title: Development and Validation of the Expectations of Aesthetic Rhinoplasty Scale.
abstract: BACKGROUND
  There is a growing concern in the field of aesthetic surgery about the need to measure patients' expectations preoperatively. The present study was designed to develop and validate the Expectations of Aesthetic Rhinoplasty Scale (EARS), and to compare expectations between rhinoplasty patients with and without body dysmorphic disorder (BDD).
  
  
  METHODS
  In total, 162 college students and 20 rhinoplasty candidates were recruited. The measures included the newly developed EARS, a measure of psychopathology, and demographics. The DSM-IV structured clinical interview for BDD was used to confirm the diagnosis in rhinoplasty patients.
  
  
  RESULTS
  The EARS was constructed of six items based on their significant content validity. In the scale development phase, Cronbach's alpha was 0.87. The test-retest reliability coefficient of the scale was satisfactory (intraclass correlation coefficient, 0.94; 95% confidence interval, 0.82-0.98) over a four-week period. Scores on the EARS were significantly positively correlated with psychopathological symptoms (r=0.16; P<0.05). Moreover, comparison of EARS scores between BDD (M=25.90, standard deviation [SD]=6.91) and non-BDD rhinoplastic patients (M=15.70, SD=5.27) suggested that BDD patients held significantly higher expectations (P<0.01).
  
  
  CONCLUSIONS
  The expectations of aesthetic rhinoplasty patients toward surgery may play a crucial role in their postoperative satisfaction. While the value of patients' expectations is clinically recognized, no empirical study has measured these expectations in a psychometrically sound manner. The current study developed and validated the EARS. It may be easily used as a valid and reliable instrument in clinical and research settings.
authors.affiliation: Division of Rhinology and Facial Plastic Surgery, Department of Otorhinolaryngology, Head and Neck Surgery, Tehran University of Medical Sciences, Tehran, Iran.; Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.; Rhinology Research Society, Tehran, Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Naraghi
authors.affiliation: Department of Psychology, Faculty of Psychology and Education, University of Tehran, Tehran, Iran.
authors.forename: Mohammad
authors.identifier: 0000-0002-4358-7783
authors.initials: M
authors.lastname: Atari
keywords: Body dysmorphic disorders; Psychology; Psychometrics; Rhinoplasty