title: Effect of early body image dissatisfaction on subsequent psychological and physical adjustment after disfiguring injury.
abstract: OBJECTIVE
  The impact of body image dissatisfaction on quality of life after severe burn injury was investigated after controlling for other determinants of outcome (i.e., injury, distress, and preburn quality of life).
  
  
  METHODS
  The postburn quality of life (2-months postdischarge) of groups with and without body image dissatisfaction was studied after controlling for preburn quality of life (measured 2-3 days postadmission). The patient population (N = 86) was 77.9% men, had an average total body surface area burned of 17.02%, and average full-thickness burn of 6.09%. Forty percent had facial injuries, 68.6% required surgery, most were injured by flame (39.5%), and 76.8% were employed.
  
  
  RESULTS
  Multivariate analysis of covariance (covarying preburn level of Mental quality of life, facial injury, and size of burn) contrasting body image dissatisfaction groups found significantly lower psychosocial adjustment at 2-month follow-up in those with greater body image dissatisfaction (multivariate F = 3.61; p<.01). A second MANCOVA (covarying the preburn level of Physical quality of life and both facial injury and size of burn) found significantly lower physical functioning at 2-month follow-up in those with greater body image dissatisfaction (multivariate F = 2.78; p < .03). Adding two more covariates (depression and posttrauma distress) eliminated the effect of body image dissatisfaction on postburn Physical but not Mental adjustment.
  
  
  CONCLUSIONS
  Body image dissatisfaction affects quality of life after severe burn injury. Distress moderates this impact on aspects of physical but not psychosocial health.
authors.affiliation: Johns Hopkins University School of Medicine, Johns Hopkins Bayview Medical Center, Baltimore, MD 21224, USA. jfauerba@jhmi.edu
authors.forename: J A
authors.initials: JA
authors.lastname: Fauerbach
authors.forename: L J
authors.initials: LJ
authors.lastname: Heinberg
authors.forename: J W
authors.initials: JW
authors.lastname: Lawrence
authors.forename: A M
authors.initials: AM
authors.lastname: Munster
authors.forename: D A
authors.initials: DA
authors.lastname: Palombo
authors.forename: D
authors.initials: D
authors.lastname: Richter
authors.forename: R J
authors.initials: RJ
authors.lastname: Spence
authors.forename: S S
authors.initials: SS
authors.lastname: Stevens
authors.forename: L
authors.initials: L
authors.lastname: Ware
authors.forename: T
authors.initials: T
authors.lastname: Muehlberger
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D001828:Body Image; D002056:Burns / Q000523:psychology*; D005151:Facial Injuries / Q000523:psychology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010555:Personality Inventory; D011788:Quality of Life