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to identify and clarify factors contributing to ‘resilience’ and positive adjustment. The result was a descriptive, working framework of inputs, mediating processes and outputs designed to be broad enough to capture the range of experiences of those affected, but specific enough to allow for predictions about the susceptibility to distress or positive adjustment of those affected by a visible difference. The framework was used to consider the emerging findings of the project, and was further refined during the analysis process (Figure 1). 14
STAGE ONE (Inputs/Predisposing Factors) Demographics Parental influence Peer influence Societal and Media Influence Cause of Disfigurement STAGE TWO INTERVENING COGNITIVE PROCESSES Appearance Schema Salience Valence Perceived Noticeability Ideals Self Cultural Social Comparison Processes Dispositional Style Coping Strategies Perceptions of Social Support Figure 1: Working framework of adjustment to disfiguring conditions STAGE THREE (Outcomes) Social Anxiety Social avoidance / isolation Psychological wellbeing Within this framework, the process of adjustment to visible differences is conceptualised as having three facets. The first is the social and psychological context comprised of predisposing factors such as demographic characteristics, socio-cultural setting, and family environment. While all of these factors play a part in adjustment and an understanding of their influence is important, their relative impermeability may make them less amenable to intervention. The current programme of research therefore acknowledges the presence and influence of these factors, but maintains a predominant focus on cognitive and behavioural processes, which are more amenable to change through interventions. The second facet of the model comprises intervening cognitive processes, which are believed to contribute to the differentiation between good and poor adjusters. We believe that these are best understood from a social cognition perspective, with particular reference to the functioning of the self-concept. From this viewpoint, individuals can be conceptualised as having a cognitive representation of themselves, which includes a representation of appearance. The appearance aspect of the self-representation can be more or less salient at any time, and thus play a greater or lesser part in the working self-concept (Higgins & Brendl, 1995). As a result of this, there will be variation in the extent to which a person’s perception of their own appearance is involved in attending to and appraising activity in the social environment and in subsequent memories of past experiences (Moss & Carr, 2004 Bargh, Lombardi & Higgins, 1988). In addition to the salience of appearance within the self-concept, there can also be a variation in the evaluative valence of the appearance (i.e. the way a person looks can be seen by that person in a positive or negative light (Sarwer & Crerand, 2004)). Appearance can also be judged by individuals as being closer to, or further from their internalised cultural ideals (Altabe & Thompson, 1996). When appearance is generally more salient, negatively valenced, and further from ideals, adjustment will be poorer. Some of the important ways in which appearance can be made more salient and prone to negative evaluation include social comparison processes (Green & Sedikides, 2001) and positive or negative experiences of social 15
Page 1: Identifying the psychosocial factor
Page 4 and 5: Follow-on Studies: Emma Halliwell,
Page 6 and 7: Warwick Site (Lead: Dr. Rodger Char
Page 8 and 9: SECTION 3 Page OVERALL SYNTHESIS OF
Page 10 and 11: Study 3 3.1 Response rates for resp
Page 13 and 14: Introduction EXECUTIVE SUMMARY This
Page 15 and 16: The Impact of Appearance-Related Di
Page 17: Research Further investigation shou
Page 20 and 21: Participants were recruited from ho
Page 23 and 24: BACKGROUND & RATIONALE FOR THE RESE
Page 25: The challenge of developing compreh
Page 29 and 30: In order to address the first aim o
Page 31 and 32: Role of the advisory panel in the r
Page 33: credit is due to Anjte Lindenmeyer,
Page 36 and 37: INTRODUCTION The largest part of th
Page 38 and 39: South West (via the Bristol site) a
Page 40 and 41: INPUTS/ PREDISPOSING FACTORS Age Ge
Page 42 and 43: Appearance-related processing Valen
Page 44 and 45: Anger/hostility The Refined Aggress
Page 46 and 47: RESULTS Due to the size of the data
Page 48 and 49: Figure 4.1(b) Comparative box-and-w
Page 50 and 51: Table 4.2 Correlation of quantitati
Page 52 and 53: Table 5.1(c) Frequency of number of
Page 54 and 55: Table 6.1(a) Frequency and percenta
Page 56 and 57: 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
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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
Page 94 and 95:
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
Page 114 and 115:
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
Page 122 and 123:
“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
Page 130 and 131:
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
Page 138 and 139:
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
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identified themselves as South Asia
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“…my parents would have been de
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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
Page 176 and 177:
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,
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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