BPQ Manual

Body Perception Questionnaire (BPQ) Manual

Stephen W. Porges © 1993, 2015

This document was prepared by

Jacek Kolacz, PhD
Logan Holmes
Stephen W. Porges, PhD

Document last updated: 9.15.2018

For questions or inquiries, please contact:

Jacek Kolacz
The Traumatic Stress Research Consortium at the Kinsey Institute
Indiana University
[email protected]

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 BPQ Manual

This document includes an overview and scoring instructions for:

Body Perception Questionnaire (BPQ)
Body Perception Questionnaire – Short Form (BPQ-SF)
Body Perception Questionnaire – Very Short Form (BPQ-VSF)

Table of Contents

1. Theoretical Background
2. Questionnaire Development
3. Subscale Descriptions
4. Formatting Scores
5. Calculating Raw Scores
6. Calculating Percentile Rank and T Scores
7. BPQ Version Comparison

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 BPQ Manual

Theoretical Background

The Body Perception Questionnaire (BPQ) is a self-report measure of body awareness and
autonomic reactivity. Its items are based on the organization of the autonomic nervous system
(ANS), a set of neural pathways connecting the brain and body. These pathways send
information from the body about the status of organs and tissues (i.e., afferent projections).
Some of these incoming signals form a basis for the subjective awareness of the body. The ANS
also carries signals that control the functions of these organs and tissues (i.e., efferent
projections). These signals can alter the functions of the body, depending on internal and
external needs.

For further reading on the autonomic nervous system, see:

Porges S. W. (1995). Orienting in a defensive world: Mammalian modifications of our

evolutionary heritage. A Polyvagal Theory. Psychophysiology, 32, 301-318.

Porges, S. W. (2007). The polyvagal perspective. Biological psychology, 74(2), 116-143.

Porges, S. W. (2009). The polyvagal theory: new insights into adaptive reactions of the
autonomic nervous system. Cleveland Clinic Journal of Medicine, 76(S2), S86-S90.

Porges S. W. (2011). The Polyvagal Theory: Neurophysiological foundations of emotions,

attachment, communication, and self-regulation. New York: Norton.

Porges, S. W. (2017). The Pocket Guide to The Polyvagal Theory: The Transformative Power of
Feeling Safe. New York: WW Norton.

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 BPQ Manual

Questionnaire Development

The original 122-item measure was developed by Dr. Stephen Porges at the University of
Maryland. Its goals were to assess body awareness, stress response, autonomic nervous system
(ANS) reactivity, stress style, and health history (Porges, 1993). Items were chosen based on
their relation with the autonomic nervous system. As research using the BPQ proliferated, the
questionnaire was applied to a range of international neural, behavioral, and clinical studies
and translated into several languages.

After two decades of use, our research team set out to improve the BPQ’s usability. The
first step of the revision was length reduction. This was accomplished first by reducing the
number of domains to those with the highest popularity – body awareness and ANS reactivity.
We further reduced the item pool by selecting body awareness items which had precision in
capturing aspects of direct functional control of autonomic pathways. Items which were related
to autonomic circuits but were “noisy” due to their incorporation of extra-autonomic systems
were removed (e.g., the item “clumsiness of bumping into people” also includes
proprioception). Importantly, all changes to the revision were reductions. No new items were
added, nor was item wording altered in any way. Thus, items from the original BPQ form are
compatible with the new (short form) version. All new subscales may be scored with data
collected from the original BPQ document.

Psychometric properties were assessed from data in three samples: an American online
study, a Spanish online study, and an American undergraduate student study (total n = 1320).
For a full description of the factor structure, reliability, and validity, see:

Cabrera, A., Kolacz, J., Pailhez, G., Bulbena-Cabre, A., Bulbena, A., & Porges, S. W. (2018).
Assessing body awareness and autonomic reactivity: Factor structure and psychometric
properties of the Body Perception Questionnaire-Short Form (BPQ-SF). International
Journal of Methods in Psychiatric Research, 27(3), e1596. doi: 10.1002/mpr.1596

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Subscale Descriptions

Domain Subscale Form Description Item

Count
Body Body Awareness BPQ; A measure of sensitivity for internal 26
Awareness BPQ-SF bodily functions. Values at the high
end of the scale reflect
hypersensitivity and values at the
low scale reflect hyposensitivity.
Body Awareness BPQ-VSF A shorter version of the body 12
awareness subscale composed of
selected items from full 26-form
above; available for contexts in
which questionnaire brevity is a
priority
Autonomic Supradiaphragmatic BPQ; A measure of the responses of 15
Reactivity Reactivity BPQ-SF autonomically-innervated organs
above the diaphragm. These are
likely to reflect the withdrawal of
neural circuits promoting social
engagement and calm resting state
as well as activation of sympathetic
“fight or flight” responses
Subdiaphragmatic BPQ; A measure of the responses of 6
Reactivity BPQ-SF autonomically-innervated
gastrointestinal organs below the
diaphragm. These likely reflect
reactivity of the unmyelinated vagus
nerve, the sympathetic nervous
system, and the enteric nervous
system

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Formatting Scores

Once data are collected, two item response formats are available for the Body Perception
Questionnaire, as outlined in the table below.

Item Response
Method Properties Available Scores
Values
1 = Never

2 = Occasionally Raw
Sum of full item
More sensitivity for
responses
3 = Sometimes individual differences at Percentile Ranks
high end of the subscales
[Recommended]
4 = Usually T Scores

5 = Always

Reduced sensitivity for

individual differences at
0 = Never highest level of the
subscales; raw values
Sum of binary
1 = Occasionally, tend to correspond Raw
responses
Sometimes, Usually, better to a normal
or Always distribution than raw
values using the sum of
full item responses

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Calculating Raw Scores

Once the item responses have been formatted, use the following table to calculate raw scores.
Scoring code for R is available upon request (see cover page for contact information).

When missing data are present, imputation may be used at the researcher’s discretion. Scores
for participants with a high amount of missing item-level data should be interpreted with
extreme caution or not at all.

Subscale Items for Scoring

BPQ Body Awareness
BPQ BPQ Short Form
Very Short Form
(122 items) (46 items)
(12 items)
1, 3, 5, 6, 7, 9, 12, 15,
16, 17, 18, 19, 22, 24,
Body Awareness 1 – 26 All items (1 – 12)
25, 26, 28, 29, 31, 32,
33, 40, 42, 43, 44, 45
57, 59, 60, 61, 63, 64,
Supradiaphragmatic
65, 66, 67, 69, 72, 73, 27 - 41
Reactivity
74, 79, 80
Subdiaphragmatic
62, 63, 75, 76, 77, 78 41 - 46
Reactivity*
*one item (#63 in full BPQ, #41 in BPQ short form) is included in both Supra- and Sub-
diaphragmatic Reactivity subscales

A note on translated versions: Available translations of the BPQ may be based on any of the
versions outlined in the table above. Please check the version and item numbering before
scoring a BPQ translation.

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Calculating Percentile Rank and T Scores

Percentile rank and T scores are available for raw scores computed by the sum of full item
responses. These transformed scores are based on a combined sample of American and Spanish
participants recruited online (n = 1005). Participant age ranged from 18 to 77 years (Mean =
34.4, SD = 11.2) and 63% were female. Age- and sex-specific norms are not yet available. To
transform raw values to percentile ranks and T-scores, use the tables on the next pages. R code
for transformations is available by request (see cover page for contact information).

Percentile rank scores reflect the percentage of values that are equal or lower to the
individual’s score. For example, a score in the 5th percentile rank means that the individual’s
score is greater or equal to 5% of the scores in a normative sample. A 95th percentile rank
means that the individual’s score is greater or equal to 95% of the scores in a normative
sample.

T scores reflect a standardized value according to a normal distribution based on a mean of 50

and a standard deviation of 10. This transformation is recommended for parametric statistical
models.

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Body Awareness
Raw Score Percentile Rank T-Score Raw Score Percentile Rank T-Score

26 1.4% 28.0 66 62.2% 53.1

27 3.1% 31.3 67 63.4% 53.4
28 3.6% 32.0 68 64.8% 53.8
29 4.5% 33.0 69 66.4% 54.2
30 5.7% 34.2 70 68.0% 54.7
31 7.0% 35.3 71 69.5% 55.1
32 8.3% 36.1 72 70.5% 55.4
33 9.4% 36.8 73 71.7% 55.8
34 10.3% 37.4 74 72.8% 56.1
35 10.9% 37.7 75 73.7% 56.4
36 11.7% 38.1 76 74.9% 56.7
37 12.7% 38.6 77 76.3% 57.2
38 14.3% 39.3 78 77.5% 57.5
39 16.2% 40.1 79 78.3% 57.8
40 18.0% 40.9 80 79.5% 58.2
41 19.8% 41.5 81 80.8% 58.7
42 21.3% 42.0 82 81.6% 59.0
43 22.5% 42.4 83 82.3% 59.3
44 23.8% 42.9 84 83.0% 59.5
45 25.8% 43.5 85 83.7% 59.8
46 28.0% 44.2 86 84.6% 60.2
47 30.0% 44.8 87 85.5% 60.6
48 32.0% 45.3 88 86.2% 60.9
49 33.8% 45.8 89 86.6% 61.1
50 35.5% 46.3 90 87.3% 61.4
51 37.7% 46.9 91 88.0% 61.7
52 39.7% 47.4 92 88.5% 62.0
53 41.6% 47.9 93 89.0% 62.3
54 43.4% 48.3 94 89.7% 62.6
55 45.0% 48.7 95 90.4% 63.0
56 46.6% 49.2 96 91.0% 63.4
57 48.2% 49.6 97 91.5% 63.7
58 50.0% 50.0 98 92.1% 64.1
59 51.5% 50.4 99 92.8% 64.6
60 53.0% 50.8 100 93.6% 65.2
61 54.8% 51.2 101 94.2% 65.7
62 56.5% 51.6 102 94.6% 66.1
63 57.9% 52.0 103 95.0% 66.5
64 59.2% 52.3 104 95.3% 66.8
65 60.7% 52.7 105 95.6% 67.0

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Body Awareness (Cont.)

Raw Score Percentile Rank T-Score Raw Score Percentile Rank T-Score

106 95.7% 67.2 119 98.9% 73.0

107 95.9% 67.4 120 99.0% 73.2
108 96.1% 67.6 121 99.1% 73.5
109 96.4% 68.0 122 99.2% 74.1
110 96.7% 68.3 123 99.4% 74.9
111 96.9% 68.7 124 99.4% 75.3
112 97.2% 69.1 125 99.5% 75.8
113 97.5% 69.6 126 99.6% 76.5
114 98.0% 70.5 127 99.7% 77.2
115 98.4% 71.5 128 99.7% 77.9
116 98.6% 72.0 129 99.8% 78.7
117 98.7% 72.3 130 99.9% 79.7
118 98.9% 72.8

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Body Awareness Very Short Form (VSF)

Raw Score Percentile Rank T-Score Raw Score Percentile Rank T-Score

12 2.5% 30.5 37 79.3% 58.2

13 6.2% 34.6 38 81.5% 59.0
14 8.6% 36.3 39 83.4% 59.7
15 11.4% 38.0 40 84.7% 60.2
16 14.2% 39.3 41 85.7% 60.7
17 17.0% 40.5 42 87.1% 61.3
18 20.8% 41.9 43 88.8% 62.1
19 24.3% 43.0 44 90.2% 62.9
20 27.1% 43.9 45 91.7% 63.9
21 31.4% 45.2 46 93.0% 64.7
22 36.4% 46.5 47 93.8% 65.4
23 40.3% 47.6 48 94.7% 66.1
24 43.5% 48.4 49 95.5% 67.0
25 46.4% 49.1 50 96.2% 67.7
26 49.7% 49.9 51 96.6% 68.2
27 52.7% 50.7 52 97.1% 68.9
28 55.8% 51.5 53 97.6% 69.8
29 59.1% 52.3 54 98.1% 70.8
30 62.3% 53.1 55 98.6% 72.0
31 65.4% 54.0 56 99.0% 73.1
32 68.2% 54.7 57 99.1% 73.7
33 70.6% 55.4 58 99.3% 74.3
34 72.9% 56.1 59 99.5% 75.8
35 75.0% 56.7 60 99.8% 78.8
36 77.1% 57.4

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Supradiaphragmatic Reactivity
Raw Score Percentile Rank T-Score Raw Score Percentile Rank T-Score

15 7.4% 35.5 43 93.3% 65.0

16 19.1% 41.3 44 94.0% 65.5
17 26.5% 43.7 45 94.5% 66.0
18 33.1% 45.6 46 95.2% 66.6
19 39.3% 47.3 47 95.8% 67.2
20 44.1% 48.5 48 96.4% 68.0
21 49.4% 49.8 49 96.9% 68.7
22 54.3% 51.1 50 97.2% 69.1
23 58.9% 52.2 51 97.6% 69.8
24 62.8% 53.3 52 97.9% 70.4
25 65.7% 54.0 53 98.0% 70.6
26 68.8% 54.9 54 98.2% 70.9
27 71.4% 55.7 55 98.6% 71.9
28 73.9% 56.4 56 98.8% 72.4
29 76.4% 57.2 57 98.9% 72.9
30 78.8% 58.0 58 99.2% 73.9
31 81.0% 58.8 59 99.4% 75.1
32 82.7% 59.4 60 99.5% 75.8
33 84.2% 60.0 61 99.5% 76.0
34 85.6% 60.6 62 99.6% 76.5
35 86.8% 61.2 63 99.8% 78.1
36 87.9% 61.7 64 99.9% 80.9
37 88.8% 62.1 65 99.9% 82.4
38 89.6% 62.6 66 > 99.9% 83.9
39 90.4% 63.0 67 > 99.9% 85.3
40 91.0% 63.4 68 > 99.9% 86.6
41 91.6% 63.8 69 > 99.9% 88.0
42 92.3% 64.3

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Subdiaphragmatic Reactivity
Raw Score Percentile Rank T-Score

6 9.0% 36.6
7 22.2% 42.3
8 30.4% 44.9
9 37.9% 46.9
10 45.3% 48.8
11 52.9% 50.7
12 61.1% 52.8
13 68.3% 54.8
14 73.6% 56.3
15 78.4% 57.9
16 82.4% 59.3
17 85.5% 60.6
18 88.8% 62.2
19 91.9% 64.0
20 94.0% 65.5
21 95.6% 67.1
22 96.8% 68.5
23 97.5% 69.5
24 98.2% 71.0
25 98.9% 72.8
26 99.4% 75.1
27 99.8% 78.8
28 99.9% 80.9

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Version Comparison of BPQ Forms

BPQ
BPQ-Short Form (BPQ-SF)
BPQ Body Awareness Very Short Form (BPQ-VSF)

BPQ # BPQ-SF # BPQ-VSF # Item

1 1 Swallowing frequently
2 A ringing in my ears
3 2 An urge to cough or clear my throat
4 My body swaying when I am standing
5 3 1 My mouth being dry
6 4 2 How fast I am breathing
7 5 Watering or tearing of my eyes
8 My skin itching
9 6 Noises associated with my digestion
10 Eye fatigue or pain
11 Muscle tension in my back and neck
12 7 3 A swelling of my body or parts of my body
13 An urge to urinate
14 Tremor in my hands
15 8 An urge to defecate
16 9 4 Muscle tension in my arms and legs
17 10 5 A bloated feeling because of water retention
18 11 Muscle tension in my face
19 12 6 Goose bumps
20 Facial twitches
21 Being exhausted
22 13 7 Stomach and gut pains
23 Rolling or fluttering my eyes
24 14 8 Stomach distension or bloatedness
25 15 Palms sweating
26 16 Sweat on my forehead
27 Clumsiness or bumping into people
28 17 9 Tremor in my lips
29 18 Sweat in my armpits
30 Sensations of prickling, tingling, or numbness in my body
31 19 The temperature of my face (especially my ears)
32 20 Grinding my teeth
33 21 General jitteriness
34 Muscle pain

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35 Joint pain
36 Fullness of my bladder
37 My eye movements
38 Back pain
39 My nose itching
40 22 10 The hair on the back of my neck "standing up"
41 Needing to rest
42 23 Difficulty in focusing
43 24 11 An urge to swallow
44 25 12 How hard my heart is beating
45 26 Feeling constipated

56 I feel nauseous.
57 27 I have difficulty coordinating breathing and eating.
58 My nose is runny, even when I am not sick.
59 28 When I am eating, I have difficulty talking.
60 29 My heart often beats irregularly.
61 30 When I eat, food feels dry and sticks to my mouth and
throat.
62 42 I have "sour" stomach.
63 41 I feel like vomiting.
64 31 I feel shortness of breath.
65 32 I have difficulty coordinating breathing with talking.
66 33 When I eat, I have difficulty coordinating swallowing,
chewing, and/or sucking with breathing.
67 34 I have a persistent cough that interferes with my talking
and eating.
68 I drool, especially when I am excited.
69 35 I gag from the saliva in my mouth.
70 I produce a lot of saliva even when I am not eating.
71 I have difficulty adjusting my eyes to changes in
illumination.
72 36 I have chest pains.
73 37 I gag when I eat.
74 38 When I talk, I often feel I should cough or swallow the
saliva in my mouth.
75 43 I am constipated.
76 44 I have indigestion.
77 45 After eating I have digestive problems.
78 46 I have diarrhea.
79 39 When I breathe, I feel like I cannot get enough oxygen.
80 40 I have difficulty controlling my eyes.

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81 I get dizzy when urinating or having a bowel movement.

82 I have trouble focusing when I go into dimly or brightly
illuminated places.

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References

Cabrera, A., Kolacz, J., Pailhez, G., Bulbena-Cabre, A., Bulbena, A., & Porges, S. W. (2018).
Assessing body awareness and autonomic reactivity: Factor structure and psychometric
properties of the Body Perception Questionnaire-Short Form (BPQ-SF). International
Journal of Methods in Psychiatric Research, 27(3), e1596. doi: 10.1002/mpr.1596

Porges, S. W. (1993). Body Perception Questionnaire. Laboratory of Developmental Assessment,

University of Maryland.

Porges S. W. (1995). Orienting in a defensive world: Mammalian modifications of our

evolutionary heritage. A Polyvagal Theory. Psychophysiology, 32, 301-318.

Porges, S. W. (2007). The polyvagal perspective. Biological psychology, 74(2), 116-143.

Porges, S. W. (2009). The polyvagal theory: new insights into adaptive reactions of the
autonomic nervous system. Cleveland Clinic Journal of Medicine, 76(S2), S86-S90.

Porges S. W. (2011). The Polyvagal Theory: Neurophysiological foundations of emotions,

attachment, communication, and self-regulation. New York: Norton.

Porges, S. W. (2017). The Pocket Guide to The Polyvagal Theory: The Transformative Power of
Feeling Safe. New York: WW Norton.

17