Assessing body image investment in breast cancer patients undergoing reconstructive surgery: Validation of the Appearance Schemas Inventory-Revised (ASI-R) measure
Breast cancer treatment is known to significantly affect a patient’s body image as it typically involves partial or complete loss of one or both breasts. Body image investment refers to the value or importance one places on appearance and physical attributes. We evaluated the factor structure of the 20-item Appearance Schemas Inventory-Revised (ASI-R) with a sample of breast cancer patients and explored the differences in item functioning of the ASI-R items. The 20-item ASI-R measure was administered to 373 female breast cancer patients at The University of Texas M.D. Anderson Cancer Center. We performed a Confirmatory Factor Analysis (CFA) to evaluate the original factor structure of ASI-R. As the model did not fit, we then performed an Exploratory Factor Analysis (EFA) and a secondary CFA to compare the two models. We also explored the differences in item functioning of the ASI-R measure with the Graded Response Model (GRM) utilizing Item Response Theory (IRT) methods. The CFA showed a deviation of the data for the original 2-factor structure of ASI-R in our breast cancer sample. EFA indices revealed a different factor structure for ASI-R in our sample—a 3-factor model. Most items loaded on the original two factors, with two items loaded on a distinct third factor. We named the three factors as Appearance Self-Evaluation, Appearance Standards/Behavior and Appearance Power/Control, respectively. IRT analysis found that some items are not as effective as other items in determining their corresponding factor scores. There is sufficient evidence to believe that a 3-factor model of the ASI-R measure is a better fit for our breast cancer sample. Furthermore, three items in the ASI-R measure seemed less informative in capturing information for the construct of body image investment, suggesting that the measure may be streamlined for future use. In light of these findings, health professionals can now better understand the role of body image investment for breast cancer patients and consider the use of our findings on the ASI-R measure in both research and clinical arenas.
Biostatistics|Behavioral psychology|Quantitative psychology|Oncology
Chua, Alicia Seow Yen, "Assessing body image investment in breast cancer patients undergoing reconstructive surgery: Validation of the Appearance Schemas Inventory-Revised (ASI-R) measure" (2013). Texas Medical Center Dissertations (via ProQuest). AAI1552313.