Effect of early body image dissatisfaction on subsequent psychological andphysical adjustment after disfiguring injury

Objective: The impact of body image dissatisfaction on quality of life afte r severe burn injury was investigated after controlling for other determina nts of outcome (ie, injury, distress, and preburn quality of life). Methods : The postburn quality of life (2-months postdischarge) of groups with and without body image dissatisfaction was studied after controlling for prebur n quality of life (measured 2-3 days postadmission). The patient population (N = 86) was 77.9% men, had an average total body surface area burned of 1 7.02%, and average full-thickness burn of 6.09%. Forty percent had facial i njuries, 68.6% required surgery, most were injured by flame (39.5%), and 76 .8% were employed. Results: Multivariate analysis of covariance (covarying preburn level of Mental quality of life, facial injury, and size of burn) c ontrasting body image dissatisfaction groups found significantly lower psyc hosocial adjustment at 2-month follow-up in those with greater body image d issatisfaction (multivariate F = 3.61; p < .01). A second MANCOVA (covaryin g the preburn level of Physical quality of life and both facial injury and size of burn) found significantly lower physical functioning at 2-month fol low-up in those with greater body image dissatisfaction (multivariate F = 2 .78; p < .03). Adding two more covariates (depression and posttrauma distre ss) eliminated the effect of body image dissatisfaction on postburn Physica l but not Mental adjustment. Conclusions: Body image dissatisfaction affect s quality of life after severe burn injury. Distress moderates this impact on aspects of physical but not psychosocial health.