Body Image After Mastectomy Scale: A New Measure of Body Image Behaviors and Beliefs in Women Following Mastectomy

Abstract

Background: Body image distress is frequently reported by women after mastectomy and is associated with negative health outcomes, such as reduced quality of life, elevated depression and anxiety symptoms, and impaired sexual functioning. To reduce body image distress after mastectomy, we must first understand the factors that contribute to its development and maintenance. We therefore developed a new measure, the Body Image after Mastectomy Scale (BIMS), to comprehensively assess maladaptive appearance-related beliefs and behaviors (e.g., avoidance and rituals) that may trigger and maintain body image distress after mastectomy. Materials and Methods: Forty-seven female patients undergoing mastectomy with breast reconstruction completed the BIMS and other measures 3 months after breast reconstruction. Results: Evaluation of the BIMS' initial psychometric properties showed that the overall scale has good internal consistency and strong construct validity. Domain-specific subscales ranged in reliability from good to poor. Conclusions: The BIMS can be used clinically to identify cognitive and behavioral psychotherapy targets to reduce body image distress resulting from mastectomy. It can also be used in research to identify factors that contribute to the development and maintenance of body image distress after mastectomy. ClinicalTrials.gov identifier: NCT03428399.

Keywords: body image; breast cancer; breast reconstruction; mastectomy; measurement.

Conflict of interest statement

H.W. and S.W. have received salary support from Koa Health and are presenters for the Massachusetts General Hospital Psychiatry Academy in educational programs supported through independent medical education grants from pharmaceutical companies. S.W. has also received royalties from Elsevier Publications, Guilford Publications, New Harbinger Publications, Springer, and Oxford University Press. S.W. has received speaking honoraria from various academic institutions and foundations, including the International Obsessive Compulsive Disorder Foundation, Tourette Association of America, and Brattleboro Retreat, payment from the Association for Behavioral and Cognitive Therapies for her role as Associate Editor for the Behavior Therapy journal, and payment from John Wiley & Sons, Inc., for her role as Associate Editor on the journal Depression & Anxiety. S.W. has received honorarium from One-Mind for her role in PsyberGuide Scientific Advisory Board, and she has received salary support from Novartis. Z.E.L., I.L., and W.G.A., Jr. have no competing interests to report.