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How to recognise symptoms of appearance-related distress  . How do we recognise symptoms of appearance related distress?. Does it relate to physical indicators, e.g. Severity & extent of the ‘difference’ in appearance? Location/body site affected? Other indicators …..

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how do we recognise symptoms of appearance related distress
How do we recognise symptoms of appearance related distress?

Does it relate to physical indicators, e.g.

Severity & extent of the ‘difference’ in appearance?

Location/body site affected?

Other indicators …..

Face to face interaction/discussions

Observing behaviour

Psychometric methods

severity extent of the difference adjustment
Severity & extent of the ‘difference’& adjustment

Anecdotally, the severity of a difference in appearance is associated with poor adjustment

But . . .

who is most self conscious of their appearance1
Who is most self conscious of their appearance?

WE CAN’T POSSIBLY KNOW FROM THESE PHOTOGRAPHS

physical indicators severity location
Physical indicators: Severity & location

In a study by Moss (2005), over 500 participants with body image concerns (e.g., weight, size) and / or visible differences (e.g., scarring, burns) rated their levels of wellbeing in reltion to their appearance.

the impact of the severity of a difference in appearance
The impact of the severity of a difference in appearance

Half of these 500 participants self-assessed how different they looked from the norm

The other half were assessed by plastic surgeon (appearance expert) as to how different they looked from the ‘norm’

moss 2005 severity analysis
Moss (2005): Severity analysis

The Selfassessed severity ratings of appearance differences – did predict levels of well being, however

Surgeon assessed severity ratings of appearance differences – did not predict well being

slide9
How different someone THINKS they look predicts well being

How different someone ACTUALLY looks does NOT predict well being

examples
Examples:
  • Alan feels unable to socialise with his peers. When in conversation, he often covers his mouth with his hands, and if possible, avoids talking at all. He is self-conscious “because of my bad habit of keeping my mouth open my bottom lip has become really fat.” Others do not perceive his mouth as looking different.
  • Bob is a shop assistant in his town. He enjoys meeting regular customers and new people. He is aware of scarring on his lips following an infection, and sometimes gets asked about it. However, he is used to this, and does not consider this a very significant part of his life.
examples1
Examples:
  • Carol has a birth mark about 3cm in diameter on her neck. She is terribly concerned that this is noticeable to everyone she meets, and that they will imagine that this is a “love bite”, and assume she is promiscuous. As a result of this, she avoids others as far as possible, and if she needs to leave the house, always wears a scarf (which she continually re-adjusts)
  • Diana was scalded by steam as a child when she opened the radiator in her parents’ car. She has extensive visible scarring on her arms and neck. However, she has grown up accepting the attention this sometimes generates, and is practiced at fielding questions. Her work as a teacher, and personal relationships have not been unduly affected by her feelings about appearance.
body site physical location of a difference in appearance
Body site/physical location of a ‘difference’ in appearance

Moss (2005) found that the physical location of the affected body site(s) is a poor predictor of well being

Areas which are not normally visible to others (eg those hidden by clothes are as influential as normally visible areas – see graph on next slide).

In female samples, sensitivity about abdomen/breasts is most associated with poor well being

slide13

Moss (2005) location analysis

Appearance distress

Taller column indicates more distress associated with sensitivity about this body part

slide14

Moss (2005) location analysis

Sexually significant,

Normally kept hidden

Sexually significant,

Normally kept hidden

Appearance distress

Low numbers, unreliable figure

Taller column indicates more distress associated with sensitivity about this body part

slide15
Non-visible areas of difference (including size differences, skin conditions, scarring, etc.) can sometimes be associated with MORE distress than normally visible areas

Non-visible areas introduce the problem of carrying a “secret”

When, and to whom, is the “secret” revealed?

Especially an issue in relation to romantic/sexual relationships

other methods of recognising appearance related distress
Other methods of recognising appearance-related distress

Face to face discussion?

Observing behaviour?

Psychometric assessment?

Appropriate for vocational trainers

Appropriate for psychologists

slide17
Face to face discussionACTIVITY – identify potential advantages/disadvantages of face-to-face assessment

Advantages

Disadvantages

face to face discussion
Face to face discussion

Advantages

Disadvantages

Highly skilled

Time

Unreliable assessment

Subject to bias

Flexibility

Depth - can cover variety of times and domains

Individualistic

observing behaviour
Observing behaviour

Anxiety symptoms

Social avoidance

Nervousness

Blushing

Social awkwardness

Not necessarily the case that these are caused by appearance anxiety

observing behaviour1
Observing behaviour

Is there an unusually high preoccupation with appearance, eg reflected in…

Behaviours and conversation

Concealing aspects of body (gestures/clothing)

Checking mirrors/reflection more than necessary

Appearance concerns disrupting the person’s ability to function (causes lateness, cancellations of appointments, avoidance of social situations, anxiety about interviews etc).

observing behaviour2
Observing behaviour

Advantages

Disadvantages

Requires high level of skill

Time consuming

Which behaviours?

Context specific behaviours may be missed

Focus on individual

Can analyse social interaction in depth

psychometrics assessment by psychology professionals
Psychometrics – assessment by psychology professionals

Trainers may refer people to psychologists for a more formal assessment

Trainers may be supplied with a formal assessment by a psychologist and may need to interpret/understand this

psychometrics assessment by psychology professionals advantages
Psychometrics – assessment by psychology professionals: Advantages

Is carefully defined– Clarity needed about what is being measured

Has known validity – Assesses the aspect we think we want to assess

Is reliable – Measurement is likely to be consistent over time

activity
Activity:

Think about what your appearance means to you, and how it affects your thoughts, feelings, and behaviours.

What questions would you need to be asked to enable you to communicate this to someone else?

challenges of psychometric assessment
Challenges of psychometric assessment

When assessing appearance concern using psychometric methods, there are a plethora of scales, often measuring very similar sounding things

body image

Weight satisfaction

Body dysphoria

Body distortion

Body concern

Body image

Appearance satisfaction

Body schema

Appearance evaluation

(Thompson, Heinberg, Altabe, & Tantleff-Dunn, 1999)

Body satisfaction

Body dysmorphia

Body esteem

Body perception

Appearance orientation

Size perception accuracy

slide28

When interpreting psychometric assessments of body image and appearance concerns, it is important to know which aspects a measure HAS and HAS NOT assessed.

psychometric assessment
Psychometric assessment

Advantages

Disadvantages

Which constructs to measure?

May oversimplify

Language/literacy skills

Data management

Valid and reliable assessment

Known constructs used

Quick/easy

Can track change/outcomes

slide30
Gender differences

Men tend to evaluate and discuss the body as one entity

"I like, sort of my, the whole bit that is relatively slim, and it's all together so to speak, nothing’s out of place.. areas I don’t like, um, my stomach especially, when it flops over the trousers” (Man, 33)

"I’m happy with it, yeah.. it’s an overall thing” (Man, 39)

slide31
Women conceptualise the body as many distinct parts

"I have quite a naturally flat stomach, which I like a lot, and I’ve got my stomach pierced because I like the way it looks with that… I’m pleased with my stomach and I try to do sit-ups just to keep it looking okay... I don’t mind my back, I think that looks alright, I’m not very keen on my legs because I think they look very stumpy. Um.. and I think they’re also, they don’t seem to have a lot of shape… they just look like sticks, matchsticks (laughing).. um I like my arms I think they’re fine um.. my bum’salright (laughing) a bit dimply sometimes and I’d probably choose to have bigger boobs if I could” (Woman, 24)

activity1
Activity:

Who might need to recognise“symptoms” of appearance distress?

Is the word “symptoms” a problem? What associations/subtexts does it convey?

summary
Summary
  • Physical characteristics are poor predictors of appearance self-consciousness
  • Face-to-face or observational methods provide one way of assessing self-consciousness
  • Psychologists may use more systematic, psychometric methods