Beruflich Dokumente
Kultur Dokumente
Body Image
journal homepage: www.elsevier.com/locate/bodyimage
Department of Psychology, University of Westminster, 309 Regent Street, London W1B 2UW, UK
Department of Psychology, Goldsmiths, University of London, London, UK
c
Department of Psychology, University College London, London, UK
b
A R T I C L E I N F O
A B S T R A C T
Article history:
Received 7 July 2008
Received in revised form 22 September 2008
Accepted 26 September 2008
This study examined the association between several attitudinal constructs related to acceptance of
cosmetic surgery, and participant demographics, personality, and individual difference variables. A
sample of 332 university students completed a battery of scales comprising the Acceptance of Cosmetic
Surgery Scale (ACSS) and measures of the Big Five personality factors, self-esteem, conformity, selfassessed attractiveness, and demographics. Multiple regressions showed that the predictor variables
explained a large proportion of the variance in ACSS factors (Adj. R2 ranging between .31 and .60). In
addition, structural equation modelling revealed that distal factors (sex and age) were generally
associated with acceptance of cosmetic surgery through the mediate inuence of more proximate
variables (in the rst instance, the Big Five personality factors, followed by self-esteem and conformity,
and nally self-assessed attractiveness). These results allow for the presentation of a preliminary model
integrating personality and individual differences in predicting acceptance of cosmetic surgery.
2008 Elsevier Ltd. All rights reserved.
Keywords:
Cosmetic surgery
Body image
Personality
Individual differences
Introduction
Cosmetic surgery refers to a subspecialty that is concerned
primarily with the maintenance, restoration, or enhancement of an
individuals physical appearance through surgical and medical
techniques. In the Western hemisphere, the number of cosmetic
surgery procedures has risen dramatically in the past decade (e.g.,
Davis, 2003; Rohrich, 2003). In the United States, for instance, 11.7
million cosmetic procedures were performed in 2007, with the vast
majority being minimally invasive procedures (American Society for
Aesthetic Plastic Surgery, 2008). Moreover, Sarwer and Crerand
(2008) suggest that these statistics underestimate the actual number
of procedures being performed, as they do not cover appearanceenhancing treatments performed by non-plastic surgeons.
As discussed by Sarwer and colleagues (Sarwer, Crerand, &
Gibbons, 2007; Sarwer & Magee, 2006; Sarwer, Magee, & Crerand,
2003), a number of factors may underscore this increase in the
popularity of cosmetic surgery. These include the growing
importance of physical appearance in contemporary Western
culture (Swami, 2007; Swami & Furnham, 2008), which has served
to normalise the pursuit of appearance-enhancing behaviours
(Sarwer et al., 2003). Higher disposable incomes among patients,
advances in surgical procedures (particularly in terms of safety),
and the lower cost of treatments have also served to reduce patient
anxiety about cosmetic procedures (Edmonds, 2007). Finally, the
past decade has witnessed a dramatic increase in media coverage
of cosmetic surgery (see Crockett, Pruzinsky, & Persing, 2007;
Sarwer et al., 2003), which has mainstreamed public awareness of
such procedures (Tait, 2007).
In line with these developments, there has emerged a relatively
large body of work examining psychological aspects of cosmetic
surgery. In terms of factors affecting the likelihood of having
cosmetic surgery, for instance, the available evidence suggests that
women report a greater likelihood of willingness to undergo
various cosmetic procedures compared with men (Brown, Furnham, Glanville, & Swami, 2007; Swami, Arteche, ChamorroPremuzic, Furnham, Stieger, Haubner, et al., 2008), which has
been explained as a function of the greater sociocultural pressure
on women to attain ideals of physical and sexual attractiveness
(Swami, 2007; Swami & Furnham, 2008). This research has also
shown that lower self-ratings of physical attractiveness predict
higher likelihood of having cosmetic surgery (Brown et al., 2007),
and that media exposure may mediate the relationship between
participant sex and likelihood of having cosmetic surgery (Swami,
Arteche, et al., 2008).
In terms of attitudinal dispositions towards cosmetic surgery,
Sarwer et al. (2005) reported that their sample of college women
generally held favourable attitudes toward cosmetic surgery as a
means of appearance-enhancement. Henderson-King and Henderson-King (2005), however, have argued that participants may
Table 1
Descriptive statistics and bivariate correlation coefcients (Pearsons r).
M SD
ACSS Intrapersonal
ACSS Consider
ACSS Social
ACSS Intrapersonal
ACSS Consider
ACSS Social
M SD = 4.41 1.37
M SD = 3.89 1.61
M SD = 2.90 1.35
.84**
.58**
.53**
Age
Sex
M SD = 24.74 7.51
.19**
.00
.13*
.16**
.11*
.05
Extraversion
Agreeableness
Conscientiousness
Emotional Stability
Openness
M SD = 10.18 2.50
M SD = 11.11 1.82
M SD = 10.49 1.88
M SD = 9.05 2.73
M SD = 10.38 2.42
.07
.00
.05
.03
.42**
.08
.09
.01
.06
.43**
.00
.01
.37**
.20**
.33**
Self-esteem
Conformity
M SD = 30.08 3.70
M SD = 4.85 13.95
.03
.21**
.09
.25**
.18**
.47**
Self-assessed attractiveness
M SD = 101.02 13.42
.16**
.34**
.07
10
Multiple regressions
A series of stepwise multiple regressions were carried out to
examine the amount of variance in each of the ACSS factors
explained by the other variables. We chose stepwise regressions in
order to select the fewest number of variables offered to the model
that best describe the occurrence of the outcome. Three regressions were conducted (one for each ACSS factor) and in each
regression, age, sex, the Big Five factors, self-esteem, conformity,
and self-assessed attractiveness were entered as predictors in the
same block. The regression predicting Intrapersonal accounted for
31.1% of the variance, with Openness (b = .62, t = 10.85, p < .001,
R2 = .18), Emotional Stability (b = .42, t = 6.59, p < .001, DR2 = .08),
sex (b = .21, t = 3.76, p < .001, DR2 = .02), Extraversion (b = .19,
t = 3.63, p < .001, DR2 = .02), and self-assessed attractiveness
(b = (.12, t = 2.07, p < .05, DR2 = .01) being retained as signicant
predictors.
The regression predicting Social accounted for 60.6% of the
variance and Emotional Stability (b = .73, t = 16.75, p < .001,
R2 = .23), conformity (b = .46, t = 9.86, p < .001, DR2 = .23), Openness (b = .42, t = 8.75, p < .001, DR2 = .06), age (b = .28, t = 7.13,
p < .001, DR2 = .05), and Conscientiousness (b = .18, t = 4.61,
p < .001, DR2 = .02) were signicant predictors. Finally, the
regression predicting Consider explained 40.8% of the variance,
with Openness (b = .63, t = 11.01, p < .001, DR2 = .19), Emotional
Stability (b = .52, t = 8.34, p < .001, DR2 = .02), sex (b = .47, t = 8.71,
p < .001, DR2 = .09), self-assessed attractiveness (b = .26, t = 5.41,
p < .001, DR2 = .05), Agreeableness (b = .32, t = 5.74, p < .001,
DR2 = .02), Conscientiousness (b = .25, t = 4.67, p < .001,
DR2 = .02), and age (b = .13, t = 2.48, p < .001, DR2 = .01) all
emerging as signicant predictors.
It is noteworthy that Emotional Stability emerged as a strong
predictor of the three ACSS factors despite being uncorrelated with
two of these factors and only modestly correlated with the other
ACSS Social, which suggests suppressor effects in the regressions.
In order to explore a tentative model for integrating the various
predictors of ACSS, we next conducted structural equation
modelling (SEM) with the data.
Structural equation modelling
SEM was performed using AMOS 4.0 (Arbuckle & Wothke, 1999;
Byrne, 2001). Fitness of the model was assessed using the following
indices: x2 (Bollen, 1989; tests the hypothesis that an unconstrained model ts the covariance or correlation matrix as well as
the given model; ideally values should not be signicant);
Goodness-of-Fit Indicator (GFI; Tanaka & Huba, 1985; a measure
of tness where values close to 1 are acceptable); Parsimony
Goodness-of-Fit Indicator (PGFI; Mulaik et al., 1989; a measure of
power that is optimal around .50); Comparative Fit Index (CFI;
Bentler, 1990; comparison of the hypothesised model with a model
in which all correlations among variables are zero, and where
values around .90 indicate very good t); Root-Mean-Square Error
of Approximation (RMSEA; Browne & Cudeck, 1993; values of .08
or below indicate reasonable t for the model; Akaikes Information Criterion (AIC; Akaike, 1973; gives the extension to which the
parameter estimates from the original sample will cross-validate
in future samples; Hoelters Critical N (CN; Hoelter, 1983; provides
the maximum sample size for which a model with same sample
size and df would be acceptable at .01 level).
The modied model consisted of a hierarchical path analysis
where the three factors of ACSS were treated as inter-correlated,
endogenous variables (to the very right of the model). Direct paths
to the three endogenous variables were then drawn from selfassessed attractiveness, which, in turn, was hypothesised to be
11
Fig. 1. A possible model for understanding the determinants of acceptance of cosmetic surgery. Note: All coefcients are Standard Beta values signicant at p < .001. SAA: Selfassessed attractiveness, RSE: self-esteem, CONF: Conformity; Intra: ACSS Intrapersonal, Social: ACSS Social, Consider: ACSS Consider, ES: Emotional Stability (low
neuroticism), E: Extraversion, O: Openness to Experience, A: Agreeableness, C: Conscientiousness; sex coded 1 = men, 2 = women. Regression paths <.20, error variances, and
covariances not shown here for simplicity.
12
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