Protocol Overview

October 1, 2015

Body Figure Perceptions Scales from Collins, Stunkard et al., and Pulvers et al.

This protocol encompasses the self-reported prior, current, or ideal body image of the respondents and their children. The majority of studies using pictograms have used the Stunkard Figure Rating Scale, which contains nine silhouettes on an ordinal scale. An alternative, the Collins scale, has also been provided. Specific pictograms for African Americans and children are also included.

Participants are instructed to choose the picture from the pictogram that they 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 or body image of participants’ children. Proxy assessments are appropriate for participants’ children only and not for other adults. See Protocol Text for more detail.

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, 199-208.

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, 115-120.

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, 199-208.

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, 115-120.

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, 199-208.

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, 199-208.

Export Variables

Variable Name	Variable ID	Variable Description	Version	Mapping
PX020401_Body_Image_Gender_5	PX020401010100	Male or female pictures presented/chosen for the age of 5.	4	N/A
PX020401_Body_Image_5	PX020401010200	Choose the picture that most closely resembles your (or your child's) body shape at the age of 5.	4	N/A
PX020401_Body_Image_5_Scale	PX020401010300	Scale Used for Child Body Image.	4	N/A
PX020401_Body_Image_Gender_10	PX020401020100	Male or female pictures presented/chosen for the age of 10.	4	N/A
PX020401_Body_Image_10	PX020401020200	Choose the picture that most closely resembles your (or your child's) body shape at the age of 10.	4	N/A
PX020401_Body_Image_10_Scale	PX020401020300	Scale Used for Child Body Image.	4	N/A
PX020401_Body_Image_Gender_20	PX020401030100	Male or female pictures presented/chosen for the age of 20.	4	N/A
PX020401_Body_Image_20	PX020401030200	Choose the picture that most closely resembles your body shape at the age of 20.	4	N/A
PX020401_Body_Image_20_Scale	PX020401030300	Scale Used for Adult Body Image.	4	N/A
PX020401_Body_Image_Gender_30	PX020401040100	Male or female pictures presented/chosen for the age of 30.	4	N/A
PX020401_Body_Image_30	PX020401040200	Choose the picture that most closely resembles your body shape at the age of 30.	4	N/A
PX020401_Body_Image_30_Scale	PX020401040300	Scale Used for Adult Body Image.	4	N/A
PX020401_Body_Image_Gender_40	PX020401050100	Male or female pictures presented/chosen for the age of 40.	4	N/A
PX020401_Body_Image_40	PX020401050200	Choose the picture that most closely resembles your body shape at the age of 40.	4	N/A
PX020401_Body_Image_40_Scale	PX020401050300	Scale Used for Adult Body Image.	4	N/A
PX020401_Body_Image_Gender_Current_Age	PX020401060100	Male or female pictures presented/chosen currently.	4	N/A
PX020401_Body_Image_Current_Age	PX020401060200	Choose the picture that most closely resembles your body shape currently.	4	N/A
PX020401_Body_Image_Current_Age_Scale	PX020401060300	Scale Used for Adult Body Image.	4	N/A

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. That is, the figures have been assigned body mass index (BMI, kg/m²) percentiles and age-appropriate BMI for tracking relative weight changes (loss or gain) from childhood through adulthood. Use of an ethnic group-specific body image is advisable because size and perception may vary by ethnicity.

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., . . . 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.

Child, Adolescent, Adult, Senior

English

Participant aged 6 years or older for self-report

None

Flash cards depicting body image scales

Standard	Name	ID	Source
Common Data Elements (CDE)	Person Body Image Rating Scale Value	2794263	CDE Browser
Logical Observation Identifiers Names and Codes (LOINC)	Body image proto	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-S59.

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 self-esteem in African American, European American, and Mexican American middle-class women. Health Care for Women International, 23(5), 460-466.

Self- or proxy-reported value

None

Requirement Category	Required
Average time of greater than 15 minutes in an unaffected individual	No
Major equipment	No
Specialized requirements for biospecimen collection	No
Specialized training	No

The Expert Review Panel #1 reviewed the measures in the Anthropometrics, Diabetes, Physical Activity and Physical Fitness, and Nutrition and Dietary Supplements domains.

Guidance from the ERP includes:

• Revised descriptions of measure

Back-compatible: no changes to Data Dictionary

Previous version in Toolkit archive (link)