TY - JOUR
T1 - Development and Validation of the Body Concealment Scale for Scleroderma
AU - the Canadian Scleroderma Research Group
AU - Jewett, Lisa R.
AU - Malcarne, Vanessa L.
AU - Kwakkenbos, Linda
AU - Harcourt, Diana
AU - Rumsey, Nichola
AU - Körner, Annett
AU - Steele, Russell J.
AU - Hudson, Marie
AU - Baron, Murray
AU - Haythornthwaite, Jennifer A.
AU - Heinberg, Leslie
AU - Wigley, Fredrick M.
AU - Thombs, Brett D.
AU - Pope, J.
AU - Masetto, D. A.
AU - Sutton, E.
AU - Khalidi, N. A.
AU - Robinson, D.
AU - Jones, N.
AU - Kaminska, E.
AU - Docherty, P.
AU - Mathieu, J. P.
AU - Ligier, S.
AU - Grodzicky, T.
AU - Mittoo, S.
AU - LeClercq, S.
AU - Thorne, C.
AU - Fortin, P.
N1 - Publisher Copyright:
© 2016, American College of Rheumatology
PY - 2016/8/1
Y1 - 2016/8/1
N2 - Objective: Body concealment is a component of social avoidance among people with visible differences from disfiguring conditions, including systemic sclerosis (SSc). The study objective was to develop a measure of body concealment related to avoidance behaviors in SSc. Methods: Initial items for the Body Concealment Scale for Scleroderma (BCSS) were selected using item analysis in a development sample of 93 American SSc patients. The factor structure of the BCSS was evaluated in 742 Canadian patients with single-factor, 2-factor, and bifactor confirmatory factor analysis models. Convergent and divergent validity were assessed by comparing the BCSS total score with the Brief-Satisfaction with Appearance Scale (Brief-SWAP) and measures of depressive symptoms and pain. Results: A 2-factor model (Comparative Fit Index [CFI] 0.99, Tucker-Lewis Index [TLI] 0.98, Root Mean Square Error of Approximation [RMSEA] 0.08) fit substantially better than a 1-factor model (CFI 0.95, TLI 0.94, RMSEA 0.15) for the 9-item BCSS, but the Concealment with Clothing and Concealment of Hands factors were highly correlated (α = 0.79). The bifactor model (CFI 0.99, TLI 0.99, RMSEA 0.08) also fit well. In the bifactor model, the omega coefficient was high for the general factor (ω = 0.80), but low for the Concealment with Clothing (ω = 0.01) and Concealment of Hands (ω = 0.33) factors. The BCSS total score correlated more strongly with the Brief-SWAP Social Discomfort (r = 0.59) and Dissatisfaction with Appearance (r = 0.53) subscales than with measures of depressive symptoms and pain. Conclusion: The BCSS sum score is a valid indicator of body concealment in SSc that extends the concepts of body concealment and avoidance beyond the realms of body shape and weight to concerns of individuals with visible differences from SSc.
AB - Objective: Body concealment is a component of social avoidance among people with visible differences from disfiguring conditions, including systemic sclerosis (SSc). The study objective was to develop a measure of body concealment related to avoidance behaviors in SSc. Methods: Initial items for the Body Concealment Scale for Scleroderma (BCSS) were selected using item analysis in a development sample of 93 American SSc patients. The factor structure of the BCSS was evaluated in 742 Canadian patients with single-factor, 2-factor, and bifactor confirmatory factor analysis models. Convergent and divergent validity were assessed by comparing the BCSS total score with the Brief-Satisfaction with Appearance Scale (Brief-SWAP) and measures of depressive symptoms and pain. Results: A 2-factor model (Comparative Fit Index [CFI] 0.99, Tucker-Lewis Index [TLI] 0.98, Root Mean Square Error of Approximation [RMSEA] 0.08) fit substantially better than a 1-factor model (CFI 0.95, TLI 0.94, RMSEA 0.15) for the 9-item BCSS, but the Concealment with Clothing and Concealment of Hands factors were highly correlated (α = 0.79). The bifactor model (CFI 0.99, TLI 0.99, RMSEA 0.08) also fit well. In the bifactor model, the omega coefficient was high for the general factor (ω = 0.80), but low for the Concealment with Clothing (ω = 0.01) and Concealment of Hands (ω = 0.33) factors. The BCSS total score correlated more strongly with the Brief-SWAP Social Discomfort (r = 0.59) and Dissatisfaction with Appearance (r = 0.53) subscales than with measures of depressive symptoms and pain. Conclusion: The BCSS sum score is a valid indicator of body concealment in SSc that extends the concepts of body concealment and avoidance beyond the realms of body shape and weight to concerns of individuals with visible differences from SSc.
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U2 - 10.1002/acr.22819
DO - 10.1002/acr.22819
M3 - Article
C2 - 26663624
AN - SCOPUS:84978827345
SN - 2151-464X
VL - 68
SP - 1158
EP - 1165
JO - Arthritis Care and Research
JF - Arthritis Care and Research
IS - 8
ER -