How to recognise symptoms of - PowerPoint Presentation

Slide1

How to recognise symptoms ofappearance-related distress  Slide2

How do we recognise symptoms of appearance related distress?

Physical indicators

SeverityLocation/body site

Other indicatorsFace to face interaction/discussionsObserving behaviourPsychometric methodsSlide3

Physical severity & adjustment

Anecdotally,

severity associated with poor adjustment

But . . . Slide4

Who is most self conscious

of their appearance?Slide5

Who is most self conscious

of their appearance?

WE CAN’T POSSIBLY KNOW FROM THESE PHOTOGRAPHSSlide6

Moss (2005): Severity analysis

Over 500 participants with body image concerns (e.g., weight, size) and / or visible differences (e.g., scarring, burns) assessed appearance well being.Slide7

Moss (2005): Severity analysis

Half of this 500 self-assessed how different they looked from the norm

Other half

of this 500

assessed by plastic surgeon (appearance expert) as to how

different they looked from the normSlide8

Moss (2005): Severity analysis

Self

assessed

severity ratings of appearance differences – does predict

well beingSlide9

Moss (2005): Severity analysis

Surgeon assessed

severity ratings of appearance differences –

did not predict

well beingSlide10

Moss (2005): Severity analysis

How different someone THINKS they look predicts well being

How different someone ACTUALLY looks does NOT predict well beingSlide11

Examples:

Alan feels unable to socialise with his peers. When in conversation, he often covers his mouth with his hands, and if possible, avoids talking at all. He is self-conscious “

because

of my bad habit of keeping my mouth open my bottom lip has become really fat.” Others do not perceive his mouth as looking different.

Bob is a shop assistant in his town. He enjoys meeting regular customers and new people. He is aware of scarring on his lips following an infection, and sometimes gets asked about it. However, he is used to this, and does not consider this a very significant part of his life.Slide12

Examples:

Carol has a birth mark about 3cm in diameter on her neck. She is terribly concerned that this is noticeable to everyone she meets, and that they will imagine that this is a “love bite”, and assume she is promiscuous. As a result of this, she avoids others as far as possible, and if she needs to leave the house, always wears a scarf (which she continually re-adjusts)

Diana was scalded by steam as a child when she opened the radiator in her parents’ car. She has extensive visible scarring on her arms and neck. However, she has grown up accepting the attention this sometimes generates, and is practiced at

f

ielding questions. Her work as a teacher, and personal relationships have not been unduly affected by her feelings about appearance.Slide13

Moss (2005): Location analysis

Physical location

of body areas poor predictor of well being

Normally non-visible areas

as influential as normally visible areas – see graph following.

In female samples, sensitivity about abdomen/breasts is most associated with poor well beingSlide14

Taller column indicates more distress associated with sensitivity about this body part

Appearance distress

Moss (2005) location analysisSlide15

Taller column indicates more distress associated with sensitivity about this body part

Appearance distress

Sexually significant,

Normally kept hidden

Sexually significant,

Normally kept hidden

Low numbers, unreliable figure

Moss (2005) location analysisSlide16

Moss (2005): Location analysis

Non-visible areas of difference (including size differences, skin conditions, scarring, etc.) can be associated with MORE distress than normally visible areas

Non-visible areas introduce the problem of carrying a “secret”

When, and to whom, is the “secret” revealed?

Especially relevant in romantic/sexual relationshipsSlide17

AssessmentFace to face discussion?

Observing behaviour?

Psychometric assessment?

Appropriate for vocational trainers

Appropriate for psychologistsSlide18

Face to face discussionACTIVITY – identify potential advantages/disadvantages of face-to-face assessment

Advantages

DisadvantagesSlide19

Face to face discussion

Advantages

Flexibility

Depth - can cover variety of times and domains

Individualistic

Disadvantages

Highly skilled

Time

Unreliable assessment

Subject to biasSlide20

Observing behaviour

Anxiety symptoms

Social avoidanceNervousness

BlushingSocial awkwardnessNot necessarily the case that these are caused by appearance anxietySlide21

Observing behaviour

Appearance focus

Behavioural and conversational preoccupation with appearance

Concealing aspects of body (gestures/clothing)Checking mirrors/reflection more than necessaryAppearance concern disrupts ability to function (causes lateness, cancellations of appointments,

etc

).Slide22

Observing behaviour

Advantages

Individualistic

Can analyse social interaction in depth

Disadvantages

Highly skilled

Time

Which behaviours?

Context specific behaviours missedSlide23

Psychometrics – assessment by psychology professionals

Trainers may refer to psychologists for formal assessment

Trainers may need to interpret/understand psychologists’ formal assessmentsSlide24

Psychometrics – assessment by psychology professionals

Is carefully defined

- What should we measure?

Has known validity – Assessing what we thing we are assessingIs reliable

– Consistent over timeSlide25

What are we measuring when we measure body image?Slide26

Activity:

Think about what your appearance means to you, and how it affects your thoughts, feelings, and behaviours.

What questions would

you need to be asked to enable you to communicate this to someone else?Slide27

When assessing appearance concern using psychometric methods, there are a plethora of scales, often measuring very similar sounding thingsSlide28

Body image

Weight satisfaction

Size perception accuracy

Body satisfaction

Appearance satisfaction

Appearance evaluation

Body esteem

Appearance orientation

Body concern

Body

dysphoria

Body

dysmorphia

Body schema

Body

perception

Body distortion

(Thompson,

Heinberg

, Altabe, &

Tantleff

-Dunn, 1999)Slide29

When interpreting psychometric assessment of body image and appearance concerns, it is important to know what the test HAS and HAS NOT assessed.Slide30

Valid and reliable assessment

Known constructs used

Quick/easy

Can track change/outcomes

Subjective assessment:

Psychometrics

Advantages

Disadvantages

Which construct/measure?

May oversimplify

Language/literacy skills

Data managementSlide31

Men tend to evaluate and discuss the body as

one entity

"I like, sort of my, the

whole bit that is relatively slim, and it's all together so to speak, nothing’s out of place.. areas I don’t like, um, my stomach especially, when it flops over the trousers”

(Man, 33

)

"I’m happy with it, yeah.. it’s

an overall

thing

”

(Man, 39

)Slide32

Women conceptualise the body as

many distinct parts

"I have quite a naturally flat

stomach, which I like a lot, and I’ve got my stomach pierced because I like the way it looks with that… I’m pleased with my stomach and I try to do sit-ups just to keep it looking okay... I don’t mind my back, I think that looks alright, I’m not very keen on my

legs

because I think they look very stumpy. Um.. and I think they’re also, they don’t seem to have a lot of shape… they just look like sticks, matchsticks (laughing).. um I like my

arms

I think they’re fine um.. my

bum’s

alright (laughing) a bit

dimply

sometimes and I’d probably choose to have bigger

boobs

if I

could”

(Woman, 24

)Slide33

Activity:

Who

might need to recognise

“symptoms” of appearance distress? Is the word “symptoms” a problem

? What associations/subtexts does

it

convey?Slide34

Summary

Physical characteristics are poor predictors of appearance self-consciousnessFace-to-face or observational methods provide one way of assessing self-consciousness

Psychologists may use more systematic, psychometric methods