Multidimensional Body-Self Relations Questionnaire (MBSRQ)

Abstract

The Multidimensional Body-Self Relations Questionnaire (MBSRQ) is one of the most widely used and psychometrically validated self-report instruments designed to assess the cognitive, behavioral, and affective dimensions of body image. Developed by Thomas F. Cash and colleagues, the MBSRQ grew out of the earlier Body-Self Relations Questionnaire (BSRQ) to provide an extensive, multidimensional operationalization of somatic attitudes. Unlike unidimensional measures that assess only physical appearance dissatisfaction, the MBSRQ evaluates attitudes across three distinct somatic domains: Appearance, Fitness, and Health/Illness. Within each domain, the instrument explicitly differentiates between two fundamental conceptual components: Evaluation (the degree of satisfaction or positive/negative appraisal of one's physical self) and Orientation (the degree of cognitive-behavioral investment, attentiveness, and behavioral effort devoted to that somatic attribute).

The full standard version of the MBSRQ comprises 69 items distributed across 10 distinct subscales: Appearance Evaluation (AE, 7 items), Appearance Orientation (AO, 12 items), Fitness Evaluation (FE, 3 items), Fitness Orientation (FO, 13 items), Health Evaluation (HE, 6 items), Health Orientation (HO, 8 items), Illness Orientation (IO, 5 items), the Body Areas Satisfaction Scale (BASS, 9 items), Overweight Preoccupation (OWP, 4 items), and Self-Classified Weight (SCW, 2 items). A popular 34-item abbreviated version—the MBSRQ-Appearance Scales (MBSRQ-AS)—isolates the appearance-specific subscales. Responses on the primary 57 items are rated on a 5-point Likert-type agreement scale ranging from 1 (Definitely Disagree) to 5 (Definitely Agree), while subsequent sections utilize specialized 5-point rating scales measuring weight perception, dieting behavior, and discrete anatomical satisfaction. Extensive psychometric investigations demonstrate robust internal consistency (Cronbach's alpha coefficients typically ranging from .70 to .91 across subscales), commendable test-retest reliability (.71 to .89 over multi-week intervals), and well-established convergent, discriminant, and structural validity across diverse clinical, athletic, and community populations globally.

Keywords

Multidimensional Body-Self Relations Questionnaire, MBSRQ, body image, appearance evaluation, appearance orientation, body areas satisfaction scale, eating disorders, body dissatisfaction, psychometrics, somatic perception

Authors

The Multidimensional Body-Self Relations Questionnaire was developed, refined, and validated by leading clinical psychologists and psychometricians specializing in body image, somatic psychology, and experimental psychopathology:

• Thomas F. Cash, Ph.D.: Professor Emeritus of Clinical Psychology at Old Dominion University (Norfolk, Virginia, USA). Dr. Cash is internationally recognized as a pioneering scholar in body image research, authoring over 200 scientific publications, clinical manuals, and seminal books on body image assessment, cognitive-behavioral therapy for body image distress, and the psychology of physical appearance.
• Timothy A. Brown, Psy.D.: Professor of Psychology and Director of Research at the Center for Anxiety and Related Disorders at Boston University (Boston, Massachusetts, USA). Dr. Brown is a distinguished quantitative methodologist and clinical psychologist whose expertise in confirmatory factor analysis and structural equation modeling established the factorial validity of the MBSRQ.
• Peter J. Mikulka, Ph.D.: Professor Emeritus of Psychology at Old Dominion University. Dr. Mikulka contributed extensive expertise in experimental psychology, behavioral psychometrics, and quantitative multivariate methodologies during the initial empirical validation of the instrument.

Purpose

The primary purpose of the Multidimensional Body-Self Relations Questionnaire is to provide an empirically grounded, nuanced, and comprehensive assessment of an individual's attitudinal relationship with their physical self. Historically, psychological research conceptualized body image almost exclusively as a unidimensional construct synonymous with dissatisfaction regarding physical appearance, adiposity, or body weight. Dr. Cash and his collaborators identified this conceptualization as overly narrow, failing to capture the profound complexities of somatic experience. Human beings relate to their physical bodies not merely as aesthetic objects to be viewed, but as biological organisms functioning in states of physical fitness, cardiovascular capacity, metabolic health, and vulnerability to disease.

The MBSRQ serves several critical clinical and research purposes:

• Deconstructing Attitudinal Dimensions (Evaluation vs. Orientation): The instrument explicitly decouples how people evaluate their physical attributes (evaluative satisfaction vs. dissatisfaction) from how much psychological and behavioral investment they commit to maintaining or enhancing those attributes (cognitive-behavioral orientation). For example, an individual may evaluate their appearance very positively while demonstrating low orientation (low daily investment), or conversely, report profound appearance dissatisfaction accompanied by obsessive, compulsive appearance orientation—a pattern prototypical of body dysmorphic disorder.
• Broadening Somatic Domains: Beyond appearance alone, the MBSRQ assesses the fitness and health/illness domains. This broad diagnostic spectrum enables clinicians and researchers to capture healthy vs. pathological compensatory behaviors, distinguishing individuals who exercise for physical capacity and functional vitality from those driven by aesthetic dysphoria or pathological weight control.
• Clinical Diagnosis and Treatment Monitoring: In clinical settings, the MBSRQ is widely utilized in the baseline assessment and treatment monitoring of patients undergoing cognitive-behavioral therapy for eating disorders (such as anorexia nervosa, bulimia nervosa, and binge-eating disorder), body dysmorphic disorder, and somatic symptom disorders. It is similarly employed in pre- and post-operative psychosocial evaluations for bariatric surgery, reconstructive or cosmetic plastic surgery, and post-oncological rehabilitation (e.g., following mastectomy in breast cancer survivors).
• Epidemiological and Sports Psychology Research: The scale serves as a foundational measurement instrument in public health initiatives, physical education research, sports psychology investigations of muscle dysmorphia and exercise dependence, and cross-cultural examinations of physical self-concept across the adult lifespan.

Psychological Construct

The MBSRQ is grounded in the operational definition of body image as a multifaceted psychological construct encompassing perceptual, cognitive, affective, and behavioral dispositions toward one's physical appearance, bodily functions, and biological health. The complete 69-item instrument organizes this broad construct into 10 distinct subscales:

1. Appearance Evaluation (AE; 7 items)

Appearance Evaluation measures an individual's overall subjective satisfaction and happiness with their physical looks and aesthetic presentation. High scorers perceive themselves as physically attractive, aesthetically pleasing, and generally content with their physical appearance. Low scorers exhibit marked physical dissatisfaction, viewing themselves as unattractive, physically flawed, or aesthetically deficient (e.g., Item 56: “I am satisfied with my physical appearance”; Item 53 [Reverse Scored]: “I am physically unattractive”).

2. Appearance Orientation (AO; 12 items)

Appearance Orientation quantifies the degree of cognitive importance, attentional vigilance, and behavioral grooming effort an individual invests in their physical appearance. High scorers dedicate substantial time, energy, and resources to enhancing their looks, frequently checking their reflection, planning outfits, and actively managing their grooming behaviors. Importantly, high AO does not signify positive body satisfaction; rather, it reflects high psychological investment, which can exist alongside either high satisfaction or severe body image dysphoria (e.g., Item 1: “Before going out in public, I always notice how I look”; Item 10: “I am always trying to improve my physical appearance”).

3. Fitness Evaluation (FE; 3 items)

Fitness Evaluation captures subjective perceptions of being physically fit, athletic, and in good physical condition. Individuals scoring high on FE consider themselves physically capable, strong, and in top cardiovascular or muscular shape. Low scorers evaluate their physical conditioning negatively, considering themselves sedentary, weak, or out of shape (e.g., Item 27: “I am physically fit”; Item 28: “My body is in top physical condition”).

4. Fitness Orientation (FO; 13 items)

Fitness Orientation assesses cognitive-behavioral investment in physical conditioning, exercise participation, and athletic training. High scorers actively structure their routines to incorporate vigorous exercise, continually strive to improve physical endurance, and view physical activity as a core component of daily lifestyle. Low scorers demonstrate minimal engagement in physical conditioning activities and place little psychological priority on physical fitness (e.g., Item 18: “I try to be physically active every day”; Item 22: “I work hard to stay in good physical shape”).

5. Health Evaluation (HE; 6 items)

Health Evaluation measures the subjective appraisal of biological wellness, physiological vitality, and relative freedom from physical illness. High scorers perceive themselves as physically robust, biologically resilient, and rarely vulnerable to sickness or infections. Low scorers perceive their health as delicate, compromised, or consistently suboptimal (e.g., Item 38: “I am in excellent physical health”; Item 40: “I am rarely sick”).

6. Health Orientation (HO; 8 items)

Health Orientation gauges the degree of proactive behavioral investment in establishing and maintaining somatic health and lifestyle wellness. High scorers intentionally consume nutritious diets, prioritize restorative sleep, maintain regular preventive medical checkups, and actively monitor bodily habits to avert disease. Low scorers exhibit relative indifference to preventative lifestyle behaviors and health-promoting practices (e.g., Item 31: “I do things to make sure I am healthy”; Item 35: “I am careful about the foods I eat to stay healthy”).

7. Illness Orientation (IO; 5 items)

Illness Orientation reflects somatic vigilance, bodily symptom attentiveness, and reactivity to early indicators of physical sickness. High scorers are hyper-attentive to internal physiological alterations, quickly noticing pain, fever, or fatigue, and rapidly seek professional medical consultation. Low scorers pay little attention to subtle physiological symptoms and delay seeking medical attention until illness becomes incapacitating (e.g., Item 44: “At the first sign of illness, I seek medical help”; Item 48: “I am quick to notice physical symptoms of being ill”).

8. Body Areas Satisfaction Scale (BASS; 9 items)

The BASS provides an anatomically granular assessment of satisfaction or dissatisfaction across specific bodily regions and features: facial features, hair, lower torso (buttocks, hips, thighs), mid torso (waist, stomach), upper torso (chest/breasts, shoulders, arms), muscle tone, body weight, height, and overall appearance. Unlike global appearance evaluation, the BASS allows clinicians to detect focal somatic dissatisfactions that are central to clinical eating pathology and body dysmorphia.

9. Overweight Preoccupation (OWP; 4 items)

Overweight Preoccupation assesses specific cognitive anxieties regarding weight gain, intense weight vigilance, calorie-restriction behaviors, and histories of radical crash dieting or fasting. This subscale correlates strongly with core clinical markers of anorexia nervosa and bulimia nervosa (e.g., Item 3: “I would pass up the chance to eat something delicious if it made me gain weight”; Item 60: “I have tried to lose weight by fasting or going on crash diets”).

10. Self-Classified Weight (SCW; 2 items)

Self-Classified Weight evaluates self-perceived body weight status along a continuum from very underweight to very overweight, measuring both subjective personal perception (Item 58) and projected social appraisal from the “looking-glass” perspective of others (Item 59). Discrepancies between objective body mass index (BMI) and SCW provide key clinical insights into cognitive body image distortions.

Theoretical Framework

The MBSRQ is rooted in cognitive-behavioral models of body image formulated primarily by Thomas F. Cash (1996, 2002, 2011). In Cash's social-cognitive perspective, body image is conceptualized as a complex psychological construction comprising internal cognitive schemas, self-evaluative structures, and behavioral feedback loops rather than a passive, mirror-like reflection of physical reality.

The theoretical architecture of the MBSRQ is built upon several foundational principles:

• The Schema-Driven Nature of Somatosensory Processing: Cash posits that individuals construct mental representations or “body schemas” through cumulative historical developmental influences (e.g., childhood peer teasing, parental modeling of dieting, athletic socialization, and sociocultural exposure to media ideals). Once crystallized, these schemas serve as cognitive processing filters that selectively guide attention, interpretation, and recall of bodily experiences.
• The Evaluative versus Investment Dichotomy: A central theoretical innovation of the MBSRQ is its formal structural distinction between body image evaluations (cognitive appraisals and emotional valences toward the body) and body image investment (the cognitive centrality, salience, and behavioral energy allocated to managing the body). Drawing on Higgins' Self-Discrepancy Theory, Cash argued that distress does not stem merely from perceiving a physical flaw; rather, distress emerges when a discrepancy occurs between one's perceived physical self and an internalized “ideal self” within a domain of high psychological investment. If appearance is of low cognitive orientation/investment to an individual, aesthetic shortcomings will not trigger emotional distress. Conversely, when investment is elevated, even minor perceived deviations elicit profound affective disruptions.
• Multiplicity of the Somatic Self: Influenced by Paul Schilder's classical neuropsychological treatises on the image and appearance of the human body, Cash acknowledged that the physical self is inherently multifaceted. Somatic identity synthesizes bodily aesthetics (appearance), functional kinetic capabilities (fitness), and physiological homeostasis and disease vulnerability (health/illness). Separating these domains prevents confounding physical exercise performed for functional mastery with exercise performed compulsively for cosmetic or weight-control motives.
• Social Comparison and Reflected Appraisals: Integrating Festinger's Social Comparison Theory and Cooley's “looking-glass self,” the MBSRQ incorporates operational measures (such as Item 59 in Self-Classified Weight) that assess how individuals infer other people judge their physical characteristics. This captures the interpersonal and sociocultural dynamics driving body image disturbances.

Validity

Decades of psychometric research across diverse global samples provide robust empirical evidence supporting the construct, convergent, discriminant, and predictive validity of the MBSRQ.

Construct and Factorial Validity

Construct validity was initially established by Brown, Cash, and Mikulka (1990) through extensive factor analytic investigations involving large university cohorts. Exploratory and confirmatory factor analyses systematically verified the distinctness of the 10-factor structure, showing that the evaluative and investment dimensions of appearance, fitness, and health separate cleanly into empirical components. Structural equation modeling across diverse non-clinical and clinical groups consistently validates this multidimensional framework over alternative unidimensional models.

Convergent Validity

The MBSRQ demonstrates extensive convergent validity through consistent, theoretically predictable associations with established psychological instruments:

• Eating Disorder Psychopathology: Subscales such as Overweight Preoccupation (OWP), Appearance Orientation (AO), and low Appearance Evaluation (AE) correlate strongly with the Eating Disorder Inventory (EDI; Garner et al.), particularly with the Drive for Thinness ($r = .65$ to $.78$) and Body Dissatisfaction ($r = -.60$ to $-.75$ with AE) subscales. Similar strong associations emerge with the Bulimic Investigatory Test, Edinburgh (BITE).
• Self-Esteem and Affective Well-Being: Appearance Evaluation and the Body Areas Satisfaction Scale (BASS) demonstrate moderate-to-strong positive correlations with the Rosenberg Self-Esteem Scale (RSES; $r = .45$ to $.60$), indicating that subjective appraisal of bodily aesthetics is an integral determinant of global self-worth. Conversely, low AE and high OWP correlate positively with depressive symptomatology assessed via the Beck Depression Inventory (BDI; $r = .35$ to $.48$).
• Objective Fitness and Health Behaviors: The Fitness Orientation (FO) and Fitness Evaluation (FE) subscales correlate significantly with objective physiological indices of aerobic endurance, weekly exercise logs ($r = .50$ to $.68$), and athletic self-efficacy. Similarly, Health Orientation (HO) correlates positively with preventive healthcare utilization, balanced dietary patterns, and adherence to medical regimens.

Discriminant Validity

The MBSRQ successfully differentiates between distinct theoretical dimensions that unidimensional scales often conflate. For instance, Appearance Evaluation and Appearance Orientation exhibit near-zero or weak correlations with each other ($r = -.05$ to $.15$), proving that investing substantial behavioral effort into physical appearance is independent of whether one feels attractive. Furthermore, the MBSRQ effectively differentiates clinical cohorts; individuals diagnosed with anorexia nervosa or bulimia nervosa score substantially higher on Overweight Preoccupation and Appearance Orientation, and significantly lower on Appearance Evaluation and BASS, compared to age-matched non-clinical controls.

Predictive and Ecological Validity

Longitudinal and prospective studies confirm the predictive validity of the MBSRQ. Baseline scores on Overweight Preoccupation, Appearance Orientation, and low Appearance Evaluation reliably predict the onset of pathological dieting practices, binge eating, and compensatory purging over 1-to-3-year follow-up periods in adolescent and young adult populations. In cosmetic surgery settings, pre-operative AE and BASS scores predict post-surgical psychological satisfaction and improvements in quality of life.

Reliability

The MBSRQ demonstrates high reliability across diverse populations, displaying both high internal consistency and temporal stability.

Internal Consistency

In the foundational validation studies by Brown, Cash, and Mikulka (1990) and subsequent extensive normative standardization samples compiled in Cash's MBSRQ manual (comprising thousands of male and female participants), Cronbach's alpha coefficients for the 10 subscales consistently met or exceeded standard psychometric benchmarks ($lpha ge .70$ to $.91$):

• Appearance Evaluation (AE): $lpha = .88$ for females, $.86$ for males
• Appearance Orientation (AO): $lpha = .88$ for females, $.85$ for males
• Fitness Evaluation (FE): $lpha = .77$ for females, $.77$ for males
• Fitness Orientation (FO): $lpha = .91$ for females, $.89$ for males
• Health Evaluation (HE): $lpha = .78$ for females, $.82$ for males
• Health Orientation (HO): $lpha = .75$ for females, $.76$ for males
• Illness Orientation (IO): $lpha = .76$ for females, $.73$ for males
• Body Areas Satisfaction Scale (BASS): $lpha = .77$ for females, $.82$ for males
• Overweight Preoccupation (OWP): $lpha = .76$ for females, $.73$ for males
• Self-Classified Weight (SCW): Inter-item correlation $r = .71$ to $.84$; $lpha = .84$ to $.89$

Test-Retest Reliability

Stability across time has been examined across repeated test-retest intervals ranging from two weeks to three months in non-clinical samples. In a standard 1-month test-retest study conducted by Cash and colleagues, stability coefficients remained remarkably high across all subscales: AE ($r_{tt} = .89$), AO ($r_{tt} = .88$), FE ($r_{tt} = .81$), FO ($r_{tt} = .84$), HE ($r_{tt} = .79$), HO ($r_{tt} = .75$), IO ($r_{tt} = .71$), and BASS ($r_{tt} = .86$). These statistics indicate that the MBSRQ measures enduring, trait-like cognitive-affective dispositions toward the somatic self rather than transient, fluctuating emotional states.

Factor Analysis

The factorial evolution of the MBSRQ from its predecessor, the 105-item Body-Self Relations Questionnaire (BSRQ; Winstead & Cash, 1984), represents an exemplary application of psychometric refinement through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA).

Exploratory Factor Analysis (EFA)

Brown, Cash, and Mikulka (1990) conducted comprehensive exploratory factor analyses on a standardization cohort of 1,070 university students (569 women, 501 men). Utilizing principal axis factoring with both orthogonal (Varimax) and oblique (Oblimin) rotations, the researchers extracted clear, robust factors across the somatic domains. Items with low primary factor loadings ($< .35$) or significant cross-loadings ($> .25$ on multiple factors) were systematically eliminated, reducing the original 105-item pool down to the psychometrically clean 69-item structure of the modern MBSRQ.

The resulting factors clearly mapped onto the proposed theoretical matrix: Appearance, Fitness, and Health each split into independent Evaluation and Orientation factors, while specialized constructs (Illness Orientation, BASS, Overweight Preoccupation, and Self-Classified Weight) emerged as cohesive, statistically distinct dimensions. Primary factor loadings for designated items consistently fell between $.45$ and $.84$, confirming exceptional item-to-subscale convergence.

Confirmatory Factor Analysis (CFA)

Subsequent confirmatory factor analyses conducted by independent research teams across diverse international contexts have examined the structural integrity of the MBSRQ across genders, age groups, and cultural backgrounds. In extensive CFA investigations evaluating both the 69-item full scale and the 34-item Appearance Scales version (MBSRQ-AS):

• Model Fit Indices: CFA models specifying the established multidimensional subscales routinely produce strong goodness-of-fit indices meeting modern psychometric criteria: Comparative Fit Index ($ ext{CFI} ge .90$ to $.94$), Tucker-Lewis Index ($ ext{TLI} ge .90$ to $.93$), Root Mean Square Error of Approximation ($ ext{RMSEA} le .048$ to $.062$), and Standardized Root Mean Square Residual ($ ext{SRMR} le .055$).
• Measurement Invariance: Multigroup structural equation modeling has supported configural, metric, and scalar invariance across biological sex and age cohorts (from early adolescence to older adulthood). This confirms that the MBSRQ measures equivalent psychological constructs across diverse demographics, enabling legitimate, unbiased group comparisons in clinical and epidemiologic research.

Instrument / Measurement Tool

The Multidimensional Body-Self Relations Questionnaire is administered as a structured, paper-and-pencil or computer-administered self-report inventory. Its operational parameters are detailed below:

• Test Type: Multidimensional psychometric self-report rating scale.
• Target Population: Adults and adolescents aged 15 years and older (normative validation established primarily on ages 18 to 65+).
• Administration Time: Approximately 10 to 15 minutes for the complete 69-item instrument; 5 to 7 minutes for the 34-item MBSRQ-AS.
• Total Item Count: 69 items across 10 distinct subscales.
• Subscale Breakdown:
  • Appearance Evaluation (AE): 7 items (Items 49, 50, 51, 52, 53, 54, 56)
  • Appearance Orientation (AO): 12 items (Items 1, 2, 4, 5, 6, 7, 8, 9, 10, 11, 55, 57)
  • Fitness Evaluation (FE): 3 items (Items 26, 27, 28)
  • Fitness Orientation (FO): 13 items (Items 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25)
  • Health Evaluation (HE): 6 items (Items 38, 39, 40, 41, 42, 43)
  • Health Orientation (HO): 8 items (Items 30, 31, 32, 33, 34, 35, 36, 37)
  • Illness Orientation (IO): 5 items (Items 44, 45, 46, 47, 48)
  • Body Areas Satisfaction Scale (BASS): 9 items (Items 61, 62, 63, 64, 65, 66, 67, 68, 69)
  • Overweight Preoccupation (OWP): 4 items (Items 3, 12, 29, 60)
  • Self-Classified Weight (SCW): 2 items (Items 58, 59)
• Response Scales:
  • Items 1–57: 5-point Likert scale: $1 = \text{Definitely Disagree}$, $2 = \text{Mostly Disagree}$, $3 = \text{Neither Agree Nor Disagree}$, $4 = \text{Mostly Agree}$, $5 = \text{Definitely Agree}$.
  • Items 58–59 (Self-Classified Weight): 5-point scale: $1 = \text{Very Underweight}$, $2 = \text{Somew\hat Underweight}$, $3 = \text{Normal Weight}$, $4 = \text{Somew\hat Overweight}$, $5 = \text{Very Overweight}$.
  • Item 60 (Dieting/Fasting Behavior): 5-point frequency scale: $1 = \text{Never}$, $2 = \text{Rarely}$, $3 = \text{Some\times}$, $4 = \text{Often}$, $5 = \text{Very Often}$.
  • Items 61–69 (Body Areas Satisfaction Scale): 5-point satisfaction scale: $1 = \text{Very Dissatisfied}$, $2 = \text{Mostly Dissatisfied}$, $3 = \text{Neither Satisfied Nor Dissatisfied}$, $4 = \text{Mostly Satisfied}$, $5 = \text{Very Satisfied}$.
• Scoring and Transformation Procedures:
  • Reverse Scoring: Multiple negatively phrased items must be reverse-scored prior to calculating subscale totals ($1 \rightarrow 5$, $2 \rightarrow 4$, $3 \rightarrow 3$, $4 \rightarrow 2$, $5 \rightarrow 1$). The specific items requiring reversal are: Items 7, 9, 13, 23, 24, 29, 30, 37, and 53.
  • Mean Subscale Scores: For each of the 10 subscales, calculate the arithmetic mean of the constituent items (sum of item scores divided by the number of completed items in that subscale). This yields a continuous subscale score from $1.00$ to $5.00$. Computing subscale averages rather than raw sums permits meaningful cross-subscale comparisons and accommodates occasional missing data points through mean imputation where statistically appropriate.

Permissions & Fee and Test Year

The Multidimensional Body-Self Relations Questionnaire was formally validated and published in its modern standardized format in 1990 (Brown, Cash, & Mikulka, 1990), with extensive normative user manuals subsequently published and revised by Dr. Thomas F. Cash in 2000 and 2018.

Copyright and Licensing: The MBSRQ instrument, scoring manual, and normative comparative tables are protected under international copyright held by Thomas F. Cash, Ph.D. While the instrument is widely accessible for non-commercial academic and clinical research purposes, formal permission and acquisition of the authorized scoring manual must be obtained through Dr. Cash's official distribution portal (Body-Images.com). A nominal fee is typically charged for the comprehensive user manual and scoring keys, supporting ongoing test maintenance and normative database preservation. Commercial applications, sponsored pharmaceutical trials, and integration into proprietary digital health platforms require a formal commercial license from the copyright holder.

References

• Brown, T. A., Cash, T. F., & Mikulka, P. J. (1990). Attitudinal body-image assessment: Factor analysis of the Body-Self Relations Questionnaire. Journal of Personality Assessment, 55(1–2), 135–144. https://doi.org/10.1080/00223891.1990.9674053
• Cash, T. F. (2000). The Multidimensional Body-Self Relations Questionnaire (MBSRQ) User's Manual. Old Dominion University.
• Cash, T. F. (2002). Cognitive-behavioral perspectives on body image. In T. F. Cash & T. Pruzinsky (Eds.), Body image: A handbook of theory, research, and clinical practice (pp. 38–46). Guilford Press.
• Cash, T. F. (2011). Cognitive-behavioral perspectives on body image. In T. F. Cash & L. Smolak (Eds.), Body image: A handbook of science, practice, and prevention (2nd ed., pp. 39–47). Guilford Press.
• Cash, T. F., & Pruzinsky, T. (1990). Body images: Development, deviance, and change. Guilford Press.
• Cash, T. F., Winstead, B. A., & Janda, L. H. (1986). The great American shape-up: Body image survey report. Psychology Today, 20(4), 30–37.
• Garner, D. M., Olmsted, M. P., & Polivy, J. (1983). Development and validation of a multidimensional eating disorder inventory for anorexia nervosa and bulimia. International Journal of Eating Disorders, 2(2), 15–34. https://doi.org/10.1037/0033-295X.94.3.319
• Schilder, P. (1950). The image and appearance of the human body. International Universities Press.

Items of the Scale