Body Image
Protocol Id
020401
Description This protocol encompasses self-reported prior, current, or ideal body image of the
of Protocol respondents and their children. The majority of studies using pictograms have used
Stunkard’s scale, which contains nine silhouettes that are on an ordinal scale. An
alternate using Collins has also been provided. Specific pictograms for African
Americans and children are also included.
Specific
Participants are instructed to choose the picture from the pictogram that they
Instructions think represents their actual size at a specific age or, as instructed and when
appropriate, circle the size they would ideally like to be at another age or
currently. The pictograms can also be used to provide input on body size/image of
children and/or parents. See Protocol Text for more detail.
Protocol
Text
The following protocol is taken from a personal interview study in which study
participants are asked to self-report about their own body image and then report
about first-degree family members.
Please refer to the following adult and child pictures below to answer the
following questions about yourself and your first-degree family members (e.g.,
mother, father, and/or children).
TO BEGIN:
Step 1: Look at the pictures below of males or females and try to choose the
picture that most closely resembles how you looked at each age listed below.
Step 2: Look at the adult and child pictures. Choose the picture that most closely
resembles your (or your child’s) body shape right now and at the ages of 5, 10, and
20. The child pictures should be used for ages 5 & 10 and the adult pictures for
ages 20 or older.
Editor’s Note: The participant is shown pictures that display various body shapes
associated with a scale. For adults, three scales are provided here. The Stunkard
graphics show nine images for men and for women. Consequently, the responses
should be recorded on a form that includes 1 through 9. Pulvers et al. provided
graphics validated for African American men and women on a 1 to 9 scale. Collins
presents a range of seven male and seven female figures. Consequently, the forms
indicated can be used with those graphics. (The Working Group was not aware of
other population-specific graphics.) For children, Collins provides graphics for
boys and for girls on a 1 to 7 scale. All graphics are provided below.
PARTICIPANT (Stunkard or Pulvers Scale)
PARTICIPANT (Collins Scale)
PARTICIPANT’S CHILDREN (Collins Scale)
PARTICIPANT’S CHILDREN (Collins Scale)
Collins Adult Female
Editor’s Note: To score this scale, please record a number 1 through 7
corresponding to the figure the respondent indicates for the Collins scale.
Adapted from Collins, M. E. (1991). Body figure perceptions and preferences
among preadolescent children. International Journal of Eating Disorders, 10,199208.
Stunkard Adult Female
Editor’s Note: To score this scale, please record 1 through 9 corresponding to the
figure the respondent indicates for the Stunkard scale.
Adapted from Stunkard, A. J., Sorensen, T., & Schulsinger, F. (1983). Use of the
Danish Adoption Register for the study of obesity and thinness. Research
Publications - Association for Research in Nervous and Mental Disease, 60, 115120.
Collins Adult Male
Editor’s Note: To score this scale, please record a number 1 through 7
corresponding to the figure the respondent indicates for the Collins scale.
Adapted from Collins, M. E. (1991). Body figure perceptions and preferences
among preadolescent children. International Journal of Eating Disorders, 10,199208.
Stunkard Adult Male
Editor’s Note: To score this scale, please record 1 through 9 corresponding to the
figure the respondent indicates for the Stunkard scale.
Adapted from Stunkard, A. J., Sorensen, T., & Schulsinger, F. (1983). Use of the
Danish Adoption Register for the study of obesity and thinness. Research
Publications - Association for Research in Nervous and Mental Disease, 60, 115120.
Pulvers Adult African American Female
Editor’s Note: To score this scale, please record a number 1 through 9
corresponding to the figure the respondent indicates for the Pulvers scale.
Adapted from Pulvers, K. M., Lee, R. E., Kaur, H., Mayo, M. S., Fitzgibbon, M. L.,
Jeffries, S. K., Butler, J., Hou, Q., & Ahluwalia, J. S. (2004). Development of a
culturally relevant body image instrument among urban African Americans. Obesity
Research, 12, 1641-1651.
Pulvers Adult African American Male
Editor’s Note: To score this scale, please record a number 1 through 9
corresponding to the figure the respondent indicates for the Pulvers scale.
Adapted from Pulvers, K. M., Lee, R. E., Kaur, H., Mayo, M. S., Fitzgibbon, M. L.,
Jeffries, S. K., Butler, J., Hou, Q., & Ahluwalia, J. S. (2004). Development of a
culturally relevant body image instrument among urban African Americans. Obesity
Research, 12, 1641-1651.
Collins Child Female
Editor’s Note: To score this scale, please record a number 1 through 7
corresponding to the figure the respondent indicates for the Collins scale.
Adapted from Collins, M. E. (1991). Body figure perceptions and preferences
among preadolescent children. International Journal of Eating Disorders, 10,199208.
Collins Child Male
Editor’s Note: To score this scale, please record a number 1 through 7
corresponding to the figure the respondent indicates for the Collins scale.
Adapted from Collins, M. E. (1991). Body figure perceptions and preferences
among preadolescent children. International Journal of Eating Disorders, 10,199208.
Selection
Rationale
Pictograms have been associated with health outcomes including diabetes,
hypertension, coronary disease, and mental health status. They may be used to
identify current, younger, and/or ideal body image; and when used to assess image
over time, a chronological approach for age-specific groups has been used. Use of
an ethnic group-specific body image is advisable, as size and perception may vary
by ethnicity.
Source
Collins, M. E. (1991). Body figure perceptions and preferences among
preadolescent children. International Journal of Eating Disorders, 10, 199-208.
Pulvers, K. M., Lee, R. E., Kaur, H., Mayo, M. S., Fitzgibbon, M. L., Jeffries, S. K.,
Butler, J., Hou, Q., & Ahluwalia, J. S. (2004). Development of a culturally relevant
body image instrument among urban African Americans. Obesity Research,
12, 1641-1651.
Stunkard, A. J., Sorensen, T., & Schulsinger, F. (1983). Use of the Danish Adoption
Register for the study of obesity and thinness. Research Publications - Association
for Research in Nervous and Mental Disease, 60, 115-120.
Language
English
Participant
Participant, aged 6 years and older for self-report
Personnel
and
None
Training
Required
Equipment
Needs
Standards
Flash cards depicting body image scales
Standard
Name
ID
Common Data Elements (CDE)
Person Body Image
Rating Scale Value
2794263 CDE Browser
Logical Observation Identifiers Names Body image proto
and Codes (LOINC)
General
References
Source
63522-7 LOINC
Cachelin, F. M., Monreal, T. K., & Juarez, L. C. (2006). Body image and size
perceptions of Mexican American women. Body Image, 3(1), 67-75.
Costello, E. J., Sung, M., Worthman, C., & Angold, A. (2007). Pubertal maturation
and the development of alcohol use and abuse. Drug and Alcohol
Dependence, 88(Suppl. 1), S50-59.
Doswell, W. M., Millor, G. K., Thompson, H., & Braxter, B. (1998). Self-image and
self-esteem in African-American preteen girls: implications for mental
health. Issues in Mental Health Nursing, 19(1), 71-94.
Graber, J. A., Seeley, J. R., Brooks-Gunn, J., & Lewinsohn, P. M. (2004). Is
pubertal timing associated with psychopathology in young adulthood. Journal of
the American Academy of Child and Adolescent Psychiatry, 43(6), 718-726.
Maximova, K., McGrath, J. J., Barnett, T., O’Loughlin, J., Paradis, G., & Lambert,
M. (2008). Do you see what I see? Weight status misperception and exposure to
obesity among children and adolescents. International Journal of Obesity, 32(6),
1008-1115.
Must, A., Phillips, S. M., Stunkard, A. J., & Naumova, E. N. (2002). Expert opinion
on body mass index percentiles for figure drawings at menarche.International
Journal of Obesity, 26(2), 876-879.
Olvera, N., Suminski, R., & Power, T. G. (2005). Intergenerational perceptions of
body image in Hispanics: role of BMI, gender, and acculturation. Obesity
Research,, 13(11), 1970-1979.
Siegel, J. M., Yancey, A. K., Aneschensel, C. S., & Schuler, R. (1999). Body image,
perceived pubertal timing, and adolescent mental health. Journal of Adolescent
Health, 25(2), 155-165.
Snooks, M. K., & Hall, S. K. (2002). Relationship of body size, body image, and selfesteem in African American, European American, and Mexican American middleclass women. Health Care for Women International, 23(5), 460-466.
Protocol
Type
Self- or proxy-reported value
Derived
Variables
None
Requiremen Requirement Category
ts
Average time of greater than 15 minutes in an unaffected individual
Required
No
Average time of greater than 15 minutes in an unaffected individual
Major equipment
No
This measure requires a specialized measurement device that may not
be readily available in every setting where genome wide association
studies are being conducted. Examples of specialized equipment are
DEXA, Echocardiography, and Spirometry
Specialized requirements for biospecimen collection
No
This protocol requires that blood, urine, etc. be collected from the
study participants.
Specialized training
This measure requires staff training in the protocol methodology
and/or in the conduct of the data analysis.
No