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In the UK, around 6400 children experience a burn injury every year. This can have a profound impact on a child's psychological and physical wellbeing—but how are parents affected when their child suffers a burn? Catrin Griffiths explores the effect of a child's burn injury on parents' coping skills and wellbeing, and highlights the importance of adequately assessing parents' needs and providing appropriate support

An appearance-altering condition can have a negative impact on an individual's psychosocial wellbeing. This may extend into the important spheres of love and intimacy and can affect existing relationships, as well as the formation of new partnerships. Nick Sharratt discusses why intimacy is a topic that is often not discussed with health professionals and offers initial suggestions as to how this may be redressed

© 2017 Elsevier Ltd This study experimentally examined the impact of exposure to fitspiration images and self-compassion quotes on social media on young women's body satisfaction, body appreciation, self-compassion, and negative mood. Female undergraduate students (N=160) were randomly assigned to view either Instagram images of fitspiration, self-compassion quotes, a combination of both, or appearance-neutral images. Results showed no differences between viewing fitspiration images compared to viewing neutral images, except for poorer self-compassion among those who viewed fitspiration images. However, women who viewed self-compassion quotes showed greater body satisfaction, body appreciation, self-compassion, and reduced negative mood compared to women who viewed neutral images. Further, viewing a combination of fitspiration images and self-compassion quotes led to positive outcomes compared to viewing only fitspiration images. Trait levels of thin-ideal internalisation moderated some effects. The findings suggest that self-compassion might offer a novel avenue for attenuating the negative impact of social media on women's body satisfaction.

© 2017, The Author(s). In recent years, elements of the modern environment (such as television, Internet, toys and clothes) have been criticized for having an increasingly sexualized or appearance focus, which has been suggested to be detrimental to girls’ development. The current study examined the impact of an appearance-focused Internet game on young girls’ body image and career cognitions and aspirations. Eighty British girls aged 8–9 years were randomly assigned to play an appearance-focused or a non-appearance focused game for 10 minutes. Girls in the appearance-focused game condition displayed greater body dissatisfaction compared to the control condition. Type of game did not impact girls’ perceived capacity to do various jobs. However, girls who played the appearance-focused game reported a greater preference for feminine careers compared to the control group. This provides preliminary evidence that appearance-focused Internet games may be detrimental to young girls’ body image and aspirations. Internet games should be included in our consideration of influential messages for young girls.

© 2017 The present study aimed to identify the specific social networking sites (SNS) features that relate to body image concerns in young women. A total of 259 women aged 18–29 years completed questionnaire measures of SNS use (Facebook and Instagram) and body image concerns. It was found that appearance-focused SNS use, rather than overall SNS use, was related to body image concerns in young women. Specifically, greater engagement in photo activities on Facebook, but not general Facebook use, was associated with greater thin-ideal internalisation and body surveillance. Similarly, following appearance-focused accounts on Instagram was associated with thin-ideal internalisation, body surveillance, and drive for thinness, whereas following appearance-neutral accounts was not associated with any body image outcomes. Implications for future SNS research, as well as for body image and disordered eating interventions for young women, are discussed.

© 2017 Positive body image among adults is related to numerous indicators of well-being. However, no research has explored body appreciation among children. To facilitate our understanding of children's positive body image, the current study adapts and validates the Body Appreciation Scale-2 (BAS-2; Tylka & Wood-Barcalow, 2015a) for use with children. Three hundred and forty-four children (54.4% girls) aged 9–11 completed the adapted Body Appreciation Scale-2 for Children (BAS-2C) alongside measures of body esteem, media influence, body surveillance, mood, and dieting. A sub-sample of 154 participants (62.3% girls) completed the questionnaire 6-weeks later to examine stability (test-retest) reliability. The BAS-2C displayed a unidimensional factor structure and evidence of internal consistency, test-retest reliability, and construct, criterion-related, and incremental validity. Additionally, the results suggest adaptive properties of body appreciation for body-related and emotional well-being among children. The BAS-2C could serve as an essential component within research to understand and estimate children's positive body image.

© 2017 Taylor & Francis. This qualitative study sought to explore the experiences of patients who had undergone successful ptosis correction surgery. Participants were recruited from Bristol Eye Hospital. Nine participants were interviewed using a semi-structured interview schedule and open ended questions. Data were analysed using inductive thematic analysis. Four major themes were identified from patient accounts. Patients described the psychosocial and functional difficulties they experienced living with ptosis, and the subsequent benefits of surgery. Patients reported experiencing appearance related anxiety pre-operatively due to their condition and engaging in behaviours to avoid social encounters. Gender differences were noted in the internalization of perceived negative reactions from others, with men describing fewer adverse impacts. Patients described perceived barriers to seeking surgery including a lack of awareness of ptosis as a treatable condition, the perception that being concerned with their appearance could be seen as vain and the view that ptosis surgery is synonymous with cosmetic surgery. Following successful surgery patients outlined positive impacts on their vision, appearance and psychosocial well-being after successful surgery. This qualitative study highlights the complexities of the factors and processes contributing to the psychosocial impacts of ptosis and the potential benefits of surgery and/or psychosocial support. An increased awareness amongst people with ptosis of the potential positive impacts of surgery and an enhanced understanding of the reasons why patients may not seek treatment amongst health care professionals are likely to benefit this often overlooked patient group.

Copyright © 2016 John Wiley & Sons, Ltd. Background: Very little UK-based research has examined breast cancer-related experiences of Black and Minority Ethnic populations, and we do not know whether the psychosocial impact of diagnosis and treatment in this group is any different to that of White women. Therefore, this study examined similarities and differences amongst Black, South Asian and White breast cancer survivors. Methods: A quantitative, cross-sectional survey was conducted; 173 breast cancer survivors (80 White, 53 South Asian and 40 Black) completed a questionnaire, which assessed psychological functioning, social support, body image and beliefs about cancer. Results: Significant differences (p < 0.05) were reported between White and South Asian participants: compared with White women, South Asian participants reported higher levels of anxiety and depression, poorer quality of life and held higher levels of internal and fatalistic beliefs pertaining to cancer. Black and South Asian women reported higher levels of body image concerns than White women, and held stronger beliefs that God was in control of their cancer. South Asian women turned to religion as a source of support more than Black and White women. Conclusion: This study enhances current understanding of the experience and impact of breast cancer amongst Black and South Asian women, and demonstrates similarities and differences between the ethnic groups. The findings highlight implications for healthcare professionals, particularly in relation to providing culturally sensitive care and support to their patients. Copyright © 2016 John Wiley & Sons, Ltd.

© 2015 Elsevier Ltd Despite recent advances in developing evidence-based psychological interventions, substantial changes are needed in the current system of intervention delivery to impact mental health on a global scale (Kazdin & Blase, 2011). Prevention offers one avenue for reaching large populations because prevention interventions often are amenable to scaling-up strategies, such as task-shifting to lay providers, which further facilitate community stakeholder partnerships. This paper discusses the dissemination and implementation of the Body Project, an evidence-based body image prevention program, across 6 diverse stakeholder partnerships that span academic, non-profit and business sectors at national and international levels. The paper details key elements of the Body Project that facilitated partnership development, dissemination and implementation, including use of community-based participatory research methods and a blended train-the-trainer and task-shifting approach. We observed consistent themes across partnerships, including: sharing decision making with community partners, engaging of community leaders as gatekeepers, emphasizing strengths of community partners, working within the community's structure, optimizing non-traditional and/or private financial resources, placing value on cost-effectiveness and sustainability, marketing the program, and supporting flexibility and creativity in developing strategies for evolution within the community and in research. Ideally, lessons learned with the Body Project can be generalized to implementation of other body image and eating disorder prevention programs.

© 2016 Elsevier Ltd The study aimed to investigate whether a message informing readers about digital alteration read before exposure to thin ideal advertisements would enhance the effectiveness of disclaimer labels. Participants were 280 female undergraduate students who viewed eleven thin ideal fashion magazine advertisements. Half viewed the advertisements in their original format, and half viewed the same advertisements with a digital alteration disclaimer label. Prior to viewing the advertisements, participants read either a brief message informing them that advertisements are commonly digitally altered, or a control message. Irrespective of experimental condition, exposure to the thin ideal advertisements led to increased body dissatisfaction, with social comparison predicting this increase. Neither the disclaimer label nor the pre-exposure message, nor their combination, led to reductions in perceived realism, social comparison, or body dissatisfaction. However, trait appearance comparison moderated the effect of pre-exposure message on perceived realism, such that women high on trait appearance comparison in the digital alteration pre-exposure message condition rated the models as relatively more realistic than did women low on this trait. It was concluded that more research is needed to identify brief and easy-to-implement universal prevention strategies that can reduce the negative effects of thin ideal media imagery on women's body image.

© 2016 Informa UK Limited, trading as Taylor & Francis Group. Objective: A congenital craniofacial anomaly (CFA) is expected to impact upon several domains of psychological, emotional and social functioning, yet no recent reviews have comprehensively summarised the available literature. Further, existing reviews tend to draw upon literature in the field of cleft lip and palate, and do not give substantive attention to other types of CFAs. Design: A review of 41 papers published between January 2000 and March 2016 pertaining to psychological adjustment to CFAs. Main outcome measures: Findings are presented according to key psychological domains: General Psychological Well-being, Quality of Life, Behaviour, Emotional Well-being, Social Experiences, Appearance, and Treatment-Related Experiences. Results: Current literature offers a contradictory picture of adjustment to CFAs. Psychological adjustment appeared to be comparable to norms and reference groups in approximately half of the papers related to non-syndromic CFAs, while more variation was found across domains among samples with syndromic CFAs. Associations were found between adjustment, physical health and cognitive function in several papers. The review identified a number of gaps in the literature, such as the inclusion of a wide range of diagnoses within research samples. Conclusions: This review demonstrates the complexity of findings, both within and across domains, and highlights a number of methodological challenges.

© 2017 Acta Chirurgica Scandinavica Society. Background and aim: Parents of children with a cleft lip and palate may be emotionally affected by the child’s diagnosis. Their experiences and perceptions are important when evaluating the complexity of satisfactory treatment outcomes. The objective was to examine parents’ social and emotional experiences related to their child’s cleft diagnosis, and their perceptions of the child’s adjustment to living with a visible difference. Design: International multicentre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. Methods: A cohort of 448 children born with a non-syndromic UCLP were included. A total of 356 parents completed the Scandcleft Parent Questionnaire. Results: The majority of parents experienced practical and emotional support from family, friends, and health professionals. Nevertheless, parents had to cope with other people’s reactions to the cleft, experiences that were described as ranging from hurtful to neutral and/or positive. According to parents, 39% of the children had experienced cleft-related comments and/or teasing. More than half of the parents reported specific worries related to their child’s future. Conclusion: While the majority of the parents experienced positive support and coped well with the child’s diagnosis, some parents were at risk for psychological and emotional challenges that should be identified by the cleft team. To optimise outcomes and the child’s adjustment, these parents should be offered psychological support when necessary. Trial registration: ISRCTN29932826.

© 2017 Acta Chirurgica Scandinavica Society. Background and aim: Few studies have explored children’s emotional and behavioural reactions to cleft surgery and treatment-related stress. The objective was to investigate parents’ evaluations of appearance and treatment outcomes in their 5-year-old child with unilateral cleft lip and palate (UCLP), and their perceptions of how their child was coping with treatment, comparing this information with recorded postsurgical complications. Design: Three parallel group randomised clinical trials were undertaken as an international multicentre study by 10 cleft teams in five countries: Denmark, Finland, Sweden, Norway, and the UK. Methods: Three different surgical procedures for primary palatal repair were tested against a common procedure in the total cohort of 448 children born with a non-syndromic UCLP. A total of 356 parents completed the Scandcleft Parent Questionnaire, and 346 parents completed the Cleft Evaluation Profile. Results: The results indicated that the majority of parents were satisfied with cleft-related features of their child’s appearance. Further, most children coped well with treatment according to their parents. Nevertheless, 17.5% of the children showed minor or short-term reactions after treatment experiences, and 2% had major or lasting difficulties. There were no significant relationships between parent perceptions of treatment-related problems and the occurrence of post-surgical medical complications. Conclusions: Most parents reported satisfaction with their child’s appearance. However, treatment-related problems were described in some children, urging cleft centres to be aware of potential negative emotional and behavioural reactions to treatment in some young children, with a view to preventing the development of more severe treatment-related anxiety. Trial registration: ISRCTN29932826.

© 2016 British Association of Plastic, Reconstructive and Aesthetic Surgeons Background PEGASUS is an intervention to facilitate shared decision-making by helping prospective patients consider their expectations of surgery, so that surgeons have a clear understanding of their individual goals. To date, shared decision-making interventions within aesthetic surgery are lacking. The present mixed methods study therefore explored the acceptability of implementing PEGASUS into routine private practice with breast augmentation patients and aesthetic providers. Method Seventeen women presenting for breast augmentation surgery from three practices received the PEGASUS intervention pre-operatively and completed a process evaluation post-operatively. Semi-structured interviews exploring 3 aesthetic providers’ experiences of using PEGASUS were subjected to a thematic analysis, whilst a content analysis was conducted on the 77 goals identified by patients. Results The majority of patients reported that the PEGASUS intervention was relevant, helpful and useful, and they felt comfortable during it. Qualitatively, patients and aesthetic providers found that PEGASUS enabled them to reflect on and discuss about their expectations from surgery. Aesthetic providers discussed some of the issues and barriers associated with implementing PEGASUS in routine private practice, factors that must be considered prior to further evaluation. Conclusion This study provides preliminary support for the acceptability of PEGASUS to breast augmentation patients and to aesthetic providers working in the private sector.

© 2017 Taylor & Francis Group, LLC. An altered appearance can impact the psychosocial well-being of adolescent cancer patients, yet patient reports imply a dearth of appearance-related support. Using a two-phase qualitatively driven mixed method design, 62 health professionals from a range of UK oncology care settings provided data relating to their views on the impact of appearance changes on adolescent patients (aged 12–18 years), of delivering appearance-related care, and their training needs. Integrated findings were divided into two main outcomes. The first comprises health professionals' perceptions of the psychosocial and behavioral impacts of appearance-related distress in their patients and their experiences of interventions that prevent or ameliorate appearance concern. The second illustrates personal barriers (among health professionals, adolescents, and parents) and organizational barriers that inhibit the delivery of appearance-related support, together with suggestions about how these may be overcome. The needs of patients are extensive and varied, but due to the barriers identified can be poorly addressed. Nonetheless, some practitioners are utilizing a variety of interventions supported by theory and/or evidence of their success in other clinical areas. Recommendations are made for the content, design, and coordination of interventions for adolescents and for the content of education programs to meet the training needs identified by participants.

© 2016 Wiley Periodicals, Inc. Objective: The primary aim of the study was to examine the relationship across time between Facebook use and body image concern in adolescent girls. Method: A sample of 438 girls in the first two years (Years 8 and 9) of high school (aged 13-15 years) at Time 1 completed questionnaire measures of Facebook consumption and body image concerns, and again two years later (Time 2). Results: Facebook involvement increased substantially over the two year time period. Body image concerns also increased. Number of Facebook friends was found to prospectively predict the observed increase in drive for thinness. On the other hand, internalization and body surveillance prospectively predicted the observed increase in number of Facebook friends. Discussion: It was concluded that Facebook “friendships” represent a potent sociocultural force in the body image of adolescent girls. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2017; 50:80–83).

Background Despite the use of multidisciplinary services, little research has addressed issues involved in the care of those with cleft lip and/or palate across disciplines. The aim was to investigate associations between speech, language, reading, and reports of teasing, subjective satisfaction with speech, and psychological adjustment. Design Cross-sectional data collected during routine, multidisciplinary assessments in a centralized treatment setting, including speech and language therapists and clinical psychologists. Participants Children with cleft with palatal involvement aged 10 years from three birth cohorts (N = 170) and their parents. Outcome Measures Speech: SVANTE-N. Language: Language 6-16 (sentence recall, serial recall, vocabulary, and phonological awareness). Reading: Word Chain Test and Reading Comprehension Test. Psychological measures: Strengths and Difficulties Questionnaire and extracts from the Satisfaction With Appearance Scale and Child Experience Questionnaire. Results Reading skills were associated with self- and parent-reported psychological adjustment in the child. Subjective satisfaction with speech was associated with psychological adjustment, while not being consistently associated with speech therapists’ assessments. Parent-reported teasing was found to be associated with lower levels of reading skills. Having a medical and/or psychological condition in addition to the cleft was found to affect speech, language, and reading significantly. Conclusions Cleft teams need to be aware of speech, language, and/or reading problems as potential indicators of psychological risk in children with cleft. This study highlights the importance of multiple reports (self, parent, and specialist) and a multidisciplinary approach to cleft care and research.

©, © Taylor & Francis Group, LLC. This study explored how British gay men make sense of their appearance and clothing practices and the pressures and concerns they attend to in discursively negotiating their visual identities. A convenience sample of 20 mostly young, White, and middle-class self-identified gay men responded to a qualitative survey on dress and appearance. The participants clearly understood the rules of compulsory heterosexuality and the risks of looking “too gay.” In the data, there was both a strong resistance to the notion of gay as a “master status” and an orientation to the “coming out” imperative in gay communities. The analysis revealed the overriding importance of discourses of authentic individuality for making sense of visual identity and the reported cultivation of appearance and clothing practices that communicate the message that: “I’m not hiding (too closeted), I’m not shouting (too gay), I’m just me (an authentic individual who just happens to be gay).”.

Copyright © 2016 by the American Burn Association. Patient-reported outcome measures (PROMs) are vital for evaluating patient needs and therapeutic progress. This review aimed to identify the PROMs used in adult burn care and establish their quality. Computerized bibliographic searches of Psychinfo, Social Sciences Citation Index, Cinahl, Psycharticles, AMED, Medline, and HAPI were used to find English-language articles using English-language PROMs from January 2001 to September 2016. Psychometric quality assessment of the PROMs was conducted. A total of 117 studies achieved the entry criteria and reported using 77 different PROMs (71 generic and 6 burn-specific). Overall, the psychometric quality of the PROMs was low; only 17 (13 generic and 4 burn-specific) had psychometric evidence appropriate to adults with burn injuries completing an English language version of the PROM. Although this review identified a number of generic and burn-specific PROMs that have some psychometric evidence with adult burn patients, research is still needed to further examine these preexisting measures and validate them in different languages. This will enable researchers and clinicians to better understand the potential impact of a burn injury on adults, and evaluate the effectiveness of therapeutic interventions.

Many of the images used in traditional forms of mass media have been modified to portray unrealistic and idealised beauty characteristics. Further to this, members of the general public have now begun to digitally enhance their own pictures for social media posts, in order to fulfil these often unattainable standards. Ella Guest explores the impact exposure to idealised images of peers may have on health and wellbeing

BACKGROUND: Sibling relationships are among the most unique social connections, significantly affecting psychosocial adjustment. Previous reviews in the fields of chronic illness and disability have concluded that unaffected siblings of children with long-term conditions are at risk of poorer psychological functioning as a consequence. Much research has investigated the psychosocial impact of CL/P on affected individuals and their parents, yet comparatively little is known about the impact on other close family members. OBJECTIVE: To gain a better understanding of the experience of unaffected siblings of children born with CL/P, with a view to informing service provision and support. DESIGN: Individual qualitative interviews conducted over the telephone/Internet with five siblings and eight parents, including five sibling-parent pairs from the same family. RESULTS: Thematic analysis identified three key themes applicable across both parent and sibling interviews: perceptions of positive and negative impacts, factors affecting the degree of impact, and support for families. CONCLUSIONS: This study provides insight into a population that is often overlooked in the context of cleft care. The analysis identified a number of sibling support and information needs, along with suggestions of how to incorporate support for siblings in practice. The findings suggest that an inclusive approach to health care encompassing all members of the family is essential for optimal familial adjustment.

A number of feminist scholars have argued that dress and appearance can be used to critique the dominant culture and explore alternative subjectivities. Research on non-heterosexual visual identities has explored the role that appearance and clothing practices can play in the construction of individual identities and collective communities. However, bisexual women are largely invisible in these discussions. The minimal existing research suggests that bisexual women are unable to communicate their sexuality through their clothing and appearance. This study explored how bisexual women manage their bodies and appearance in relation to their bisexuality. Qualitative interviews were conducted with 20 self-identified bisexual women and the data were analysed using thematic analysis. The participants reported particular visual aesthetics associated with an embodied lesbian identity; however, they reported no visual image of bisexual women. Nonetheless, despite their lack of access to a distinct visual identity, the women negotiated ways in which to incorporate their bisexual identity into their dress and appearance, and considered their bisexuality an important aspect of their identity, which they would like to be recognised and acknowledged.

There is now a considerable body of research exploring how culturally dominant gendered norms are implicated in mobilising girls' and women's 'anorexic' and 'bulimic' experiences and practices. However, much less is known about lesbian experiences of 'eating disorders'. This article explores some of those specificities. Drawing on interviews with self-identified lesbian women with a history of 'anorexia' and/or 'bulimia', our analysis suggests that while many of the ways in which participants discursively constituted their 'eating disorders' were similar to those identified in research with girls and women assumed to be heterosexual, there were also important differences where participants' actual or emerging lesbian subjectivities were integral to their accounts of developing, living with and recovering from 'anorexia' and/or 'bulimia'. Our analysis suggests that the processes of coming to recognise oneself as a lesbian and of 'coming out' to others in predominantly hetero-normative contexts may be profoundly implicated in the discursive production of lesbian women's 'eating disorders' and that further research is required to better understand lesbian perspectives on 'eating disorders'. © 2013 Copyright Taylor and Francis Group, LLC.

This research aimed to explore (predominantly heterosexual) students' perceptions of sexuality and appearance. A short qualitative survey, which contained questions about the 'typical appearance' of lesbians, gay men, bisexual and heterosexual people, was completed by 36 university students. Previous research on dress and appearance in relation to sexuality has mainly focused on lesbian, gay or 'queer' individuals and communities. Minimal research has considered whether heterosexual people recognise non-heterosexuality through the dress and appearance of lesbians, gay men and bisexual people, and it would seem that previous studies have not explicitly considered the notion that heterosexuality might also be recognisable through appearance. Data were analysed using thematic analysis. Findings indicated that while students were able to provide appearance norms for lesbians and gay men (which conformed to those identified in previous research), they were also reluctant to give credence to (what they perceived as) 'stereotypes' of sexuality and appearance. They described heterosexual men and women in ways that conformed to 'traditional' gender norms, but were less able to identify any appearance norms for bisexual people, reflecting the invisibility of bisexuality within Western culture. © 2013 Copyright Taylor and Francis Group, LLC.

© 2016, National Society of Genetic Counselors, Inc. Neurofibromatosis type 1 (NF1) is a genetic condition which can result in varying degrees of visible difference (disfigurement). Adolescence is a time when appearance concerns become more salient for many young people and is acknowledged as a particularly challenging time for individuals with NF1. There is currently little research into the psychosocial impact of the appearance changes associated with NF1 during this stage of life. In order to address this, surveys of young people with NF1 aged 14–24years (n=73), and parents of young people with NF1 (n=55) were developed following interview studies with these groups. The surveys included the Perceived Stigma Questionnaire, Social Comfort Questionnaire, Body Esteem Scale (appearance subscale) and the Subjective Happiness Scale. Young people and parents identified appearance as central to young peoples’ experience of NF1, however no significant difference was found on measures of body esteem, happiness, stigma or social comfort between those young people who reported their NF1 was noticeable to others and those who reported it was not. Findings from the parent survey indicated that their reports of greater perceived noticeability did relate to greater perceived stigma and lower levels of social comfort. Findings highlight the importance of attending to young people’s concerns around appearance in general and managing the possibility of future appearance changes, rather than the current noticeability of NF1.

© 2016 Elsevier Ltd Despite widespread public concern about the early sexualization of young girls, as yet there has been little empirical examination of potential negative effects. In the present study a sample of 300 6–9 year-old girls completed individual interviews assessing exposure to sexualized media, internalization of sexualized messages (measured via preference for sexualized clothing), and body image attitudes (body esteem, body dissatisfaction). Exposure to sexualized media was found to be correlated with internalization of sexualization messages, itself correlated with negative body image. The findings provide preliminary evidence that sexualized messages appear to be internalized by very young girls which, in turn, has negative implications for how they feel about their bodies.

© 2016 American Psychological Association. Objective: Poor body image is a public health issue. Mothers are a key influence on adolescent girls' body image. This study evaluated an accessible, scalable, low-intensity internet-based intervention delivered to mothers (Dove Self Esteem Project Website for Parents) on mothers' and their adolescent daughters' body image and psychosocial well-being. Method: British mother-daughter dyads (N = 235) participated in a cluster randomized controlled trial (assessment-only control; mothers viewed the website without structured guidance [website-unstructured]; mothers viewed the website via a tailored pathway [website-tailored]). Dyads completed standardized self-report measures of body image, related risk factors, and psychosocial outcomes at baseline, 2 weeks post-exposure, 6-week, and 12-month follow-up. Results: Dyadic models showed that relative to the control, mothers who viewed the website reported significantly higher self-esteem at post-exposure (website-tailored), higher weight esteem at 6-week follow-up (website-tailored), lower negative affect at 12-month follow-up (website-tailored), engaged in more self-reported conversations with their daughters about body image at post-exposure and 6-week follow-up, and were 3-4.66 times more likely to report seeking additional support for body image issues at post-exposure (website-tailored), 6-week, and 12-month (website-tailored) follow-up. Daughters whose mothers viewed the website had higher self-esteem and reduced negative affect at 6-week follow-up. There were no differences on daughters' body image, and risk factors among mothers or daughters, at post-exposure or follow-up. Tailoring website content appeared beneficial. Conclusions: This intervention offers a promising 'first-step' toward improving psychosocial well-being among mothers and daughters. In order to further optimize the intervention, future research to improve body image-related outcomes and to understand mechanisms for change would be beneficial.

© 2016 Elsevier Ltd During adolescence, romantic relationships are a key developmental milestone. Coupled with the increasing salience of appearance and social acceptance, adolescents with an appearance-altering condition may feel particularly vulnerable when it comes to romantic relationships. This study aimed to explore the prevalence of romantic experiences among adolescents with a cleft lip and/or palate (CL/P), and to investigate how these experiences could be related to depressive symptoms and global self-worth. The study included 661 Norwegian adolescents with CL/P, who were compared to a large national sample. The prevalence of romantic relationships was lower among adolescents with CL/P compared to the reference group, although the overall impact on depressive symptoms and global self-worth appeared to be low. This study is one of few to explore the impact of a congenital visible condition on experiences of romantic relationships and provides preliminary insight into a significant, yet complex topic.

Objective. Women diagnosed with breast cancer or ductal carcinoma in situ (DCIS), and those with a genetic susceptibility to developing this disease, face the challenging decision of whether or not to undergo breast reconstruction following mastectomy. As part of a large randomized controlled trial, this qualitative study examined women‟s experiences of using the Breast RECONstruction Decision Aid (BRECONDA), and health professionals‟ feedback regarding the impact of this resource on patients‟ knowledge and decision-making about breast reconstruction. Method. Semi-structured interviews were conducted with women who accessed the BRECONDA intervention (N=36), and with their healthcare providers (N=6). All interviews were transcribed verbatim and subjected to thematic analysis by three independent coders. Results. Participants reported an overall positive impression, with all interviewees endorsing this decision aid as a useful resource for women considering reconstructive surgery. Thematic analysis of patient interviews revealed four themes: Overall impressions and aesthetics; Personal relevance and utility; Introducing BRECONDA; and, Advantages and suggested improvements. Analysis of health professionals‟ interviews also revealed four themes: Need for BRECONDA, Impact of BRECONDA, Potential difficulties that may arise in using the decision aid, and Recommending BRECONDA to patients. Patients indicated that they derived benefit from this resource at all stages of their decision-making process, with the greatest perceived benefit being for those early in their breast reconstruction journey. Conclusion. These findings support the use of BRECONDA as an adjunct to clinical consultation and other information sources. Women diagnosed with breast cancer or ductal carcinoma in situ (DCIS), and those with genetic susceptibility to developing this disease, often face challenging decisions regarding whether to undergo breast reconstruction following mastectomy. Decision-making is complicated by the myriad of reconstruction options available, each with unique benefits and costs (1-9). Women contemplating breast reconstruction at the same time as their mastectomy must often make their reconstruction decision within days of cancer diagnosis and during a time fraught with anxiety and decisional conflict (6, 10). To help counteract negative psychosocial outcomes, women need sufficient information to make an informed decision about breast reconstruction, as well as opportunities to fully process and consider all available options. We therefore developed an online, interactive decisional support tool, Breast RECONstruction Decision Aid (BRECONDA) to facilitate informed decision making regarding whether or not to have breast reconstruction (see breconda.bcna.org.au) BRECONDA (11) contains modules concerning reconstruction options and potential risks and benefits, incorporating values clarification exercises (12) enabling users to see how other women weighed up their options, and then undergo this process themselves. Stress-management guidance and videos of women describing their experiences of reconstruction decision-making are also included. Individual log-in passwords ensure privacy. Core screens provide basic reconstruction information, with This article is protected by copyright. All rights reserved. optional detailed material (e.g., photo galleries) allowing users to tailor their use of BRECONDA to match their information processing style (13, 14). See Table 1 for more details. Pilot testing indicated high user-acceptability and ease-of-use, enabling women to feel secure in their reconstruction decisions and well prepared for surgical consultations (11). Findings from a randomized controlled trial (RCT) demonstrated that women accessing BRECONDA were more satisfied with information and experienced less decisional conflict over a 6-month period, compared with women receiving standard breast reconstruction information (15). When evaluating patient resources it is important that along with patient reported outcomes (e.g., decisional conflict), all users‟ experiences of using the resource are documented. Accordingly, we conducted semi-structured interviews on women‟s experiences of BRECONDA, and health professionals‟ feedback regarding its impact on patient knowledge and assistance with breast reconstruction decision making. This article is protected by copyright. All rights reserved.

© 2016, Copyright © Taylor & Francis Group, LLC. ABSTRACT: Research suggests certain aspects of military life, especially operational deployments, may negatively impact military marriages. However, much of this research is from the United States and uses deductive quantitative methods. Qualitative research investigating the lived experiences of forming and maintaining marriages was conducted with six male U.K. Army personnel. Semistructured interviews were analyzed, using Interpretative Phenomenological Analysis, identifying five themes, each representing different dilemmas the soldiers’ had to balance to maintain successful marriages and Army careers. These five themes are best understood as practical, emotional, and cultural dilemmas that can be alleviated with practical and emotional methods; such factors could be used to build resilience in soldier’s marriages. These possible resilience factors could shape the content of interventions to increase resiliency in military marriages.

© 2016 Elsevier Ltd. There is widespread concern about young girls displaying 'grown up' or sexualized behaviours, as well as experiencing body image and appearance concerns that were previously thought to only impact much older girls. The present study examined the influence of three maternal attributes, self-objectification, materialism and parenting style, on sexualized behaviours and appearance concerns in young girls. A sample of 252 Australian mothers of 5-8 year old girls reported on the behaviours and appearance concerns observed in their daughters and also completed measures of their own self-objectification, materialism and parenting style. It was found that a significant proportion of young girls were engaging with 'teen' culture, using beauty products and expressing some degree of appearance concern. Maternal self-objectification was related to daughters' engagement in teen culture, use of beauty products and appearance concern. Maternal materialism was related to girls' engagement in teen culture and appearance concern, while an authoritative parenting style was negatively related to girls' use of beauty products. The findings suggest that maternal self-objectification and materialism play a role in the body image and appearance concerns of young girls, and in so doing, identify these maternal attributes as novel potential targets for intervention.

© 2016 Elsevier Ltd and ISBI. All rights reserved. This investigation surveyed burn health professionals in the UK and US to investigate the psychosocial issues facing burn survivors and the psychological services available to them through their burns service. Methods One hundred and sixty six burn care professionals (132 from the United States and 34 from the United Kingdom) from 76 different hospitals (60 in the US and 16 in the UK) completed an online survey. Mental health practitioners (MHPs) answered questions regarding their psychotherapy practice with burn survivors. Results Respondents reported that psychosocial issues are common among burn survivors. Burn teams in the UK were more likely than those in the US to include psychologists, but social workers were more common in the US. Participants reported that routine screening for psychosocial issues was more common in the UK than the US, and indicated it was easier for burn survivors to access mental health care after discharge in the UK. Burn services in both countries routinely referred burn survivors to support organizations such as the Phoenix Society or Changing Faces. The preferred mental health treatment modality in the UK was psychotherapy without medications. Reported psychotropic medications use was more common in the US. MHPs had two primary orientations - eclectic and cognitive behavioral therapy. Among MHPs there was a modest tendency to favor evidence-based interventions. Discussion The provision of mental health services varies between these two countries. Creating international standards for assessing and treating psychosocial complications of burns could facilitate the improvement of burn mental health services.

© 2016 Elsevier Ltd. The current study aimed to investigate the effect of digital alteration disclaimer labels appended to fashion magazine advertisements, as well as instructional condition, on women's social comparison and body dissatisfaction. Participants were 378 female undergraduate students who viewed 11 thin ideal advertisements with either no disclaimer, a generic disclaimer, or a more detailed specific disclaimer. There were three instructional conditions: neutral, distractor, and social comparison. Disclaimer labels did not affect appearance comparison or body dissatisfaction, but instructional condition did, with the social comparison instructions producing the highest appearance comparison and body dissatisfaction. In addition, there was a three-way interaction with trait appearance comparison, such that women high on trait appearance comparison who saw specifically worded disclaimers in the distractor instructional condition experienced increased body dissatisfaction, whereas women low on this trait experienced decreased body dissatisfaction. It seems that both instructions and individual differences may influence responses to disclaimer labels.

Breast cancer in men is rare. Diagnostic methods and treatment are the same as for women, but awareness of male breast cancer is low, as breast cancer is often perceived as a disease specific to women. This can delay diagnosis and cause psychological distress by threatening men’s gendered sense of identity. In this article, Helena Lewis-Smith reviews research exploring the psychosocial impact of breast cancer for men.

© Copyright 2016 American Cleft Palate-Craniofacial Association. Background: Cleft lip and/or palate (CL/P) is one of the most common birth conditions in the world, but little is known about its causes. Professional opinion remains divided as to which treatments may be the most beneficial for patients with CL/P, and the factors that contribute to psychological adjustment are poorly understood. The use of different methodological approaches and tools plays a key role in hampering efforts to address discrepancies within the evidence base. A new UK-wide program of research, The Cleft Collective, was established to combat many of these methodological challenges and to address some of the key research questions important to all CL/P stakeholders. Objective: To describe the establishment of CL/P cohort studies in the United Kingdom and to consider the many opportunities this resource will generate. Results: To date, protocols have been developed and implemented within most UK cleft teams. Biological samples, environmental information, and data pertaining to parental psychological well-being and child development are being collected successfully. Recruitment is currently on track to meet the ambitious target of approximately 9800 individuals from just more than 3000 families. Conclusions: The Cleft Collective cohort studies represent a significant step forward for research in the field of CL/P. The data collected will form a comprehensive resource of information about individuals with CL/P and their families. This resource will provide the basis for many future projects and collaborations, both in the United Kingdom and around the world.

© 2016 Elsevier Ltd. Previous research in both the general population and in those with a visible facial difference has identified potential associations between teasing, dissatisfaction with appearance and emotional distress. However, most studies are based on cross-sectional and retrospective methodology, restricting the interpretation of findings. The present study explored the longitudinal impact of perceived teasing on satisfaction with appearance and depressive symptoms in young people with and without a visible congenital condition. Routine psychological assessments were conducted at ages 10 and 16 years (N = 340). Experiences of teasing after the age of 10 significantly impacted on appearance evaluations and depressive symptoms in adolescent females. The impact of teasing on adolescent males was possibly counteracted by reports of more positive social experiences. Early identification of perceived teasing in all children to prevent the development of emotional problems and dissatisfaction with appearance is of vital importance.

© 2016 Elsevier Ltd Barbie doll ownership is high among girls in early primary school. It has been suggested that exposure to Barbie impacts negatively on body image. The present study sought to investigate the effect of exposure to Barbie on young girls’ thin-ideal internalisation, body esteem, and body dissatisfaction. Participants were 160 girls (aged 5–8 years) from Adelaide, South Australia. They were randomly allocated one of three Barbie conditions (physical engagement, physical observation, print observation) or to a control toy. Results indicated that exposure to Barbie, irrespective of format, led to higher thin-ideal internalisation than exposure to the control, but had no impact on body esteem or body dissatisfaction. This suggests that interacting with Barbie may encourage girls in early primary school to adopt a preference for a thin body, but with no immediate effect on body image. The long-term impact of Barbie exposure on body image remains unknown.

© 2016 Informa UK Limited, trading as Taylor & Francis Group. Objective: Adjustment to cleft lip and/or palate (CL/P) is multifaceted, involving several domains of psychological and social functioning. A substantial increase in research in this area has been evident in recent years, along with a preliminary shift in how adjustment to CL/P is conceptualised and measured. An updated and comprehensive review of the literature is needed in light of the rapidly expanding and changing field. Design: A narrative review of 148 quantitative and qualitative studies published between January 2004 and July 2015. Main outcome measures: Findings are presented according to five key domains of adjustment: Developmental Trajectory, Behaviour, Emotional Well-being, Social Experiences and Satisfaction with Appearance and Treatment. Data pertaining to General Psychological Well-being were also examined. Results: The overall impact of CL/P on psychological adjustment appears to be low. Nonetheless, the review demonstrates the complexity of findings both within and across domains, and highlights recurring methodological challenges. Conclusions: Research findings from the last decade are considered to be largely inconclusive, although some areas of emerging consensus and improvements in the approaches used were identified. Efforts to collect data from large, representative and longitudinal samples, which are comparable across studies and encompassing of the patient perspective, should be doubled.

AimThe aim of this study was to understand the possible influence of personality traits on the importance and significance of perception of body image and self-awareness of appearance in individuals.Method214 online recruited subjects between the ages of 17 and 64 years answered to a socio-demographic questionnaire, the Portuguese version of the instruments NEO-FFI (NEO-Five Factor Inventory), ASI-R (The Appearance Schemas Inventory – Revised) and DAS-24 (Derriford Appearance Scale – short).ResultsIt was found that age, Neuroticism and Agreeableness dimensions significantly influence an individual's investment in body image and self-awareness of appearance. Sexual orientations differed with regard to Self-Evaluative Salience and Self-Consciousness of Appearance.ConclusionThe performed analysis showed that neuroticism and agreeableness are related to Self-Evaluative Salience and Self-Consciousness of Appearance.

In our beauty-obsessed world, where incessant dissatisfaction with appearance is considered to be ‘normal’, it can seem as though those with ‘good looks’ are the ones who have it all. But is it the case that being beautiful can get you further in life? Nicola Stock explores the human fascination with keeping up appearances and highlights the impact of attempting to meet modern unrealistic ideals of beauty

Accidents are inevitable but burn injuries can be traumatic and distressing for the affected individual and their family, with a prolonged period of recovery. In this short review, emotional difficulties in parents (particularly depression) as both an antecedent and a consequence of burn injuries to children will be discussed, as well as intervention considerations to help families to cope with such distress.

This article reports a feminist analysis of interview data with 10 British women, in which they discuss sex and affection in their heterosexual relationships. We explore the popular cultural notion that women lack sexual desire and are more concerned with love and affection. Feminist research has highlighted how in mainstream cultural discourses, men's sexuality has been positioned as superior to women's. Women's (lack of) desire is viewed as problematic and men's (active) 'need' for sex contrasts sharply with the construction of women as (passive) recipients of men's desire. The women in this research reported a lack of sexual desire, but positioned themselves as wanting to want sex, or 'desiring desire'. They expected penis-in-vagina intercourse to be an inherent part of (hetero)sex, and some participated in unwanted (consensual) sex in order to satisfy what they perceived as men's inherent 'need' for sex. We conclude by discussing the implications of our findings for feminist research and practice. © 2012 Elsevier Ltd.

© 2015, Singh and Moss; licensee Springer. Background: Patients with craniofacial anomalies often have appearance concerns and related social anxiety which can affect their quality of life. This study assessed the psychological impact of facial and dental appearance in patients with craniofacial anomalies in comparison to a general population control group. Methods: The study involved 102 adult patients (51% male) with congenital craniofacial anomalies and 102 controls (49% male). Both groups completed the Nepali version of Derriford Appearance Scale (DAS) and the Psychological Impact of Dental Aesthetic Questionnaire (PIDAQ) in a clinical setting to assess appearance-related distress, avoidance, and anxiety. Results: There was a significant difference between patients and controls on both PIDAQ (mean score for patients 33.25 ± 9.45 while for controls 27.52 ± 5.67, p < 0.001) and DAS59 scores (mean score for patients 159.16 ± 31.54 while for controls 77.64 ± 6.57, p < 0.001), indicating that patients experienced greater negative psychological impact of living with their appearance (PIDAQ) and more appearance-related distress (DAS) than controls. DAS scores were not associated with gender. There was no association of the place of residence (rural vs. urban) with PIDAQ or DAS59 scores. Conclusions: There is a significant psychological impact of altered facial and dental appearance in patients with craniofacial anomalies compared to controls. There was no effect of locality (rural/urban) on the psychological impact of facial and dental appearance in patients.

OBJECTIVES: We summarize and critique the methodology and outcomes from a substantial study which has investigated the impact of reconfigured cleft care in the United Kingdom (UK) 15 years after the UK government started to implement the centralization of cleft care in response to an earlier survey in 1998, the Clinical Standards Advisory Group (CSAG).SETTING AND SAMPLE POPULATION: A UK multicentre cross-sectional study of 5-year-olds born with non-syndromic unilateral cleft lip and palate. Data were collected from children born in the UK with a unilateral cleft lip and palate between 1 April 2005 and 31 March 2007.MATERIALS AND METHODS: We discuss and contextualize the outcomes from speech recordings, hearing, photographs, models, oral health and psychosocial factors in the current study. We refer to the earlier survey and other relevant studies.RESULTS: We present arguments for centralization of cleft care in healthcare systems, and we evidence this with improvements seen over a period of 15 years in the UK. We also make recommendations on how future audit and research may configure.CONCLUSIONS: Outcomes for children with a unilateral cleft lip and palate have improved after the introduction of a centralized multidisciplinary service, and other countries may benefit from this model. Predictors of early outcomes are still needed, and repeated cross-sectional studies, larger longitudinal studies and adequately powered trials are required to create a research-led evidence-based (centralized) service.

Every year, in the United Kingdom (UK), around 1:700 infants are born with a cleft lip and/or palate [CLP] 1,2. This condition is associated with adverse physical outcomes for the child such as poor facial growth and dental anomalies 3,4 and communication issues such as speech disorders and poor hearing 5–7. It is well known that, from childhood onwards, attributions about an individual’s character, personality, academic performance and social relationships are based, at least in part, on his or her appearance and perceived attractiveness 8,9. For children born with CLP, there is evidence that impaired facial growth and dental anomalies are associated with adverse psychosocial outcomes 1,10 including low self-confidence 11, an increased risk of being teased and bullied 12 and problematic social relationships 13,14. Treatment for CLP is undertaken with the aim of achieving the best aesthetic result and optimizing function in terms of hearing, feeding and speech 1, but it does require multiple surgical and dental interventions across infancy, childhood and adulthood. In 1998, a study commissioned by the Clinical Standards Advisory Group (CSAG) examined the process of care, treatment and outcomes for children born with CLP. This research comprised surveys of parents of 5- and 12-year-old children who had received treatment for a unilateral cleft lip and palate (UCLP). Parental perceptions of key psychosocial outcomes were assessed using a self-report questionnaire developed by the Royal College of Surgeons of England Steering Group [RCS] 8. Questionnaire items asked about parental perceptions of the child’s self-confidence, their satisfaction with the child’s facial appearance (teeth, lips, nose, profile, hearing and speech) and also with the level of care provided by the cleft service. Nineteen per cent of parents believed that the cleft had a negative impact on their 5-year-old child’s self-confidence, but the vast majority (93%) also reported that the care and attention they had received within the cleft service and associated treatment and outcomes were either good or excellent 1. The 1998 CSAG report also presented findings from a survey undertaken by the Cleft Lip and Palate Association (CLAPA) in 1996 1. Data were collected from 102 parents of children aged 4 years and under about their satisfaction with the service and treatment provided. Most parents were satisfied with the service they and their child received, but there were concerns around a lack of communication with service providers and also provision of information about cleft lip and palate and its associated treatment. Having taken into account the findings from the cross-sectional survey of children with cleft lip and palate and the CLAPA survey of parental opinion, the key recommendation from the 1998 CSAG study was one of service centralization. Government was advised to reduce the 57 cleft services in the UK to between 8 and 15 centres in order to ensure high-quality clinical experience and a full range of readily available clinical services, including psychological support. Since 1998, this process of centralization has been ongoing and by 2011, eleven centres or managed clinical networks were providing cleft care for all children born with a cleft lip/palate in the UK 9. There were two main aims to this Cleft Care UK (CCUK) study. The first was to examine the impact of centralization on parental reports of child self-confidence at 5 years of age and parental satisfaction with 1) the child’s facial appearance and 2) the provision of cleft services. This was performed by comparing these psychosocial outcomes from the 1998 study with findings from the current study. The second aim was to report parental perceptions on a broader range of measures not previously assessed in the 1998 CSAG study of 5-year-old children. These included parental perceptions of whether their child was experiencing teasing and/or bullying, whether parents felt they or their child would benefit from counselling services (someone to talk to about the cleft), additional difficulties in parents’ lives associated with the cleft and parental perceptions of their relationship with the cleft team.

Having previously discussed the possibility that appearance-altering conditions may impact on the intimate and sexual lives of some patients, Nick Sharratt, PhD researcher at the Centre for Appearance Research, looks more closely at the Ex-PLISSIT model of interaction which may be deployed in discussing this potentially sensitive topic. He also explores the impact of visible differences on intimacy

Over the past few years, an increasing number of men have received surgery to enhance or restore facial hair. This came at a time when beards re-entered mainstream fashion. Drawing on the research literature, this article explores the apparent link between facial hair fashion and rates of beard transplants, and considers deeper-seated psychological explanations for the trend, including perceptions of masculinity, social dominance, age and attractiveness. The question of whether beard transplants will continue to proliferate is also explored.

Long are the days when the success of an operation was determined by the surgeon alone. Surgical teams are increasingly eliciting the opinions of patients themselves to ascertain surgery success, argues Catrin Griffiths. It is vital for clinicians to identify patient expectations and help patients to develop realistic surgical expectations, as meeting these are key to satisfaction.

This paper presents a feminist Foucauldian analysis of women's interpretations of images of women in post-feminist advertising. Building on Ros Gill's analysis of post-feminist advertising images of women, and more specifically the figure of 'the midriff', the paper presents an analysis of focus group discussions with seven young women who were asked to discuss 'midriff' advertising images. Whilst participants sometimes construed these images positively as 'sexy' and independent, midriff figures were more frequently constituted negatively as 'bimbos' and/or 'slutty' 'sex objects' whose seeming independence was achieved through or limited only to attracting men. In interpreting midriff figures negatively, participants, we suggest, constituted the midriff as other; as different and distant from themselves and 'normal' women. Where occasionally participants interpreted images more favourably, the midriff figure was, in contrast, constituted as 'normal' and 'natural' and as being about 'what she likes, not what he likes'. Participants did not identify themselves or their arguments as feminist. Nevertheless, they articulated critiques of these images which often converged significantly with critical feminist analyses. Our analysis suggests, therefore, that young women read these images in complex ways. These complexities of interpretation, we argue, should be central in understanding the relationships between women, bodies and post-feminist images of women's bodies. © The Author(s) 2011.

The present study examined associations between high levels of appearance concern and information processing biases in interpretation and attention. An opportunity sample (N = 79) categorised ambiguous stimuli as related or unrelated to appearance. Participants then responded to the same stimuli in a modified visual dot-probe task assessing attentional bias. Participant responses were assessed in relation to level of appearance concern. The results indicated a valence specific bias towards interpretation of ambiguous stimuli as negative and appearance-related in individuals with higher levels of concern. There was also evidence of attentional bias towards information perceived as appearance-related in participants with higher levels of appearance concern. The study findings suggest that association between appearance-orientated information processing biases and level of appearance concern; this association may lead to mutually reinforcing bias and concern. © 2010 Elsevier Ltd. All rights reserved.