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Body Image 11 (2014) 201–205

Contents lists available at ScienceDirect

Body Image

journa l h om epa ge: www.elsev ier .com/ locat e/bodyimage

rief research report

alidation of the factor structure of the Greek adaptation of theociocultural Attitudes Towards Appearance Questionnaire (SATAQ-3)

arios Argyrides ∗, Natalie Kkeli, Panayiota Kendeoueapolis University Pafos, Cyprus

r t i c l e i n f o

rticle history:eceived 11 June 2013eceived in revised form 25 February 2014ccepted 26 February 2014

eywords:ociocultural Attitudes Towards

a b s t r a c t

The current study aimed to confirm the factor structure and reliability of the newly translated Greekversion of the Sociocultural Attitudes Towards Appearance Questionnaire-3 (SATAQ-3) among 1753Greek-Cypriot high school students. Results of the structural equation modeling indicated a very goodfit with the original four-factor structure of the SATAQ-3 for both males and females. The Cronbach’salpha coefficients for the four subscales were .92 for ‘Internalization-General’, .82 for ‘Internalization-Athlete’, .94 for ‘Pressure’ and .88 for ‘Information’. Further analyses showed no significant differences

ppearance Questionnairereek version validationedia influences

ody image

between BMI categories with respect to the Internalization-General, Internalization-Athlete and Infor-mation factors but there were significant differences on the Pressure factor. The findings of the currentstudy support the existence of the original four-factor structure of the SATAQ-3. The validity and reli-ability results of the Greek version of the SATAQ-3 support its use in Greek-speaking countries orpopulations.

Introduction

Several researchers have focused their attention on the impactf sociocultural factors for the development of body image prob-ems and eating pathology (Cash, 2005; McCabe & Ricciardelli,001; Thompson & Heinberg, 1999; Thompson, van den Berg,oehrig, Guarda, & Heinberg, 2004). This work has shown thatedia influences and negative comments from peers and parents

bout physical appearance seem to represent some of the most crit-cal contributors to body image disturbance (Thompson & Heinberg,999).

The variety of media influences and the internalization of thedeal body shape can be assessed by a widely used instrument;he Sociocultural Attitudes Towards Appearance Questionnaire-

(SATAQ-3; Thompson et al., 2004). The SATAQ-3 has beenhown to have high internal consistency and good reliabilitynd validity among ‘Western’ populations (English: Thompsont al., 2004; German: Knauss, Paxton, & Alsaker, 2009; French:ousseau, Valls, & Chabrol, 2010; Spanish: Sánchez-Carracedo,

arrada, López-Guimerà, Fauquet, Almenara, & Trepat, 2012) asell as ‘Non-Western’ populations (Chinese: Jackson & Chen, 2010;rabic: Madanat, Hawks, & Brown, 2006; Malaysian: Swami, 2009).

∗ Corresponding author at: Neapolis University Pafos, 8042 Pafos, Cyprus.el.: +357 26843608; fax: +357 26931944.

E-mail address: m.argyrides.1@nup.ac.cy (M. Argyrides).

ttp://dx.doi.org/10.1016/j.bodyim.2014.02.003740-1445/© 2014 Elsevier Ltd. All rights reserved.

© 2014 Elsevier Ltd. All rights reserved.

The measure has been also validated for eating disordered patients(Calogero, Davis, & Thompson, 2004) and for middle school boysand girls (Smolak, Levine, & Thompson, 2001). The SATAQ-3 hasbeen used in several countries and translated and validated in sev-eral other languages (Arabic: Madanat et al., 2006; German: Knausset al., 2009; Malay: Swami, 2009) and across a range of age groupsbut mainly in high school and college population (Knauss et al.,2009; Rousseau et al., 2010). This instrument can also be usedas a good screening tool assessing the negative impact of mediainfluences and thereby helping specialists intervene as early as pos-sible in an attempt to decrease this negative impact and promote ahealthier body image (Thompson & Heinberg, 1999).

A thorough review of the available literature demonstrated thatquestionnaires evaluating body image, influences of the media andinternalization of the thin ideal in the Greek cultural context andlanguage are lacking. Moreover, a detailed review of the recentpublication of Stalikas, Triliva, and Roussi (2012), which includesa collection of all the validated psychometric tools in Greek, didnot identify any measures assessing body image, and specificallymedia effects and internalization of the thin ideal. In combinationwith recent findings in Cyprus which indicated significantly higherbody image issues in Greek Cypriot females (Argyrides, 2013;Hadjigeorgiou, Tornaritis, Savva, Solea, & Kafatos, 2012; Katsounari,

2009), there was a perceived need for the Greek adaptation of theSATAQ-3. Specifically, a study conducted by Hadjigeorgiou, Tornari-tis, Savva, Solea, and Kafatos (2012) who conducted a 6-year followup (2004 and 2010) in a large sample of Greek-Cypriot adolescents

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evealed that 18.8% of males and 34.4% females in 2003 and 18.8%f males and 35.9% of females in 2010 had significant disorderedating attitudes and behaviours (Eating Attitudes Test-26 scoreigher than 20; Garner, Olmsted, Bohr, & Garfinkel, 1982). Thebove percentages, especially for females, are higher than manyther ‘Western’ and ‘Non-Western’ countries (Singapore’s 10.5%,o, Tai, Lee, Cheng, & Liow, 2006; Saudi Arabia’s 24.6%, Al-Subaie,l-Shammari, Bamgboye, Al-Sabhan, Al-Shehri, & Bannah, 1996;nited Arab Emirates’ 23.4%, Eapen, Mabrouk, & Bin-Othman, 2006;hina’s 10.8%, Lee & Lee, 2000; Iran’s 16.7%, Gargari, Kooshavar,ajadi, Karami, Behzad, & Shahrokhi, 2011; South Africa’s 21.2%,aradas, Lambert, & Charlton, 2001; Szabo & Allwood, 2001; Brazil’s5.8%, Vilela, Lamounier, Dellaretti, Filho, Barros Neto, & Horta,004; Israel’s 32.4%, Maor, Sayag, Dahan, & Hermoni, 2006; andeveral other European countries of up to 18%, Halvarsson, Lunner,

esterberg, Anteson, & Sjödén, 2002; Saporetti, Sancini, Bassoli,astelli, & Pellai, 2004; Thomas, James, & Bachmann, 2002; Vegalonso, Rasillo Rodriguez, Lozano Alonso, Rodriguez Carretero, &artin, 2005).The current study, which is part of a larger scale study in Cyprus,

imed to confirm the original factor structure of the SATAQ-3,ssess the reliability of the scale among Greek-Cypriot high-schooltudents, and examine possible differences on SATAQ-3 subscalesetween different body mass index (BMI) categories.

Method

articipants

Participants consisted of a convenient sample of 1753 highchool students (715 males, 1038 females), Greek fluent speak-rs with no reported history of speech, attention, neurological,r sensory difficulties. Participants ranged in age from 13 to8 years (M = 15.22, SD = 1.21) and in BMI from 13.15 to 41.12M = 20.87, SD = 3.36). Based on participants’ BMI score, their BMIeight category was calculated using the teenage BMI scale: 0-

th percentile = underweight, 5th-85th percentile = normal weight,5th-95th percentile = overweight, and greater than 95th per-entile = obese. This frequency distribution revealed that partici-ants (18.9%) fell in the underweight category, 915 (69.7%) in theormal weight category, 120 (9.1%) in the overweight category, and9 (2.3%) in the obese category. The sample was Greek-Cypriots in

ts majority (87.6%) with a small percentage of non-Greek-Cypriots12.4%), which generally reflects the demographic make-up ofhe Republic of Cyprus. Participants’ self-reported answers alsoevealed that they came mostly from middle to upper-middle classamilies: 14.2% low SES; 60% middle SES; 15.8% high SES.

easures

Sociocultural Attitudes Towards Appearance Questionnaire- (SATAQ-3; Thompson et al., 2004). All participants completedhe Greek version of the SATAQ-3, a 30-item scale measuringhe multi-dimensional impact of sociocultural influences on bodymage. Participants rated to what extent they agreed with eachf the items on a 5-point Likert-type scale (1 = “Definitely Dis-gree”, 5 = “Definitely Agree”). The developers of the questionnaireave shown that the SATAQ-3 consists of four factors measur-

ng the degree to which various media types are considered anmportant source of information about being attractive (Informa-ion, 9 Items), feeling pressured by various media types to strive

or cultural ideals of beauty (Pressure, 7 Items), endorsement andcceptance of media messages and the striving towards these idealsInternalization-General, 9 Items), and endorsement and accep-ance of an athletic and toned body ideal (Internalization-Athlete,

ge 11 (2014) 201–205

5 Items). The four factors have been reported highly reliable, withCronbach’s � coefficients generally exceeding .80 (e.g., Madanatet al., 2006; Thompson et al., 2004). For the current sample, theCronbach’s alphas were .92 for Internalization-General, .82 forInternalization-Athlete, .94 for Pressure and .88 for Information.

Translation and Pilot Study

The recommendations of Beaton, Bombardier, Guillemin, andFerraz (2000) and Stalikas et al. (2012) were followed in translatingthe SATAQ-3 into Greek using a forward and backward translationmethod. The first step included the translation of the English ver-sion of the SATAQ-3 in Greek by a professional translator and then adifferent professional translator back-translated the Greek versionto English. Next, the two translations were evaluated by a bilingualspeaker and a licensed professional psychologist who specializesin body image issues. The two professionals discussed any possiblediscrepancies, evaluated them and continued with the final correc-tions. When the final decision about the items was made, a pilotversion of the scale was administered to a convenience sample of100 undergraduate and graduate students to evaluate face validityand receive feedback on the clarity of the questionnaire. No majorchanges were made after this pilot study and the final version ofthe scale was administered to the 1753 participants of the currentstudy.

Procedure

Initially, the appropriate permission by the Ministry of Educa-tion and Culture of Cyprus was granted in order to be able to collectdata within the public school system. Next, all the gymnasiums andlyceums in the country were contacted and informed about thenature of the study and were asked to participate. Twenty-threeschools (23.5%) agreed to participate in the study. Parents of thestudents in these schools were informed of the nature and goals ofthe study and were asked to give their consent. All students whoparticipated had parental consent, were informed that their partic-ipation was anonymous and voluntary and were asked to completethe questionnaire in the classroom during a scheduled class period.In case the students had any questions, a research assistant waspresent in the classroom to provide answers. No specific questionswere asked that could be problematic to the results of the study.The class teacher, who was also present, was asked to interveneonly in the case of disciplinary problems.

Results

In the present study, we used structural equation model-ing (SEM) that offered several advantages over more traditionalapproaches. SEM allowed us to estimate a latent construct foreach factor and to test the fit of the hypothetical factor structureusing non-experimental data while explicitly controlling for mea-surement error. In evaluating the goodness of fit to the data wereport the model chi-square statistic associated with the p value,the comparative fit index (CFI), and the root mean square error ofapproximation (RMSEA). A non-significant value of the chi-squarestatistic indicates a good fit, however the test is sensitive to samplesize and should be considered in relation to its degrees of freedom(i.e., dividing chi-square value by its degrees of freedom shouldresult in a value below 2, indicating a good model; Byrne, 2006).We used Hu and Bentler’s (1999) combinational fit criteria for CFI

and RMSEA indices. CFI equal to or superior to .95 and RMSEA lessthan .05 are considered to indicate a good fit. CFI equal to or supe-rior to .90 and RMSEA less than .08 are considered to indicate amoderate but acceptable fit.

M. Argyrides et al. / Body Image 11 (2014) 201–205 203

Q2

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ig. 1. Structural Equation Model for SATAQ-3 in Greek. The rectangles represent obariables: IG = Internalization-General; IA = Internalization-Athlete; PRESS = Pressurll coefficients were significant at p < .05 level.

The model included four latent variables. These werenternalization-General, Internalization-Athlete, Pressure, andnformation. Indicators for Internalization-General were SATAQ-3tems 3, 4, 7, 8, 11, 12, 15, 16 and 27. Indicators for Internalization-thlete were SATAQ-3 Items 19, 20, 23, 24, and 30. Indicators forressure were SATAQ-3 Items 2, 6, 10, 14, 18, 22, and 26. Finally,ndicators for Information were SATAQ-3 Items 1, 5, 9, 13, 17, 21,5, 28, and 29. We hypothesized that the four latent variablesere interrelated. Two models were fit, one for females and one

or males (Fig. 1). As indicated by the fit indexes, both models fithe data well: Females, �2 (399, N = 715) = 1077.24, p < .05; CFI = .90;MSEA = .049; Males, �2 (399, N = 1038) = 1245.17, p < .05; CFI = .94;MSEA = .045.

The Cronbach’s alphas were .92 for Internalization-General, .82

or Internalization-Athlete, .94 for Pressure and .88 for Informa-ion. We also examined the extent to which underweight, normaleight, overweight, and obese students differed with regards to

he four extracted factors. Table 1 shows the mean and standard

d variables. The circles represent the latent variables. Abbreviations for factors and = Information. Coefficients for females are listed first, coefficient for males second.

deviation for each of the four subscales separated by BMI category.With respect to the Internalization-General factor, the analysisshowed no significant differences between the four BMI categories,F(3, 1640) = 1.80, p = .14. With respect to the Internalization-Athletefactor, the analysis also showed no significant differences betweenthe four BMI categories, F(3, 1640) = 1.28, p = .28. Similar patternof results was obtained for the Information factor; the analysisalso showed no significant differences between the four BMI cat-egories, F(3, 1640) = 1, p = .72. For the Pressure factor though, theanalysis showed significant differences between the four BMI cate-gories, F(3, 1640) = 7.82, p < .001. Post hoc analysis using the TukeyHSD showed that obese students scored significantly higher on thePressure factor than underweight students t(1640) = 2.94, p = .001and normal weight students t(1640) = 1.89, p = .05, but did not dif-

fer from overweight students t(1640) < 1, p = .61, indicating thatthey felt significantly more pressure from the media to look a cer-tain way. Overweight students also scored significantly higher onthe Pressure factor than normal weight t(1640) = 2.33, p = .02 and

204 M. Argyrides et al. / Body Image 11 (2014) 201–205

Table 1Means and standard deviations for each SATAQ-3 factor by BMI category.

BMI category Internalization- General Internalization- Athlete Information Pressure

M SD M SD M SD M SD

Obese (n = 36) 2.72 0.96 2.89 0.86 2.87 0.65 2.48* 0.92Overweight (n = 122) 2.61 0.88 2.81 0.81 2.99 0.71 2.41** 0.92Normal weight (n = 1099) 2.63 0.94 2.83 0.93 2.93 0.74 2.22*** 0.84Underweight (n = 387) 2.51 0.92 2.72 0.98 2.96 0.75 2.06 0.75

ight (prweig

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* Obese category significantly higher than underweight (p = .001) and normal we** Overweight category significantly higher than normal weight (p = .02) and unde

*** Normal weight category significantly higher than underweight (p = .001).

nderweight students t(1640) = 4.02, p < .001, also indicating a sig-ificantly higher pressure from the media. Finally, normal weighttudents also scored significantly higher on the Pressure factorhan underweight students, t(1640) = 3.31, p = .001, indicating moreressure.

Discussion

The appropriateness of a scale that is developed and validatedn one culture to be translated and used in another is always ofreat importance (Knauss et al., 2009), especially in the absence ofuch a scale in the target cultural and language context. Therefore,

widely used measure assessing media influences and the extento which individuals internalize the thin ideal known as the Socio-ultural Attitudes Towards Appearance Questionnaire-3rd Version;ATAQ-3 (Thompson et al., 2004) was translated in Greek and anttempt was made to confirm its initial factor structure and assessts reliability in a large Greek-Cypriot adolescent sample.

Results indicated that the original four-factor structure of theATAQ-3 was retained in the current sample and fitted very wellith the original model for both males and females. Results also

ndicated that the factors were correlated between them, suggest-ng potential relations among the four unique dimensions of medianfluence. Similar findings with correlations between the factors

ere found in the original Thompson et al. (2004) study as well asith the German translation of the measure (Knauss et al., 2009).

When comparing the four different categories of weight basedn BMI, results indicated that regardless of weight category, thereere no significant differences on the internalization of the thin

deal (Internalization-General), the internalization of the athleticdeal (Internalization-Athlete) and the media as a good source ofnformation of body ideals (Information). This result is indicativef the ‘power’ of the media as an influential factor, as it does noteem to ‘discriminate’ between weight categories, a finding sup-orted by previous research (Thompson et al., 2004). Furthermore,esults indicated that the heavier participants were, the more pres-ure they felt from the media to look a certain way, a finding alsoupported by recent research data (Bayyari, Henry, & Jones, 2013).

In sum, the current study provides validation support and reli-bility data for the Greek version of the SATAQ-3. All four subscales,s developed in the original measure, are appropriate for use inssessing media influences (internalization, pressures and informa-ion) in Greek-speaking countries and populations. Since no otherimilar measure in Greek has been found to exist, the SATAQ-3reek version enables the assessment of sociocultural influencesn body image in countries and populations where Greek is spoken.he Greek version of the SATAQ-3 allows for possible cross-culturalomparisons with other countries using the four-factor structuref the SATAQ-3. One should be careful though with cross-cultural

omparisons since the original four-factor structure of the measureoes not seem to work as well in all languages (i.e., Malay: Swami,009). Future research is recommended to utilize this measure inhe country of Greece which is also Greek-speaking for further

= .05).ht (p < .001).

validation as well as evaluating the questionnaire in a populationwith reported disordered eating behaviour as well as individualsclinically diagnosed with an eating disorder in order to furthervalidate its sensitiveness. Finally, the measure can also be usedas a tool to measure the effectiveness of interventions addressingissues related to media and body image (pre- and post-interventionassessment). It is worth noting that the current study is limited tothe specific age and ethnic group which it addresses.

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