher Denton⁴⁵, Robyn Domsic⁴⁶, James V Dunne⁴⁷, Paul Fortin⁴¹, Anna Gill⁴⁵, Jessica Gordon⁴⁸, Genevieve Gyger³⁷, Ariane L Herrick⁴⁹, Monique Hinchcliff⁵⁰, Alena Ikic⁴¹, Niall Jones⁵¹, Artur Jose de B Fernandes⁴², Suzanne Kafaja¹¹, Nader Khalidi³¹, Benjamin Korman⁵⁰, Patrick Liang⁴², Joanne Manning⁵², Ariel Masetto⁴², David Robinson⁵³, Sophie Roux⁴², Elena Schiopu³⁰, Doug Smith⁵⁴, Robert Spiera⁵⁵, Virginia Steen⁵⁶, Evelyn Sutton⁵⁷, Carter Thorne⁵⁸, John Varga⁵⁰, Pearce Wilcox⁴⁷, Vanessa C Delisle³⁷, Claire Fedoruk⁵⁹, Brooke Levis³⁷, Mia R Pepin⁵⁹, Jennifer Persmann²¹

Affiliations

¹ Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada.
² Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Behavioural Science Institute, Clinical Psychology, Radboud University, Nijmegen, The Netherlands.
³ Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada.
⁴ Department of Psychology, San Diego State University and University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
⁵ Centre for Appearance Research, University of the West of England, Bristol, England, United Kingdom.
⁶ University of Texas McGovern School of Medicine, Houston, TX, USA.
⁷ Scleroderma Society of Canada, Ottawa, Ontario, Canada.
⁸ Asociación Española de Esclerodermia, Madrid, Spain.
⁹ Lady Davis Institute for Medical Research, Jewish General Hospital, Montréal, Québec, Canada; Department of Educational and Counselling Psychology, McGill University, Montréal, Québec, Canada; Department of Psychiatry, McGill University, Montréal, Québec, Canada; Department of Medicine, McGill University, Montréal, Québec, Canada; Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montréal, Québec, Canada; Department of Psychology, McGill University, Montréal, Québec, Canada. Electronic address: brett.thombs@mcgill.ca.
¹⁰ McGill University, Montréal, Québec, Canada.
¹¹ University of California, Los Angeles, California, USA.
¹² Scleroderma Foundation, Los Angeles, California, USA.
¹³ Radboud University Medical Center and Sint Maartenskliniek, Nijmegen, The Netherlands.
¹⁴ Université Paris Descartes, Paris, France.
¹⁵ St. Joseph's Health Care, London, Ontario, Canada.
¹⁶ Scleroderma Foundation, Danvers, Massachusetts, USA.
¹⁷ Scleroderma Society of Ontario, Hamilton, Ontario, Canada.
¹⁸ Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
¹⁹ Université Paris Descartes, and Assistance Publique-Hôpitaux de Paris, Paris, France.
²⁰ University of Minho, Braga, Portugal.
²¹ Université du Québec à Montréal, Montréal, Québec, Canada.
²² Sint Maartenskliniek, Nijmegen, The Netherlands.
²³ Scleroderma Society, London, UK.
²⁴ University of Utah, Salt Lake City, Utah, USA.
²⁵ Association des Sclérodermiques de France, Sorel-Moussel, France.
²⁶ New York University, New York, New York, USA.
²⁷ Midwestern University, Downers Grove, Illinois, USA.
²⁸ Toronto Scleroderma Program, Mount Sinai Hospital, Toronto Western Hospital, and University of Toronto, Toronto, Ontario, Canada.
²⁹ Federation of European Scleroderma Associations, Dublin, Ireland.
³⁰ University of Michigan, Ann Arbor, Michigan, USA.
³¹ McMaster University, Hamilton, Ontario, Canada.
³² Memorial University, St. John's, Newfoundland, Canada.
³³ University of New Mexico, Albuquerque, New Mexico, USA.
³⁴ University of Western Ontario, London, Ontario, Canada.
³⁵ Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
³⁶ Leiden University Medical Center, Leiden, The Netherlands.
³⁷ Jewish General Hospital and McGill University, Montréal, Québec, Canada.
³⁸ University of Texas MD Anderson Cancer Center, Houston, Texas, USA.
³⁹ NVLE Dutch Patient Organization for Systemic Autoimmune Diseases, Utrecht, The Netherlands.
⁴⁰ Canadian Organization for Rare Disorders, Toronto, Ontario, Canada.
⁴¹ Université Laval, Québec, Québec, Canada.
⁴² Sherbrooke University, Sherbrooke, Québec, Canada.
⁴³ Servicio de Reumatologia del Hospital 12 de Octubre, Madrid, Spain.
⁴⁴ Stanford University, Stanford, California, USA.
⁴⁵ Royal Free London Hospital, London, UK.
⁴⁶ University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
⁴⁷ St. Paul's Hospital and University of British Columbia, Vancouver, British Columbia, Canada.
⁴⁸ Hospital for Special Surgery, New York City, New York, USA.
⁴⁹ University of Manchester, Salford Royal NHS Foundation Trust, Manchester, UK.
⁵⁰ Northwestern University, Chicago, Illinois, USA.
⁵¹ University of Alberta, Edmonton, Alberta, Canada.
⁵² Salford Royal NHS Foundation Trust, Salford, UK.
⁵³ University of Manitoba, Winnipeg, Manitoba, Canada.
⁵⁴ University of Ottawa, Ottawa, Ontario, Canada.
⁵⁵ Hospital for Special Surgery, New York, New York, USA.
⁵⁶ Georgetown University, Washington, DC, USA.
⁵⁷ Dalhousie University, Halifax, Nova Scotia, Canada.
⁵⁸ Southlake Regional Health Centre, Newmarket, Ontario, Canada.
⁵⁹ Jewish General Hospital, Montréal, Québec, Canada.

PMID: 28068643
DOI: 10.1016/j.bodyim.2016.11.007

Abstract

Body concealment is an important component of appearance distress for individuals with disfiguring conditions, including scleroderma. The objective was to replicate the validation study of the Body Concealment Scale for Scleroderma (BCSS) among 897 scleroderma patients. The factor structure of the BCSS was evaluated using confirmatory factor analysis and the Multiple-Indicator Multiple-Cause model examined differential item functioning of SWAP items for sex and age. Internal consistency reliability was assessed via Cronbach's alpha. Construct validity was assessed by comparing the BCSS with a measure of body image distress and measures of mental health and pain intensity. Results replicated the original validation study, where a bifactor model provided the best fit. The BCSS demonstrated strong internal consistency reliability and construct validity. Findings further support the BCSS as a valid measure of body concealment in scleroderma and provide new evidence that scores can be compared and combined across sexes and ages.

Keywords: Body concealment; Body image avoidance; Measurement; Scleroderma; Systemic sclerosis; disfigurement.

Publication types

Validation Study

MeSH terms

Adult
Aged
Body Image / psychology*
Female
Humans
Male
Middle Aged
Psychometrics / instrumentation*
Reproducibility of Results
Scleroderma, Systemic / psychology*
Surveys and Questionnaires / standards*