title: Does severity predict distress? The relationship between subjective and objective measures of appearance and psychological adjustment, during treatment for facial lipoatrophy.
abstract: The intuitive or lay belief that the severity of a disfiguring condition predicts psychological distress is not demonstrated in clinical practice, nor in research studies. This within group study used standardised measures repeated at six month intervals, to investigate the relationship between subjective and objective measures of appearance and psychological adjustment in 51 patients undergoing treatment for facial lipoatrophy using a synthetic filler, Newfill. Results demonstrate a dissociation between objective and subjective measures with only subjective assessment predicting psychological outcomes. It is recommended that Moss's (2005) hypothesis of discrete group membership (normal/not normal) should be adapted to include an internal standard for comparison, and that all evaluations of treatment modifying disfigurement should include a standardised subjective measure of appearance.
authors: Department of Plastic and Reconstructive Surgery, The Royal Free Hampstead NHS Trust, United Kingdom.
authors: Juling
authors: J
authors: Ong
authors: Alex
authors: A
authors: Clarke
authors: Paul
authors: P
authors: White
authors: Margaret
authors: M
authors: Johnson
authors: Simon
authors: S
authors: Withey
authors: Peter E M
authors: PE
authors: Butler
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D023241:Antiretroviral Therapy, Highly Active / Q000009:adverse effects; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D001828:Body Image; D002508:Cephalometry; D003469:Culture; D005145:Face / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D039682:HIV-Associated Lipodystrophy Syndrome / Q000139:chemically induced / Q000523:psychology* / Q000601:surgery; D006801:Humans; D007091:Image Processing, Computer-Assisted; D019344:Lactic Acid; D007834:Lasers; D008297:Male; D008875:Middle Aged; D017060:Patient Satisfaction; D010555:Personality Inventory; D011091:Polyesters; D011108:Polymers; D019736:Prostheses and Implants; D019651:Plastic Surgery Procedures / Q000523:psychology*; D012649:Self Concept; D012984:Software
chemical_list: D011091:Polyesters; D011108:Polymers; D019344:Lactic Acid; C033616:poly(lactide)