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appearance of younger people (Harris & Carr, 2001). Not surprisingly those with higher appearance-related salience and valence also engaged in greater social avoidance. Lower levels of satisfaction with social support and lower levels of acceptance, along with greater functional disability, were other predictors. Group differences did not significantly contribute to the explanation of variance in social anxiety and avoidance when it was initially introduced into the equation, although it did gain significance in the later stages of the analyses; this may however, be a statistical artefact. There are number of limitations which need to be recognised when interpreting these data. Generalization of these findings to the RA population is limited both by the modest sample size and by the potential selectivity bias as only those well enough to attend an outpatient clinic were included. Due to the cross sectional nature of the study it is not possible to draw conclusions about the direction of the causality. Further comprehensive longitudinal studies with adequate power and therefore greater sample sizes are required to further understand these relationships. CONCLUSION The findings suggest that in the presence of a disabling condition such as RA, an objective judgement of visible hand disfigurement does not independently predict mood, but may contribute to feelings of appearance-related social anxiety and avoidance. Conversely, subjective judgements of appearance play an integral role in anxiety (HADS) and appearancerelated anxiety and avoidance (DAS 24). It is not the observable nature of the hand disfigurement, but the resultant functional disability and possible visibility of this disability (in not being able to complete tasks, for example) which has an effect on feelings of stigmatization and the evaluation of their own appearance. This suggests that disfigurement is not necessarily just about how a person looks in terms of their body, skin or facial features, but encompasses how a person appears as a whole, particularly when they move. Signs of physical impairment may be considered as a highly salient form of visible difference. 190
STUDY 13 WORKING WITH PATIENTS WITH VISIBLE DIFFERENCES: GENERAL PRACTITIONERS’ BELIEFS, DECISION MAKING PROCESSES AND TRAINING NEEDS. Study leads: Elizabeth Jenkinson and Tim Moss 191
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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
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• The myths about the foetal diso
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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 198 and 199: Table 12.1 Demographic data by grou
Page 200 and 201: variance in anxious mood was accoun
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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