Appearance Distress and Dysfunction in the Elderly: International Contrasts Across Italy and the UK Using DAS59

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ORIGINAL ARTICLE

EXPERIMENTAL/SPECIAL TOPICS

Appearance Distress and Dysfunction in the Elderly: International Contrasts Across Italy and the UK Using DAS59 Timothy P. Moss • Annalisa Cogliandro • Maddalena Pennacchini • Vittoradolfo Tambone Paolo Persichetti



Received: 26 March 2013 / Accepted: 9 August 2013 / Published online: 3 October 2013 Ó Springer Science+Business Media New York and International Society of Aesthetic Plastic Surgery 2013

Abstract Background As the global population grows, the percentage of those over 60 will escalate disproportionately. Their needs will become an ever more dominant feature of public policy and healthcare provision. Older adults’ appearance is often removed from cultural ideals and stereotypes of beauty, often seen as synonymous with ‘‘youth.’’ This has seen older adults’ concerns about appearance and body image somewhat sidelined in practice and in research. This study investigates the extent to which self-consciousness of appearance is associated with distress and dysfunction in those over 60 years old. Furthermore, we contrast the extent of this phenomenon in two European nations, UK and Italy, and consider the direct impact and interaction of cultural context and participant gender. Method To make an objective measurement of distress and dysfunction, we translated a widely used psychometric measure, the Derriford Appearance Scale 59 following an established and reliable translation protocol. Data were collected from community samples. Results The Italian translation was sound, with acceptability in the Italian-speaking sample and acceptable internal consistency scores for full-scale and subscales.

T. P. Moss (&) Department of Psychology, University of the West of England, Coldharbour Lane, Bristol BS16 1QY, UK e-mail: [email protected] A. Cogliandro  P. Persichetti Plastic Surgery Department, Campus Bio Medico University, via Alvaro del Portillo 21, 00128 Rome, Italy M. Pennacchini  V. Tambone Institute of Philosophy of Scientific and Technological Activity, via Alvaro del Portillo 21, 00128 Rome, Italy

ANOVA analysis demonstrated that for overall adjustment, and all subscale scores, the Italians were more distressed about their appearance than UK comparators. Moreover, there were significant differences between Italian women and men, with Italian women more distressed than Italian men overall, and also general self-consciousness, sexual self-consciousness, and social self-consciousness subscales. Conclusion These results are considered in the context of aging and cultural and gender issues in appearance, including the Italian concept of bella figura. 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. Keywords DAS59  Appearance  Older adults  Bella figura

Introduction Older adulthood is a complex psychological life stage, which presents an increasin