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Published in final edited form as: Body Image. 2019 Aug 30;31:198–203. doi: 10.1016/j.bodyim.2019.08.006

Thomas F. Cash: A multidimensional innovator in the measurement of body image; Some lessons learned and some lessons for the future of the field

J Kevin Thompson a, Lauren M Schaefer b,*
PMCID: PMC6897500  NIHMSID: NIHMS1059973  PMID: 31477440

Abstract

Accurate measurement of constructs under investigation is an often-overlooked ingredient of research. However, sound use of strategies to ensure valid and reliable assessment is the building block for any research design, data analysis, and outcome interpretation. In this paper, we note how Thomas F. Cash has pioneered and steered this process in the field of body image for over 30 years—in fact, in the inaugural issue of Body Image, the first article after the editorial introduction focused on measurement (see Thompson, 2004). In the current paper, we detail some of the seminal measures developed by Thomas Cash as well as update the common errors in the (mis)measurement of body image noted in Thompson (2004). The future of body image assessment is bright if we focus on the illumination of past work by Thomas Cash.

Keywords: Thomas Cash, measurement, assessment, body image

1. Introduction

Thomas Cash’s contributions to the field of body image are deep and broad, including foundational work in the areas of risk and maintenance factors, body image-related psychosocial impairment, psychological and medical comorbidities, and intervention (Cash & Pruzinsky, 1990; Cash & Smolak, 2011; Cash, 2012a). However, Dr. Cash’s most enduring mark on the field has perhaps been made through his thoughtful and prolific production of body image assessment instruments, which continue to be used the world over. As any scientist knows, the accurate operationalization and design of measures to assess constructs in a reliable and valid manner is a critically important step in conducting solid and replicable scientific research (Thompson, Schaefer, & Dedrick, 2018). Fancy research designs, prospective analyses, and large sample sizes often obscure basic measurement problems, leading to faulty statements about the validity or implications of study results. In the area of body image, Cash has championed the importance of the essential focus on measurement as the prima facie step in research (Cash, 2011b). His work over the past 30 years has provided a template for how to conceptualize and assess distinct dimensions of body image, offering to researchers and clinicians an array of measures to index the multidimensional aspects of body image. His work has guided our research team since the early 1980s and informed scientists internationally, with his instruments translated into numerous languages (e.g., Spanish, Polish, German, Greek, French, Chinese), and validated among samples across the globe. In this paper, we hope to provide not only a review of his influence and measurement creativity, but also to offer some guidelines of our own to inform future work in the assessment of the often-ephemeral concept of body image.

2. Multidimensional Measurement of Body Image and Related Factors

Consistent with his cognitive-behavioral conceptualization of body image as a multidimensional construct (Cash, 2011a, 2012b), Cash revolutionized the measurement of body image by providing a set of psychometrically sound tools to assess a range of relevant cognitive, affective, and behavioral experiences. Thus, the appeal of Cash’s assessment instruments lies not only in their trustworthy psychometric properties (a critical and too often overlooked element when selecting measures), but in their unique ability to precisely assess specific and well-defined elements of body image with demonstrated importance to clinical outcomes. In this section, we review several of Cash’s published instruments, offering a brief description of each measure as well as information regarding populations in which the scale has been validated. In line with the purpose of this article, the review primarily cites investigations by his own research teams, rather than providing a more comprehensive review of the literature.

2.1. Assessment of Body Image Cognitive Distortions (ABCD)

The ABCD (Jakatdar, Cash, & Engle, 2006) assesses cognitive body image distortions and is a perfect representation of the symbiosis between Cash’s work in the area of intervention and his work in measurement. Those familiar with his Body Image Workbook (Cash, 1997, 2008) will likely recognize the eight types of distorted thinking (e.g., Unfair to Compare, Beauty-or-Beast), which are theorized to contribute to body image dysphoria and are directly targeted within the treatment manual using cognitive-behavioral techniques. In 2006, Cash and his colleagues published a psychometric investigation of the scale, ultimately producing two 18-item parallel forms of the unidimensional measure (Jakatdar et al., 2006). In that investigation and additional validation work (e.g., Rudiger, Cash, Roehrig, & Thompson, 2007), the ABCD has demonstrated strong psychometric properties including good reliability and validity among college women, with preliminary support for its use with college men (Cash, 2012b). The instrument provides an excellent tool for researchers interested in examining correlates of distorted thinking related to body image, as well as a fantastic resource for clinicians seeking to reduce body image concerns among their patients. Indeed, we commonly use the measure in our own clinical work and have found it to be a helpful measure of patients’ problematic cognitions and progress through treatment.

2.2. Appearance Schemas Inventory-Revised (ASI-R)

The ASI-R (Cash, Jakatdar, & Williams, 2004; Cash, 2009; Cash, Maikkula, & Yamamiya, 2004; Cash, Melnyk, & Hrabosky, 2004; Cash, Morrow, Hrabosky, & Perry, 2004; Cash, Phillips, Santos, & Hrabosky, 2004) is a revision of the original Appearance Schemas Inventory (Cash & Labarge, 1996) and assesses individuals’ psychological investment in their own appearance. The history of this measure demonstrates Cash’s unwavering commitment to excellence in measurement, as well as his ability to objectively critique his own work in this pursuit. Despite empirical support for the original ASI, Cash humbly acknowledged the limitations of the measure and sought to further improve the scale in his meticulously constructed 2004 revision. The revised measure contains 20 items and two subscales assessing Self-Evaluative Salience of appearance (i.e., individuals’ beliefs about how their appearance influences their personal or social worth and sense of self) and Motivational Salience of appearance (i.e., the extent to which individuals attend to or seek to manage their appearance). Ultimately, Cash achieved his goal, producing an excellent measure, which has demonstrated strong psychometrics in college men and women (see also Cash & Grasso, 2005). Other published research from his lab provides substantial support for the ASI-R’s convergent validity (Cash, Phillips et al., 2004; Cash, Jakatdar et al., 2004; Cash, Maikkula et al., 2004; Cash, Melnyk et al., 2004; Cash, Morrow et al., 2004; Jakatdar et al., 2006), predictive validity (e.g., Melnyk, Cash, &Janda, 2004; Rudiger et al., 2007), and utility in distinguishing clinical groups (Hrabosky et al., 2009) and treatment outcomes (Cash & Hrabosky, 2003).

2.3. Body Exposure during Sexual Activities Questionnaire (BESAQ)

The BESAQ(Cash, Phillips et al., 2004; Cash, Jakatdar et al., 2004; Cash, Maikkula et al., 2004; Cash, Melnyk et al., 2004; Cash, Morrow et al., 2004; Hangen & Cash, 1991) signals part of Cash’s important contributions to the intersection of sexual functioning and body image. This 28-item measure assesses the respondent’s degree of anxious self-focus on and avoidance of exposing aspects of his or her physical appearance in sexual contexts. The instrument has demonstrated good psychometric properties in samples of college men and women (Cash, Phillips et al., 2004; Cash, Jakatdar et al., 2004; Cash, Maikkula et al., 2004; Cash, Melnyk et al., 2004; Cash, Morrow et al., 2004; Faith & Schare, 1993; Yamamiya, Cash, & Thompson, 2006), correlating strongly with body satisfaction and appearance investment. The BESAQ was a potent predictor of sexual functioning (e.g., pleasure, desire), suggesting the importance of considering body image when treating individuals with sexual dysfunction (Cash, Phillips et al., 2004; Cash, Jakatdar et al., 2004; Cash, Maikkula et al., 2004; Cash, Melnyk et al., 2004; Cash, Morrow et al., 2004). Moreover, Cash’s studies indicate that the contextual BESAQ measure predicts sexual functioning better than trait body image (e.g., body dissatisfaction) does. With the BESAQ, he brought attention to an important aspect of human behavior, quality of life, and interpersonal functioning, which is frequently negatively impacted by body image concerns.

2.4. Body Image Coping Strategies Inventory (BICSI)

The BICSI (Cash, Santos, & Williams, 2005) is a 29-item instrument indexing both the adaptive and maladaptive ways that individuals seek to manage situations which threaten or challenge their body image experiences. The measure contains three subscales reflecting Avoidance (e.g., withdrawal from threatening situations), Appearance Fixing (e.g., attempts to alter or improve one’s appearance), and Positive Rational Acceptance (e.g., reminding oneself that the feeling will pass). The reliability and validity of the measure has been demonstrated in male and female college students, with scores correlating significantly with self-esteem, social support, and eating disturbance (Cash & Grasso, 2005; Cash et al., (2005). Moreover, Hrabosky et al. (2009) used the BICSI to identify differences in body image coping approaches among clinical groups (anorexia nervosa, bulimia nervosa, body dysmorphic disorder) relative to clinical controls. Despite the clear clinical importance of understanding and assessing body image coping, prior to the publication of the BICSI, limited work had been devoted to this construct. Therefore, the BICSI filled a critical gap in the body image literature, offering researchers and clinicians a reliable and valid tool for assessing individuals’ body image coping style.

2.5. Body Image Disturbance Questionnaire (BIDQ)

With the BIDQ (Cash, Phillips et al., 2004; Cash, Jakatdar et al., 2004; Cash, Maikkula et al., 2004; Cash, Melnyk et al., 2004; Cash, Morrow et al., 2004), Cash again argued for the distinction between body dissatisfaction and body image disturbance, as well as the need develop instruments capable of assessing these constructs separately. Accordingly, the BIDQ sought to assess body image disturbance based on the premise that this experience is marked by a combination of body dissatisfaction, associated preoccupations, distress, impairment, and interference in one’s life. Items for the scale were modified from the Body Dysmorphic Disorder Questionnaire (Phillips, 2005) and carefully evaluated within a mixed gender sample. The resulting questionnaire contains seven scaled items assessing the aforementioned domains, as well as five open-ended items which can be used in clinical settings or qualitative research to further explore the respondent’s experiences in each of the examined areas. The measure has demonstrated good psychometric properties among college men and women and clinical samples (Cash & Grasso, 2005; Hrabosky et al., 2009). Scores correlate significantly with measures of body image (e.g., evaluation, investment, quality of life), as well as with measures of psychosocial functioning (e.g., self-esteem, anxiety, depression, eating disturbance), supporting the construct validity of scale scores (Cash, Phillips et al., 2004; Cash, Jakatdar et al., 2004; Cash, Maikkula et al., 2004; Cash, Melnyk et al., 2004; Cash, Morrow et al., 2004). Importantly, the measure also predicts body image states in everyday life using experiential sampling methodology (Rudiger et al., 2007). Overall, the BIDQ offers a brief but careful assessment of body image experiences which raise clinical concern and may signify disorder.

2.6. Body-Image Ideals Questionnaire (BIQ)

The BIQ (Cash & Szymanski, 1995; Cash, 2000; Szymanski & Cash, 1995) draws upon Self-Discrepancy Theory (Higgins, 1987) to assess the respondent’s degree of perceived discrepancy between their current appearance and their ideal appearance on 11 different physical attributes (e.g., weight, facial features, muscle tone/definition, physical strength, overall appearance). In addition to assessing one’s self-ideal discrepancy, the measure also indexes the importance of each physical attribute to the respondent. A weighted discrepancy score, which represents the degree to which the respondent experiences self-ideal discrepancies of high importance, can also be calculated. Scores on the BIQ have been shown to be reliable and valid in college women, correlating with other measures of body image, perfectionism, social anxiety, depression, and eating pathology (Cash & Szymanski, 1995). Similar psychometric support has been found for men as well as women (e.g., Cash et al., 2005; Cash et al., 2005; Giovannelli, Cash, Henson, & Engle, 2008; Muth & Cash, 1997). Further, scores have shown sensitivity to body image interventions (Cash, 2000).

2.7. Body Image States Scale (BISS)

In 2002, Cash responded to another critical need in the field, with the BISS (Cash, Fleming, Alindogan, Steadman, & Whitehead, 2002). Although clinicians and researchers had long commented on the plasticity of body image (i.e., its ability to vary across situations and time), most existing measures focused on body image as a stable trait (Cash, 2002a). Researchers interested in examining the impact of short-term experimental manipulations (e.g., exposure to images of idealized female bodies) on state body image were therefore forced to modify existing scales or create their own with little psychometric testing. The BISS filled this gap by offering a brief six-item, psychometrically sound measure of momentary evaluative and affective experiences regarding one’s physical appearance. The scale has demonstrated acceptable internal consistency and convergent validity in college men and women, as well as sensitivity to experimental manipulations-for example, priming respondents to think about their weight history and ideal weight (Cash et al., 2002), or exposing women to thin media images (Yamamiya, Cash, Melnyk, Posavac, & Posavac, 2005). In more naturalistic studies, Cash and his colleagues successfully used the BISS to study the variation in body image states in everyday life (Melnyk et al., 2004; Rudiger et al., 2007). Given the measure’s sensitivity to change, it represents a valuable tool for clinicians interested in evaluating treatment progress and researchers interested in assessing short-term fluctuations in appearance evaluation.

2.8. Body Image Quality of Life Inventory (BIQLI)

The BIQLI (Cash & Fleming, 2002) further reflects Cash’s seamless integration of science and practice. Preliminary items from the BIQLI first appeared within Cash’s Body Image Workbook (1997) and were used to raise patients’ awareness of the ways in which poor body image negatively affected various aspects of their lives. The scale was subsequently modified and expanded upon in order to index specific domains of psychosocial functioning with empirically-supported relevance to body image, as well as the beneficial effects of positive or healthy body image in one’s life. Scores on the revised 19-item scale have been shown to be reliable and valid, correlating with measures of body image evaluation and investment, and psychosocial functioning among college men and women (Cash & Fleming, 2002; Cash, Phillips et al., 2004; Cash, Jakatdar et al., 2004; Cash, Maikkula et al., 2004; Cash, Melnyk et al., 2004; Cash, Morrow et al., 2004; Jakatdar et al., 2006). The BIQLI also differentiates among various clinical and non- clinical groups (Hrabosky et al., 2009), and has been translated into Dutch (Belgium, Netherlands), French (France, Canada), German (Germany), Italian (Italy), Spanish (Spain, US), and Swedish (Sweden).

2.9. Multidimensional Body Self-Relations Questionnaire (MBSRQ)

The MBSRQ (Brown, Cash, & Mikulka, 1990; Cash, 2017, 2018) is perhaps the best example of Cash’s multidimensional approach to the assessment of body image attitudes. In the MBSRQ, Cash highlights the existence of several possible body images — that is, attitudes towards one’s physical appearance, one’s physical fitness, and one’s health. He further suggests that body image in each of these domains can be divided into evaluative (e.g., satisfaction/dissatisfaction) and cognitive (attention/importance) dimensions. Accordingly, the 69-item MBSRQ contains 10 subscales: Appearance Evaluation, Appearance Orientation, Fitness Evaluation, Fitness Orientation, Health Evaluation, Health Orientation, Illness Orientation, Overweight Preoccupation, Self-Classified Weight, and the Body Areas Satisfaction Scale. For researchers whose focus is on appearance-related body image, the 34-item MBSRQ-Appearance Scales (AS) is available and contains only five of the above subscales.

The initial development of the MBSRQ came from a large stratified sample of the United States population in a Psychology Today magazine survey conducted in 1985 and published in 1986 (see Cash, Winstead, & Janda, 1985; Cash, Winstead, & Janda, 1986). The current MBSRQ subscales have demonstrated acceptable internal consistency and stability, and strong construct validity in community samples of men and women (Brown et al., 1990; Cash, 2018), as well as clinical or quasi-clinical groups (e.g., Brown, Cash, & Lewis, 1989; Hrabosky et al., 2009). Because Cash’s research teams used the MBSRQ-AS in numerous surveys (n = 22) at his university (Old Dominion University in Norfolk, Virginia) over the years, he was able to examine cross-sectional changes in college students’ body images from 1983 through 2001 as a function of gender and race/ethnicity (Cash, Phillips et al., 2004; Cash, Jakatdar et al., 2004; Cash, Maikkula et al., 2004; Cash, Melnyk et al., 2004; Cash, Morrow et al., 2004). Furthermore, MBSRQ subscales have been successfully utilized as outcome measures in cognitive-behavioral body-image treatment studies (Butters & Cash, 1987; Cash & Hrabosky, 2003; Cash & Lavallee, 1997; Grant & Cash, 1995; Nye & Cash, 2006; Strachan & Cash, 2002), exercise intervention studies (e.g., Williams & Cash, 2001), and weight-loss treatment research (Cash, 1994a).

2.10. Situational Inventory of Body-Image Dysphoria (SIBID)

Consistent with the observation that body image evaluation may vary across situational contexts, the SIBID (Cash, 1994b, 2002b) was developed to assess respondents’ levels of body dysphoria or distress elicited within 48 specific social and nonsocial contexts (e.g., during experiences of body exposure, social scrutiny, social comparisons, exercise). In addition, from this instrument Cash constructed a shortened form of the measure (SIBID-S), which assesses situational dysphoria across 20 contexts. Both measures have undergone extensive psychometric evaluation, revealing good reliability and convergence with appearance evaluation and investment among men and women (Cash, 2002b). The SIBID has served as a responsive outcome variable in body image treatment studies (Cash & Hrabosky, 2003; Cash & Lavallee, 1997; Grant & Cash, 1995; Nye & Cash, 2006; Strachan & Cash, 2002). Given the focus on distressing body image emotions experienced in one’s daily life, the SIBID may be particularly well-suited to assessing “negative body image” (as compared with measures that assess appearance investment/importance or body satisfaction/dissatisfaction), serving as an important research and clinical tool. Specifically, clinicians are able to use the SIBID to identify situations which elicit significant distress. Consistent with strategies outlined in the Body Image Workbook (1997, 2008), cognitive-behavioral exercises may be designed to help patients confront and manage painful thoughts and emotions experienced within those situations.

3. Common Pitfalls in Body Image Measure Selection

While not an exhaustive list, the summary of measures provided above begins to illustrate Cash’s unique ability to identify distinct elements of body image, and to translate those constructs into psychometrically-sound and well-validated measures which have clear clinical and empirical relevance. This review also highlights the myriad assessment options that researchers and clinicians encounter when embarking on a new study or selecting the most appropriate body image measure for their purpose. Consistent with Cash’s conceptualization of body image as a multidimensional construct, scientists and practitioners need to not only be aware of which specific aspect or dimension of body image they wish to assess, but also take great care in selecting a measure that adequately taps the intended construct. Importantly, this task is not as simple as it may seem, or as commonly practiced as one might hope.

In the spirit of aiding in this selection process, we now turn to a topic that has occupied our work for many years (Schaefer et al., 2015; Schaefer, Harriger, Heinberg, Soderberg, & Thompson, 2017; Schaefer & Thompson, 2018, 2018; Thompson, Heinberg, Altabe, & Tantleff-Dunn, 1999, 2018), which is not only an attempt to develop measures in the analytic model provided by Thomas Cash, but to also outline common problems that continually appear in the literature and potentially lead researchers and clinicians down a path to measurement error. In our service as members of the editorial board of Body Image (JKT and LMS) and as Associate Editor for the journal for 10 years (JKT), our experience is that, oftentimes, there seems to be a lack of awareness of the need to be selective in one’s choice of a body image measure and/or a misuse of the assessment tool in the research design. While the vast array of available measurement options renders this problem quite understandable, the need to safeguard the field against inappropriate measurement approaches (and ultimately bolster confidence in associated findings) remains a priority. Towards this end, below we review briefly what we believe are some of the most common or concerning mistakes, and provide suggestions for avoiding these pitfalls (see also Cash, 2011b; Thompson, 2004).

3.1. Creating a ‘new’ measure when adequate measures (often much better measures) exist

There is no need (and a tremendous amount of time is wasted) developing a new measure of a given dimension of body image when perusal of the literature would yield an extant measure. As the above review readily demonstrates, decades of work (much of it conducted by Cash), has produced an extensive catalogue of body image measures with carefully examined psychometric properties. While we certainly advocate the continued improvement of published measures and the production of new instruments to assess novel constructs, this is balanced by an appreciation for existing scales and the benefits of using tried and true measures without needing to continually reinvent the wheel. Assuming an existing scale has demonstrated adequate reliability and validity, perhaps the key benefit of using such a measure is the ability to compare one’s results with those from other studies. When measures differ across studies, direct comparisons are rendered nearly impossible, and the ability to draw conclusions across the broader research base becomes increasingly difficult. We therefore hope that the review of measures provided within this article will support increased awareness and use of Cash’s well-established collection of assessments.

3.2. Failing to adequately demonstrate the psychometric properties of new measures

When new measures are developed, it is critically important that investigators allot sufficient time and attention to demonstrating the reliability and validity of scores on the new scale. Ideally, this investigation would occur in a dedicated development/validation paper, which provides adequate space for authors to report on the factor structure, internal consistency, score stability, and construct validity. We also highly encourage authors to demonstrate the incremental validity of the newly developed scale. In other words, when other measures of the same or similar constructs exist, authors can provide justification of the need for a new measure by demonstrating that the new scale is better (e.g., explains additional variance in a proposed outcome) than the older scales (for examples of incremental validity, see Alleva, Tylka, & Kroon Van Diest, 2017; Stasik-O’Brien & Schmidt, 2018; Talmon & Ginzurg, 2018; Zuba & Warschburger, 2018). Given increased interest in examination of body image among diverse groups, examination of the new scale within multiple and varied samples (e.g., males and females, youth and adults, cultural groups) is also encouraged (for examples, see Halliwell, Jarman, Tylka, & Slater, 2017; Kertechian & Swami, 2017; Swami, Garcia, & Barron, 2017, 2019; Zuba & Warschburger, 2018). Swami and Barron (2019), this issue) provide helpful guidance for researchers seeking to translate and validate measures within new cultural or linguistic populations.

3.3. Incorrect selection of a measure for the problem (construct/methodology) at hand

Researchers will want to be careful in selecting a measure that is well-suited to their empirical question and research design. For example, is the researcher interested in appearance investment or appearance evaluation (see Cash’s ASI-R and MBSRQ) and/or a subjective attitudinal measure of body image, or a perceptual measure? In a field where many options exist, identifying the best measure to assess the specific construct of interest is no small feat, particularly for those who may be newer to the area. Again, we refer to the above review or previously published texts to assist with this task (Allison & Baskin, 2009). In addition to considering the match between the item content and intended research focus, investigators will also need to consider their research design and select an assessment tool that is most appropriate for that design. A common mistake is the use of a trait measure when the study (usually an experimental manipulation or longitudinal design such as ecological momentary assessment) calls for an assessment of state body image. The key issue here is ensuring that the selected measure is able to detect (perhaps subtle) changes in scale scores across time or experimental conditions. Failure to select an appropriate measure handicaps the researcher’s ability to detect effects and may result in null findings that are difficult to interpret.

3.4. Not picking a measure appropriate for the demographics of the sample

While previous work with a given measure may support the psychometric properties of scale scores within a specific sample(s), it is important to note that measures may operate differently within new or diverse samples, and some measures may be entirely inappropriate for use within alternative populations. Our years of conducting psychometric investigations of measures across diverse groups (e.g., genders, racial/ethnic groups, cultures, countries, ages, diagnostic characteristics) proves that language or items which may have one meaning for a certain demographic group, may have a completely different meaning in another group. As a consequence, the scale may yield alternative factor structures, reduce content coverage, impair score reliability, or result in a poorer functioning scale overall (Swami & Barron, 2019, this issue). This becomes especially concerning when scales originally developed for use in adult populations are employed without adjustment or appropriate pilot work among younger age ranges. Therefore, if at all possible, researchers should be cautious to select measures that have been previously validated in samples with comparable characteristics (e.g., gender, age, cultural background, etc.) to the sample under current investigation, and to cite prior psychometric investigations within their measure descriptions.

3.5. Failure to conduct even minimal psychometric testing within the current sample

Importantly, even when scale scores have previously demonstrated strong psychometric properties within similar samples, researchers should conduct and report the results from basic psychometric testing within their own sample. At a minimum, this would entail providing reliability statistics (e.g., Cronbach’s alpha, McDonald’s omega) for scale/subscale scores within the utilized sample. However, examining the factor structure via exploratory or confirmatory factor analysis is a wise idea, as published factor structures may not replicate in new samples.

3.6. Incorrect labeling of the body image dimension under investigation

Given the multidimensionality of body image and the availability of measures that assess specific facets of body image, it is important for researchers to be as precise as possible in labeling the exact dimension under investigation. A frequent mistake in published papers or manuscripts under peer review is the use of the terms “body image,” “negative body image,” “body dissatisfaction,” “positive body image,” and “body satisfaction” as interchangeable terms. As evidenced above, body image is a broad non-specific term referring to a host of cognitive, affective, perceptual, and behavioral elements which describe the various ways that individuals relate to their physical selves. Positive and negative body image generally reference healthy/adaptive versus unhealthy/maladaptive relationships with one’s physical self. Body satisfaction or dissatisfaction represent components of positive or negative body image, frequently referring to the positive or negative evaluation of one’s overall appearance (although some measures may specifically assess satisfaction/dissatisfaction with weight/shape or other aspects of appearance). Importantly, researchers utilizing a negatively valanced measure of body image (e.g., a measure of body dissatisfaction) cannot assume that low scores on the measure are indicative of a positive body image (e.g., body satisfaction), as individuals with low dissatisfaction may not necessarily endorse high satisfaction (see especially the work by Tylka on positive body image; Tylka & Wood-Barcalow, 2015; Webb, Wood-Barcalow, & Tylka, 2015).

4. Conclusions

Thomas Cash’s impact on the field of body image has been profound, and his legacy is eminently deserving of thoughtful reflection and tribute. As a colleague, mentor, luminary, and friend, he has served as a personal role model embodying a commitment to hard work, academic excellence, and the steady advancement of scientific inquiry in the field. More broadly, his incredible body of research has inspired an army of young (or not-so-young, as the case may be) academics ready to continue the important work that he helped to pioneer. We hope that this summary of his contributions in the area of measurement at least partially communicates our deep well of appreciation for his private and public example, as well as provides a helpful roadmap for investigators seeking to follow the path that he so brilliantly illuminated.

Acknowledgement

This work was supported by the National Institute of Mental Health (grant number T32 MH082761).

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