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Table 12.1 Demographic data by group Group 1 2 n 48 30 Age M(range) 60(23-85) 56.47(29-78) Gender female n(%) 42(85.7) 25(78.1) Marital status Married or living with partner n(%) 32(65.3) 22(68.8) Living alone n(%) 11(22.4) 5(15.6) Living with friends or relatives n(%) 4(8.2) 4(12.5) Nationality British/English n(%) 44(89.8) 24(75) Ethnicity White n(%) 41(83.7) 25(78.1) Note: Group 1. Observable hand disfigurement; Group 2. No observable hand disfigurement Measures Using a checklist participants were asked to tick those areas of their body about which they felt most sensitive and to indicate how difficult they felt it was to hide or disguise this area on a seven point Likert scale ranging from 1 (extremely easy) to 7 (impossible). Participants completed the following battery of psychosocial measures: The Hospital Anxiety & Depression Scale (HADS; Zigmond & Snaith, 1983) Derriford Appearance Scale short form (DAS 24; Moss, Harris & Carr, 2004) Feelings of social acceptance Physical Appearance Discrepancy Questionnaire (PADQ) The Life Orientation Test Revised (LOT-R; Scheier and Carver, 1987) The Social Networks Scale (Sarason, Levine, Basham & Sarason, 1983) CARVAL & CARSAL (Rosser, 2008) The Stanford Health Assessment Questionnaire-II (HAQ-II; Wolfe, Michaud & Pincus, 2004) – a measure of functional disability Feelings of Stigmatization questionnaire (FSQ) (Schmid-Ott, Jaeger, Kuensebeck, Ott & Lamprecht, 1996) RESULTS The majority (54%) of participants with an observer rated hand disfigurement considered their hands to be the main area of concern in terms of appearance. For the non-disfigured group the area of most concern was the abdomen (22%). Participant characteristics An exploration of group characteristics revealed no significant differences in age between those with and without an observable hand difference and no significant association between gender, nationality, ethnicity or marital status and allocation to either group. 186
Preliminary analysis Mean, standard deviations and scale ranges for all variables according to group are presented in Table 12.2. Analysis reveals that those with an observable hand disfigurement experience higher levels of functional disability, perceived stigmatization, a more negative view of their appearance and felt they were able to disguise their area of concern more than those with no observable hand disfigurement. Table 12.2: Means and standard deviations for all variables by group Group 1 2 Variable Scale range M (SD) n M(SD) n Depression 0-21 8.78(3.31) 49 7.97(3.26) 32 Anxiety 0-21 7.55(3.48) 49 7.31(3.94) 32 DAS-24 11-96 33.62(11.89) 48 33.71(14.94) 32 HAQ-II 0-30 1.50(0.81) 47 0.71(0.64) 32 Disguisability 1-7 4.87(1.59) 45 3.69(1.67) 26 Social acceptance 2-14 11.84(2.91) 49 12.13(2.86) 30 Ideal PADQ 4-28 13.88(6.09) 49 12.73(6.53) 30 Should PAQD 4-28 12.96(6.27) 49 11.65(6.63) 31 LOT-R 4-20 14.96(3.03) 48 14.28(2.85) 32 CARVAL 6-36 19.79(6.61) 47 16.28(7.73) 32 CARSAL 7-36 29.20(8.26) 49 29.83(8.09) 30 Perceived Stigma 10-60 24.65(7.69) 48 20.47(8.03) 32 Note. Group 1. Observable hand disfigurement; Group 2. No observable hand disfigurement PADQ: Physical Appearance Discrepancy Questionnaire; LOT-R: Life Orientation Test Revised; CARVAL: Centre of Appearance Research Valence; CARSAL: Centre of Appearance Research Salience; DAS-24: Derriford Appearance Scale-24; HAQ-II: Health Assessment Questionnaire-II. In order to examine whether the differences observed between the groups were due to differences in functional disability, analyses were conducted controlling for functional disability scores. These indicated that there were no significant differences between the two groups on any of the variables except optimism. However, the difference in mean scores between the group with a visible hand disfigurement and those with no visible hand disfigurement was also extremely small on this variable. Of the 49 RA patients with visible hand disfigurement, 14.3% were clinically anxious and 32.7% clinically depressed. Of 32 participants with no observable hand disfigurement 21.9% were clinically anxious and 15.6% clinically depressed. Results suggest that participants with an observable hand disfigurement were 2.62 times more likely to be clinically depressed than those with no observable hand disfigurement. Conversely those with no hand differences were 1.68 times more likely to be clinical anxious. Predictors of anxious mood The demographic variables and the disfigurement grouping variable failed to make any significant contribution to the final model. After entry of the remaining variables, 42.7% of the 187
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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
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STUDY 3 LONGITUDINAL QUANTITATIVE S
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Table 3.1 Response rates for respon
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Table 3.4 Regression Model for DAS2
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Table 3.6 Regression Model for Depr
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Table 3.8 Regression Model for Posi
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0.016), and optimism (r = -0.183, n
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and follow up). However, focusing o
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SUMMARY • Twenty-six participants
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There were ten well adjusted stable
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Stage 1 - predisposing factors - ch
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Appearance schema - beliefs about o
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“I’m in charge ...I think that
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“Only when people don’t underst
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appearance anxiety and coping with
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114
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116
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SUMMARY • This study aimed to exp
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A focus group methodology was chose
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any situation. Strategies involved
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CONCLUSIONS Whereas previous resear
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SUMMARY • Nine focus group interv
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RESULTS Eight key themes were ident
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2e. Medical Interpretation There wa
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“I think I am nicer to a person w
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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
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
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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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Page 196 and 197: SUMMARY • This study investigates
Page 200 and 201: variance in anxious mood was accoun
Page 202 and 203: appearance of younger people (Harri
Page 204 and 205: SUMMARY • This study is recruitin
Page 206 and 207: METHOD Participants GPs from across
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Page 210 and 211: The results of each study have been
Page 212 and 213: Others expressed dissatisfaction wi
Page 214 and 215: Age Gender Ethnicity Relationship s
Page 216 and 217: Whilst the main thrust of this rese
Page 218 and 219: a strong evidence base in other are
Page 220 and 221: Nurses in a counseling role, clinic
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Page 224 and 225: This series of studies represents t
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Page 228 and 229: Ben-Tovim, D.I. and Walker, M.K. (1
Page 230 and 231: Crocker, J., Voelkl, K., Testa, M.
Page 232 and 233: Greenberg, L. S. and Safran, J. D.
Page 234 and 235: Macgregor, F., Abel, T.M., Brut, A.
Page 236 and 237: Pollard, L., Choy, E.H. and Scott,
Page 238 and 239: Scheier, M.F., Carver, C.S. and Bri
Page 240 and 241: Wright, G.E., Parker, J.C., Smarr,
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