Validation of the Body Concealment Scale for Scleroderma (BCSS): Replication in the Scleroderma Patient-centered Intervention Network (SPIN) Cohort

Abstract

Body concealment is an important component of appearance distress for individuals with disfiguring conditions, including scleroderma. The objective was to replicate the validation study of the Body Concealment Scale for Scleroderma (BCSS) among 897 scleroderma patients. The factor structure of the BCSS was evaluated using confirmatory factor analysis and the Multiple-Indicator Multiple-Cause model examined differential item functioning of SWAP items for sex and age. Internal consistency reliability was assessed via Cronbach's alpha. Construct validity was assessed by comparing the BCSS with a measure of body image distress and measures of mental health and pain intensity. Results replicated the original validation study, where a bifactor model provided the best fit. The BCSS demonstrated strong internal consistency reliability and construct validity. Findings further support the BCSS as a valid measure of body concealment in scleroderma and provide new evidence that scores can be compared and combined across sexes and ages.

Reliability and Validity of Three Versions of the Brief Fear of Negative Evaluation Scale in Patients With Systemic Sclerosis: A Scleroderma Patient‐Centered Intervention Network Cohort Study

“…The 9‐item BCSS measures body concealment and avoidance behaviors and is designed specifically for use with SSc patients . It is composed of 2 subscales measuring Concealment of Hands and Concealment with Clothing, which are summed to yield a total score.…”

An Update of Outcome Measures in Systemic Sclerosis

“…In 742 patients, the BCSS total score had good internal consistency ( α = 0.88) and correlated as predicted with the Brief‐SWAP social discomfort ( r = 0.59), Brief‐SWAP dissatisfaction with appearance ( r = 0.53), PHQ‐9 ( r = 0.39), CES‐D ( r = 0.39), and McGill Pain Questionnaire ( r = 0.30) (103). Psychometric properties were replicated in the SPIN cohort (n = 897) (104).…”