Understanding adjustment to disfigurement: the role of the self-concept

Abstract

The objective of this study was to determine whether variation in psychological adjustment to physically disfiguring conditions is related to organisation of the content of appearance-related information in the self-concept. A cross-sectional design was employed, using 70 participants with a range of appearance problems recruited from support groups and the NHS. A postal paper and pencil task was completed by participants which assessed the level of their adjustment using the Derriford Appearance Scale, and measured the three self-concept variables – differential importance, compartmentalisation and complexity. Regression analyses showed that poor adjustment to disfigurement is related to greater differential importance of appearance-related self-aspects, greater compartmentalisation of appearance-related information and greater self-concept complexity. No moderating effects were found between these independent variables. The results have implications for psychological treatment strategies, particularly cognitive behavioural therapeutic interventions.

Keywords:

• Disfigurement
• Psychological adjustment
• Self-concept
• Compartmentalization
• Self-complexity

Acknowledgements

The authors would like to thank Mr D.L. Harris (Consultant Plastic Surgeon, Derriford Hospital, Plymouth), Dr. Antonietta DiCaccavo, and two anonymous reviewers for valuable comments on an earlier draft of the manuscript.