Predicting interest in cosmetic surgery: Interactive effects of appearance-based rejection sensitivity and negative appearance comments

This study investigated effects of appearance-based rejection sensitivity (Appearance-RS) – the dispositional tendency to anxiously expect rejection based on one's appearance – in a sample of 133 American college students. Participants were randomly assigned to write an essay about either a negative or positive appearance comment they had received in the past. Compared to participants with lower Appearance-RS, those with higher Appearance-RS felt more rejected and expressed greater interest in cosmetic surgery after recalling a negative versus positive appearance comment. Content analysis of the essays revealed that negative appearance comments were most often made in reference to one's body weight/shape/size; positive appearance comments were most often made in reference to one's overall appearance. Peers/friends/romantic partners were the most frequently cited source of both positive and negative appearance comments. Overall, this research suggests that the interaction between the person and the situation is important to consider when predicting cosmetic surgery interest.     

SOCIOCULTURAL INFLUENCE AND APPEARANCE-BASED REJECTION SENSITIVITY AMONG COLLEGE STUDENTS

The present research examined the influence of parents, peers, and the media in predicting college students' Appearance-based Rejection Sensitivity (Appearance-RS)—the degree to which individuals anxiously expect to be rejected based on their physical appearance. Given that women are socialized to be more appearance-focused than men, women were hypothesized to show greater Appearance-RS in response to sociocultural influences than men. A survey was administered to 220 students at a large public university in the United States. Overall, women showed greater sensitivity to appearance rejection than men. Specifically, perceptions of peer conditional acceptance based on appearance were associated with Appearance-RS among women. In addition, the more women and men internalized media ideals and felt media pressure to look attractive, the more sensitive they were to appearance rejection. No significant effects of parental influence were found. Thus, peer conditional acceptance predicted Appearance-RS among women, and media influence predicted Appearance-RS among women and men.     

Interpersonal effects of Appearance-based Rejection Sensitivity

Appearance-based Rejection Sensitivity (Appearance-RS) is the tendency to anxiously expect, readily perceive, and overreact to rejection based on one’s physical attractiveness. In the present research, we examined how sensitivity to appearance-based rejection influenced desire for social contact. High Appearance-RS participants wanted to avoid social interaction in general (Study 1) and even close others (Study 2) following appearance-based rejection, but not appearance-based acceptance or rejection based on perceived intelligence. Results of a daily diary study revealed that high Appearance-RS participants showed greater social avoidance on days when they felt sensitive to rejection based on their looks (Study 3). High Appearance-RS individuals therefore overreact to appearance rejection by withdrawing from social interactions. Implications for motivation, interpersonal processes, and clinical disorders are discussed.     

Objectification Theory Predicts College Women’s Attitudes Toward Cosmetic Surgery

This study investigated cosmetic surgery attitudes within the framework of objectification theory. One hundred predominantly White, British undergraduate women completed self-report measures of impression management, global self-esteem, interpersonal sexual objectification, self-surveillance, body shame, and three components of cosmetic surgery attitudes. As expected, each of the objectification theory variables predicted greater consideration of having cosmetic surgery in the future. Also, as expected, sexual objectification and body shame uniquely predicted social motives for cosmetic surgery, whereas self-surveillance uniquely predicted intrapersonal motives for cosmetic surgery. These findings suggest that women’s acceptance of cosmetic surgery as a way to manipulate physical appearance can be partially explained by the degree to which they view themselves through the lenses of sexual and self-objectification.     

Appearance-based rejection sensitivity: implications for mental and physical health, affect, and motivation

Appearance-Based Rejection Sensitivity (Appearance-RS) is a personality-processing system characterized by anxious concerns and expectations about being rejected based on one's physical attractiveness. People differ in their sensitivity to rejection based on appearance, with consequences for mental and physical health, self-esteem, affect, and feelings of belonging. Study 1 describes the development and validation of the Appearance-RS scale, its relation to personality variables and to health-related outcomes. Study 2 provides experimental evidence that high Appearance-RS people feel more alone and rejected when asked to think about negative aspects of their appearance. Finally, Study 3 tests ways to reduce the negative effects of receiving an appearance threat among high Appearance-RS participants. Specifically, high Appearance-RS participants who engaged in self-affirmation (thought of their personal strengths) or received a secure attachment prime (thought of a close, caring relationship) were buffered from the negative effects of an appearance threat on subsequent state self-esteem and mood.     

Body image and cosmetic medical treatments

Cosmetic medical treatments have become increasingly popular over the past decade. The explosion in popularity can be attributed to several factors—the evolution of safer, minimally invasive procedures, increased mass media attention, and the greater willingness of individuals to undergo cosmetic procedures as a means to enhance physical appearance. Medical and mental health professionals have long been interested in understanding both the motivations for seeking a change in physical appearance as well as the psychological outcomes of these treatments. Body image has been thought to play a key role in the decision to seek cosmetic procedures, however, only recently have studies investigated the pre- and postoperative body image concerns of patients. While body image dissatisfaction may motivate the pursuit of cosmetic medical treatments, psychiatric disorders characterized by body image disturbances, such as body dysmorphic disorder and eating disorders, may be relatively common among these patients. Subsequent research on persons who alter their physical appearance through cosmetic medical treatments are likely provide important information on the nature of body image.     

Predicting consideration of cosmetic surgery in a college population: a continuum of body image disturbance and the importance of coping strategies

Elective cosmetic surgeries are increasing in the American population with reasons linked to body image disturbance and body dysmorphic disorder (BDD). Little research exists documenting the continuum of body image disturbance and its relationship to seeking surgery. The present research examined data from 544 participants, 55 of whom were diagnosable with BDD. Using assessments for body image disturbance, problematic coping strategies, and BDD symptomatology, results provided evidence for a continuum of body image distress. Logistic regression analysis supported the hypothesis that increased levels of body image disturbance and one type of problematic coping strategy (Appearance Fixing) predicted consideration of cosmetic surgery. Of participants diagnosable with BDD, those who considered cosmetic surgery showed more severe body image disturbance and problematic coping than those who did not consider surgery. These results have implications for pre-surgical assessment as well as psychological interventions rather than invasive medical interventions.     

A cascade of rejection and appearance preoccupation: Adolescents’ body dysmorphic symptoms and appearance rejection sensitivity over 4 years

Adolescence is a high-risk period for body image disturbance and appearance concerns. In a cascade model, we examined interrelations of body dysmorphic symptoms (BDS) with appearance rejection sensitivity (ARS) and tested gender moderation. Participants were 397 Australian adolescents (T1 Mage = 11.7, SD = 0.91; 56% girls) who completed six surveys over 4 years. In a random-intercept cross-lag model, two (of five possible) paths showed ARS predicted higher subsequent BDS, and three (of five possible) paths showed BDS predicted higher subsequent ARS. Girls reported more BDS and ARS than boys, and random intercepts of BDS and ARS were correlated with the correlation stronger in girls than boys. Cross-lag BDD-ARS associations over the six waves were not significantly moderated by gender. Overall, girls are at higher risk of appearance concerns than boys, but BDD-ARS cascade effects do not differ between girls and boys.     

Cosmetic surgery in inpatients with eating disorders: attitudes and experience

Body image disturbance is frequent among individuals undergoing cosmetic surgery and core to the pathology of eating disorders (ED); however, there is little research examining cosmetic surgery in ED. This study examined body image related measures, ED behaviors, and depression as predictors of attitudes toward cosmetic surgery in 129 women with ED. Patients who had undergone surgery (n = 16, 12%) were compared to those who had not. Having a purging diagnosis, linking success to appearance, and making physical appearance comparisons were predictive of more favorable cosmetic surgery attitudes. All of those who had undergone surgery had purging diagnoses and, on average, were older, had higher BMIs, and were more likely to make physical appearance comparisons and know someone who had undergone surgery. In ED, acceptance and pursuit of cosmetic surgery appears to be related to social group influences more than weight and shape disturbance, media influences, or mood.     

Exploring the link between self-compassion and body image in university women

The purpose of the present research was to examine the relationships between self-compassion and women's body image. In Study 1, female undergraduates (N=142) completed three measures of body image and measures of self-esteem and self-compassion. Results showed that high self-compassion predicted fewer body concerns independently of self-esteem. Moreover, when both self-compassion and self-esteem were included as predictors, self-compassion accounted for unique variance in body preoccupation and weight concerns whereas self-esteem did not. In Study 2, this finding was partially replicated with one component (self-judgment) of self-compassion uniquely predicting body preoccupation in undergraduate women (N=187). High scores on self-compassion also predicted less eating guilt independent of self-esteem. Additionally, self-compassion was shown to partially mediate the relationship between body preoccupation and depressive symptoms. The findings highlight the possibility that a consideration of self-compassion for body image may contribute to identifying who is most at risk for body/shape concerns.     

Victimization,social anxiety,and body dysmorphic concerns: Appearance-based rejection sensitivity as a mediator

Body dysmorphic disorder (BDD) is characterized by extreme preoccupation with perceived deficits in physical appearance, and sufferers experience severe impairment in functioning. Previous research has indicated that individuals with BDD are high in social anxiety, and often report being the victims of appearance-based teasing. However, there is little research into the possible mechanisms that might explain these relationships. The current study examined appearance-based rejection sensitivity as a mediator between perceived appearance-based victimization, social anxiety, and body dysmorphic symptoms in a sample of 237 Australian undergraduate psychology students. Appearance-based rejection sensitivity fully mediated the relationship between appearance-based victimization and body dysmorphic symptoms, and partially mediated the relationship between social anxiety and body dysmorphic symptoms. Findings suggest that individuals high in social anxiety or those who have a history of more appearance-based victimization may have a bias towards interpreting further appearance-based rejection, which may contribute to extreme appearance concerns such as BDD.     

MATERIALISM, SOCIOCULTURAL APPEARANCE MESSAGES, AND PATERNAL ATTITUDES PREDICT COLLEGE WOMEN'S ATTITUDES ABOUT COSMETIC SURGERY

Rates of cosmetic surgery procedures have increased dramatically over the past several decades, but only recently have studies of cosmetic surgery attitudes among the general population begun to appear in the literature. The vast majority of those who undergo cosmetic surgery are women. We examined cosmetic surgery attitudes among 218 undergraduate women, most of whom were White. Specifically, we examined their acceptance of cosmetic surgery and expressed desire to undergo cosmetic surgery procedures, and several potential predictors: appearance attitudes of mothers, fathers, and friends; awareness and internalization of sociocultural appearance messages; and materialism. Multiple regression analyses indicated that materialism and internalization of sociocultural messages consistently emerged as significant predictors of acceptance of cosmetic surgery and desire for cosmetic surgery procedures. Paternal attitudes positively predicted acceptance of cosmetic surgery for social reasons and desire for cosmetic surgery; nonmaterialism negatively predicted considering cosmetic surgery and the desire for cosmetic surgery procedures.     

Predicting Adolescents’ Self-Objectification from Sexualized Video Game and Instagram Use: A Longitudinal Study

A growing body of research has demonstrated negative effects of sexualization in the media on adolescents’ body image, but longitudinal studies and research including interactive and social media are scarce. The current study explored the longitudinal associations of adolescents’ use of sexualized video games (SVG) and sexualized Instagram images (SII) with body image concerns. Specifically, our study examined relations between adolescents’ SVG and SII use and appearance comparisons, thin- and muscular-ideal internalization, valuing appearance over competence, and body surveillance. A sample of 660 German adolescents (327 female, 333 male; M_age?=?15.09 years) participated in two waves with an interval of 6 months. A structural equation model showed that SVG and SII use at Time 1 predicted body surveillance indirectly via valuing appearance over competence at Time 2. Furthermore, SVG and SII use indirectly predicted both thin- and muscular-ideal internalization through appearance comparisons at Time 1. In turn, thin-ideal internalization at Time 1 predicted body surveillance indirectly via valuing appearance over competence at Time 2. The results indicate that sexualization in video games and on Instagram can play an important role in increasing body image concerns among adolescents. We discuss the findings with respect to objectification theory and the predictive value of including appearance comparisons in models explaining the relation between sexualized media and self-objectification.

     

Predicting interest in liposuction among women with eating problems: a population-based study

The purpose of this paper was to examine predictors of an interest in liposuction among women with eating problems. A questionnaire was sent to 3500 women aged 18-35 years, whereof 378 of 1861 responders screened positively on eating problems. Assessments included sociodemographic status, social network, physical exercise, attitudes towards cosmetic surgery, teasing history, body dysmorphic disorder-like symptoms, body image, self-esteem, personality, interpersonal attachment and emotional distress. Fifty-two percent reported an interest in liposuction, which was independently predicted by appearance orientation, appearance evaluation, being critical/quarrelsome, teasing history, wish for a better relationship with father, low education and being unmarried. Predictors differed somewhat from those previously found in the general population. Considering that our sample consisted of women with self-reported eating problems, the association between liposuction and eating behaviors should be further examined in a sample of patients with a formal eating disorder diagnosis.     

Investment in body image among patients diagnosed with or at risk for malignant melanoma

We examined investment in body image among 48 patients diagnosed with, or at risk for malignant melanoma (MM), as well as factors hypothesized as related to increased investment, such as gender, perceived stress, mood, fatigue, and personality characteristics. Investment in body image was evaluated using the Measure of Body Apperception [Carver, C. S., Pozo-Kaderman, C., Price, A. A., Noriega, V., Harris, S. D., Derhagopian, R. S., Robinson, D. S., & Moffat, F. L. Jr. (1998). Concern about aspects of body image and adjustment to early state breast cancer. Psychosomatic Medicine, 60, 168–174]. Results showed that women reported more concerns about physical appearance than men, and patients with MM exhibited more concerns about body integrity than at-risk patients. Concerns about body integrity were related to more compulsive personality characteristics, whereas concerns about appearance were associated with more histrionic personality characteristics. Body image investment was related to poorer adjustment as indicated by heightened symptoms of fatigue and stress. This study suggests that further research on investment in body image in this patient population is warranted.     

Social connectedness,conformity, and internalization of societal standards of attractiveness

Internalization of societal standards of attractiveness is known to play a role in the development of body dissatisfaction and disordered eating, and researchers are now working toward identifying factors that influence the internalization of those societal standards. The present study examined to what extent social connectedness and conformity were related to internalization. Female college students (n = 300) completed measures of social connectedness, conformity, and internalization, as well as measures of body image concerns, dietary restraint, and bulimic symptoms. Path analysis showed that social connectedness was negatively related to conformity, and that conformity was positively related to internalization. Consistent with past research, internalization predicted body image concerns and dietary restraint, which in turn predicted bulimic symptoms. Conformity appears to be a risk factor for the internalization of societal standards of attractiveness, and could be targeted in efforts to reduce internalization, negative body image, and disordered eating.     

Body dysmorphic disorder and appearance enhancing medical treatments

This article reviews the literature on body dysmorphic disorder (BDD) in persons who seek appearance enhancing medical treatments such as cosmetic surgery and dermatological treatment. We begin with a discussion of the growing popularity of cosmetic surgical and minimally invasive treatments. The literature investigating the psychological characteristics is briefly highlighted. Studies investigating the rate of BDD among persons who seek appearance enhancing treatments are detailed and, collectively, suggest that approximately 5–15% of individuals who seek these treatments suffer from BDD. Retrospective reports suggest that persons with BDD rarely experience improvement in their symptoms following these treatments, leading some to suggest that BDD is a contraindication to cosmetic surgery and other treatments. The clinical management of patients with BDD who present for these treatments is briefly described and directions for future research are provided.     

Cosmetic Surgery: A Common and Accepted Form of Self‐Improvement?1

The pursuit of beauty through alteration of physical appearance is a growing trend. Rates of cosmetic surgery have soared, suggesting that surgery is a common, acceptable solution to the desire for self‐improvement. Despite indications that surgeries are increasing in frequency, there have been few empirical investigations about popular attitudes toward cosmetic surgery. In the present study, 302 female undergraduate students were surveyed. Approximately 3% of the sample had undergone cosmetic surgery themselves, and half knew at least 1 person among their friends and family who had undergone cosmetic surgery. As hypothesized, approval and reported future likelihood of cosmetic surgery were predicted by greater media exposure, greater vicarious experience of cosmetic surgery, and greater importance of appearance to self‐worth. No significant differences among ethnic groups were found.     

Self-Presentation Concerns and Health Behaviors Among Cosmetic Surgery Patients

The present investigation examined the relationship between self-presentational motives and physical activity in a population of cosmetic surgery participants. Participants were 50 female and 5 male cosmetic surgery patients (CSPs; M age = 38.5 years) who completed a battery of self-report measures following either vein or acne treatment. Analyses revealed significant group differences on self-presentational concern and public self-consciousness between: (a) those who elected the treatment for appearance motives and those who elected treatment for health-based motives, and (b) the more frequent (3 or more times per week) and less frequent (2 or less times per week) exercisers. Greater self-presentational concerns and greater public self-consciousness were associated with having appearance-related motives for treatment and with being a less frequent exerciser.     

Body Dysmorphic Disorder among Diverse Racial/Ethnic and Sexual Orientation Groups: Prevalence Estimates and Associated Factors

Body Dysmorphic Disorder (BDD) is a psychological disorder characterized by excessive appearance concerns. This cross-sectional study assessed an undergraduate sample of 1,041 participants from a southeastern American university to estimate an overall prevalence of BDD; investigate differences by gender, race/ethnicity, and sexual orientation; and also examine the contributions of other related constructs including appearance comparison, obligatory exercise, body image disturbance, and self-esteem. Results indicated an overall prevalence of 4.9%. Women endorsed more symptoms of BDD than men, among women Caucasians and Latinas endorsed more symptoms than African Americans, and sexual minorities endorsed more symptoms than heterosexuals. Overall, BDD symptomatology was negatively correlated with body satisfaction and self-esteem and positively correlated with appearance comparison and obligatory exercise.