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These results suggest that more pessimistic people, who compare themselves to others and place a high value on appearance, experience a change in aggression. Optimism is the best predictor and in a multiple regression model both optimism and social comparison are statistically significant predictors of absolute changes in aggression ( = 0.266, F(2, 316) = 12.042, MSE = 16.801, p < 0.001). Positive Affect None of the variables are significantly correlated with absolute changes in Positive Affect. Negative Affect Changes from baseline to follow-up in negative affect were found to be negatively associated with age (r = -0.169, n = 334, p = 0.002), social acceptance (r = -0.213, n = 336, p < 0.001), optimism (r = -0.257, n = 336, p < 0.001), satisfaction with social support (r = -0.123, n = 335, p = 0.025, two-sided) and positively associated with appearance discrepancy (r = 0.227, n = 336, p < 0.001, two-sided), valence (r = 0.212, n = 340, p < 0.001), social comparison (r = 0.163, n = 338, p = 0.003), salience (r = 0.182, n = 337, p = 0.001, two-sided) and FNE (r = 0.261, n = 340, p < 0.001). These results suggest that younger, pessimistic people, who do not feel socially accepted, who are less satisfied with their social support and self-report a large appearance discrepancy from the norm, negatively evaluate their own appearance, place a high value on appearance and fear negative evaluations from others are more likely to experience change in negative affect. Optimism and appearance discrepancy are the best two predictors and both are jointly predictive of absolute change in negative affect in a multiple regression ( = 0.098, F(2, 313) = 16.935, MSE = 20.779, p < 0.001). DISCUSSION The findings of this study provide further, strong support for the framework operationalised by the research programme. Indeed, the regression model accounted for a very impressive 70.7% of variation in the DAS24 at 9 month follow up – a figure that is greater than the (already very sizeable) variance accounted for at baseline. Similarly, the regression model predicted greater variance in the measures of HADS anxiety, HADS depression, and positive and negative affect at 9 month follow up than at baseline. Furthermore, the majority of the components that predicted appearance-related anxiety at baseline continued to do so at follow-up and there was also a high degree of consistency in the predictors of HADS anxiety and depression, aggression, positive affect and negative affect at both baseline and follow-up. Overall, the results of this study indicate a picture of stability rather than change over the 9 month follow-up period: mean scores on most outcome measures changed relatively little over time (although there was a small, significant increase in mean DAS scores between baseline 96
and follow up). However, focusing on relatively consistent mean scores could detract from the fact that many participants did report a change in self-report outcomes over time. Participants who reported a change in outcomes tended to be younger, have a more pessimistic outlook and be more affected by appearance cognitions (salience and discrepancy) and their views of others (feeling socially excluded and more bothered by others’ judgements of them). This follow up data thereby supports the findings of study 1 by once again identifying changeable, sociocognitive factors to inform appropriate, supportive interventions. However, as with the crosssectional study, it would be an error to assume from these findings that appearance-related distress and concerns are not an issue for older people. Given the challenges of recruitment into longitudinal research (see Rumsey & Harcourt 2005), the response rate achieved in the current study (27.5%) is very good and suggests that the research questions and study design were acceptable and of importance to the study group. On the whole, the sample in this study can be considered representative of the cross-section sample (study 1). However, compared with non-respondents, those who participated in the follow-up study had, at baseline, reported placing slightly more importance on appearance and greater discrepancy between self and ideal appearance – supporting the suggestion (Rumsey & Harcourt 2005) that people experiencing difficulties in relation to their appearance may be more engaged with research in this area than those who are resilient to appearance-related distress. Until now, there has been a paucity of longitudinal research into psychosocial adjustment to visible difference. With a sample of 349, this data set constitutes, to the best of our knowledge, the largest follow-up study in this field. However, there is still a need for further longitudinal research with a longer follow-up than was possible in the current study. There is also a need to explore individuals’ subjective experiences of change over time and, for this reason, the qualitative study (study 4) was carried out with a subset of participants from this longitudinal study. 97
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Identifying the psychosocial factor
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Follow-on Studies: Emma Halliwell,
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Warwick Site (Lead: Dr. Rodger Char
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SECTION 3 Page OVERALL SYNTHESIS OF
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Study 3 3.1 Response rates for resp
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Introduction EXECUTIVE SUMMARY This
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The Impact of Appearance-Related Di
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Research Further investigation shou
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Participants were recruited from ho
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BACKGROUND & RATIONALE FOR THE RESE
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The challenge of developing compreh
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STAGE ONE (Inputs/Predisposing Fact
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In order to address the first aim o
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Role of the advisory panel in the r
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credit is due to Anjte Lindenmeyer,
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INTRODUCTION The largest part of th
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South West (via the Bristol site) a
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INPUTS/ PREDISPOSING FACTORS Age Ge
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Appearance-related processing Valen
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Anger/hostility The Refined Aggress
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RESULTS Due to the size of the data
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Figure 4.1(b) Comparative box-and-w
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Table 4.2 Correlation of quantitati
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Table 5.1(c) Frequency of number of
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Table 6.1(a) Frequency and percenta
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Table 7.1 summarises the degree of
Page 58 and 59: Figure 7.1(a): Scores on the DAS 24
Page 60 and 61: 10.1 Appearance-related Social Anxi
Page 62 and 63: HADS Anxiety, and the relative magn
Page 64 and 65: 10.4 Aggression When entering the v
Page 66 and 67: elatively small but statistically s
Page 68 and 69: 11. Clinic Specific Data In order t
Page 70 and 71: Table 11.3: Percentage of participa
Page 72 and 73: anxiety was in the low to mild rang
Page 74 and 75: Visibility and areas of concern The
Page 76 and 77: affect and 46% for both anxiety and
Page 78 and 79: likely they are to have difficultie
Page 80 and 81: Information Attention Encoding/Stor
Page 82 and 83: such as shame, were omitted. Where
Page 84 and 85: RATIONALE In an attempt to offer pa
Page 86 and 87: FINDINGS Theme I. Descriptive Accou
Page 88 and 89: easts made her ‘flat chested’ a
Page 90 and 91: confidence to other people’s reac
Page 92 and 93: them noticing: ‘I try to hide my
Page 94 and 95: 5.) Time Structures What was striki
Page 97 and 98: STUDY 3 LONGITUDINAL QUANTITATIVE S
Page 99 and 100: Table 3.1 Response rates for respon
Page 101 and 102: Table 3.4 Regression Model for DAS2
Page 103 and 104: Table 3.6 Regression Model for Depr
Page 105 and 106: Table 3.8 Regression Model for Posi
Page 107: 0.016), and optimism (r = -0.183, n
Page 112 and 113: SUMMARY • Twenty-six participants
Page 114 and 115: There were ten well adjusted stable
Page 116 and 117: Stage 1 - predisposing factors - ch
Page 118 and 119: Appearance schema - beliefs about o
Page 120 and 121: “I’m in charge ...I think that
Page 122 and 123: “Only when people don’t underst
Page 124 and 125: appearance anxiety and coping with
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Page 128 and 129: 116
Page 130 and 131: SUMMARY • This study aimed to exp
Page 132 and 133: A focus group methodology was chose
Page 134 and 135: any situation. Strategies involved
Page 136 and 137: CONCLUSIONS Whereas previous resear
Page 138 and 139: SUMMARY • Nine focus group interv
Page 140 and 141: RESULTS Eight key themes were ident
Page 142 and 143: 2e. Medical Interpretation There wa
Page 144 and 145: “I think I am nicer to a person w
Page 146 and 147: 6d. Generational differences Elders
Page 148 and 149: • The myths about the foetal diso
Page 150 and 151: SUMMARY • Vitiligo is a condition
Page 152 and 153: identified themselves as South Asia
Page 154 and 155: “…my parents would have been de
Page 156 and 157: 2a. Appearance shame and disgust Ma
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much…sometimes I just want to bec
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For respondents like AA (described
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study 6, that in addition to indivi
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AIMS The aims of this study were to
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154
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SUMMARY • Participants (n=38) too
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leaving 82 invitations not responde
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The vignettes alternated between de
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162
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SUMMARY • The study involved the
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METHOD Participants Student sample
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Clinic attendees On the anxiety sub
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170
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SUMMARY • Semi-structured intervi
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Seven key themes were identified an
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“I've heard tell that a lot of pe
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4. Physical adaptation From so smal
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6. Emotional impact & Emotional sup
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182
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SUMMARY • This study investigates
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Table 12.1 Demographic data by grou
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variance in anxious mood was accoun
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appearance of younger people (Harri
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SUMMARY • This study is recruitin
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METHOD Participants GPs from across
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196
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The results of each study have been
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Others expressed dissatisfaction wi
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Age Gender Ethnicity Relationship s
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Whilst the main thrust of this rese
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a strong evidence base in other are
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Nurses in a counseling role, clinic
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210
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This series of studies represents t
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214
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Ben-Tovim, D.I. and Walker, M.K. (1
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Crocker, J., Voelkl, K., Testa, M.
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Greenberg, L. S. and Safran, J. D.
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Macgregor, F., Abel, T.M., Brut, A.
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Pollard, L., Choy, E.H. and Scott,
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Scheier, M.F., Carver, C.S. and Bri
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Wright, G.E., Parker, J.C., Smarr,
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