title: From survival to socialization: a longitudinal study of body image in survivors of severe burn injury.
abstract: OBJECTIVE
  Little is known about the course of body image dissatisfaction following disfiguring injury or illness. The objective of this study was to test a proposed framework for understanding the trajectory of body image dissatisfaction among burn survivors and to longitudinally investigate the role of body image in overall psychosocial functioning.
  
  
  METHODS
  A sample of 79 survivors of severe burn injuries completed the Satisfaction with Appearance Scale (SWAP), the Importance of Appearance subscale of the Multidimensional Body-Self Relations Questionnaire, and the SF-36 in the hospital and at 6 and 12 months postdischarge (SWAP and SF-36). A repeated-measures analysis of covariance model was used to assess the course of body image dissatisfaction over time, and a path analysis model tested the role of body image dissatisfaction in mediating the relationship between preburn and postburn psychosocial functioning.
  
  
  RESULTS
  Female sex (P<.05), total body surface area burned (P<.01), and importance of appearance (P<.01) predicted body image dissatisfaction. From hospitalization to 12 months postdischarge, body image dissatisfaction increased for women (P<.01) and individuals with larger burns (P<.01) compared, respectively, to men and individuals with smaller burns. In the path analysis, body image dissatisfaction was the most salient predictor of psychosocial function at 12 months (beta=.53, P<.01) and mediated the relationship between preburn and 12-month psychosocial function.
  
  
  CONCLUSIONS
  Findings from this study suggest the importance of routine psychological screening for body image distress during hospitalization and after discharge.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA. brett.thombs@mcgill.ca
authors.forename: Brett D
authors.initials: BD
authors.lastname: Thombs
authors.forename: Lisa D
authors.initials: LD
authors.lastname: Notes
authors.forename: John W
authors.initials: JW
authors.lastname: Lawrence
authors.forename: Gina
authors.initials: G
authors.lastname: Magyar-Russell
authors.forename: Melissa G
authors.initials: MG
authors.lastname: Bresnick
authors.forename: James A
authors.initials: JA
authors.lastname: Fauerbach
mesh_terms: D000293:Adolescent; D000328:Adult; D001828:Body Image; D002056:Burns / Q000453:epidemiology / Q000523:psychology* / Q000534:rehabilitation; D005260:Female; D005500:Follow-Up Studies; D006760:Hospitalization; D006801:Humans; D007398:Interpersonal Relations; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D012944:Social Support; D012951:Socialization; D013534:Survival