A Theoretical Model for the Qualitative Analysis of Disfigurement Adjustment

Sheryl MacMath, M.A. and Jillian Roberts, Ph.D.

Acknowledgements

The authors gratefully acknowledge funding provided by the Canadian Institute of Health Research.

Abstract

Disfigurement adjustment refers to how individuals regulate their cognitions, emotions, and behaviors in response to having a body disfigurement. The types of adjustments made and the affect of these adjustments on quality of life vary across individuals. While researchers have attempted to understand the intricacies of disfigurement adjustment, most have done so without the guidance of a theoretical model. As a result, it is difficult to compare findings and build upon previous research in a meaningful or informative manner. One such exception has been the work of Gerry Kent (2000, 2002). Using a theoretical model looking at triggering events, cognitive biases, and impression management behaviors, Kent explored the disfigurement adjustments of individuals with cosmetic blemishes (eg. vitiligo). Noting similarities between the subjective experiences reported by Kent and the experiences reported by adolescents with pectus excavatum, a congenital disfigurement resulting in chest concavity, we have expanded Kent’s model to include the mediating effects of body image disturbances and social skills, as well as the perceived affect on quality of life. By detailing results from a phenomenological inquiry into adolescent perceptions of their pectus excavatum and the effects of choosing to undergo corrective surgery (Nuss procedure), we explore implications for a theoretical model for the analysis of disfigurement adjustment.