Does severity predict distress? The relationship between subjective and objective measures of appearance and psychological adjustment,during treatment for facial lipoatrophy

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.     

How do i know what i feel? Evidence for the role of self‐categorisation in symptom perceptions

This paper extends the self‐categorisation model of symptom appraisals to predict that individuals who believe they have a given illness will perceive concurrent symptoms relevant to that illness to be more severe when they categorise themselves as members of a group of people with that illness. These predictions are supported with opportunity samples of individuals reporting, or not reporting a common cold (Study 1, N = 60) and reporting colds or tinnitus (Study 2, N = 64). In both studies, relevant symptoms were rated as more severe when illness group memberships were salient. The methodological, theoretical and clinical implications of these findings and possible therapeutic applications of self‐categorisation theory (SCT) to symptom perceptions are discussed. Copyright © 2007 John Wiley & Sons, Ltd.