Article

Journal of Health Psychology

Assessment of body
17(4) 556­–566
© The Author(s) 2011
Reprints and permission:
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DOI: 10.1177/1359105311417913
properties of the Body hpq.sagepub.com

Image Questionnaire

Eva Penelo1, Paola Espinoza2, Mariona Portell3

and Rosa M. Raich2

Abstract
This study investigated the psychometric properties of the Body Image Questionnaire (QÜIC) in Spanish
adolescents. The sample comprised 254 girls and 189 boys, aged 12–15. Principal component analyses
showed that the 18 satisfaction items could be summarized using two moderately interrelated dimensions,
torso and head/limbs, with satisfaction with chest/breast and genitals loading on a different factor for boys
(torso) and girls (head/limbs). The QÜIC measures of body satisfaction, body problems, general physical
appearance and conformity with weight and height presented satisfactory test-retest reliability, internal
consistency and convergent validity. Our findings support the use of the QÜIC when assessing body image.

Keywords
Adolescents, body image problems, body image satisfaction, QÜIC, reliability, validity

The altered perception of, and dissatisfaction and McCabe, 2001); almost 30 percent having
with, body image are among the most common developed low body satisfaction (Neumark-
features of patients with eating disorders (ED). Sztainer et al., 2006), and nearly 25 percent of
However, numerous studies have shown that
body image disturbance is not only present in 1 Laboratori d’Estadística Aplicada, Departament de
ED patients, but also occurs in the general Psicobiologia i Metodologia de les Ciències de la Salut,
population (eg, Neumark-Sztainer et al., 2006; Universitat Autònoma de Barcelona, Spain
Striegel-Moore et al., 2009; Tiggemann, 2 Departament de Psicologia Clínica i de la Salut,

2004). The assessment of body image distur- Universitat Autònoma de Barcelona, Spain
3 Departament de Psicobiologia i Metodologia de les
bance in adolescents is especially important
Ciències de la Salut, Universitat Autònoma de Barcelona,
because, at this stage, there are significant Spain
physical and psychological changes in self-
image that play a unique role in the construc- Corresponding author:
tion of identity and gender role. In adolescence, Prof. Dr. Rosa M. Raich, Departament de Psicologia Clínica
i de la Salut, Facultat de Psicologia, Universitat Autònoma
a high percentage of individuals (60% of girls de Barcelona. Edifici B (Campus Bellaterra UAB, Campus
and 30% of boys) state that they want to d’Excel·lència Internacional), 08193 Bellaterra (BCN), Spain.
change their height and weight (Ricciardelli Email: [email protected]

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Penelo et al. 557

girls showing a clinically significant level of specific body parts, rather than examining the
body dissatisfaction (Stice and Whitenton, overall body. Between such tools, a popular
2002). Therefore, body dissatisfaction consti- measure is the Body Areas Satisfaction Scale
tutes an important factor of risk and mainte- (BASS; Cash, 1997; Cash and Henry, 1995),
nance not only for dieting, unhealthy which is used to rate how dissatisfied or satis-
weight-control behaviours and binge eating in fied respondents are with their overall appear-
adolescents (Jacobi et al., 2004; McCabe and ance and with eight specific areas/attributes
Ricciardelli, 2001; 2003; Stice, 2002), but also (face, hair, lower torso, mid torso, upper torso,
for depressed moods, low self-esteem, low muscle tone, height, and weight). The validity of
physical activity, substantial morbidity, stress, the BASS and its revised version (BASS-R) is
substance abuse, and obesity (Neumark- supported by their significant relationships with
Sztainer et al., 2006; Paxton et al., 2006; Stice most variable criteria for both sexes (Giovannelli
and Peterson, 2007). Although such symptoms et al., 2008), including dysfunctional eating atti-
may not culminate in an ED, they do interfere tudes measured with EAT.
with the development of children and adoles- Moreover, the body image construct includes
cents (Levine and Smolak, 2006). Body image an affective/evaluative component and a cogni-
dissatisfaction, therefore, is considered an tive/investment component (Cash, 2002; Cash
important predictor of maladaptive eating atti- et al., 2004). The former refers to self-ideal dis-
tudes and behaviours within the general popu- crepancies and body satisfaction-dissatisfaction,
lation (Kichler et al., 2008). whereas the latter refers to the importance of
In addition, socio-cultural influences that may cognitive-behavioural salience of one’s appear-
contribute to a negative body image are family, ance (Cash, 2002). The literature often includes
peers, and media, with an overall pressure to be only the evaluative dimension and neglects body
thin. The cultural messages on the importance of image investment. But it is important to study
appearance are experienced at an early age both dimensions (Cash, 2002; Cash et al., 2004),
(Grogan, 2006; Hargreaves and Tiggemann, since each of these dimensions can have a differ-
2006) and the attempts to achieve this ideal body ent effect on eating disturbances (Allen et al.,
are a factor that interacts in the development of 2008). Specifically, cognitive/investment dimen-
an ED (Martínez-González et al., 2003). The tri- sion appears to be more powerful in predicting
partite influence model (Thompson et al., 1999) eating attitudes and behaviours (Cash et al., 2004;
also details that the internalization of the thin Espinoza et al., 2010). In addition, Giovannelli
ideal yields body dissatisfaction, which can be a et al. (2008) encourage researchers and clinicians
risk factor for ED. to measure both dimensions with comprehensive,
Since the DSM-IV-TR (APA, 2000) includes empirically validated assessments.
over-concern with weight and shape as a crite- To date, only two Spanish self-report ques-
rion for the diagnosis of anorexia nervosa and tionnaires assessing body image have been vali-
bulimia nervosa, it is essential to properly assess dated in adolescents (Gómez-Peresmitré and
this ED component. Several self-report ques- Acosta Garcia, 2002; Maganto and Cruz, 2008),
tionnaires have been developed to assess body and usually adult versions have been used
dissatisfaction (for a detailed revision, see (Miró, 2006). Both instruments present differ-
Thompson and van den Berg, 2002). Most of ent body shapes: the discrepancy between the
these instruments present text items with a figures selected as current and ideal figure is
closed response format or use different whole interpreted as the degree of body satisfaction-
schematic silhouettes of the body (mainly a dissatisfaction, and the discrepancy between
frontal view of the female body) to be rated the current figure selected and the figure corre-
globally and without an anchor point. On the sponding to the real BMI is a measure of distor-
other hand, Stanford and McCabe (2002) con- tion. However, none of these questionnaires
cluded that it was an advantage to examine assess the body satisfaction of certain parts of

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558 Journal of Health Psychology 17(4)

the body, which is especially relevant for ado- 2005; Jones, 2004; Lawler and Nixon, 2011;
lescents because particular areas are often Levine and Murnen, 2009), and that body image
which determine the overall dissatisfaction dissatisfaction is associated to more dysfunc-
level of each person (Maganto and Cruz, 2008; tional eating attitudes (Giovannell et al., 2008;
Stanford and McCabe, 2002). Kichler et al., 2008; Maganto & Cruz, 2008).
The present study investigated the psychomet-
ric validation of the QÜIC (Qüestionari d’Imatge
Corporal or ‘Body Image Questionnaire’ in Method
English). This self-report instrument includes
Participants
both affective (through body satisfaction items)
and cognitive (through body problem items) Participants were recruited from second-year
dimensions, as suggested by Giovannelli et al. compulsory secondary education from three
(2008), with one single figure which is adapted for urban state and four state-subsidized schools in
girls and boys and includes several parts of the the city of Terrassa, located in the Barcelona
body, as proposed by Maganto and Cruz (2008) area (Catalonia, Spain), selected by means of
and Stanford and McCabe (2002). The QÜIC was incidental sampling. Of 478 initial participants,
initially developed in Catalan (Miró, 2006) from data were obtained from 443 adolescents
clinical experience to assess body image aspects (92.7%; 254 girls and 189 boys), the drop in
considered in the DSM. Like the BASS, it includes sample size being due to some of the question-
several sections (overall appearance, satisfaction naires not being fully answered. The mean age
with different parts of the body, height, and for the final sample was 13.5 years (SD = 0.4).
weight), but introducing the drawing of a body Mean body mass index, based on in situ meas-
shape, rather than just text items, and taking into urements of height and weight, was 21.2 (SD =
account the cognitive/investment dimension. 3.8) for girls and 21.2 (SD = 3.5) for boys.
The aim was to evaluate the validity and Weight status, according to international criteria
reliability of the QÜIC in a Spanish sample of that consider sex and age (Cole et al., 2000; Cole
adolescent girls and boys. The specific objec- et al., 2007) was: 4.8 percent underweight, 63.4
tives were fourfold: a) to evaluate the factor percent normal-weight, 27.3 percent over-
structure of the body satisfaction items; b) to weight, and the remaining 4.5 percent being
present data on the internal consistency and classified as obese. The distribution of partici-
test-retest reliability of the derived scores; c) to pants in terms of origin was: 91.5 percent from
examine the convergent and divergent validity Spain/Europe, 4.3 percent from Central and
with other disordered eating questionnaires South America, 2.9 percent from Morocco, and
adapted to the Spanish population; and d) to 1.3 percent from other countries. Therefore, the
provide validity evidence in relation to sex and majority of participants were Caucasian, reflect-
age. With respect to convergent validity, we ing the ethnicity of the school populations from
expected influences of the aesthetic body ideal, which participants were drawn.
shape concern, and disordered eating attitudes A second and a third assessment were con-
to be directly associated with total body ducted one month (T2) and seven months (T3)
problems and negatively related to body satis- later in the same way, in one of the three urban
faction, general physical appearance, and state schools and two of the four state-subsidized
conformity with weight and height. These
­ schools randomly selected. Thus, 190 (116 girls
hypotheses were based on the notion that expo- and 74 boys) and 195 (118 girls and 77 boys)
sure to mass media, and specially interioriza- adolescents were included at T2 and T3, respec-
tion of the body ideal, is related to body tively, who were essentially the same at both
dissatisfaction, both in girls and boys (Ahern time points (181 participants responded both at
et al., 2011; Barlett et al., 2008; Cafri et al., T2 and T3, nine only at T2, and 14 only at T3).

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Penelo et al. 559

Instruments Questionnaire on Influences of Aesthetic Body

Ideal/Cuestionario de Influencias del Modelo
Body Image Questionnaire/Qüestionari d’Imatge Estético Corporal (CIMEC-26: Toro et al., 2005;
Corporal (QÜIC; Miró, 2006). The Spanish ver- CIMEC-V: Toro et al, 1994). This 26-item self-
sion of the QÜIC assesses body image in children report questionnaire evaluates the impact that
and adolescents. The QÜIC contains three sec- different social agents (advertising, verbal
tions.1 First, on the basis of the figure of a girl or messages, social models and social situations)
a boy, the participants rate their level of satisfac- can have on the development of attitudes to
tion (affective dimension) with each of the 18 one’s body in adolescents and young men and
parts of the body that appear in a drawing (0–10), women aged 12–24. The CIMEC was devel-
and whether each of these parts of the body con- oped and validated in the same geographic
stitutes a problem (cognitive dimension) (yes/no). area of Spain as that of this study, and has
For the former, body image satisfaction scores are shown satisfactory psychometric properties in
derived from the average of the corresponding girls, with Cronbach’s alpha value of .93 for
items, and for the latter, body image problem the total score, sensitivity of 83.1 percent and
scores are obtained through the sum of the num- specificity of 64.4 percent for a cut-off point
ber of body parts that are considered a problem of 17 (CIMEC-26; Toro et al., 1994). This also
by the respondent. Items are un-weighted, since occurs in boys, discriminating significantly
scales that equally average evaluations across all between clinical ED patients and non-clinical
attributes seem as valid and reliable as measures groups (CIMEV-V; Toro et al., 2005). Partici-
that take into account the subjective importance pants rate items on a 3-point Likert-type scale
of body areas (Giovannelli et al., 2008). Second, from 0 (never) to 2 (always), and higher scores
participants rate the level of their own general reflect a greater influence of the aesthetic
physical appearance (‘In general, how do you body ideal. The wording of some items is
score your physical appearance (0 to 10)?’); the adapted to the sex of the respondent (for
higher, the better. And third, participants also rate example, for girls/boys, respectively: ‘When
two more questions about their conformity with you are watching a film, are you especially
their current weight and height (conformity, wish interested in the actress/actor’s body?’). In the
for more, or wish for less). For conformity with present sample the internal consistency was
weight, participants choose between one of the satisfactory (Cronbach’s α = .92).
following three options: ‘I would like to weigh
more’, ‘I would like to weigh less’, or ‘I’m happy Eating Disorder Examination Questionnaire (EDE-Q;
with my weight’. For conformity with height, Fairburn and Beglin, 1994). The Spanish adapta-
participants choose one of the three following tion of the EDE-Q-4 was used, which has shown
options: ‘I would like to be taller’, ‘I would like satisfactory psychometric properties in female
to be shorter’, or ‘I’m happy with my height’. college students (Villarroel et al., 2011) and male
college students (Penelo et al., 2011). It includes
Eating Attitudes Test (EAT-40; Garner and Garfinkel, 22 attitudinal items on ED psychopathology over
1979). This 40-item self-report questionnaire the past 28 days, with higher scores indicating
assesses attitudes, feelings and behaviors that more concern. For the present study, we used the
are characteristic of individuals with ED, and is Shape Concern (EDE-Q-SC) score (eight items),
therefore considered a good screening tool for which showed satisfactory internal consistency
assessing and identifying people at risk of hav- in our sample (Cronbach’s α = .94).
ing an ED. We applied the Spanish adaptation,
which has adequate psychometric properties
(Castro et al., 1991). In this study, the total
Procedure
score was used, which showed satisfactory The study was approved and mediated by the
internal consistency (Cronbach’s α = .86). Terrassa Municipal Institute of Health and

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560 Journal of Health Psychology 17(4)

Social Welfare. Informed written consent from (body problems) evaluated the internal consist-
parents and oral consent from adolescents were ency of the resulting scales. Pearson’s correla-
obtained. After conformity with teachers, the tions for quantitative measures or Cohen’s
questionnaires were voluntarily administered in Kappa for categorical measures were calculated
class, as part of a larger assessment conducted to study the one month and seven month test-
by two members of our team and with the pres- retest reliability. Results for girls and boys were
ence of the teacher in charge. Students who compared with t-Student tests for quantitative
chose not to participate were asked to leave the measures and chi-square tests for categorical
class. Confidentiality was assured, as well as the measures. Finally, depending on the measure-
possibility of getting feedback through a mne- ment scale, Pearson or biserial correlation coef-
monic code. Two team members were responsi- ficients also evaluated the relation between
ble for weighing and measuring the adolescents QÜIC measures and age, EAT-40, CIMEC, and
individually and confidentiality, to maintain the EDE-Q-SC scores.
confidentiality of this information, which might
otherwise have proved embarrassing for the stu-
dents when shown. Data from the first assess- Results
ment were collected during the fall of 2005.
Factor structure and internal
consistency
Statistical analysis Mean (and standard deviation) values for the 18
Statistical analyses were conducted with body satisfaction items ranged from 6.04 (SD =
PASW17 for Windows (SPSS Inc., Chicago, IL, 2.70; thighs) to 8.33 (SD = 1.96; eyes) for girls,
USA). Items on body satisfaction were ana- and from 6.49 (SD = 2.38; skin) to 8.17 (SD =
lysed separately for each sex, using principal 1.84; eyes) for boys. Median (in absolute value,
components analysis, with direct oblimin- for girls and boys, respectively) of skewness
oblique rotation. Listwise deletion was applied. was 0.7 and 0.9, and median of kurtosis was 0.4
For both analyses, solutions based on 1 to 4 fac- and 0.6, which is adequate to factorization. The
tors were considered final candidates. Only Kaiser-Meyer-Olkin (KMO) index of sampling
components with an eigenvalue higher than 1 adequacy was also satisfactory (.88 for girls and
were retained and the Cattell’s scree test for the .90 for boys), and the Bartlett sphericity test
number of factors was applied (Cattell, 1966). was statistically significant (p < .001).
A minimum of 50 percent of the explained vari- Table 1 shows the rotated factor loadings for
ance was required to select a final model, which the pattern matrices. In girls, the 2-factor model
should also explain a relevant percentage of explained 52.1 percent of the variance. Factor 1
variance in comparison with the rejected ones. included seven items (arms, abdomen, waist,
Items showing cross-loading were allocated to buttocks, hips, thighs, and legs), and can be
the factor with the highest loading, when the labelled ‘torso’. Therefore, factor 2 consisted of
difference with respect to the second highest the remaining 11 items (hair, skin, eyes, nose,
value (in absolute value) was above .10. In con- mouth, lips, neck, chest/breast, hands, genitals,
trast, when the difference between factor load- and feet) and can therefore be labelled ‘head
ings was below .10, the contribution of the item and limbs’. Both factors correlated moderately
to the internal consistency of each scale was (r = .41). Cronbach’s alpha values were excel-
taken into account, based on Cronbach’s α if lent for factor 1 (α = .92), factor 2 (α = .84), and
item deleted coefficient. the total score (α = .91).
Next, Cronbach’s α for quantitative items In boys, the 2-factor model explained 53.5
(body satisfaction) or Kuder-Richardson percent of the variance and the 2-factor structure
Formula 20 (KR20) for dichotomous items was almost the same, with few exceptions:

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Penelo et al. 561

Table 1. Body satisfaction items of the QÜIC: factors correlated highly (r = .60). Cronbach’s
Principal components analysis for girls and boys. alpha values were excellent for factor 1 (α = .90),
Girls Boys
factor 2 (α = .86), and the total score (α = .93).
(N = 254) (N = 189) Total body satisfaction scores correlated highly
with general physical appearance (r = .74; p <
% explained 52.1 (.88) 53.5 (.90) .001).
variance Percentages of endorsement for the 18 parts
(KMO) of the body being problematic ranged from 1.59
Factor F1 F2 F1 F2 percent (lips) to 25.30 percent (abdomen) for girls
loadings and from 2.75 percent (eyes and neck) to 19.13
percent (abdomen) for boys. Internal consistency
Satisfaction with was acceptable for the total score both for girls
hair .00 .60 −.15 .78
and boys (KR20 = .74). Total body problem scores
skin .26 .41 .22 .42
correlated moderately and negatively with total
eyes .04 .53 −.14 .84
body satisfaction (r = −.42; p < .001) and general
nose −.09 .70 .01 .73
physical appearance (r = −.40; p < .001).
mouth −.11 .76 .18 .63
lips −.02 .78 .27 .55
neck .34 .46 .15 .61 Test-retest reliability
chest/breast −.04 .47 .72 .10
arms .54 .23 .37 .33 The 1-month and 7-month test-retest reliability
hands .40 .39 .13 .59 was high, with coefficients ranging, respec-
abdomen .86 −.15 .92 −.14 tively, from .66 and .54 (conformity with
waist .86 −.08 .91 −.11 height) to .85 and .76 (satisfaction with torso in
genitals .41 .52 .54 .15 girls and boys) (Table 2).
buttocks .82 .02 .63 .14
hips .89 −.04 .67 .22 Convergent and divergent validity
thighs .90 −.08 .78 −.01
legs .80 .06 .69 .07 Table 2 also presents the correlation coefficients
feet .43 .36 .16 .52 valuing the convergent and divergent validity
Correlation .41 .60 between QÜIC measures and EAT-40, CIMEC,
between and EDE-Q-SC scores. Influences of the aes-
factors thetic body ideal and shape concern correlated
Cronbach’s a .92 (7) .84 (11) .90 (9) .86 (9) highly and negatively with total body satisfac-
value (length)* tion, satisfaction with torso (factor 1), general
Total .91 (18) .93 (18)
physical appearance, and conformity with weight
Cronbach’s a
value (r between −.38 and −.53; p < .001), and highly
and positively with the number of body parts
Note: factor loadings ≥ .30 are in bold. being problematic (r between .53 and .55;
*Cronbach’s a value of each subscale based on items with p < .001). The same pattern was found for cor-
factor loadings underlined
relations with eating attitudes, the magnitudes
being slightly lower (r from /.23/ to /.45/ in abso-
satisfaction with chest/breast and genitals. lute value; p < .001). Conformity with height
Hence, the solution for boys differed slightly also correlated negatively and moderately with
from that obtained for girls, but the factors can EAT-40 (r = −.33; p < .001) and CIMEC
also be labelled ‘torso’ (factor 1, which included (r = −.24; p < .001) scores, while the correlation
chest/breast, arms, abdomen, waist, genitals, but- with EDE-Q-SC was null (r = −.14; p = .084).
tocks, hips, thighs, and legs) and ‘head and The correlations involving satisfaction with
limbs’ (factor 2, which included hair, skin, eyes, head and limbs (factor 2) were low and non-
nose, mouth, lips, neck, hands, and feet). Both statistically significant (r between −.03 and −.21;

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562 Journal of Health Psychology 17(4)

Table 2. Test-retest reliability of the measures of QÜIC one and seven months later (left) and correlation
coefficients between the measures of QÜIC and eating attitudes (EAT-40), influences of aesthetic body ideal
(CIMEC), and shape concern (EDE-Q-SC) scores (right).

Test-retest reliability1 Convergent validity2

1 month 7 months EAT-40 CIMEC EDE-Q-SC

(N = 190) (N = 195)
Total body satisfaction .79 .70 −.23** −.38** −.42**
Satisfaction with torso (girls) .85 .76 −.39** −.51** −.52**
Satisfaction with torso (boys) .85 .76 −.25** −.48** −.53**
Satisfaction with head and limbs (girls) .77 .68 −.03 −.12 −.19
Satisfaction with head and limbs (boys) .66 .61 −.06 −.22* −.21
Total body problems .67 .67 .45** .55** .53**
General physical appearance .71 .63 −.28** −.44** −.45**
Conformity with height .66 .54 −.33** −.24** −.14
Conformity with weight .80 .73 −.42** −.51** −.51**
1 all
p values < .001; Pearson’s correlations for quantitative measures. Kappa for categorical measures (in italics)
2 *p
< .05; ** p < .001; Pearson’s correlations for quantitative measures. Point biserial correlations for dichotomous
measures (in italics) (conformity: yes versus no)

p > .05), except with CIMEC in boys (r = −.22; emerged between girls and boys: the items about
p = .002). satisfaction with chest/breast and satisfaction with
genitals loaded higher on factor 1 (torso) in boys
Relation to sex and age and on factor 2 (head and limbs) in girls. It seems
that, for girls, the factor ‘head and limbs’ (face ele-
Girls showed less body satisfaction (6.92 versus ments, neck, hair, hands, and feet) is extended to
7.31; p = .007; 95% CI [0.11; 0.66]), less general chest/breast, including the cleavage. And the fac-
physical appearance (6.61 versus 7.15; p = .003; tor ‘torso’ includes only the elements from waist
95% CI [0.19; 0.90]), and more body parts being to legs, and arms, but not genitals. In contrast, for
problematic (2.23 versus 1.34; p < .001; 95% CI boys the factor ‘torso’ also includes satisfaction
95% [0.44; 1.34]) than boys. More than half of with chest/breast, the same areas covered by the
the girls wished to weigh less, whereas only a BASS (Cash, 1997; Cash and Henry, 1995) as
third of the boys did (53.9% versus 34.7%; upper, mid, and lower torso, and it also includes
p < .001). No differences were found for con- satisfaction with genitals; and the factor ‘head and
formity with height (54.2% in girls versus 48.5% limbs’ is restricted to facial elements, neck, and
in boys; p = .388), regarding sex.2 hair. This result agrees with the issue that satisfac-
Age only correlated positively with total body tion with chest size is a more important aspect of
satisfaction (r = .14; p = .003), satisfaction with body image and self-esteem for men than satisfac-
head and limbs in girls (r = .18; p = .003), and tion with breast size is for women (Tantleff-Dunn
general physical appearance (r = .13; p = .007), and Thompson, 2000). Therefore, in our case, sat-
but the magnitudes were low. isfaction with chest/breast loaded on one or the
other factor according to its ‘importance’ for body
image in each group of respondents: greater
Discussion importance for boys yields to load on the factor
The QÜIC satisfaction items presented an ade- ‘torso’, while less importance for girls yields to
quate 2-factor structure, with two components load on the factor ‘head and limbs’. It seems that a
that can be broadly summarized as ‘torso’ and similar rule underlies the allocation of satisfaction
‘head and limbs’. Only two noticeable differences with genitals. In fact, genital perception varies as a

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Penelo et al. 563

function of gender, and females tend to be more shape concern: a direct relationship with total
neutral than males toward their genitalia (Morrison body problems and an inverse relationship with
et al., 2005). As a result, the item on satisfaction satisfaction with torso (factor 1) and conformity
with genitals loaded higher on the most important with weight. These results are aligned with the
factor for body image (‘torso’) only in boys. fact that interiorization of the body ideal is
In addition, a brief mention should be made related to body dissatisfaction in both genders
of the two items asking about satisfaction with (Barlett et al., 2008; Cafri et al., 2005; Jones,
hands and feet, which loaded higher on factor 2 2004; Lawler and Nixon, 2011; Levine and
(‘head and limbs’) in boys and showed cross- Murnen, 2009). In addition, the low or null cor-
loadings in girls. Both refer to the two most relations involving satisfaction with head and
extreme elements of limbs or extremities, and limbs (factor 2) and the other questionnaires
both contributed further to the internal consist- also provide evidence of divergent validity.
ency of this less important component of body Regarding sex, girls showed more dissatisfac-
image, rather than to factor 1 (‘torso’). tion than boys, as in previous research (see, for
Beyond the use of an anatomic criterion to example, Anderson and Bulik, 2004; Bearman et
label the underlying dimensions of the QÜIC sat- al., 2006; Lawler and Nixon, 2011; Neumark-
isfaction items following Cash (Cash, 1997; Cash Sztainer et al., 2006), whereas boys reported low
and Henry, 1995), another approach can be con- levels of overall body image investment or con-
sidered, based on the possibility of control over cern (Hargreaves and Tiggemann, 2006). Girls
one’s appearance. Thus, items loading on factor 1 were also less conformable with their current
would mainly refer to body parts that are disguised weight than boys, as in Lawler and Nixon (2011),
or concealed with clothing in Western cultures, but there were no differences regarding conform-
while modifiable with dieting, compared to the ity with height between both sexes. Although
body part items loading on factor 2 that are not. ours is not a random sample, the percentages of
Despite the fact that the bidimensional factor conformity with these two questions were simi-
structure of body satisfaction is slightly different lar to those reported by Ricciardelli and McCabe
for girls and boys, the single total score for the (2001), who found that 60 percent of girls and 30
18 items can be also used, which allows direct percent of boys wish to change their weight and
comparability between both genders. Total body height. In relation to age, correlations with QÜIC
satisfaction and body problems were moderately measures were almost small or null, as reported
and inversely correlated, supporting the exist- by Lawler and Nixon (2011).
ence of both dimensions (affective and cogni- The usual cautions about generalizing beyond
tive, respectively) of the body image construct the sample used should be exercised. Using a
(Cash, 2002; Cash et al., 2004). General physi- community sample does not ensure the inclusion
cal appearance was more related to body satis- of only non-clinical participants. Another limita-
faction than to body problems, thus the general tion could be the absence of an item on muscu-
evaluation of oneself seems to be closer to the larity, which is especially relevant for boys
affective dimension than the cognitive one. (eg, Grogan, 2006; Hargreaves and Tiggemann,
Reliability of QÜIC measures was satisfac- 2006; McCabe et al., in press; McCabe and
tory, in terms of test-retest after one and seven Ricciardelli, 2001; McCabe et al., 2006;
months. As expected, one month test-retest Shomaker and Furman, 2010; Yanover and
coefficients were slightly higher than seven Thompson, 2010). Finally, we were not able to
month ones. Internal consistency was also good, include EDI-2 body dissatisfaction assessment,
above .70 (Nunnally and Bernstein, 1994). to evaluate convergent validity with QÜIC.
The highest correlation coefficients (in abso- To conclude, the QÜIC appears to be an easily
lute value) between QÜIC measures and the administrated and brief self-report questionnaire
other questionnaires administered corresponded with satisfactory psychometric properties in our
to influences of the aesthetic body ideal and community sample. It includes the evaluation of

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564 Journal of Health Psychology 17(4)

both affective and cognitive components of body Allen KL, Byrne SM, McLean NJ and Davis EA
image, by means of a female or male figure, spe- (2008) Overconcern with weight and shape is not
cially adapted for children and adolescents. The the same as body dissatisfaction: Evidence from
QÜIC makes it possible to assess satisfaction and a prospective study of pre-adolescent boys and
girls. Body Image 5: 261–270.
concern for the overall body and for different
Anderson CB and Bulik CM (2004) Gender differ-
parts of it, which may be an advantage over the
ences in compensatory behaviors, weight and
test of silhouettes that limit the assessment of shape salience, and drive for thinness. Eating
body dissatisfaction to aspects involving body Behaviors 5(1): 1–11.
size (Holmqvist and Frisén, 2010). Moreover, the American Psychiatric Association (APA) (2000)
fact that it comprises the assessment of 18 differ- DSM-IV-TR: Diagnostic and Statistical Manual
ent parts of the body enables the inclusion of of Mental Disorders, 4th edn. Washington, DC.
items that are not usually considered, such as Barlett CP, Vowels CL and Saucier DA (2008)
head hair and genitals, which are also sources of Meta–analyses of the effects of media images on
concern for men (Tiggemann et al., 2008). men’s body–image concerns. Journal of Social
Thus, the availability of a valid and reliable and Clinical Psychology 27(3): 279–310.
Bearman SK, Presnell K, Martínez E and Stice E
Spanish version of this new questionnaire may
(2006) The skinny on body dissatisfaction: A lon-
benefit not only research conducted in Spain,
gitudinal study of adolescent girls and boys. Jour-
but also in other Spanish-speaking countries. nal of Youth and Adolescence 35(2): 217–229.
The assessment of body image will contribute to Cafri G, Yamamiya Y, Brannick M and Thompson
the diagnosis, prevention and intervention in JK (2005) The influence of sociocultural factors
body image disorders in adolescent girls and on body image: A meta-analysis. Clinical Psy-
boys, who are the population at risk of ED. chology: Science and Practice 12(4): 421–433.
Knowledge of body image satisfaction and body Cash TF (1997) The Body Image Workbook. An
image problems can help to identify high-risk 8-step Program for Learning to Like your Looks.
groups for selective preventive intervention and Oakland, CA: New Harbinger Publications.
to develop the required preventive strategies. In Cash TF (2002) Cognitive-behavioral perspectives
on body image. In: Cash TF and Pruzinsky
future research of the Spanish QÜIC we propose
T (eds) Body Image: A Handbook of Theory,
the incorporation of a clinical sample, in order to
Research, and Clinical Practice. New York:
obtain evidence of the predictive validity of the Guilford Press, 38–46.
questionnaire, in terms of appearance and main- Cash TF and Henry PE (1995) Women’s body
tenance of eating disturbances. images: The results of a national survey in the
USA. Sex Roles 33(1-2): 19-28.
Acknowledgements Cash TF, Melnyk SE and Hrabosky JI (2004) The
This work was partly supported by the Spanish assessment of body image investment: An exten-
Ministerio de Ciencia y Tecnología (grant number sive revision of the Appearance Schemas Inven-
CBS02002-03689) and the Spanish Ministerio de tory. International Journal of Eating Disorders
Educación y Ciencia (grant number SEJ2005-07099). 35(3): 305–316.
Castro J, Toro J, Salamero M and Guimerá E (1991).
Notes The Eating Attitudes Test: Validation of the
1. A copy of the entire questionnaire can be requested Spanish version. Evaluación Psicológica/Psy-
from the corresponding author. chological Assessment 7(2): 175–190.
2. Descriptive statistics are available upon request. Cattell RB (1966) The scree test for the number of
factors. Multivariate Behavioral Research 1(2):
245–276.
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