Testing the Measurement Invariance of the Body Image Acceptance and
Action Questionnaire Between Women With and Without Binge-Eating
Disorder Symptomatology: Further Evidence for an Abbreviated
Jake Linardon and Mariel Messer
Arizona State University
The Body Image Acceptance and Action Questionnaire (BI-AAQ), a measure designed to assess body
image flexibility, was originally developed for and psychometrically investigated with nonclinical
populations, but it has been recently administered to people with binge-eating disorder (BED) symp-
tomatology. Tests of measurement invariance are needed to understand whether the BI-AAQ operates in
the same way for BED and non-BED populations, thereby ensuring meaningful comparison across these
groups. We thus tested the measurement invariance of the BI-AAQ in participants with and without
clinically significant BED symptomatology. Data were analyzed from 358 community-based partici-
pants. Participants were either classified as with (n⫽179) or without (n⫽179) “probable BED” based
on self-reported symptom frequency. An unacceptable model fit was found across both groups, indicating
that the unidimensional structure of the BI-AAQ was not replicated. We then sought to confirm the
unidimensional structure of a recently proposed five-item version of the BI-AAQ. A unidimensional
structure of this abbreviated version was replicated, and tests of measurement variance were upheld.
Internal consistency, convergent validity, and incremental validity were documented for both the original
and abbreviated BI-AAQ across individuals with and without BED symptomatology. Present findings
provide further psychometric support for an abbreviated five-item BI-AAQ, although it is important for
future research to replicate both the full and abbreviated BI-AAQ in more diverse samples. Overall, an
abbreviated BI-AAQ may be an attractive alternative for researchers studying body image flexibility.
Public Significance Statement
This study enhances our understanding on the assessment of body image flexibility in binge-eating
disorder. Suggestions for using this measure in an abbreviated form in clinical and nonclinical
populations are provided.
Keywords: body image flexibility, binge eating, eating disorder, psychometric properties
Body image has been thought of as a multidimensional construct
comprised of both positive and negative features with behavioral,
perceptual, and attitudinal components (Smolak & Cash, 2011).
Research has traditionally focused on describing, explaining, and
predicting negative body image in the absence of considering
positive body image (e.g., Cash, 2012;Kearney-Cooke & Tieger,
2015). For example, several theoretical models have garnered
support in understanding precipitating and perpetuating factors of
negative body image, and more recent research demonstrates that
distinct negative components of body image differentially predict
various ill-health outcomes (Linardon, Fuller-Tyszkiewicz, de la
Piedad Garcia, Messer, & Brennan, 2019;Linardon et al., 2018a,
2018b;Lydecker, White, & Grilo, 2017). Such work has helped
inform effective prevention and intervention strategies for negative
body image (Alleva, Sheeran, Webb, Martijn, & Miles, 2015).
However, focusing on minimizing negative body image without
considering how to promote positive body image is a limitation, as
it said to have limited a comprehensive understanding of body
image, and may have prevented the development of more potent
interventions (Tylka & Wood-Barcalow, 2015). Thus, the impor-
This article was published Online First July 25, 2019.
XJake Linardon and Mariel Messer, School of Psychology, Deakin
University; Sohee Lee, Department of Psychology, Arizona State Univer-
sity; Matthew Fuller-Tyszkiewicz, School of Psychology, Deakin Univer-
Correspondence concerning this article should be addressed to Jake
Linardon, School of Psychology, Deakin University, 221 Burwood, High-
way, Burwood, VIC 3125, Australia. E-mail: email@example.com
This document is copyrighted by the American Psychological Association or one of its allied publishers.
This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.
© 2019 American Psychological Association 2019, Vol. 31, No. 11, 1368–1376
ISSN: 1040-3590 http://dx.doi.org/10.1037/pas0000761