Burden, Nic and Simpson, Jane (2016) Body image and self-disgust as self-appraisals influencing adjustment to limb amputation. PhD thesis, Lancaster University.
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Abstract
This thesis explored the roles of body image and self-disgust, as self-appraisals, in their relationship to psychosocial adjustment and related factors in people with limb amputations. The thesis includes a systematic literature review of body image relating to psychosocial adjustment and a research paper examining the relationship of self-disgust to psychosocial adjustment following limb amputation. A critical appraisal of the research process and an ethics section are also included. Section one presents a quantitative systematic literature review of sixteen studies examining body image perception as a correlate or predictor of demographic, clinical and psychosocial factors related to adjustment following limb amputation. Body image concerns were found to be associated with poorer outcomes on several psychosocial factors, such as depression, anxiety, activity restriction and self-esteem, as well as prosthesis satisfaction. Findings are discussed in regard to theories of body image. Body image is proposed as an important consideration for clinical and prosthetic services, in working with people with limb amputations. In section two, an empirical study of quantitative, cross sectional methodology is presented, in which correlational and hierarchical regression analysis are used to examine the relationship of self-disgust to psychosocial adjustment and related factors; prosthesis use, prosthesis satisfaction, and body image. Self-disgust was found to correlate with each of the outcome measures and to significantly contribute to variance in psychosocial adjustment, prosthesis use, aesthetic prosthesis satisfaction and body image. Self-disgust emerged as an important consideration in understanding poor adjustment to amputation. Section three includes a critical appraisal of the research process, in which reflections are presented on the design of the study, the importance of researching difficult topics, such as selfdisgust, and potential areas for future research.