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    Acceptance of cosmetic surgery: Personality and individual ... Acceptance of cosmetic surgery: Personality and individual ... Document Transcript

    • Body Image 6 (2009) 7–13 Contents lists available at ScienceDirect Body Image journal homepage: www.elsevier.com/locate/bodyimageAcceptance of cosmetic surgery: Personality and individual difference predictorsViren Swami a,*, Tomas Chamorro-Premuzic b, Stacey Bridges a, Adrian Furnham ca Department of Psychology, University of Westminster, 309 Regent Street, London W1B 2UW, UKb Department of Psychology, Goldsmiths, University of London, London, UKc Department of Psychology, University College London, London, UKA R T I C L E I N F O A B S T R A C TArticle history: This study examined the association between several attitudinal constructs related to acceptance ofReceived 7 July 2008 cosmetic surgery, and participant demographics, personality, and individual difference variables. AReceived in revised form 22 September 2008 sample of 332 university students completed a battery of scales comprising the Acceptance of CosmeticAccepted 26 September 2008 Surgery Scale (ACSS) and measures of the Big Five personality factors, self-esteem, conformity, self- assessed attractiveness, and demographics. Multiple regressions showed that the predictor variablesKeywords: explained a large proportion of the variance in ACSS factors (Adj. R2 ranging between .31 and .60). InCosmetic surgery addition, structural equation modelling revealed that distal factors (sex and age) were generallyBody image associated with acceptance of cosmetic surgery through the mediate influence of more proximatePersonalityIndividual differences variables (in the first instance, the Big Five personality factors, followed by self-esteem and conformity, and finally self-assessed attractiveness). These results allow for the presentation of a preliminary model integrating personality and individual differences in predicting acceptance of cosmetic surgery. ß 2008 Elsevier Ltd. All rights reserved.Introduction and the lower cost of treatments have also served to reduce patient anxiety about cosmetic procedures (Edmonds, 2007). Finally, the Cosmetic surgery refers to a subspecialty that is concerned past decade has witnessed a dramatic increase in media coverageprimarily with the maintenance, restoration, or enhancement of an of cosmetic surgery (see Crockett, Pruzinsky, & Persing, 2007;individual’s physical appearance through surgical and medical Sarwer et al., 2003), which has mainstreamed public awareness oftechniques. In the Western hemisphere, the number of cosmetic such procedures (Tait, 2007).surgery procedures has risen dramatically in the past decade (e.g., In line with these developments, there has emerged a relativelyDavis, 2003; Rohrich, 2003). In the United States, for instance, 11.7 large body of work examining psychological aspects of cosmeticmillion cosmetic procedures were performed in 2007, with the vast surgery. In terms of factors affecting the likelihood of havingmajority being minimally invasive procedures (American Society for cosmetic surgery, for instance, the available evidence suggests thatAesthetic Plastic Surgery, 2008). Moreover, Sarwer and Crerand women report a greater likelihood of willingness to undergo(2008) suggest that these statistics underestimate the actual number various cosmetic procedures compared with men (Brown, Furn-of procedures being performed, as they do not cover appearance- ham, Glanville, & Swami, 2007; Swami, Arteche, Chamorro-enhancing treatments performed by non-plastic surgeons. Premuzic, Furnham, Stieger, Haubner, et al., 2008), which has As discussed by Sarwer and colleagues (Sarwer, Crerand, & been explained as a function of the greater sociocultural pressureGibbons, 2007; Sarwer & Magee, 2006; Sarwer, Magee, & Crerand, on women to attain ideals of physical and sexual attractiveness2003), a number of factors may underscore this increase in the (Swami, 2007; Swami & Furnham, 2008). This research has alsopopularity of cosmetic surgery. These include the growing shown that lower self-ratings of physical attractiveness predictimportance of physical appearance in contemporary Western higher likelihood of having cosmetic surgery (Brown et al., 2007),culture (Swami, 2007; Swami & Furnham, 2008), which has served and that media exposure may mediate the relationship betweento normalise the pursuit of appearance-enhancing behaviours participant sex and likelihood of having cosmetic surgery (Swami,(Sarwer et al., 2003). Higher disposable incomes among patients, Arteche, et al., 2008).advances in surgical procedures (particularly in terms of safety), 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 * Corresponding author. Tel.: +44 207 911 5000. means of appearance-enhancement. Henderson-King and Hen- E-mail address: v.swami@wmin.ac.uk (V. Swami). derson-King (2005), however, have argued that participants may1740-1445/$ – see front matter ß 2008 Elsevier Ltd. All rights reserved.doi:10.1016/j.bodyim.2008.09.004
    • 8 V. Swami et al. / Body Image 6 (2009) 7–13hold beliefs and attitudes that are accepting of cosmetic surgery affective experience (e.g., Mischel & Shoda, 1999), and are,and yet show little or no interest in actually having cosmetic therefore, likely to influence dimensions of body image generallyprocedures. In order to assess attitudes beyond likelihood of and acceptance of cosmetic surgery specifically.having cosmetic surgery, therefore, these authors developed the In addition to the Big Five, we also examined the relationshipAcceptance of Cosmetic Surgery Scale (ACSS), a 15-item measure between the ACSS and participants’ self-rated physical attractive-that was found to factor into three components: (1) Intrapersonal, ness, which previous work has shown to be negatively associatedwhich measures attitudes related to the self-oriented benefits of with the likelihood of having cosmetic surgery (Brown et al., 2007;having cosmetic surgery (e.g., increased satisfaction with appear- Swami, Arteche, et al., 2008). Concurrently, we measuredance); (2) Social, which represents social motivations that participants’ global self-esteem, which is thought to be negativelyinfluence the decision to have cosmetic surgery (e.g., appearing associated with the likelihood of having cosmetic surgery (that is,more attractive to one’s partner), and; (3) Consider, which individuals with low self-esteem may be more open to cosmeticmeasures the likelihood of having cosmetic surgery, taking into surgery as a means of improving global self-perceptions; cf.account factors that may influence the decision-making process Figueroa, 2003; Sarwer, 2007; Sarwer, Nordmann, & Herbert, 2000)(e.g., pain). and may also be linked with low self-ratings of physical In a series of four studies within university settings, Henderson- attractiveness (cf. Koff, 1998). In the present study, we alsoKing and Henderson-King (2005) showed that the ACSS has high examined the association between the ACSS and conformity, whichinternal reliability and test–retest reliability, as well as good Mehrabian (2005, p. 2) defined as ‘‘a characteristic willingness todivergent and convergent validity. In addition, they reported that identify with other and emulate them, to give in to others so as towomen and older participants expressed more positive attitudes avoid negative interactions, and generally, to be a follower ratheron the Intrapersonal subscale and that older participants had more than a leader’’ and which may be expected to be associated withfavourable attitudes on the Social subscale. For women, age was the Social subscale of the ACSS.found to be a positive predictor of considering cosmetic surgery, In short then, the present study examined the associationbut no such relationship was found for men. Other recent work between the subscales of the ACSS and participants’ sex, age, Bigusing the ACSS has shown that greater acceptance of cosmetic Five personality factors, self-rated physical attractiveness, self-surgery among college women is associated their body image esteem, and conformity. The data was analysed using correlationexperiences, with those who are dissatisfied with their appearance and structural equation modelling. Whilst the former method isor having greater body image disturbance viewing cosmetic useful for identifying relationships between two variables, thesurgery more positively (Cash, Goldenberg-Bivens, & Grasso, latter allows for simultaneous testing of several relationships2005). Furthermore, Sperry, Thompson, Sarwer, and Cash (in among different variables (including multiple criteria or ‘depen-press) reported that viewership of reality cosmetic surgery dent variables’) and is, therefore, ideal for testing or generatingtelevision shows was significantly related to acceptance of models (Byrne, 2001).cosmetic surgery, where the latter was measured using totalscores from the ACSS. While these studies have begun the task of Methoddelineating attitudes towards cosmetic surgery, it is also possibleto extend this research by examining individual difference Participantspredictors of such attitudes. The participants of this study were 332 (60.5% women, n = 201;The present study 39.5% men, n = 131) university students from a metropolitan university in Greater London (age M = 24.72, SD = 7.51). The Our first aim in the present study was to examine the majority of participants were of European Caucasian descentrelationship between the ACSS subscales and an individual’s (72.6%, n = 241), with smaller groups of Asian (10.5%, n = 35),personality, where the latter was operationalised using the Big Five African Caribbean (10.5%, n = 35), and other descent (6.3, n = 21). Inpersonality framework (McCrae & Costa, 1997). The Big Five is a terms of religion, 59.6% of participants were Christians (n = 198),hierarchical model of personality with five bipolar traits or factors 12.0% were Muslims (n = 40), 7.5% were atheists (n = 25), and 20.8%(Agreeableness, Conscientiousness, Emotional Stability, Openness, were of some other religious affiliation (n = 69). Most participantsand Extraversion), which represent personality at a broad level of were in a dating relationship (57.5%, n = 191), while others wereabstraction (McCrae & Costa, 1997). The Big Five framework has single (23.5%, n = 78), married (16.9%, n = 56), or of some otherbeen shown to have strong predictive validity in relation to various marital status (2.1%, n = 7). Finally, most participants reportedreal-world outcomes (Chamorro-Premuzic, 2007), including atti- never having had cosmetic surgery (84.0%, n = 279).tudes towards body size (Swami, Buchanan, Furnham, & Tovee, ´2008), but it has not been specifically examined in relation to Measuresattitudes towards cosmetic surgery. Even so, there were reasons why we expected the Big Five Acceptance of Cosmetic Surgery Scale (ACSS; Henderson-King &personality framework to be associated with acceptance of Henderson-King, 2005)cosmetic surgery. For one thing, previous work has shown that This is a 15-item scale measuring various aspects of anthe factors of Emotional Stability are associated with negative individual’s attitudes about cosmetic surgery and rated on a 7-appearance evaluation (e.g., Kvalem, von Soest, Roald, and point scale (1 = strongly disagree, 7 = strongly agree). Three dimen-Skolleborg, 2006), appearance orientation (e.g., Davis, Dionne, & sions of such attitudes are measured: (1) Intrapersonal (five itemsShuster, 2001), dissatisfaction with facial appearance (e.g., Thomas representing attitudes related to the self-oriented benefits of& Goldberg, 1995), and self-objectification (e.g., Miner-Rubino, cosmetic surgery; sample item: ‘In the future, I could end upTwenge, & Frederickson, 2002). Self-objectification in the latter having some kind of cosmetic surgery’); (2) Social (five itemsstudy was also associated with Agreeableness and Openness, measuring social motivations for having cosmetic surgery; samplewhereas Kvalem et al. (2006) reported a significant association item: ‘If it would benefit my career, I would think about havingbetween appearance orientation and Extraversion. More generally, plastic surgery’), and; (3) Consider (five items assessing thethe Big Five factors are significantly associated with differences in likelihood that a participant would consider having cosmetic
    • V. Swami et al. / Body Image 6 (2009) 7–13 9surgery; sample item: ‘If I could have a surgical procedure done for Rosenberg Self-Esteem Scale (RSE; Rosenberg, 1965)free I would consider trying cosmetic surgery’). Previous work has The RSE is a brief and widely used measure of self-worth,shown that the ACSS has high internal consistency, good test– consisting of 10 items rated on a 4-point scale (1 = Stronglyretest reliability after three weeks, and good convergent and disagree, 4 = Strongly agree; sample item: ‘I certainly feel useless atdiscriminant validity (Henderson-King & Henderson-King, 2005). times’). Five items were reverse-coded prior to analysis, and anIn the present study, Cronbach’s as for the three subscales were: overall score was computed by summing responses to all items.Intrapersonal .92, Social .90, Consider .90. The scale showed good internal consistency in the present study (a = .77).Ten Item Personality Inventory (TIPI; Gosling, Rentfrow, & Swann,2003) Demographics This is a brief scale for assessing the Big Five personality facets, All participants provided their demographics consisting of sex,which shows adequate convergent and discriminant validity, test– age, ethnicity, religion, and marital status. Participants alsoretest reliability, and patterns of external correlates. Participants indicated on binary (1 = Yes, 2 = No) whether or not they hadrated the extent to which a pair of traits (e.g., ‘Extraverted, had cosmetic surgery in the past.enthusiastic’) applies to them on a 7-point scale (1 = Disagreestrongly, 7 = Agree strongly). Five items are reverse-coded, and two Procedureitems are averaged to arrive at scores for each of the Big Fivepersonality traits. Cronbach’s a coefficients were as follows: Once ethical approval was obtained, a male and femaleExtraversion .63, Agreeableness .66, Conscientiousness .63, Emo- experimenter recruited about half the sample each using opportu-tional Stability .60, and Openness to Experience .61. These as are nistic sampling techniques. In practice, this meant approachingacceptable given that they were measured using only two items potential participants in various campus settings (e.g., cafeterias,(see Youngman, 1979). libraries, seminar rooms) to ensure that sampling would be comparable across experimenters. The nature of the experimentSelf-assessed attractiveness (SAA; Swami, Furnham, Georgiades, & was explained to participants, and once they provided informedPang, 2007) consent, they were given a six-page questionnaire to complete along Participants were provided with a graphical representation of a with brief instructions. All participants took part on a voluntary basisnormal distribution curve (M = 100, SD = 15) and asked to provides and were not remunerated for their participation. They wereself-estimates of their overall physical attractiveness, overall facial verbally debriefed once they had completed and returned theattractiveness, and overall attractiveness of their body weight and questionnaire to the experimenter.body shape. Although the original version of this scale includes arange of items referring to various body parts, the four items used Resultsin the present study refer to global self-perceptions and rotatedinto a single factor (all loadings >.88, eigenvalue = 3.49, 87.26% of Descriptive statisticsthe variance explained). Cronbach’s a for the four items was .95. Descriptive statistics (M and SD) for all variables are reported inConformity Scale (CS; Mehrabian, 2005) Table 1, which also shows the correlations of the three ACSS factors This 11-item scale measures conformity on a 9-point scale with other variables. As can be seen, the three factors of the ACSS(À4 = Very strong disagreement, +4 = Very strong agreement; sample were highly inter-correlated. Significant correlates (from strongestitem: ‘I often rely on, and act upon, the advice of others’). A total to weakest) of the ACSS Intrapersonal factors were Openness,score is computed by summing participants’ responses to seven conformity, self-assessed attractiveness, and age. The samepositively worded items and by subtracting this value from the variables were also correlated with the ACSS Consider factors,sum of their responses to four negatively worded items (a = .79). with the addition of sex. For the ACSS Social factor, significantPrevious work has shown that the CS has good test–retest correlates were conformity, Conscientiousness, Openness, Emo-reliability and construct validity (e.g., Mehrabian & Stefl, 1995). tional Stability, self-esteem, and age.Table 1Descriptive statistics and bivariate correlation coefficients (Pearson’s r). M Æ SD ACSS Intrapersonal ACSS Consider ACSS SocialACSS Intrapersonal M Æ SD = 4.41 Æ 1.37 – .84** .58**ACSS Consider M Æ SD = 3.89 Æ 1.61 – .53**ACSS Social M Æ SD = 2.90 Æ 1.35 –Age M Æ SD = 24.74 Æ 7.51 .19** .13* À.11*Sex À.00 .16** À.05Extraversion M Æ SD = 10.18 Æ 2.50 .07 À.08 À.00Agreeableness M Æ SD = 11.11 Æ 1.82 À.00 À.09 À.01Conscientiousness M Æ SD = 10.49 Æ 1.88 À.05 À.01 À.37**Emotional Stability M Æ SD = 9.05 Æ 2.73 .03 À.06 .20**Openness M Æ SD = 10.38 Æ 2.42 À.42** À.43** À.33**Self-esteem M Æ SD = 30.08 Æ 3.70 À.03 À.09 À.18**Conformity M Æ SD = À4.85 Æ 13.95 .21** .25** .47**Self-assessed attractiveness M Æ SD = 101.02 Æ 13.42 À.16** À.34** À.07N = 332, sex coded: 1 = men, 2 = women. * p < .05. ** p < .001.
    • 10 V. Swami et al. / Body Image 6 (2009) 7–13Multiple regressions affected by conformity and self-esteem. The two latter variables, in turn, were hypothesised to be affected by all Big Five personality A series of stepwise multiple regressions were carried out to traits, which, in turn, were hypothesised to be affected by sex andexamine the amount of variance in each of the ACSS factors age. Thus, the model progressively moved from more distalexplained by the other variables. We chose stepwise regressions in exogenous variables (to the left) to less distal variables (to theorder to select the fewest number of variables offered to the model right).that best describe the occurrence of the outcome. Three regres- Although the model is predictive rather than causal, from asions were conducted (one for each ACSS factor) and in each theoretical standpoint, sex and age are justified as exogenousregression, age, sex, the Big Five factors, self-esteem, conformity, variables as they are not influenced by any of the other variables.and self-assessed attractiveness were entered as predictors in the On the other hand, the Big Five personality factors are more generalsame block. The regression predicting Intrapersonal accounted for and ‘trait-like’ than self-esteem and conformity (which are31.1% of the variance, with Openness (b = À.62, t = 10.85, p < .001, arguably more influenced by situational factors, though they stillR2 = .18), Emotional Stability (b = .42, t = 6.59, p < .001, DR2 = .08), have a trait-like basis). With regards to self-assessed attractive-sex (b = .21, t = 3.76, p < .001, DR2 = .02), Extraversion (b = .19, ness, we decided to treat this variable as less distal than self-t = 3.63, p < .001, DR2 = .02), and self-assessed attractiveness esteem (a more over-arching self-construct) and conformity,(b = (.12, t = 2.07, p < .05, DR2 = .01) being retained as significant primarily to assess whether self-assessed attractiveness maypredictors. explain some of the effects of self-esteem and conformity on the The regression predicting Social accounted for 60.6% of the ACSS factors. Finally, the ACSS factors were considered endogenousvariance and Emotional Stability (b = .73, t = 16.75, p < .001, not only in light of the aims of the current study, but also as theseR2 = .23), conformity (b = .46, t = 9.86, p < .001, DR2 = .23), Open- attitudinal variables can be expected to be much more situationalness (b = À.42, t = 8.75, p < .001, DR2 = .06), age (b = À.28, t = 7.13, and less trait-like than the variables we treated as predictors.p < .001, DR2 = .05), and Conscientiousness (b = À.18, t = 4.61, The hypothesised model did not fit the data well: x2 (df = 49,p < .001, DR2 = .02) were significant predictors. Finally, the N = 332) = 1330, p < .01, GFI = .70, CFI = .50, PGFI = .38,regression predicting Consider explained 40.8% of the variance, RMSEA = .28 (low = .26, high = .29), AIC = 1414.3, CN = 14. Thuswith Openness (b = À.63, t = 11.01, p < .001, DR2 = .19), Emotional modifications were made in order to improve fit. In line with theStability (b = .52, t = 8.34, p < .001, DR2 = .02), sex (b = .47, t = 8.71, modification indices, the Big Five were allowed to inter-correlate,p < .001, DR2 = .09), self-assessed attractiveness (b = À.26, t = 5.41, and non-significant estimates were eliminated from the model. Inp < .001, DR2 = .05), Agreeableness (b = À.32, t = 5.74, p < .001, addition, conformity and self-esteem were allowed to inter-DR2 = .02), Conscientiousness (b = .25, t = 4.67, p < .001, correlate, and direct paths from more distal to endogenousDR2 = .02), and age (b = À.13, t = 2.48, p < .001, DR2 = .01) all variables (e.g., from sex to the ACSS factors, from the Big Fiveemerging as significant predictors. factors to the ACSS factors, and from self-esteem to the ACSS It is noteworthy that Emotional Stability emerged as a strong factors) were drawn in accordance to the modification indices. Thepredictor of the three ACSS factors despite being uncorrelated with modified model (shown in Fig. 1) fitted the data well: x2 (df = 17,two of these factors and only modestly correlated with the other N = 332) = 46.7, p < .01, GFI = .98, CFI = .99, PGFI = .34, RMSEA = .06ACSS Social, which suggests suppressor effects in the regressions. (low = .04, high = .09), AIC = 194.7, CN = 14. Although the x2 valueIn order to explore a tentative model for integrating the various was significant, this is to be expected even in well-fitting modelspredictors of ACSS, we next conducted structural equation (Byrne, 2001).modelling (SEM) with the data. Direct paths into the endogenous variables (ACSS factors) were found for several variables. Thus, women, more conscientious, lessStructural equation modelling agreeable, less open, and more emotionally stable individuals, as well as those who rated themselves lower in attractiveness, were SEM was performed using AMOS 4.0 (Arbuckle & Wothke, 1999; more likely to consider cosmetic surgery. Of these factors,Byrne, 2001). Fitness of the model was assessed using the following Openness, in particular was a strong predictor of the ACSSindices: x2 (Bollen, 1989; tests the hypothesis that an uncon- Consider factor. ACSS Social, on the other hand, was predictedstrained model fits the covariance or correlation matrix as well as by conformity (the main single predictor), followed by Emotionalthe given model; ideally values should not be significant); Stability and Conscientiousness (a negative predictor). Therefore,Goodness-of-Fit Indicator (GFI; Tanaka & Huba, 1985; a measure the less neurotic, conscientious, and more conformist an indivi-of fitness where values close to 1 are acceptable); Parsimony dual, the more likely she or he is to emphasise social motivationsGoodness-of-Fit Indicator (PGFI; Mulaik et al., 1989; a measure of for having cosmetic surgery. Finally, the Intrapersonal factor of thepower that is optimal around .50); Comparative Fit Index (CFI; ACSS was predicted by Openness (negatively) and, to a lesserBentler, 1990; comparison of the hypothesised model with a model extent, Emotional Stability, indicating that the less open and morein which all correlations among variables are zero, and where emotionally stable an individual, the more likely she or he holdsvalues around .90 indicate very good fit); Root-Mean-Square Error strong attitudes related to the self-oriented benefits of cosmeticof Approximation (RMSEA; Browne & Cudeck, 1993; values of .08 surgery.or below indicate reasonable fit for the model; Akaike’s Informa-tion Criterion (AIC; Akaike, 1973; gives the extension to which the Discussionparameter estimates from the original sample will cross-validatein future samples; Hoelter’s Critical N (CN; Hoelter, 1983; provides The results of the present study extend previous work with thethe maximum sample size for which a model with same sample ACSS by showing that acceptance of cosmetic surgery is reliablysize and df would be acceptable at .01 level). (albeit moderately) associated with participants’ sex, age, Big Five The modified model consisted of a hierarchical path analysis personality factors, self-esteem, conformity, and self-assessedwhere the three factors of ACSS were treated as inter-correlated, attractiveness. Overall, these variables explained a substantialendogenous variables (to the very right of the model). Direct paths portion of the variance in the ACSS factors (particularly for Social),to the three endogenous variables were then drawn from self- and significantly predicted each ACSS factor (though not always inassessed attractiveness, which, in turn, was hypothesised to be the same manner). Although it is important to note that this is a
    • V. Swami et al. / Body Image 6 (2009) 7–13 11Fig. 1. A possible model for understanding the determinants of acceptance of cosmetic surgery. Note: All coefficients are Standard Beta values significant at p < .001. SAA: Self-assessed attractiveness, RSE: self-esteem, CONF: Conformity; Intra: ACSS Intrapersonal, Social: ACSS Social, Consider: ACSS Consider, ES: Emotional Stability (lowneuroticism), E: Extraversion, O: Openness to Experience, A: Agreeableness, C: Conscientiousness; sex coded 1 = men, 2 = women. Regression paths <.20, error variances, andcovariances not shown here for simplicity.preliminary attempt at integrating predictors according to their given that the Conformity Scale measures the extent to which anmore-or-less distal position with respect to the ACSS factors, a individual is willing to emulate and give in to others so as to avoidnumber of conclusions are worthy of further comment. any negative interactions. Thus, this association may be tapping into First, our results showed that women were more likely than conforming individuals’ greater likelihood of accepting cosmeticmen to consider having cosmetic surgery, which is consistent with surgery in order to satisfy their partners or other close relationships.previous work in which participants were asked to rate their Moreover, our results also suggest that the Big Five personalitylikelihood of having various cosmetic procedures (Brown et al., factors of Conscientiousness and Emotional Stability help explain2007; Frederick, Lever, & Peplau, 2007; Swami, Arteche, et al., more positive social attitudes towards cosmetic surgery. It may be2008). As discussed elsewhere, this sex difference may reflect the the case more neurotic individuals are anxious about thegreater sociocultural pressure that women experience to live up to consequences of cosmetic surgery and focus on potential negativeidealised images of physical perfection (Swami, 2007; Swami & effects (e.g., pain). Likewise, high conscientious individuals may beFurnham, 2008). Our results also suggest that individuals who more wary of cosmetic surgery, perhaps stemming from their higherrated themselves lower in physical attractiveness were more likely degree of carefulness, thoroughness, and deliberation.to consider cosmetic surgery, which is consistent with previous Finally, our results suggest that less open and more emotionallywork (Brown et al., 2007; Swami, Arteche, et al., 2008). stable individuals had a greater likelihood of accepting cosmetic However, our results also suggest that more conscientiousness, surgery in order to maximise its self-oriented benefits. Asless agreeable, less open, and more emotionally stable individuals suggested above, Closed individuals may maintain more negativewere more likely to consider cosmetic surgery, thus centrally evaluations of their appearance, which in turns leads to a greaterimplicating the Big Five personality framework in such decisions. acceptance of cosmetic surgery if it is able to enhance theirOpenness to Experience, in particular, was a strong negative appearance. Emotional stability, on the other hand, may be linkedpredictor of considering having cosmetic surgery. Previous work with the Intrapersonal factor because neurotic individuals arehas reported a positive association between Openness and positive more likely to experience negative affect associated with negativeself-evaluations of appearance (Kvalem et al., 2006). Extrapolating self-evaluations of appearance (see also Kvalem et al., 2006).from this evidence, it might be suggested that Closed individuals All in all, our results suggest a complex model linkinghave a more negative appearance evaluation (possibly as a participant demographics, personality, and a number of individualfunction of their lower likelihood of accepting unconventional difference variables with acceptance of cosmetic surgery associetal norms of attractiveness; cf. Swami, Buchanan, Furnham, & measured on the ACSS. As can be seen in Fig. 1, the Intrapersonal ´Tovee, 2008), which increases their likelihood of wanting to have factor of the ACSS was strongly affected by Openness and modestlycosmetic surgery to enhance their appearance. It is also important affected by Emotional Stability. The Social factor was stronglyto note that, in the present study, low self-esteem was not affected by Emotional Stability and Conformity, and to a lessercorrelated with higher likelihood of having cosmetic surgery. degree, Conscientiousness. Most notably, consideration of cos-Rather, self-esteem was associated with self-assessed attractive- metic surgery was affected by 6 of the 10 predictors (including fourness, which in turn was negatively associated with greater of the Big Five factors), namely Openness, sex, self-assessedlikelihood of considering cosmetic surgery. attractiveness, Agreeableness, Emotional Stability, and Conscien- Our results also showed that the Social factor of the ACSS, which tiousness. In sum, these results indicate that most of the variancemeasures social motivations for wanting to have cosmetic surgery, in ACSS factors was explained by the Big Five, with all traits exceptwas strongly predicted by conformity. This is perhaps not surprising, Extraversion affecting one ACSS factor or more.
    • 12 V. Swami et al. / Body Image 6 (2009) 7–13Limitations and conclusion cosmetic surgery. Poster presented at the Conference of the Association for Beha- vioral and Cognitive Therapies, Washington, DC. Chamorro-Premuzic, T. (2007). Personality and individual differences. Oxford: Blackwell. It is important to bear in mind a number of limitations to the Costa, P. T., Jr., & McCrae, R. R. (1992). Revised NEO Personality Inventory (NEO-PI-R) andpresent study. First, although our results generally mirror findings NEO Five-Factor Inventory (NEOFFI): Professional manual. Odessa, FL: Psychological Assessment Resources.from community samples (e.g., Brown et al., 2007; Swami, Arteche, Crockett, R. J., Pruzinsky, T., & Persing, J. A. (2007). The influence of plastic surgeryet al., 2008), it is nevertheless the case that our reliance on ‘reality TV’ on cosmetic surgery patient expectations and decision making. Plasticuniversity students limits the generalisability of our findings. and Reconstructive Surgery, 120, 316–324. Davis, K. (2003). Dubious equalities and embodied differences: Cultural studies on cosmeticSecond, it will be important to replicate the present work more surgery. Lanhan, MD: Rowman and Littlefield.reliable measures of the Big Five personality framework, such as Davis, C., Dionne, M., & Shuster, B. (2001). Physical and psychological correlates ofCosta and McCrae’s (1992) revised NEO personality inventory appearance orientation. Personality and Individual Differences, 30, 21–30. Delinsky, S. S. (2005). Cosmetic surgery: A common and accepted form of self-(NEO-PI-R), as this may reveal more conclusively which aspects of improvement? Journal of Applied Social Psychology, 35, 2012–2028.personality are associated with acceptance of cosmetic surgery. Edmonds, A. (2007). ‘The poor have the right to be beautiful’: Cosmetic surgery inSimilarly, it would be useful to further explicate the relationship neoliberal Brazil. Journal of the Royal Anthropological Institute, 13, 363–381.between self-esteem and acceptance of cosmetic surgery, given Figueroa, C. (2003). Self-esteem and cosmetic surgery: Is there a relationship between the two? Plastic Surgical Nursing, 23, 21–25.possible associations between self-esteem and narcissism, and Frederick, D. A., Lever, J., & Peplau, L. A. (2007). Interest in cosmetic surgery and bodybetween narcissism and interest in cosmetic surgery. image: Views of men and women across the lifespan. Plastic and Reconstructive Third, we have not fully examined the relationships between Surgery, 120, 1407–1415. Gosling, S. D., Rentfrow, P. J., & Swann, W. B., Jr. (2003). A very brief measure of the Big-acceptance of cosmetic surgery and constructs of body image. Five personality domains. Journal of Research in Personality, 37, 504–528.Previous work, for example, has shown that attitudes about Henderson-King, D., & Henderson-King, E. (2005). Acceptance of cosmetic surgery:cosmetic surgery, as measured using the Cosmetic Surgery Scale development and validation. Body Image, 2, 137–149. Koff, E. (1998). Breast size perception and satisfaction, body image, and psychologicalAttitudes Questionnaire, were predicted by greater psychological functioning in Caucasian and Asian American college women. Sex Roles, 38, 655–investment in physical appearance and greater internalisation of 673.mass media images of physical beauty (Sarwer et al., 2005). In a Kvalem, I. L., von Soest, T., Roald, H. E., & Skolleborg, K. C. (2006). The interplay of personality and negative comments about appearance in predicting body image.similar vein, while we have focused on a number of relevant Body Image, 3, 263–273.variables to acceptance of cosmetic surgery, our study in no way McCrae, R. R., & Costa, P. T., Jr. (1997). Personality trait structure as a human universal.exhausts the list of potential variables that could be included in a American Psychologist, 52, 509–516. Mehrabian, A. (2005). Manual for the Conformity Scale. Monterey, CA: University ofstudy of this type. For instance, future work may wish to include California, Los Angeles.such factors as media exposure, vicarious experience of cosmetic Mehrabian, A., & Stefl, C. A. (1995). Basic temperament components of loneliness,surgery, and perfectionism, which previous studies have found to shyness, and conformity. Social Behavior and Personality, 23, 253–264.be associated with the likelihood of having cosmetic procedures Miner-Rubino, K., Twenge, J. M., & Fredrickson, B. L. (2002). Trait self-objectification in women: Affective and personality correlates. Journal of Research in Personality, 36,(Brown et al., 2007; Delinsky, 2005; Sherry, Hewitt, Flett, & Lee- 147–172.Baggley, 2007; Swami, Arteche, et al., 2008). 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