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6d. Generational differences Elders were considered by participants from the younger generation to be more narrow-minded and less understanding. There was evidence that skin colour was of particular significance to elders. “we (young) understand how things work now, how society is, whereas they (older) are stuck in their own times” (Pakistani young male) 7. Medical Interventions 7a. Attitudes to medical intervention Medical intervention is considered acceptable for clear medical reasons or if one’s doctor advises intervention. However non-essential cosmetic surgery is considered to be going against God/Allah’s will “medical is necessary and cosmetic that is a luxury” (Bengali young female) “It is right to do surgical reconstruction but wrong to do cosmetic surgery. It is great sin to try to change the way of looks. Allah will punish them” (Bengali older female) 8. Social Support The immediate family is considered to be the main source of support, but shame and embarrassment may prevent families seeking support from external sources (including the extended family, their community and external support services). There was a general lack of awareness of the support services available to those with a disfigurement /visible difference. For example, none of the participants had heard of the charity Changing Faces. “some people don’t want to go to the doctor because they are ashamed.” (Bengali young female) “The extended family stay uninvolved either due to lack of awareness, shame, or ‘just can’t be bothered’ attitude” (Pakistani young male) “parents are supportive then they’ll do anything the can so their child doesn’t feel singled out” ( Pakistani young male) “they would definitely not go to the community” (Bengali young female) 134
DISCUSSION The focus group interviews offered a unique insight into views regarding visible differences held by South Asian communities in the UK. A number of themes were identified, some of which have been highlighted in previous literature, in particular the impact of disfigurement upon social acceptability and the prospect of marriage (Rozario, 2007). Religious beliefs and cultural views and practices appear to be deep-rooted within the South Asian population, so it is no surprise to find these entities cutting across the majority of themes that emerged. They are applied to views about the cause and origin of the visible difference as well as to the consequences of that difference. A number of areas were identified that could inform interventions to eradicate the negative consequences of visible difference. These included education to dispel myths, raising awareness of sources of support, and the provision of medical explanations for visible differences. Members of the Bengali older female focus group were particularly keen to express their suggestions for interventions to improve the experiences of those with visible differences and those that have children with visible differences (See Table 6.1). It is also important to emphasise that focus group participants used the terms disfigurement and disability interchangeably suggesting that physical impairments may be regarded as highly salient visible differences - this may have implications for future interventions with these groups. Whilst the methodological approach utilised for this study enabled pertinent issues regarding visible difference to be highlighted without imposing ‘external’ ideas, especially the use of a semi-structured ‘topic guide’, it was not always possible to explore issues in depth or allow participants the opportunity to elaborate on points. Resources did not allow us to conduct further interviews with communities of similar backgrounds in other locations, or to cover the full range of cultural groups represented in the UK South Asian population. 135
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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
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Figure 7.1(a): Scores on the DAS 24
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10.1 Appearance-related Social Anxi
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HADS Anxiety, and the relative magn
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10.4 Aggression When entering the v
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elatively small but statistically s
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11. Clinic Specific Data In order t
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Table 11.3: Percentage of participa
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anxiety was in the low to mild rang
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Visibility and areas of concern The
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affect and 46% for both anxiety and
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likely they are to have difficultie
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Information Attention Encoding/Stor
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such as shame, were omitted. Where
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RATIONALE In an attempt to offer pa
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FINDINGS Theme I. Descriptive Accou
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easts made her ‘flat chested’ a
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confidence to other people’s reac
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them noticing: ‘I try to hide my
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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 and 108: 0.016), and optimism (r = -0.183, n
Page 109: and follow up). However, focusing o
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 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
Page 158 and 159: much…sometimes I just want to bec
Page 160 and 161: For respondents like AA (described
Page 162 and 163: study 6, that in addition to indivi
Page 164 and 165: AIMS The aims of this study were to
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Page 168 and 169: SUMMARY • Participants (n=38) too
Page 170 and 171: leaving 82 invitations not responde
Page 172 and 173: The vignettes alternated between de
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Page 176 and 177: SUMMARY • The study involved the
Page 178 and 179: METHOD Participants Student sample
Page 180 and 181: Clinic attendees On the anxiety sub
Page 182 and 183: 170
Page 184 and 185: SUMMARY • Semi-structured intervi
Page 186 and 187: Seven key themes were identified an
Page 188 and 189: “I've heard tell that a lot of pe
Page 190 and 191: 4. Physical adaptation From so smal
Page 192 and 193: 6. Emotional impact & Emotional sup
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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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