International Journal of Management, Technology, and Social SRINIVAS

Sciences (IJMTS), ISSN: 2581-6012, Vol. 9, No. 1, February 2024 PUBLICATION

Exploring the Application of the Body Image

Concern Inventory Scale in Diverse Research
Studies
Smita B. Thomas 1 & Suphala Kotian 2
1
Research Scholar, Institute of Social Science & Humanities, Srinivas University,
Mangalore, India.
Orcid ID: 0000-0001-9895-6024; E-mail: [email protected],
2
Research Professor Institute of Social Science & Humanities, Srinivas University,
Mangalore, India
Orcid ID: 0000-0002-5747-4982; E-mail: [email protected]

Area/Section: Social Science.

Type of the Paper: Review of Literature.
Type of Review: Peer Reviewed as per |C|O|P|E| guidance.
Indexed in: OpenAIRE.
DOI: https://doi.org/10.5281/zenodo.10684895
Google Scholar Citation: IJMTS
How to Cite this Paper:
Thomas, S. B. & Kotian, S. (2024). Exploring the Application of the Body Image Concern
Inventory Scale in Diverse Research Studies. International Journal of Management,
Technology, and Social Sciences (IJMTS), 9(1), 133-147. DOI:
https://doi.org/10.5281/zenodo.10684895
International Journal of Management, Technology, and Social Sciences (IJMTS)
A Refereed International Journal of Srinivas University, India.

CrossRef DOI: https://doi.org/10.47992/IJMTS.2581.6012.0336

Received on: 21/08/2023

Published on: 21/02/2024

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India are the views and opinions of their respective authors and are not the views or opinions
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party.

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International Journal of Management, Technology, and Social SRINIVAS
Sciences (IJMTS), ISSN: 2581-6012, Vol. 9, No. 1, February 2024 PUBLICATION

Exploring the Application of the Body Image Concern

Inventory Scale in Diverse Research Studies
Smita B. Thomas 1 & Suphala Kotian 2
1
Research Scholar, Institute of Social Science & Humanities, Srinivas University,
Mangalore, India.
Orcid ID: 0000-0001-9895-6024; E-mail: [email protected],
2
Research Professor Institute of Social Science & Humanities, Srinivas University,
Mangalore, India
Orcid ID: 0000-0002-5747-4982; E-mail: [email protected]
ABSTRACT
Purpose:- Body Image Concern Inventory Scale (BICI), was established by Danny Axsom,
Heather L. Littleton and Cynthia L. S. Pury in 2005 to recognize the increased prevalence of
body dissatisfaction and related psychological distress. The study employs assessment of the
Body Image Inventory Scale used in various researches and literature articles to gather rich,
in-depth insights of its reliability and validity.
Methodology: The objective of this study is to delve into the intricacies of the topic at hand in
30 research articles and literatures done over 15 years. Researchers will investigate the body
image perceptions and related psychological factors in various articles available online,
shedding light on their potential areas of distress related to body image in female & male
genders across all ages.
Findings: The study provides a holistic understanding of the various researches done about
body image with the help of BICI scale. The findings of this study establishes that the BICI
scale proves to be a robust and dependable instrument for estimating dysmorphic apprehension
in people. The scale exhibits high levels of reliability and validity, and is user friendly
indicating its suitability for use in various research articles and clinical background.
Originality/Value: The study reviews 30 cases using BICI scale to evaluate Body dysmorphic
behaviour done in last 15 years.
Paper Type: Review of prevailing literature
Keywords: BICI, BDD, Body Dissatisfaction, Research Studies
1. INTRODUCTION :
1. In today's society, body image has emerged as a significant aspect influencing individuals'
perceptions of themselves and their holistic wellness. The pursuit for an idealized body shape, often
portrayed by media and societal standards, has led to amplified incidence of body dissatisfaction and
related emotional turmoil. Considering the complexity of body image and its impact on mental health
requires reliable and valid measurement tools. The Body Image Concern Inventory Scale (BICI) is a
tool meant to evaluate the same, which has gained prominence as a comprehensive and
multidimensional instrument for evaluating body image discernments ( Furnham, A., & Greaves, N.
(1994). [1]).
The BICI scale is designed to capture the multifaceted nature of body image and its mechanisms, such
as presence of outward aspect, visage orientation, body areas satisfaction, and obese obsession. It allows
researchers and clinicians to quantitatively assess an individual's subjective experience and cognitive-
affective evaluation of their own body. By examining these dimensions, the scale helps in identifying
specific areas of concern and contributes to a more complete grasp of body image.
The findings will contribute to our knowledge of body image and the actions targeted at promoting
positive body image & reducing body dissatisfaction.

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2. OBJECTIVE :
 To illustrate the importance of incorporating valid & reliable measurement tool such as the BICI
scale in research and medical practice.
 By utilizing such scales, professionals can gain a better understanding of body image concerns.
 By utilizing such scales developing targeted interventions would be easy by the health care
professionals, It will facilitate positive body image development and improved overall well-being in
the society.
3. METHODOLOGY :
The study will employ a mixed-methods approach, studying the quantitative assessments and qualitative
interviews or focus groups of the researches done using BICI scale so as to gather rich, in-depth insights
into participants' experiences and perceptions. By utilizing this extensive methodology, the study aims
to provide a holistic understanding of body image within the selected population. This study aims to
understand the use of the BICI Scale in 30 research articles and literatures done over 15 years.
Researcher will investigate the body image perceptions and associated psychological factors in various
articles available online, shedding light on their subjective experiences, attitudes, and possible ranges
of distress related to body image in male and female genders across all ages.
4. DEFINITION :
The Body Image Concern Inventory (BICI) was developed by L. Littleton, Danny Axsom and Cynthia
L. S. Pury in the year 2005 as a 19-question assessment (scoring between 19 to 95) for measuring of
Body Dysmorphic Disorder. BICI scale has been found to be a strongly reliable and utmost valid
instrument in several studies (Littleton, H., & Breitkopf, C. (2008). [2]).
5. RESEARCH STUDIES ANALYSED :
5.1 BICI Used For Clinical and Subclinical Diagnosis of BDD
40 undergraduate students who were a known case of body dysmorphic and eating disorder disorders,
the BICI exhibited notable discriminatory power. The scale demonstrated a sensitivity of 96%,
indicating its ability to accurately identify individuals with clinical disorders. Additionally, it showed a
specificity of 67%, signifying its capacity to correctly classify individuals with and without the
symptoms. These results highlight that the scale had strong potential to diagnose of the BICI in
differentiating between the clinical and subclinical manifestations of body dysmorphic disorder and
disorders related to eating among this specific group of the students (Champlain, A., & Laumann, A.
(2015). [3]).

5.2 BICI Among those Seeking Cosmetic Surgery

In a sample of 117 individuals seeking cosmetic rhinoplasty, BICI was employed alongside psychiatric
interviews to assess the presence of body dysmorphic disorder (BDD). The scale demonstrated a
sensitivity of 93.5%, indicating its ability to accurately identify individuals with BDD. Furthermore, it
exhibited a specificity of 80.8%, suggesting its capacity to correctly classify individuals without BDD.
At a cutoff score of 42, the BICI yielded a positive predictive value of 63.4%, indicating the likelihood
of true positive BDD cases, and a negative predictive value of 96.5%, indicating the probability of true
negative cases. These findings emphasize the effectiveness of the BICI in detecting BDD among
individuals seeking cosmetic nose job, thereby facilitating the identification of patients who may benefit
from further psychiatric evaluation and intervention [4]

5.3 BICI In English And Mandarin To Access Young Adults For Body Image Concerns
Wang and his team conducted two studies to evaluate the psychometric features of the BICI among
Chinese young adults. The BICI, was administered in both Mandarin & English to a total of 1,231
participants in the first study. The first aspect examined was the test-retest reliability of the scale over
a period of six month, which yielded a consistency measure of 0.73 for the overall scale. This indicates
a satisfactory level of consistency in participants' replies in the time frame. Also a positive factor
investigation was employed to assess the underlying factor edifice of the BICI. The results supported
the three-factor model, which includes the following dimensions: avoidant behaviours (AB), safety
behaviours against perceived flaws (SB), and negative appearance evaluation (NE). These factors

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signify diverse facets of physical appearance experiences and contribute to a comprehensive

understanding of body image concerns among Chinese young adults. These findings underscore the
robustness and validity of the BICI in assessing body image perceptions within this specific population.
The observed test-retest reliability indicates the steadiness of answers in time, even though the
established three-factor structure further wires the multidimensional nature of body image skills
captured by the BICI. The Chinese version of the BICI proves to be a valuable tool for researchers and
clinicians who work with Chinese young adults, enabling a more accurate assessment of body image
concerns and facilitating targeted interventions to promote positive body image development [5].

5.4 BICI Used To Compare Body Image Disturbance In Individuals With Eating Disorders And
Matched Control Groups
In a study done by Wang and his team, BICI was utilized to investigate the differentiation of body
image trouble between individuals with disorders in eating and matched control groups. The study
encompassed 47 female patients diagnosed with eating disorders and 56 participants from the control
group.
The results showed that the avoidant behaviours measurement of the BICI scale revealed the most
significant differentiation between individuals with eating disorders and the matched control group.
This finding suggests that individuals with eating disorders tend to engage in avoidance strategies more
frequently when have to deal with body image-related situations compared to the control group.
Moreover, the safety behaviour against perceived flaws dimension of the BICI demonstrated the
strongest differentiation between non-clinical and clinical groups. This implies that safety behaviour,
which involve protective actions to conceal perceived flaws, existed among individuals with eating
disorders compared to non-clinical individuals. The effect size (Cohen's d) of 0.75 specifies a modest
distinction between these groups.
Furthermore, the negative appearance assessment measurement of the BICI is connected with adverse
effect and personal well-being, demonstrating an inverse association in both clinical and non-clinical
groups. This recommends that people with higher levels of negative appearance evaluation tend to
experience more adverse sentiments and have lower personal well-being.
Additionally, the study revealed that patients with eating disorders scored higher on the BICI scale’s
total score and on the three subscale scores (safety behaviour against perceived flaws, avoidant
behaviour and negative appearance evaluation) compared to the control group. This difference
highlights the heightened body image concerns and dysfunctions experienced by individuals with eating
disorders.
These results highlight the potential of the BICI scale to capture eloquent discrepancies amongst people
with eating ailments and control groups, providing insights into specific body image dimensions
associated with eating disorders. The BICI scale can serve as a valuable tool in assessing body image
disturbances in clinical settings and contribute to the development of personalized interferences for
people with eating disorders [5].

5.5 BICI Scale To Study Relationship Of BDD on Selfitis Disorder And Narcissism
A study was conducted to observe the mediating role of body dysmorphic disorder (BDD) in the
connection between narcissism and selfitis disorder among 400 young adults between 25-35 yrs. of age.
BICI scale was used to assess BDD. The findings revealed that narcissism positively correlated with
both BDD symptoms and selfitis disorder. Additionally, BDD was found to partially mediate the
association amongst narcissism and selfitis disorder. Outcomes revealed that both selfitis disorder and
narcissism are greater in males, while features of body dysmorphic disorder is more in females as
compared to males These results provide insights into the psychological mechanisms linking
narcissism, BDD, and the development of selfitis disorder in young adults [6].

5.6 BICI To Assess BDD In PCOD Patients And Its Association With Respect to Place of Birth
And Ethnicity.
In this cross-sectional study, the co-relation of ethnic background and place of one’s birth on emotional
and psycho-sexual health of women with disease of polycystic ovarian syndrome (PCOS) was
investigated. The study included 1008 females with polycystic ovarian disorder who completed the
study consisting of 5 components, including validated questionnaires.

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The findings revealed that females of non-white background had more rates of low body dysmorphic
disorder (BDD) but higher rates of depression compared to white females. Specifically, the females
born in India had complex levels of anxiety and depression but lower rates of BDD compared to those
born in the United Kingdom. Additionally, non-white females and females who were born in India
reported lower scores in all sexual domains, except desire, indicating advanced levels of sexual
dysfunction.
Interestingly, the study also found that white females and those born in the United Kingdom reported
elevated levels of body image anxieties & humiliation around weight. These conclusions highpoints
how important it is to consider ethnicity and place of birth while providing cross-disciplinary care for
women with PCOS, as different groups may experience distinct emotional and psychosexual challenges.
Overall, this study underscores the need for tailored interventions and support for females with PCOS,
taking into account their upbringings and origins to address the diverse emotional, psychosexual, and
concerns with body image they may face [7].

5.7 BICI In Hindi – Its Validity & Reliability.

This study aimed to adapt the Body Image Concern Inventory scale (BICI) into Hindi language and
evaluate its psychometric characteristics in a Hindi-speaking population. Following the World Health
Organization guidelines, the scale was deciphered into Hindi language. The Hindi version of the BICI,
along with other tools, was administered to 157 participants aged 15-25 years. Exploratory factor
analysis revealed 2 factors: "symptom interference" (12 items) and "dysmorphic symptoms" (7 items).
The subscales and overall scale demonstrated satisfactory reliability (ranging from .789 to .871).
Concurrent validity ranged from 0.38 to 0.42. These results specify that the Hindi Version of the BICI
is a valid & a good reliable tool for evaluating appearance concerns in Hindi-speaking populations [8].

5.8 BICI To Compare Body Image Concerns In Adolescents And Adults

This research included 4,919 Chinese adolescents and adults (3,165 women, 1,754 men) aged 15-24
who completed the Body Image Concern Inventory scale (BICI) to measure dysmorphic appearance
concern. The analysis revealed a strong relationship between age and dysmorphic appearance concern,
with the highest levels stated at around 20 years old for both sexes. Females had elevated levels of
dysmorphic appearance concern compared to males, primarily due to more frequent engagement in
protective actions. The women residing in urban areas scored more on the BICI than those living in
rural areas. Psychological anguish itself reported for a major portion of the variance in dysmorphic
appearance concern, explaining 14.7% & 17.0% of the variance among both genders, above & beyond
the impact of age and BMI. These findings suggest that dysmorphic appearance concern is prevalent
among Chinese male & female adolescents and young adults, highlighting its negative impact on
psychological well-being [9].

5.9 BICI to predict Athlete’s Success perception, Body Image and Role Efficacy
This study aimed to examine the interpreters of athletic achievement perception among physical
education students, concentrating on the functions of body image and self-efficacy, with the mediating
effect of achievement motivation. The research utilized a descriptive and correlational approach,
employing path analysis. A sample of 311 male and female physical education students from
universities in South Khorasan province, Iran, partook in the research study.
The participants completed questionnaires including the Perception of Success Questionnaire (POSQ),
Body Image Concern Inventory scale (BICI), General Self-Efficacy Scale, and Sport Orientation
Questionnaire (SOQ). The data were evaluated using structure equation modelling and path analysis in
SPSS24 and Amos24 software.
The findings revealed that body image and self-assurance directly influenced athletic success
perception, indicating a positive relationship. Additionally, these variables indirectly impacted athletic
success perception through their influence on achievement motivation. The results underscored the
reputation of these constructs in predicting athletes' success.
Overall, the study highlighted the significance of an optimistic body image and self-efficacy in athletes'
perception of success. It suggested that having a desirable body image contributes to increased interest
in sports participation and exercise, leading to higher motivation and ultimately enhancing training and

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competition success. These verdicts are in line with prior research emphasizing the association between
self-efficacy and motivation for progress [10].

5.10 BICI To Examine Effects of Media On Cosmetic Surgery:

This analysis intended to scrutinize the properties of mass media practice on the propensity of young
Iranian women towards cosmetic surgery, with a focus on the role of media pattern incorporation of
beliefs about one’s appearance, and body image. The study utilized a descriptive-correlational design
and employed structural equation modelling as the analysis method.
325 young women from the University of Isfahan in the year 2019-2020 participated in the study. They
completed various questionnaires, including the amount of media preoccupation and the beliefs about
appearance scales, body image concerns inventory, scale for sociocultural attitudes to appearance, and
scale related to compensatory tendencies for beauty and fitness questionnaires.
The findings of the study, explored using SEM, verified that the model had good fit indices. The simple
effects analysis indicated that all direct effects were significant, except for the preoccupation of beliefs
about appearance on the inclination towards cosmetic surgery. Moreover, the indirect effects analysis
displayed that all indirect effects were significant.
Overall, the results emphasize the significance of media pattern internalization and body image
concerns in shaping the inclination of Iranian females towards cosmetic surgery. The findings highlight
the influence of media exposure and societal attitudes on women's perceptions of appearance and their
decision to undergo cosmetic procedures [11].

5.11 BICI Used To Evaluate Association Between Certain Symptoms Of PCOS And Depression
This single-cantered cross-sectional research was done to understand the impression of body image
perception on the intensity of depression and quality of life in polycystic ovarian syndrome (PCOS)
patients diagnosed with depression. The study included 80 women with PCOS who met the eligibility
criteria.
The findings of the study revealed a suggestion between few indicators of PCODS and depression,
representing that these indicators may fluctuate over the course of the illness. The results highlight the
importance of implementing regular and continuous screening for psychiatric morbidity rather than
relying on one-time assessments.
Furthermore, the study demonstrated a higher likelihood of negative body image perception and
depressive signs in PCODS women with depression. This suggests that body image concerns can
contribute to psychiatric illness in PCOS patients, emphasizing the need for prioritized treatment to
enhance their quality of life.
In a nutshell, the research underscores the significance of addressing body image perception,
depression, and psychiatric well-being in PCOS patients. Continuous screening for psychiatric
morbidity is crucial, and interventions targeting body concerns image and depressive indicators can
have an important role in improving the quality of life for individuals with PCOS [12].

5.12 BICI To Understand Impact Of PCOS And Related Factors Like Income, Physical
Appearance and Physical Health On Body Image Concerns In Adolescents
This cross-sectional study compared body image concerns in youngsters with and without polycystic
ovarian syndrome disease (PCOS). The research was done on 1076 participants, with 344 having PCOS
and 732 without PCOS. The results showed that youngsters with PCOS had higher body image concerns
as compared to those who didn’t have PCOS. Factors such as hyperandrogenism, abnormal uterine
bleeding, obesity, and household income were allied with body image concerns. The study highlights
the impact of PCOS and correlated factors on body image concerns in adolescents [13].

5.13 BICI To Understand Influence Of Celebs On Males & Females

This study examined body image concerns, media influence, and satisfaction with appearance among
participants. Findings indicated that both males & females had body image problems, with females
being more influenced by celebrities. Only a small percentage of participants were gratified with their
appearance, and many spent times checking their appearance and seeking reassurance from others. The
study supported a three-factor model of negative appearance evaluation, safety behaviours & avoidant
behaviours. Female participants had a higher prevalence of body dysmorphic concerns. Overall, the

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study highpoints the prevalence of body image concerns and the impact of media and socio-personal
factors on individuals' perceptions of their appearance. Confirmatory factor analysis was in sync with
the former studies and showed 40.08 % samples showed negative appearance evaluation (NE item 1-5)
out of which 35.24% were men and 44.24% were women, 38.8% illustrated to have used safety
behaviours against perceived flaws (SB item 6-13) out of which 32.3% were men and 44.4% were
women, 33 % showed avoidant behaviours (AB items 14-19) out of which 29.5% were men and 36.0%
were women. This suggested that women had more prevalence of body dysmorphic concerns [14].

5.14 BICI To Understand Association Between Body Image Concern & Mental Distress
In this transverse study of 250 participants from universities in Islamabad, the relation between body
image concern and mental distress was examined using the Body Image Concern Inventory Scale (BICI)
&Kessler's Psychological Distress Scale (K-10). The results showed a significant correlation between
body image concern and mental distress. Additionally, male students exhibited elevated levels of
concern compared to female students. Regression analysis revealed that 40% of the variability in
psychological distress could be described by body image concern. Therefore, the study highlights the
importance of addressing body image concerns in relation to psychological well-being, particularly
among male students [15].

5.15 BICI To Assess Relationship Of BDD With Gender, Marital Status, Education And Income
The study examined 314 Iranian students between the age of 18-55 yrs. using BICI scale. BDD was
more in Unmarried students, females, those with better living standards and education or with higher
family income background [16].

5.16 BICI To Relate BDD And Exercise Addiction

This study aimed to consider the hazard and defending aspects for addiction of exercise, focusing on
alexithymia, self-esteem &body image concerns. 288 regular exercisers participated in the study, and
data analysis revealed a strong association between alexithymia and exercise addiction, due to body
image concerns. Self-esteem moderated this relationship, with higher self-esteem attenuating the effect
of alexithymia on body image concerns. The results have inferences for tailored interventions in
preventing and treating exercise addiction [17].

5.17 BICI To Body Image Concerns During Pregnancy

The study involved 172 pregnant smokers, assessing weight before pregnancy and body image concerns
during the I trimester using the Weight Concern Scale and Body Image Concern Inventory. Smoking
status was studied in the III trimester through self-report. Analysis showed that weight concerns
significantly influenced continuation of smoking in late pregnancy. The suppositions advocate that
theories about weight control properties of cigarettes may subsidize to pregnant women's smoking
behaviour, emphasizing the importance of addressing weight concerns to facilitate successful cessation
[18].

5.18 BICI To Establish Relationship Between BDD And Stress

This study compared body image and alleged stress levels between females with and without PCOS.
The study included 30 females with PCOS and 30 females without PCOS from OB Gyne clinics.
Females with PCOS had reduced body image and higher perceived stress linked to those who didn’t
have PCOS. Both groups showed a optimistic relationship between body concerns and alleged strain.
These results emphasize the position of addressing psychosocial factors in treating PCOS and adopting
multidisciplinary approaches that focus on improving psychological well-being alongside managing
physical symptoms [19].

5.19 BICI Scale Body Image Concerns And Social Media And Addiction of Internet
This study surveyed the association between Body Image Concerns Scale(BIC) and technical addictions
(Social Media Addiction & Internet addiction) in 204 samples. The results showed strong associations
between BIC and technical addictions, regardless of gender & age. The research study also found
significant correlations between internalizing and externalizing problems and these attributes in the total
sample. These discoveries underscore the significance of considering gender and developmental stage

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when studying the association between BIC and technology addictions. This study contributes to
understanding the power of technology use on body image, particularly among adolescents [20].

5.20 BICI In Relation To Self-Compassion, External Shame, Body Image Dissatisfaction, And
Management of Appearance
This study examined the connection between external shame, self-compassion, body image
dissatisfaction, and appearance management in female university students. The sample included 377
participants who completed questionnaires. The results showed significant relationships between all
variables, with shame and negative body image mediating the association between self-compassion and
appearance management. Self-compassion was found to predict appearance management through these
mediating variables. These findings suggest that self-compassion, along with addressing external shame
and body image dissatisfaction, can affect the way individuals manage their appearance [21].

5.21 BICI (modified) And Relation to Depression, Anxiety, Self-Esteem, Functional Impairment,
& Body Image Distress
The Body Image Concern Inventory Scale (BICI) was used in a sample of female undergraduates
(n=761). The BICI demonstrated good homogeneity and showed expected relationships with measures
of anxiety, self-esteem, depression, functional impairment, and body image disturbance. The inventory
consists of three factors: appearance preoccupation, appearance concern, and coping behaviour. A
shorter kind of BICI scale with nine items removed maintained its validity and reliability while
improving factor construction and reliability. The BICI scale and the shorter version can be used as
valid & reliable measures, but they are not effective diagnostic screens for Body Dysmorphic Disorder
(BDD) [22].

5.22 BICI In Relation To Family, Peer, Faith And Religious Practices

This study inspected the connotation between the Muslim religion and body image anxieties in 475
Israeli Muslim women. The findings revealed that a stronger spiritual faith and wearing the hijab were
linked to good body image, while only a stronger spiritual faith was associated with reduced body
dissatisfaction. Media pressures were found to mediate the relationship between religious faith and body
image outcomes. Peer pressures were more influential in promoting positive body image, while family
pressures had more impact on negative body image. These results highlight the need for diverse cultural
understanding of body image concepts [23].

5.23 BICI To Measure Corelation Between Self-Esteem, Loneliness, Disordered Eating, And
Depression
This study surveyed the association between body image issue concern and various psychological
factors among young adults. 80 individuals aged 20 to 25, with an equal number of males and females
were studies. Various measures of body image concern, self-esteem, loneliness, disordered eating, and
depression were used. The outcomes indicated an positive relationship between body image issues,
loneliness, disordered eating, and depression, while a negative correlation was found between body
image problems and self-esteem. Both genders expressed similar levels of issues with body image [24].

5.24 BICI To Measure Body Image Disturbances, And Self-Esteem In those With Cushing's
Disease
This study investigated the incidence of mental health ailments, body image disturbances, &self-esteem
in patients suffering with Cushing's disease (CD). Thirty-five CD patients were assessed using various
measures. Results showed that 65% of patients had psychopathology, with major depressive disorder
being the most common. Body image disturbances were present in 50% of patients, and 60% had
reduced self-esteem. Depression was correlated negatively with self-esteem and correlated positively
with body image issues. These findings highpoint the importance of addressing psychopathology and
body image issues in CD patients for better treatment outcomes [25].

5.25 BICI Used As Pre And Post Test To Study The Effectiveness Of Meta Cognitive Therapy
This study was done to measure the usefulness of Meta Cognitive Therapy in reducing negative Meta
Cognitive beliefs, increasing positive Meta Cognitive beliefs, and decreasing body image issues in

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depressed high school female students. A total of 40 students were haphazardly allocated to an
experimental group (receiving Meta Cognitive Therapy) and a control group. Nine sessions of therapy
was given to experimental group, while the control group had no intervention. Pre-test and post-test
measures was used to collect data on body image concern and metacognitive beliefs. The results
depicted that Meta Cognitive Therapy was effective in lowering the body image concern and negative
beliefs and increasing positive beliefs [26].

5.26 BICI To Examine Relationship Between Body Image, Public Anxiety, And Psychological
Distress Among Young Adults
This study was done to observe the connection between social anxiety, mental distress & body image
among young adults. 156 participants completed measures of the above said. The results showed
positive correlations between body image and public anxiety, and body image and psychological
distress. These findings highlight the importance of interventions and counselling for individuals with
increased levels of public anxiety and psychological distress related to body image concerns [27].

5.27 BICI - Acceptable Measurement Invariance Between Genders

This study examined the factor structure of the Body Image Concern Inventory Scale (BICI) in a
Japanese population. The sample included 2,060 individuals (1,030 women, 1,030 men) aged 20 to 69
years. Results showed that the BICI's second-order factor model, with three first-order factors and one
second-order aspect, fits the data perfectly. Cronbach's alpha values for the overall scale and its
subscales were satisfactory. Invariance tests indicated that the BICI had acceptable measurement
invariance between genders. These findings support the consistency of the BICI scale and its ability to
compare scores between both genders in Japan [28].

5.28 BICI And Its Discriminative Power To Assess Healthy Population And Those With BDD.
This study aimed to establish reference values for the Body Image Concern Inventory Scale (BICI),
Whitely Index (WI), and Checklist Individual Strength (CIS-20R) questionnaires in both a healthy
population and a patient with BDD, hypochondriasis, and chronic fatigue syndrome. 648 healthy
individuals and 823 patients were included in the study. Cut-off values were determined for each
questionnaire, indicating the upper limit of symptom severity. The discriminative power of the
questionnaires was too high. This can help in making clinical decisions and determining the
effectiveness of therapy [29].

5.29 BICI - Psychometric Properties, Validity, Reliability

This study aimed to estimate the psychometric properties of the Body Image Concern Inventory
Scale(BICI). 591 students in Tehran participated in the study. Concordant validity was estimated by
linking the BICI scores with the Multidimensional Student's Life Satisfaction Scale and Frost
Multidimensional Perfectionism Scale. Confirmatory factor examination confirmed the factor model of
the BICI. Correlation analysis demonstrated significant negative correlations between the BICI and the
other scales, representing convergent validity. The study concluded that BICI scale is reliable and valid
for research study & medical purposes [30].

5.30 BICI To Prove Positive Correlation Between Body Image, Exercise And Eating Attitudes
This study explored body image, eating attitudes, and exercise motivations among non-athlete women
in sport centres. A total of 315 participants participated in the Eating Attitudes Test-26 (EAT-26), Body
Image Concern Inventory Scale (BICI), and questions about their workout motivations. The outcome
indicated a positive relationship between body image and eating attitudes. Significant differences were
found in exercise motivations based on eating attitudes and body image. Women with higher scores in
eating attitudes and body image exercised for shape-related reasons rather than health reasons. These
findings suggest that factors beyond exercise may be the reason for the development of eating disorders
among women involved in athletic activities [31].

5.31 BICI To Study BDD And Relationship With Personality Factor

This study aimed to examine the connection between the Big 5 personality aspects and perfectionism
(positive and negative) with body image. 373 female pupils from Alzahra University. Measures used

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included the NEO-5 Factor Inventory, Positive and Negative Perfectionism scale the Farsi version, and
Body Image Concern Inventory Scale. The results depicted positive correlations between agreeableness,
neuroticism, and openness with body image, and a negative correlation between conscientiousness and
extraversion. Results showed that perfectionism was an important forecaster of body image, and both
positive & negative perfectionism playing a role. In conclusion, personality factors and perfectionism
dimensions can foresee body image and its factors. The findings suggest that perfectionism is associated
with body image, as perfectionists strive to present their appearance perfectly [32].

5.32 BICI To Understand Relationship Between BDD And Attentional Bias Towards Faces,
Attractive Appearance-Related Images, And Disgusting Images
This study inspected the connection between body dysmorphic concern and selective attention in
individuals with Body Dysmorphic Disorder (BDD). The participants, consisting of female
heterosexual students, were assessed using a dot probe procedure with various stimuli. The findings
revealed that dysmorphic concern was related with attentional bias towards faces, attractive appearance-
related images, and disgusting images, depending on the duration of stimulus presentation. These results
have important implications for understanding BDD and its underlying mechanisms [33].

Table 1: Summary of the Review

Various Setting in which BICI is Short Review
used
Used For Clinical and Subclinical The scale had strong potential to diagnose of the BICI in
Diagnosis of BDD differentiating between the clinical and subclinical
manifestations of body dysmorphic disorder and disorders
related to eating among this specific group of the students
BICI Among those Seeking The scale has the effectiveness of the BICI in detecting BDD
Cosmetic Surgery among individuals seeking cosmetic nose job, thereby
facilitating the identification of patients who may benefit from
further psychiatric evaluation and intervention.

5.4 BICI In English And The Chinese version of the BICI proves to be a valuable tool
Mandarin To Access for researchers and clinicians who work with Chinese young
Young Adults For Body adults, enabling a more accurate assessment of body image
Image Concerns concerns and facilitating targeted interventions to promote
positive body image development.
BICI Used To Compare Body BICI scale captures eloquent discrepancies amongst people
Image Disturbance In Individuals with eating ailments and control groups, providing insights into
With Eating Disorders And specific body image dimensions associated with eating
Matched Control Groups disorders.

BICI Scale To Study Relationship BICI provide insights into the psychological mechanisms
Of BDD on Selfitis Disorder And linking narcissism, BDD, and the development of selfitis
Narcissism disorder in young adults.
BICI To Assess BDD In PCOD BICI underscores the need for tailored interventions and support
Patients And Its Association With for females with PCOS, taking into account their upbringings
Respect to Place of Birth And and origins to address the diverse emotional, psychosexual, and
Ethnicity. concerns with body image they may face.
BICI In Hindi – Its Validity & Hindi Version of the BICI is a valid & a good reliable tool for
Reliability evaluating appearance concerns in Hindi-speaking populations.
BICI To Compare Body Image These findings suggest that dysmorphic appearance concern is
Concerns In Adolescents And prevalent among Chinese male & female adolescents and young
Adults adults, highlighting its negative impact on psychological well-
being.
BICI to predict Athlete’s Success Significance of an optimistic body image and self-efficacy in
perception, Body Image and Role athletes' perception of success.
Efficacy

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BICI To Examine Effects Of BICI helps influence of media exposure and societal attitudes
Media On Cosmetic Surgery on women's perceptions of appearance and their decision to
undergo cosmetic procedures [10].

BICI Used To Evaluate Continuous screening for psychiatric morbidity is crucial, and
Association Between Certain interventions targeting body concerns image and depressive
Symptoms Of PCOS And indicators can have an important role in improving the quality
Depression of life for individuals with PCOS
BICI To Understand Impact Of Factors such as hyperandrogenism, abnormal uterine bleeding,
PCOS And Related Factors Like obesity, and household income were allied with body image
Income, Physical Appearance and concerns
Physical Health On Body Image
Concerns In Adolescents
5.14 BICI To Understand Shows the prevalence of body image concerns and the impact
Influence Of Celebs On Males & of media and socio-personal factors on individuals' perceptions
Females of their appearance.

BICI To Understand Association Regression analysis revealed that 40% of the variability in
Between Body Image Concern & psychological distress could be described by body image
Mental Distress concern
BICI To Assess Relationship Of BDD was more in Unmarried students, females, those with
BDD With Gender, Marital Status, better living standards and education or with higher family
Education And Income income background.
BICI To Relate BDD And Self-esteem moderated this relationship, with higher self-
Exercise Addiction esteem attenuating the effect of alexithymia on body image
concerns.
BICI To Body Image Concerns The suppositions advocate that theories about weight control
During Pregnancy properties of cigarettes may subsidize to pregnant women's
smoking behaviour, emphasizing the importance of addressing
weight concerns to facilitate successful cessation.
BICI To Establish Relationship These results emphasize the position of addressing
Between BDD And Stress psychosocial factors in treating PCOS and adopting
multidisciplinary approaches that focus on improving
psychological well-being alongside managing physical
symptoms.
BICI Scale Body Image Concerns This study contributes to understanding the power of
And Social Media And Addiction technology use on body image, particularly among adolescents.
of Internet

BICI In Relation To Self- These findings suggest that self-compassion, along with
Compassion, External Shame, addressing external shame and body image dissatisfaction, can
Body Image Dissatisfaction, And affect the way individuals manage their appearance
Management of Appearance
BICI (modified) And Relation to The BICI scale and the shorter version can be used as valid &
Depression, Anxiety, Self-Esteem, reliable measures, but they are not effective diagnostic screens
Functional Impairment, & Body for Body Dysmorphic Disorder (BDD).
Image Distress

BICI In Relation To Family, Peer, Peer pressures were more influential in promoting positive
Faith And Religious Practices body image, while family pressures had more impact on
negative body image. These results highlight the need for
diverse cultural understanding of body image concepts.

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BICI To Measure Corelation The outcomes indicated an positive relationship between body
Between Self-Esteem, Loneliness, image issues, loneliness, disordered eating, and depression,
Disordered Eating, And while a negative correlation was found between body image
Depression problems and self-esteem. Both genders expressed similar
levels of issues with body image.
BICI To Measure Body Image Depression was correlated negatively with self-esteem and
Disturbances, And Self-Esteem In correlated positively with body image issues. These findings
those With Cushing's Disease highpoint the importance of addressing psychopathology and
body image issues in CD patients for better treatment outcomes.
BICI Used As Pre And Post Test The results depicted that Meta Cognitive Therapy was effective
To Study The Effectiveness Of in lowering the body image concern and negative beliefs and
Meta Cognitive Therapy increasing positive beliefs.

BICI To Examine Relationship These findings highlight the importance of interventions and
Between Body Image, Public counselling for individuals with increased levels of public
Anxiety, And Psychological anxiety and psychological distress related to body image
Distress Among Young Adults concerns.

BICI - Acceptable Measurement Invariance tests indicated that the BICI had acceptable
Invariance Between Genders measurement invariance between genders.
BICI And Its Discriminative The discriminative power of the questionnaires was too high.
Power To Assess Healthy This can help in making clinical decisions and determining the
Population And Those With BDD. effectiveness of therapy
BICI - Psychometric Properties, Correlation analysis demonstrated significant negative
Validity, Reliability correlations between the BICI and the other scales, representing
convergent validity. The study concluded that BICI scale is
reliable and valid for research study & medical purposes.
BICI To Prove Positive These findings suggest that factors beyond exercise may be the
Correlation Between Body Image, reason for the development of eating disorders among women
Exercise And Eating Attitudes involved in athletic activities.
BICI To Study BDD And Perfectionism is associated with body image, as perfectionists
Relationship With Personality strive to present their appearance perfectly
Factor
BICI To Understand Relationship The findings revealed that dysmorphic concern was related with
Between BDD And Attentional attentional bias towards faces, attractive appearance-related
Bias Towards Faces, Attractive images, and disgusting images, depending on the duration of
Appearance-Related Images, And stimulus presentation.
Disgusting Images
6. ANALYSIS :
The findings of the study demonstrate that the Body Image Concern Inventory Scale (BICI) verifies to
be a robust and dependable instrument for evaluating dysmorphic concern. The scale exhibits high
levels of validity & reliability, indicating its suitability for use in various research studies and clinical
settings. Furthermore, the user-friendly nature of the scale enhances its practicality and ease of
implementation for researchers and healthcare professionals alike. These outcomes underscore the
potential of the BIIS as a valuable tool in assessing dysmorphic concern, providing valuable insights
for both academic investigations and therapeutic interventions.
S.W.O.T ANALYSIS: S.W.O.T. is an abbreviation for Strengths, Weaknesses, Opportunities and
Threats [33].
Strengths:-
 The scale on an average demonstrated a sensitivity of 95%, indicating its ability to accurately
identify individuals with BDD. Additionally, it showed a specificity of 75%, signifying its
capacity to correctly classify individuals without clinical disorders or with subclinical
symptoms towards BDD.

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 The negative appearance evaluation dimension of the BICI scale was closely connected to
adverse effect and individual well-being, demonstrating a contrary relationship in both clinical
and non-clinical groups.
 Media pattern internalization and body image stress can be judged easily

Weakness:-
 Women dwelling in urban set up scored more on the BICI than those living in countryside areas
because the questions resonated more with them.
 Educated samples scored more on BICI as questions resonated more with them.
 The questionnaire does not directly pin point the media.

Opportunities:-
 The Tool has been translated in Spanish, Mandarin, Farsi, Japanese also recently to Hindi
 Those following fitness trends, social media and with celebrity influence BICI tools can be very
useful.

Threat
 It might not be able to score the specific areas of male and female bodily insecurities
 The questionnaire can have chances of error as it doesn’t cater to the everyday turmoil of
countryside people like body shaming, peer and family pressure etc.
7. CONCLUSION :
In conclusion, the application of the Body Image Inventory Scale emerges as a significant asset in the
assessment of individuals' perceptions regarding their body image and the interconnected psychological
elements. This scale, utilized in our research and integrated into various studies, serves as a robust
instrument to delve deeper into the intricacies of body image within a specific population. Through the
systematic utilization of the Body Image Inventory Scale, our study seeks to unravel the nuanced
dynamics that influence individuals' perceptions of their bodies. The comprehensive analysis facilitated
by this scale not only allows for a nuanced understanding of body image but also sheds light on the
intricate psychological factors that are inherently linked to these perceptions.
By employing this scale across diverse studies, our overarching goal is to contribute substantially to the
expanding body of knowledge in the field of body image research. This contribution extends beyond
the confines of a singular study, as the cumulative impact of incorporating the Body Image Inventory
Scale in various contexts is poised to deepen and refine our collective understanding of the multifaceted
nature of body image. In essence, our research endeavours aim to be a valuable and lasting addition to
the broader academic discourse on body image and its psychological underpinnings.
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