Download the report - The Healing Foundation

• The study reinforces and exemplifies findings in the related quantitative cross sectional
and longitudinal surveys and has implications for our understanding of adaptation in
visible difference and our ability to respond appropriately.
RATIONALE
Appearance altering conditions can be associated with a range of psychosocial difficulties, yet
many people adapt positively and succeed in minimising the impact of visible
difference/disfigurement on their lives.
Previous research suggests that individual adjustment is affected by a complex interplay of
physical, cultural and psychosocial factors (Thompson & Kent, 2001; Rumsey & Harcourt,
2004). Small scale longitudinal qualitative studies have followed up people with visible
difference over time. Most notably the early work of MacGregor (Macgregor et al, 1953;
Macgregor, 1979) involved interviews over a sixteen year period. However, this work has not
focussed on adaptation over the course of time and its relationship to events in the person’s life.
Little is known about the course of psychological adjustment to appearance over time and
factors which facilitate positive coping. Accordingly, our study sought to follow-up people with
visible difference over nine months, with a specific focus on factors associated with better or
worse adaptation to their appearance and its psychological concomitants.
METHOD
Aim
To explore in depth individual explanations of adjustment to appearance over a nine-month
period amongst those who defined themselves as:
1. Well adjusted to visible difference without variation during the study period (well adjusted
stable).
2. Poorly adjusted to visible difference without variation during the study period (distressed
stable).
3. Having experienced an improvement in adjustment during the study period
(improvement in adjustment’).
4. Having experienced a deterioration in adjustment during the study period (‘deterioration
in adjustment’).
Participants and Sampling
Participants were attendees at NHS clinics for a variety of appearance-related issues who had
completed measures at baseline and 9 month follow-up in our associated quantitative study.
Participants answered a questionnaire item in this study to self-select into one of the four
categories above. Twenty-six participants were recruited to the qualitative longitudinal study.
101