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Contingencies of Self-Worth and Psychological Distress in Iranian Patients Seeking Cosmetic Surgery: Integrative Self-Knowledge as Mediator

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Abstract

Background

Although previous studies have shown that people applying for cosmetic surgery experience high-intensity psychological distress, important variables that function as protective factors have rarely been the subject of study in this population. Therefore, this study aims to investigate the role of low and high self-knowledge in experiencing psychological distress and contingencies of self-worth to appearance and approval from others and to identify the mediatory role of the integrative self-knowledge in patients seeking cosmetic surgery.

Methods

Eighty-eight patients seeking cosmetic surgery were selected and completed the contingencies of self-worth and integrative self-knowledge scales, as well as the depression, anxiety and stress scale. Data were analyzed using multivariate analysis of variance (MANOVA) and path analysis using 5000 bootstrap resampling.

Results

The results of MANOVA showed that patients seeking cosmetic surgery with high self-knowledge had lower levels of depression, anxiety and stress compared to patients with low self-knowledge. They also gained lower scores in contingencies of self-worth to appearance and approval from others. The results of path analysis indicated that self-knowledge is a complete mediator in the relationship between contingencies of self-worth to appearance and approval from others and psychological distress.

Conclusion

Based on the results of this study, it can be concluded that self-knowledge as a protective factor plays a major role in relation to the psychological distress experienced by the patients seeking cosmetic surgery. In fact, by increasing self-knowledge among this group of patients, their psychological distress can be decreased.

Level of Evidence IV

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

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References

  1. International Society of Aesthetic Plastic Surgery (2015) Quick facts: highlights of the ISAPS 2015 statistics on cosmetic surgery. www.isaps.org/news/isaps-global-statistics. Accessed 27 Jan 2017

  2. American Society of Plastic Surgeons (2015) 2015 Plastic surgery statistics. www.plasticsurgery.org/news/plastic-surgery-statistics. Accessed 27 Jan 2017

  3. Molina AR, Baker RH, Nduka C (2012) ‘What women want’—the UK’s largest cosmetic surgery survey. Eur J Plast Surg 35:607–612

    Article  Google Scholar 

  4. Mojallal M, Khosrojavid M, Pakzad F, Ghanbari M (2014) Early maladaptive schemas, body image, and self-esteem in iranian patients undergone cosmetic surgery compared with normal individuals. PCP 2:201–210

    Google Scholar 

  5. Mousavizadeh SM, Shahraki FN, Hormozi AK, Fadaei Naeini AR, Lari MN (2010) Assessing tendencies and motivations of female volunteers for cosmetic surgery. Pejouhandeh 14:318–323

    Google Scholar 

  6. Collins B, Gonzalez D, Gaudilliere DK, Shrestha P, Girod S (2014) Body dysmorphic disorder and psychological distress in orthognathic surgery patients. J Oral Maxillofac Surg 72:1553–1558

    Article  PubMed  Google Scholar 

  7. Khanjani Z, Papapour J, Saba G (2012) Comparison of psychopathology in people seeking cosmetic surgery with controls. Pajoohandeh J 17:26–31

    Google Scholar 

  8. Meningaud JP, Benadiba L, Servant JM, Herve Ch, Bertrand JC, Pelicier Y (2001) Depression, anxiety and quality of life among scheduled cosmetic surgery patients: multicentre prospective study. J Craniomaxillofac Surg 29:177–180

    Article  CAS  PubMed  Google Scholar 

  9. Edgerton MT, Jacobson WE, Meyer E (1960) Surgical-psychiatric study of patients seeking plastic (cosmetic) surgery: ninety-eight consecutive patients with minimal deformity. BJPS 13:136–145

    CAS  PubMed  Google Scholar 

  10. Callaghan GM, Lopez A, Wong L, Northcross J, Anderson KR (2011) Predicting consideration of cosmetic surgery in a college population: a continuum of body image disturbance and the importance of coping strategies. Body Image 8:267–274

    Article  PubMed  Google Scholar 

  11. Di Mattei VE, Bagliacca EP, Lavezzari L, Di Pierro R, Carnelli L, Zucchi P, Baruffaldi Preis F, Sarno L (2015) Body image and personality in aesthetic plastic surgery: a case-control study. OJMP 4:35–44

    Article  Google Scholar 

  12. Napoleon A (1993) The presentation of personalities in plastic surgery. Ann Plast Surg 31:193–208

    Article  CAS  PubMed  Google Scholar 

  13. Sohrabi F, Aliloo MM, Azad MR (2011) Assessment of psychopathological profile in applicants for cosmetic surgery. J Fundam Ment Health 13:260–269

    Google Scholar 

  14. Mulkens S, Bos AE, Uleman R, Muris P, Mayer B, Velthuis P (2012) Psychopathology symptoms in a sample of female cosmetic surgery patients. J Plast Reconstr Aesthet Surg 65:321–327

    Article  PubMed  Google Scholar 

  15. Lipworth L, McLaughlin JK (2010) Excess suicide risk and other external causes of death among women with cosmetic breast implants: a neglected research priority. Curr Psychiatry Rep 12:234–238

    Article  PubMed  Google Scholar 

  16. Sarwer DB, Wadden TA, Pertschuk MJ, Whitaker LA (1998) The psychology of cosmetic surgery: a review and reconceptualization. Clin Psychol Rev 18:1–22

    Article  CAS  PubMed  Google Scholar 

  17. Cook SA, Rosser R, Toone H, James MI, Salmon P (2006) The psychological and social characteristics of patients referred for NHS cosmetic surgery: quantifying clinical need. J Plast Reconstr Aesthet Surg 59:54–64

    Article  PubMed  Google Scholar 

  18. Ferraro GA, Rossano F, D’Andrea F (2005) Self-perception and self-esteem of patients seeking cosmetic surgery. Aesthet Plast Surg 29(3):184–189

    Article  CAS  Google Scholar 

  19. Park LE, Calogero RM, Harwin MJ, DiRaddo AM (2009) Predicting interest in cosmetic surgery: interactive effects of appearance-based rejection sensitivity and negative appearance comments. Body Image 6:186–193

    Article  PubMed  Google Scholar 

  20. Delinsky SS (2005) Cosmetic surgery: a common and accepted form of self-improvement? J Appl Soc Psychol 35:2012–2028

    Article  Google Scholar 

  21. Crocker J (2002) Contingencies of self-worth: implications for self-regulation and psychological vulnerability. Self Identity 1:143–149

    Article  Google Scholar 

  22. Crocker J, Luhtanen RK, Cooper ML, Bouvrette A (2003) Contingencies of self-worth in college students: theory and measurement. J Pers Soc Psychol 85:894–908

    Article  PubMed  Google Scholar 

  23. Crocker J, Brook AT, Niiya Y, Villacorta M (2006) The pursuit of self-esteem: contingencies of self-worth and self-regulation. J Pers 74:1749–1772

    Article  PubMed  Google Scholar 

  24. Burwell RA, Shirk SR (2006) Self processes in adolescent depression: the role of self-worth contingencies. J Res Adolesc 16:479–490

    Article  Google Scholar 

  25. Ghoul A, Niwa EY, Boxer P (2013) The role of contingent self-worth in the relation between victimization and internalizing problems in adolescents. J Adolesc 36:457–464

    Article  PubMed  Google Scholar 

  26. Sargent JT, Crocker J, Luhtanen RK (2006) Contingencies of self-worth and depressive symptoms in college students. J Soc Clin Psychol 25:628–646

    Article  Google Scholar 

  27. Sturman ED, Flett GL, Hewitt PL, Rudolph SG (2009) Dimensions of perfectionism and self-worth contingencies in depression. J Ration Emot Cogn Behav Ther 27:213–231

    Article  Google Scholar 

  28. Çetin B, Akın A, Eroğlu Y (2011) The validity and reliability of contingencies of self-worth scale. J Hum Sci 8:410–426

    Google Scholar 

  29. Maricutoiu LP, Macsinga I, Silvia RUSU, Vîrgă D, Florin A (2012) Adaptation and validation of the contingencies of self-worth scale on a Romanian student sample. Cogn Brain Behav 16:121–138

    Google Scholar 

  30. Luhtanen RK, Crocker J (2005) Alcohol use in college students: effects of level of self-esteem, narcissism, and contingencies of self-worth. Psychol Addict Behav 19:99–103

    Article  PubMed  Google Scholar 

  31. Sanchez DT, Crocker J (2005) How investment in gender ideals affects well-being: the role of external contingencies of self-worth. Psychol Women Q 29:63–77

    Article  Google Scholar 

  32. Hill AP, Hall HK, Appleton PR (2011) The relationship between multidimensional perfectionism and contingencies of self-worth. Pers Individ Dif 50:238–242

    Article  Google Scholar 

  33. Park LE, Crocker J, Mickelson KD (2004) Attachment styles and contingencies of self-worth. Pers Soc Psychol Bull 30:1243–1254

    Article  PubMed  Google Scholar 

  34. Noser A, Zeigler-Hill V (2014) Investing in the ideal: does objectified body consciousness mediate the association between appearance contingent self-worth and appearance self-esteem in women? Body Image 11:119–125

    Article  PubMed  Google Scholar 

  35. Sanchez DT, Kwang T (2007) When the relationship becomes her: revisiting women’s body concerns from a relationship contingency perspective. Psychol Women Q 31:401–414

    Article  Google Scholar 

  36. Tahbaz Hoseinzadeh S, Ghorbani N, Nabavi SM (2011) Comparison of self-destructive tendencies and integrative self-knowledge among multiple sclerosis and healthy people. Contemp Psychol 6:35–44

    Google Scholar 

  37. Ghorbani N, Watson PJ, Hargis MB (2008) Integrative self-knowledge scale: correlations and incremental validity of a cross-cultural measure developed in Iran and the United States. J Psychol 142:395–412

    Article  PubMed  Google Scholar 

  38. Brown KW, Ryan RM (2003) The benefits of being present: mindfulness and its role in psychological well-being. J Pers Soc Psychol 84:822–848

    Article  PubMed  Google Scholar 

  39. Ghorbani N, Watson PJ, Farhadi M, Chen Z (2014) A multi-process model of self-regulation: influences of mindfulness, integrative self-knowledge and self-control in Iran. Int J Psychol 49:115–122

    Article  PubMed  Google Scholar 

  40. Ghorbani N, Watson PJ, Bing MN, Davison HK, LeBreton D (2003) Two facets of self-knowledge: cross-cultural development of measures in Iran and the United States. Genet Soc Gen Psychol Monogr 129:238–268

    PubMed  Google Scholar 

  41. Behjati Z, Saeedi Z, Noorbala F, Enjedani E, Meybodi FA (2011) Integrative self-knowledge and mental health. Procedia Soc Behav Sci 30:705–708

    Article  Google Scholar 

  42. Ghorbani N, Watson PJ, Hamzavy F, Weathington BL (2010) Self-knowledge and narcissism in Iranians: relationships with empathy and self-esteem. Curr Psychol 29:135–143

    Article  Google Scholar 

  43. Ghorbani N, Watson PJ, Rezazadeh Z, Cunningham CJ (2011) Dialogical validity of religious measures in Iran: relationships with integrative self-knowledge and self-control of the “Perfect Man”(Ensān-e Kāmel). Arch Psychol Relig 33:93–113

    Article  Google Scholar 

  44. Ghorbani N, Watson PJ, Chen Z, Norballa F (2012) Self-compassion in Iranian Muslims: relationships with integrative self-knowledge, mental health, and religious orientation. Int J Psychol Relig 22:106–118

    Article  Google Scholar 

  45. Mousavi A, Ghorbani N (2006) Self-criticism, self-knowledge and mental health. J Psychol Stud 2:75–93

    Google Scholar 

  46. SabzehAra Langroudi M, Sarafraz MR, Ghorbani N (2014) The study of psychometric properties of contingencies of self-worth scale. Q J New Thoughts Educ 10:119–140

    Google Scholar 

  47. Lovibond SH, Lovibond PF (1995) Manual for the depression anxiety stress scale. Psychology Foundation of Australia Inc, Sydney

    Google Scholar 

  48. Sahebi A, Asghari MJ, Salari RS (2005) Validation of depression anxiety and stress scale (DASS-21) for an Iranian population. Iran Psychol 4:299–313

    Google Scholar 

  49. Preacher KJ, Hayes AF (2008) Asymptotic and resampling strategies for assessing and comparing indirect effects in multiple mediator models. Behav Res Methods 40:879–891

    Article  PubMed  Google Scholar 

  50. Byrne BM (1989) A primer of LISREL: basic applications and programming for confirmatory factor analytic models. Springer, New York

    Book  Google Scholar 

  51. Bentler PM (1990) Comparative fit indexes in structural models. Psychol Bull 107:238

    Article  CAS  PubMed  Google Scholar 

  52. Hu L, Bentler PM (1995) Evaluating model fit. In: Hoyle RH (ed) Structural equation modeling, concepts, issues, and applications. Sage, Thousand Oaks, pp 76–99

    Google Scholar 

  53. Browne MW, Cudeck R (1993) Alternative ways of assessing model fit. In: Bollen KA, Long JS (eds) Testing structural equation models. Sage, Newbury Park

    Google Scholar 

  54. Ghorbani N, Watson PJ (2005) Self-knowledge processes and rational and experiential information processing systems in Iran and the United States. Dev Psychol 5:3–14

    Google Scholar 

  55. Asghari MS, Besharat MA (2011) The relation of perceived parenting with integrative self-knowledge. Procedia Soc Behav Sci 30:226–230

    Article  Google Scholar 

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Acknowledgements

The authors would like to thank all patients who participated in this research.

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The authors received no financial support for the research.

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Authors and Affiliations

  1. Department of Clinical Psychology, College of Education and Psychology, Shiraz University, Shiraz, Iran

    Ahmad Valikhani & Mohammad Ali Goodarzi

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  1. Ahmad Valikhani
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  2. Mohammad Ali Goodarzi
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Correspondence to Mohammad Ali Goodarzi.

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Valikhani, A., Goodarzi, M.A. Contingencies of Self-Worth and Psychological Distress in Iranian Patients Seeking Cosmetic Surgery: Integrative Self-Knowledge as Mediator. Aesth Plast Surg 41, 955–963 (2017). https://doi.org/10.1007/s00266-017-0853-8

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  • DOI: https://doi.org/10.1007/s00266-017-0853-8

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