Assessing body image in patients with systemic sclerosis (scleroderma): Validation of the Adapted Satisfaction with Appearance Scale

Abstract

People with scleroderma often experience disfiguring appearance-related changes in socially visible and interpersonally salient areas. Although disfigurement can lead to body image dissatisfaction, this phenomenon has not been well investigated due to the lack of a disfigurement-specific measure. The Satisfaction With Appearance (SWAP) scale, previously developed in burn survivors, was adapted and administered to 254 participants with scleroderma to evaluate its psychometric integrity and its validity for use in a different medical population that experiences changes in appearance. Principal component analysis revealed two factors - Subjective Dissatisfaction and Perceived Social Impact - rather than the four found in burn victims. Excellent estimates of internal consistency and temporal stability and strong evidence for the reliability of the two-factor solution were found. The resulting factor structure in a scleroderma population suggests that differing medical conditions may create alternate constellations of BID, reflects the need for body image researchers to assess psychometrics across medical populations and may have clinical implications for BID interventions.

Quality of life in systemic sclerosis

“…The Satisfaction with Appearance Scale (SWAP) [8,121] is a measure developed to assess body image in disfigured medical populations, like SSc, focusing on both subjective body image distress as well as the social impact (e.g., avoidance). It has four subscales measuring Social Distress, Facial Features, Non-facial Features, and Perceived Social Impact.…”

Body Image Dissatisfaction in Patients with Inflammatory Bowel Disease

“…19 ASWAP was administered to participants with scleroderma to evaluate its psychometric integrity and its validity for use in a different medical population that experiences changes in appearance. 18 The ASWAP re-introduces a fifteenth item that was excluded from the final version of the SWAP ("My appearance makes others feel uncomfortable") and changed items that included the word "burn" to "illness". Principal component analysis of the ASWAP revealed two factors, Subjective Dissatisfaction and Perceived Social Impact, rather than the four found in burn victims.…”

“…17 To assess BID a modified version of the Adapted Satisfaction with Appearance (ASWAP) scale was administered. 18 The ASWAP is an adaption of the Satisfaction With Appearance (SWAP) scale. SWAP and ASWAP measure non-weight-related BID at multiple body sites (e.g.…”

Associations between psychosocial functioning and smiling intensity in patients with head and neck cancer

“…Body image dissatisfaction was measured using Hopwood's Body Image Scale (BIS) (Hopwood, Fletcher, Lee, & Al Ghazal, 2001) and the Perceived Social Impact subscale of the Adapted Satisfaction With Appearance (ASWAP) scale (Heinberg et al, 2007). Body image coping, which refers to cognitive and behavioral responses to address body image challenges, was measured using the Body Image Coping Strategies Inventory (BICSI) (Cash, Santos, & Williams, 2005).…”