Eating Disorders, 10:103–113, 2002

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DOI: 10.1080 /1064026029008167 8

Beyond Body Image as a Trait:

The Development and Validation
of the Body Image States Scale

THOMAS F. CASH, EMILY C. FLEMING, JENNY ALINDOGAN,

LAURA STEADMAN, and ABIGAIL WHITEHEAD
Old Dominion University

The need exists for a psychometrically sound measure of individu-

als’ evaluative/affective body image states. In the present investiga-
tion with 174 college students, the six-item Body Image States Scale
(BISS) was developed and found to be acceptably internally consis-
tent and moderately stable. Evincing its convergent validity, the
BISS was appropriately correlated with various trait measures of
body image. It was sensitive to reactions in positive versus negative
situational contexts. Sex differences reflected those expected from
the literature. Construct validity was confirmed by an experiment
on persons’ differential reactivity to appearance-related informa-
tion as a function of level of dysfunctional body-image investment.
The BISS is a unique and much-needed measure with potential
utility in both research and clinical work.

Body image is a multifaceted construct that refers to individuals’ perceptions

of and attitudes toward their own body, especially its appearance. Numer-
ous measures exist to assess various components of this construct (Thomp-
son, Heinberg, Altabe, & Tantleff-Dunn, 1999). Attitudinal body image con-
sists of at least two dimensions (Cash, 1994a)—evaluation/affect (body-image
appraisals and satisfaction, as well as discrete emotional experiences vis-à-
vis one’s body) and investment (the salience, centrality, or extent of cogni-
tive-behavioral emphasis on one’s appearance, including “appearance
schematicity” ). Despite the fact that body image experiences vary temporally
and in situational contexts, most researchers focus on body image as a cross-
situational and stable trait (Cash, 1990, 1994b in press; Tiggemann, 2001).
The scientific investigation of body image often requires the measure-

Address correspondence to Dr. Thomas F. Cash, Department of Psychology, Old Dominion

University, Norfolk, VA 23529-0267. E-mail: TCash@odu.edu

103
104 T. F. Cash et al.

ment of evaluative or affective body image states in specific contexts or in

response to experimental manipulations. One example of a contextual ap-
proach to body image assessment is the Situational Inventory of Body Image
Dysphoria (SIBID; Cash, 1994b, 2000), on which persons rate of the fre-
quency of negative body image emotions in 48 distinct situations (e.g., exer-
cising, eating, being with attractive people, looking in the mirror, trying on
clothes, etc.). Another contextual assessment is the Body Exposure during
Sexual Activities Questionnaire (BESAQ; Hangen & Cash, 1991), which quan-
tifies one’s physical self-consciousness and body exposure avoidance while
having sexual relations. Experimental studies of the effects of informational
stimuli, media images, or interpersonal events on body image require de-
pendent measures that capture momentary body image experiences. In the
absence of a well-validated assessment of state body image, researchers of-
ten adopt or adapt extant trait measures or fashion their own scale to meet a
particular study’s needs. Reed, Thompson, Brannick, and Sacco (1991) de-
veloped a state body image questionnaire that averages one’s anxiety about
16 body parts (e.g., lips, wrist, feet, forehead, hips, etc.). However, this mea-
sure does not assess broader affective experiences concerning one’s overall
appearance. This latter domain would seem to better reflect the construct
and have greater potential utility, as Tiggemann’s (2001) findings suggest.
The purpose of this research was to develop and validate the Body
Image States Scale (BISS), a multi-item measure of momentary evaluative/
affective experiences of one’s physical appearance (see Appendix). We con-
structed a six-item questionnaire and, with a college-student sample, exam-
ined its internal consistency, test-retest reliability, relationships with body
image traits, responsiveness or sensitivity to situational contexts, and its con-
struct validity in an experiment concerning individual differences in body-
image reactivity. Regarding the latter, we tested the hypothesis that people
who are dysfunctionally invested in their appearance (i.e., appearance sche-
matic) are especially susceptible to the contextual induction of negative body
image states (Cash & Labarge, 1996; Labarge, Cash, & Brown, 1998; Lavin &
Cash, 2001).

METHOD

Participants
In exchange for extra credit in psychology classes at a large mid-Atlantic
university, 174 college students (116 women and 58 men) volunteered to
participate in the research. Their ages ranged from 17 to 54 years (median =
20), and 85% were unmarried. The sample was 55% European American,
30% African American, 8% Asian, and 7% from other minorities. Body Mass
Index (BMI; kg weight/m2 height) averaged 25.0 (SD = 4.1) for men and 24.7
(SD = 6.3) for women.
 The Body Image States Scale 105

Measures and Procedure

The study took place over two sessions. At Time 1, after an informed con-
sent procedure, participants anonymously completed questionnaires in a
private room. They were asked to return two to three weeks later for the
second (retest) session, for which the compliance rate was 95% (n = 166).
Materials included the following validated body image measures, the new
body image states assessment, and a demographics form.
Two subscales of the 34-item Multidimensional Body-Self Relations
Questionnaire—Appearance Scales (MBSRQ-AS; Brown, Cash, & Mikulka,
1990; Cash, 2000) were used. The 9-item Body Areas Satisfaction Scale (BASS)
uses 5-point scale ratings of one’s usual dissatisfaction–satisfaction with as-
pects of one’s body. The 4-item Overweight Preoccupation subscale taps
dieting and fat anxiety on a 5-point disagree–agree scale. In this sample,
Cronbach’s alphas for the two subscales were .82 and .76, respectively, for
women, and .80 and .76 for men.
The Appearance Schemas Inventory (ASI; Cash, 2000; Cash & Labarge,
1996) is a 14-item measure of dysfunctional body image investment (i.e.,
schemas or assumptions about the salience and meaning of one’s appear-
ance in one’s life), which uses a 5-point disagree–agree response format.
The internal consistency of the ASI in this study was .82 and .85, for women
and men, respectively.
The Objectified Body Consciousness Scale (OBCS; McKinley & Hyde,
1996) was designed to measure the degree to which women internalize and
accept cultural standards of physical attractiveness. The OBCS can be used
by men as well and consists of three 8-item subscales, each using a 7-point
disagree–agree response format. Body Surveillance refers to the degree to
which one monitors one’s physical appearance. Body Shame indirectly taps
internalization of cultural appearance standards by measuring the degree of
shame felt when one does not meet these standards. Body Control assesses
perceived control over one’s weight and appearance. In this study, internal
consistencies of the Body Surveillance, Body Shame, and Body Control
subscales were .78, .78, and .73, respectively, for women, and .85, .78, and
.61 for men.
Developed in this study, the Body Image States Scale (BISS) consists of
six items written to tap the following domains of current body experience:
(1) dissatisfaction–satisfaction with one’s overall physical appearance; (2)
dissatisfaction–satisfaction with one’s body size and shape; (3) dissatisfac-
tion–satisfaction with one’s weight; (4) feelings of physical attractiveness–
unattractiveness; (5) current feelings about one’s looks relative to how one
usually feels; and (6) evaluation of one’s appearance relative to how the
average person looks. Responses to each item were based on 9-point, bipo-
lar, Likert-type scales, semantically anchored at each point. The scale was
presented in a negative-to-positive direction for half of the items and a posi-
tive-to-negative direction for the other half. The instructions stated: “For each
106 T. F. Cash et al.

of the items below, check the box beside the one statement that best de-
scribes how you feel RIGHT NOW, AT THIS VERY MOMENT. Read the
items carefully to be sure the statement you choose accurately and honestly
describes how you feel right now” (see Appendix).
In addition to its administration in a neutral context (i.e., presented first
in the Time 1 questionnaire packet), we employed a methodology (see
Haimovitz, Lansky, & O’Reilly, 1993; Tiggemann, 2001) whereby participants
completed the BISS in response to imagined situational contexts. The four
contexts, two negative and two positive, were presented in a random order
across participants. Participants were asked to imagine that they were in the
situation and then to become aware of and indicate (on the six BISS items)
how they would feel in the situation:

• It is a day on the beach. You are there with some people you know and
some people you don’t know, both men and women. Like everyone else,
you are wearing a bathing suit. People are talking and laughing and just
doing whatever they want.
• You are alone in your bedroom. You are looking at the latest issue of a
magazine about fashion and fitness for persons of your own sex. You are
looking at the model on the cover. As you thumb through the magazine,
you are looking at the models in the ads for clothing and the ads for
exercise and fitness products.
• You are at a party with some friends and casual acquaintances. Over the
course of the party, a few of your friends comment on how you look.
They compliment you and tell you how nice you look in what you are
wearing that evening.
• You step on a scale to weigh yourself. You see that your weight is close to
your preferred weight.

Subsequently, in the second session, participants retook the body im-

age trait measures and the BISS (neutral context only). Female participants
were randomly assigned to one of two conditions. In the experimental con-
dition, before completing the BISS, participants first answered a demographic
form that posed questions about current height and weight, desired weight,
highest adult weight, and lowest adult weight. In the control condition, these
questions were posed after completion of the BISS. The purpose of this
manipulation was to test the hypothesis (Cash & Labarge, 1996; Labarge et
al., 1998; Lavin & Cash, 2001) that exposure to these questions would differ-
entially affect the body image states of women who were dysfunctionally
invested in their appearance (i.e., schematics versus aschematics, as assessed
by the ASI).
 The Body Image States Scale 107

RESULTS AND DISCUSSION

Scoring and Internal Consistency of the BISS
At Time 1, Cronbach’s alphas were computed to evaluate the internal consis-
tency of the BISS, both in the neutral context and in the four imagined
contexts. In each instance, BISS scores were the mean of the six items after
reverse-scoring the three positive-to-negative items. Thus, higher BISS scores
on the 9-point dimension indicate more favorable body image states. Table 1
summarizes these reliabilities as well as the scale means and standard devia-
tions for both sexes. The BISS was acceptably internally consistent across the
range of contexts. Alphas were somewhat lower in a neutral context than in
either positive or negative contexts. This was understandably due to less
variability in the neutral context for the fifth item, which entailed a compari-
son of current feelings relative to usual feelings. At Time 2, the BISS’s inter-
nal consistency was .77 for women and .72 for men.

Temporal Stability of the BISS

The test-retest reliability of the neutral-context BISS over the 2- to 3-week
period was calculated. The coefficient was .69 for women (including only
those in the Time 2 control condition) and .68 for men (ps < .001). Consistent
with the fact that the BISS is a state assessment, its stability was lower than
that observed in this study for the BASS (r = .94), a trait measure of body
image satisfaction.

Correlations of the BISS with Body Image Trait Measures

and Body Mass
State body image should be partly predictable from trait body image. There-
fore, Pearson correlations were computed to examine the convergence be-

TABLE 1. Means, Standard Deviations, and Internal Consistencies of the BISS for
Women and Men in Multiple Contexts
Women Men Women Men
BISS Cronbach’s Cronbach’s
Assessments M (SD) M (SD) alpha alpha

Neutral context 5.39 (1.38) 6.02 (0.87) 0.77 0.62

Negative context
(Day at the beach) 4.82 (1.88) 6.05 (1.04) 0.90 0.66
Negative context
(Magazine models) 4.83 (1.68) 5.90 (0.99) 0.88 0.78
Positive context
(Party compliments) 6.81 (1.31) 7.03 (0.96) 0.81 0.83
Positive context
(Ideal weight) 7.00 (1.11) 6.72 (1.06) 0.80 0.84
108 T. F. Cash et al.

TABLE 2. Correlates of the Body Image States Scale (BISS) Administered in a Neutral
Context
Pearson rs Pearson rs
with the BISS with the BISS
among women among men
Time 1 Time 2 Time 1 Time 2
Trait measure (n = 116) (n = 55) (n = 58) (n = 55)
Body Areas Satisfaction Scale (BASS) .78*** .77*** .65*** .62***
MBSRQ Overweight Preoccupation Scale –.52*** –.53*** –.34** –.20
Appearance Schemas Inventory (ASI) –.41*** –.28* –.35** –.25*
OBCS Body Surveillance –.28** –.40** –.23 –.18
OBCS Body Shame –.56*** –.39** –.42*** –.37**
OBCS Body Control .19* .24 .15 .06
Body Mass Index (BMI) –.53*** –.46*** –.34** –.31*
Note: Trait body image and BMI were assessed at Time 1.
*p < .05, **p < .01, ***p < .001

tween the neutral context BISS and selected trait measures of body image
evaluation and investment. Table 2 shows the correlations between the trait
measures from Time 1 and the BISS at Times 1 and 2. At Time 2, only those
females in the control condition were included. As expected, significantly
less favorable body image states were reported by persons of either sex who
had greater trait body image dissatisfaction and body shame, more over-
weight preoccupation, and more dysfunctional investment in their appear-
ance. For women only, modest but significant correlations with the OBCS
indicated less favorable body image states among those who engaged in
more body surveillance. Relationships with perceived body control were
weaker.
A substantial literature points to more negative body image experiences
among overweight or obese persons, especially women (Cash & Roy, 1999;
Milkewicz & Cash, 2000). Consistent with the expectation that heavier par-
ticipants would experience more negative body image states, Table 2 shows
that the significant correlations of the BISS with BMI were modest for men
and moderate for women.

Evaluation of Sex Differences on the BISS and

Its Sensitivity to Context
A comparison of means for men and women on the neutral context BISS
(given in Table 1) indicated that women reported less favorable body image
states than men did, F(1, 172) = 10.20, p < .002. To make comparisons as a
function of positive versus negative context, we collapsed over the two posi-
tive contexts and over the two negative contexts and conducted a 2 (sex) ×
2 (context type) general linear model analysis of variance (GLM ANOVA).
Significant main effects occurred for sex, F(1, 172) = 12.64, p < .001, and for
context type, F(1, 172) = 168.90, p < .0001, and the interaction was signifi-
 The Body Image States Scale 109

cant as well, F (1, 172) = 26.63, p < .001. As reflected in the data in Table 1,
our results confirmed that both sexes’ body image states were less favorable
in negative versus positive contexts. This fact supports the sensitivity of the
BISS. Furthermore, women responded more strongly to the negative con-
texts than men did, but women were comparable to men in the positive
contexts. Thus, the established gender difference in evaluative/affective body
image (e.g., Cash, 1994b; Feingold & Mazzella, 1998; Muth & Cash, 1997)
may, in part, specifically reflect women’s greater susceptibility to dysphoric
body image states.

Construct Validity of the BISS

The final set of analyses examined the results of the experiment carried out
with women at Time 2. The experimental group had been exposed to ques-
tions about their body weight prior to completing the BISS, whereas the
control group had not. Based on a median split on the ASI, participants were
divided into two groups who reported less versus more dysfunctional invest-
ment in their appearance. A 2 (ASI Groups) × 2 (Condition) GLM ANOVA
was performed on the BISS scores. The predicted Group × Condition inter-
action was significant, F(1, 104) = 4.25, p < .042. Simple-effects analysis
indicated that the high ASI group had less favorable BISS scores in the ex-
perimental versus the control condition (Ms = 5.73 versus 5.33), whereas the
opposite was actually the case for the low ASI group (Ms = 6.03 versus 6.58)
(ps <.05). A similar 2 × 2 ANOVA on the weight information reported in the
manipulated conditions revealed no differences on current, ideal, lowest, or
highest weights. Thus, the results cannot be explained by a confounding of
the variables. Rather, the findings are consistent with a cognitive perspective
on body image that posits mediating and moderating effects of body image
investment (or schematicity) on emotional reactions to appearance-related
cues or events (Cash & Deagle, 1997; Cash & Labarge, 1996; Labarge et al.,
1998; Lavin & Cash, 2001; Tiggemann, 2001; Williamson, 1996).

CONCLUSIONS AND IMPLICATIONS

The literature reveals a dearth of sound and useful assessments of persons’

momentary evaluative/affective body image experiences (Cash, in press;
Thompson et al., 1999). The scientific study of body image often requires the
measurement of such states in specific contexts or in response to experimen-
tal variables. This approach is especially important to our understanding the
dynamic cognitive and affective processes associated with eating disorders
and body image disturbances (Cash & Deagle, 1997; Cash & Strachan, 1999;
Williamson, 1996). The current research provided initial psychometric evi-
dence supportive of the reliability and validity of the new Body Image States
Scale. Whereas many body image assessments have been validated only for
110 T. F. Cash et al.

women, the BISS can be used by both sexes. The value of this measure is
further evident in its brevity (i.e., six items), its bipolarity (i.e., both positive
and negative experiences), and its item content (i.e., not a specific affect
about discrete body parts). As such, the BISS would seem to have applicabil-
ity to a wide range of contexts. Its items could be particularly useful as a
clinical tool for monitoring body image states in targeted situations over the
course of treatment.

REFERENCES

Brown, T. A., Cash, T. F., & Mikulka, P. J. (1990). Attitudinal body-image assessment:
Factor analysis of the Body-Self Relations Questionnaire. Journal of Personality
Assessment, 55, 135–144.
Cash, T. F. (1990). The psychology of physical appearance: Aesthetics, attributes,
and images. In T. F. Cash & T. Pruzinsky (Eds.), Body images: Development,
deviance, and change (pp. 51–79). New York: Guilford.
Cash, T. F. (1994a). Body-image attitudes: Evaluation, investment, and affect. Per-
ceptual and Motor Skills, 78, 1168–1170.
Cash, T. F. (1994b). The Situational Inventory of Body-Image Dysphoria: Contextual
assessment of a negative body image. The Behavior Therapist, 17, 133–134.
Cash, T. F. (2000). Users’ manuals for the Multidimensional Body-Self Relations Ques-
tionnaire, the Situaional Inventory of Body-Image Dysphoria, and the Appear-
ance Schemas Inventory. Available from the author at www.body-images.com
Cash, T. F. (in press). Beyond trails: Assessing body image states. In T. F. Cash & T.
Pruzinsky (Eds.), Body Image: A handbook of theory, research, and clinical
practice. New York: Guilford.
Cash, T. F., & Deagle, E. A. (1997). The nature and extent of body-image distur-
bances in anorexia nervosa and bulimia nervosa: A meta-analysis. International
Journal of Eating Disorders, 21, 2–19.
Cash, T. F., & Labarge, A. S. (1996). Development of the Appearance Schemas Inven-
tory: A new cognitive body-image assessment. Cognitive Therapy and Research,
20, 37–50.
Cash, T. F, & Roy, R. E. (1999). Pounds of flesh: Weight, gender, and body images. In
J. Sobal & D. Maurer (Eds.), Interpreting weight: The social management of
fatness and thinness (pp. 209–228). Hawthorne, NY: Aldine de Gruyter.
Cash, T. F., & Strachan, M. D. (1999). Body images, eating disorders, and beyond. In
R. Lemberg (Ed.), Eating disorders: A reference sourcebook (pp. 27–36). Phoe-
nix, AZ: Oryx Press.
Feingold, A., & Mazzella, R. (1998). Gender differences in body image are increas-
ing. Psychological Science, 9, 190–195.
Haimovitz, D., Lansky, L., & O’Reilly, P. (1993). Fluctuation in body satisfaction
across situations. International Journal of Eating Disorders, 13, 77–83.
Hangen, J. D., & Cash, T. F. (1991, November). Body-image attitudes and sexual
functioning in a college population. Paper presented at the convention of the
Association for Advancement of Behavior Therapy, New York.
Labarge, A. S., Cash, T. F., & Brown, T. A. (1998). Use of a modified Stroop task to
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examine appearance-schematic information processing in college women. Cog-

nitive Therapy and Research, 22, 177–188.
Lavin, M. A. & Cash, T. F. (2001). The effects of exposure to information about
appearance stereotyping and discrimination on women’s body images. Inter-
national Journal of Eating Disorders, 29, 51–58.
McKinley, N. M., & Hyde, J. S. (1996). The Objectified Body Consciousness Scale:
Development and validation. Psychology of Women Quarterly, 20, 181–215.
Milkewicz, N., & Cash, T. F. (2000, November). Dismantling the heterogeneity of
obesity: Psychosocial experiences of the obese. Poster presented at the conven-
tion of the Association for Advancement of Behavior Therapy, New Orleans,
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Muth, J. L., & Cash, T. F. (1997). Body-image attitudes: What difference does gender
make? Journal of Applied Social Psychology, 27, 1438–1452.
Reed, D. L, Thompson, J. K., Brannick, M. T., & Sacco, W. P. (1991). Development
and validation of the Physical Appearance State and Trait Anxiety Scale (PAS-
TAS). Journal of Anxiety Disorders, 5, 323–332.
Thompson, J. K., Heinberg, L. J., Altabe, M., & Tantleff-Dunn, S. (1999). Exacting
beauty: Theory, assessment, and treatment of body image disturbance. Wash-
ington, DC: American Psychological Association.
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national Journal of Eating Disorders, 29, 65–70.
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47–58.

APPENDIX
BODY IMAGE STATES SCALE

For each of the items below, check the box beside the one statement that
best describes how you feel RIGHT NOW AT THIS VERY MOMENT. Read
the items carefully to be sure the statement you choose accurately and hon-
estly describes how you feel right now.

1. Right now I feel . . .

Extremely dissatisfied with my physical appearance
Mostly dissatisfied with my physical appearance
Moderately dissatisfied with my physical appearance
Slightly dissatisfied with my physical appearance
Neither dissatisfied nor satisfied with my physical appearance
Slightly satisfied with my physical appearance
Moderately satisfied with my physical appearance
Mostly satisfied with my physical appearance
Extremely satisfied with my physical appearance
112 T. F. Cash et al.

2. Right now I feel . . .

Extremely satisfied with my body size and shape
Mostly satisfied with my body size and shape
Moderately satisfied with my body size and shape
Slightly satisfied with my body size and shape
Neither dissatisfied nor satisfied with my body size and shape
Slightly dissatisfied with my body size and shape
Moderately dissatisfied with my body size and shape
Mostly dissatisfied with my body size and shape
Extremely dissatisfied with my body size and shape

3. Right now I feel . . .

Extremely satisfied with my weight
Mostly dissatisfied with my weight
Moderately dissatisfied with my weight
Slightly dissatisfied with my weight
Neither dissatisfied nor satisfied with my weight
Slightly satisfied with my weight
Moderately satisfied with my weight
Mostly satisfied with my weight
Extremely satisfied with my weight

4. Right now I feel . . .

Extremely physically attractive
Very physically attractive
Moderately physically attractive
Slightly physically attractive
Neither attractive nor unattractive
Slightly physically unattractive
Moderately physically unattractive
Very physically unattractive
Extremely physically unattractive

5. Right now I feel . . .

A great deal worse about my looks than I usually feel
Much worse about my looks than I usually feel
Somewhat worse about my looks than I usually feel
Just slightly worse about my looks than I usually feel
About the same about my looks as usual
Just slightly better about my looks than I usually feel
Somewhat better about my looks than I usually feel
Much better about my looks than I usually feel
A great deal better about my looks than I usually feel
 The Body Image States Scale 113

6. Right now I feel that I look . . .

A great deal better than the average person looks
Much better than the average person looks
Somewhat better than the average person looks
Just slightly better than the average person looks
About the same as the average person looks
Just slightly worse than the average person looks
Somewhat worse than the average person looks
Much worse than the average person looks
A great deal worse than the average person looks