This document provides an abstract and introduction for a dissertation analyzing representations of individuals with facial disfigurements in newspaper articles using thematic analysis. The dissertation examines how media representations may influence public perceptions and behaviors towards those with facial disfigurements based on social learning theory. Previous research found biases towards facial disfigurements and stereotypical media portrayals. The dissertation aims to provide further understanding of these issues through a thematic analysis of newspaper articles.
Factors of the Tripartite Influence Model & their Implications towards Body I...Stephanie Guerard
Body image dissatisfaction (BID) has been described by Thompson et al. (1999) as a negative and subjective assessment that an individual makes about his or her body, developed by the interaction of affective, cognitive, and behavioral aspects (as cited in Rodgers & Chabrol, 2009). Siberstein et al. (1998) explains that BID has been labeled as “normative” due to its rise within Western culture and a key predictor of disordered eating (as cited in Johnson, Edwards & Gidycz, 2014; Chang, Lee, Chen, Chiu, Pan & Huang, 2012). As researchers investigate the origins of BID, one theory that has developed is the Tripartite Influence Model. With five sociocultural factors, the Tripartite Influence Model combines previous BID research and supports Thompson, Heinberg, Altabe, and Tantleff-Dunn (1999)’s understanding that body image is developed from an interaction of many factors, not in “isolation” (as cited in Sharp, Tiggemann & Mattiske, 2014). This paper will examine each of the Tripartite Influence Model’s factors, describe how the factors interact, and address other potential BID influences that are not recognized as factors within the model.
Effect of media on eating disorders and body - a book chapter by Levine and H...Xanat V. Meza
Disclaimer: all images and original texts belong to their rightful owners.
Chapter 22 of the book "Media effects. Advances in Theory and Research", edited by Bryant and Oliver.
Factors of the Tripartite Influence Model & their Implications towards Body I...Stephanie Guerard
Body image dissatisfaction (BID) has been described by Thompson et al. (1999) as a negative and subjective assessment that an individual makes about his or her body, developed by the interaction of affective, cognitive, and behavioral aspects (as cited in Rodgers & Chabrol, 2009). Siberstein et al. (1998) explains that BID has been labeled as “normative” due to its rise within Western culture and a key predictor of disordered eating (as cited in Johnson, Edwards & Gidycz, 2014; Chang, Lee, Chen, Chiu, Pan & Huang, 2012). As researchers investigate the origins of BID, one theory that has developed is the Tripartite Influence Model. With five sociocultural factors, the Tripartite Influence Model combines previous BID research and supports Thompson, Heinberg, Altabe, and Tantleff-Dunn (1999)’s understanding that body image is developed from an interaction of many factors, not in “isolation” (as cited in Sharp, Tiggemann & Mattiske, 2014). This paper will examine each of the Tripartite Influence Model’s factors, describe how the factors interact, and address other potential BID influences that are not recognized as factors within the model.
Effect of media on eating disorders and body - a book chapter by Levine and H...Xanat V. Meza
Disclaimer: all images and original texts belong to their rightful owners.
Chapter 22 of the book "Media effects. Advances in Theory and Research", edited by Bryant and Oliver.
This is a paper I completed focusing on a Fetishistic Disorder a condition many see as to taboo to talk about and one that unfortunately due to such stigma do not get help to manage.
To be clear having a fetish or kink is not a disorder, what is a disorder however is when such fetish or kink takes over different areas of one's life and becomes an obsession.
Trauma experiences in the backgrounds of violent young offenders - Gywneth Bo...nacro_programmes
Professor Gywneth Boswell, Visiting Professor at the University of East Anglia and Director of Boswell Research Fellows. Speaking on childhood and adolescent trauma – impacts on development, and on individual health across the lifecourse
Speaking at Beyond Youth Custody's conference: Childhood trauma and young people in the criminal justice system, 19 November 2013.
Beyond Youth Custody's trauma review and consultation - Mark Liddlenacro_programmes
Mark Liddle, Managing Director of ARCS (UK), Beyond Youth Custody.
Speaking on the headline findings from trauma research at Beyond Youth Custody's conference: Childhood trauma and young people in the criminal justice system, 19 November 2013.
This is a paper I completed focusing on a Fetishistic Disorder a condition many see as to taboo to talk about and one that unfortunately due to such stigma do not get help to manage.
To be clear having a fetish or kink is not a disorder, what is a disorder however is when such fetish or kink takes over different areas of one's life and becomes an obsession.
Trauma experiences in the backgrounds of violent young offenders - Gywneth Bo...nacro_programmes
Professor Gywneth Boswell, Visiting Professor at the University of East Anglia and Director of Boswell Research Fellows. Speaking on childhood and adolescent trauma – impacts on development, and on individual health across the lifecourse
Speaking at Beyond Youth Custody's conference: Childhood trauma and young people in the criminal justice system, 19 November 2013.
Beyond Youth Custody's trauma review and consultation - Mark Liddlenacro_programmes
Mark Liddle, Managing Director of ARCS (UK), Beyond Youth Custody.
Speaking on the headline findings from trauma research at Beyond Youth Custody's conference: Childhood trauma and young people in the criminal justice system, 19 November 2013.
Dissertation Research Study/Report on "Preferred financing mechanism for SME’...Anam Shahid
It is a Dissertation Research study titled "Preferred financing mechanism of small and medium enterprises based in the United Arab Emirates " Written and Conducted by Anam Shahid In partial fulfillment of the requirements for the degree Bachelors of Business Administration-Entrepreneurship in the Year 2014
At Amity University Dubai,UAE
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Dissertation-" Financial Plannning of individuals"Shubham Tandan
1. Introduction to Financial Planning
2.Six step process of Financial Planning
3. Constitute of Financial Planning
4. Objectives for the Study
5. Introduction to Financial Industry
6. Investment Avenues
7. RESEARCH METHODOLOGY
8. Case Study base Questions
9. CONCLUSION
10. SUGGESTIONS
Write a one to two (1-2) page paper in which you1. Use the p.docxericbrooks84875
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Include diagrams or screen shots created through the use of a snipping tool or print screen keyboard option. The completed diagrams / screen shots must be imported into the Word document before the paper is submitted.
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Eisend & Möller (2007) believe that media consumption plays a vital role to influence body images and body satisfaction. Television and magazine advertisement with attractive role models will raise comparison standards for physical attractiveness. Prior research on mass media exposure and its effect on body images emphasize on body dissatisfaction and body perception while it fails to integrate beauty-related consumption behavior. Eisend & Möller (2007) provide a cultivation theory that holds that the continued exposure of television t adolescents will have a subtle and cumulative effect to shape views of social reality. Most of the young people consume a lot of television content to define their representations of reality. Television reality contains a lot of distortion and reality, and that leads to heavy consumers of it to form a distorted social perception concerning the world. An increase in television viewing leads one to have biased social perceptions. Other cultivation studies provide evidence that television exposure influences perceptions of consumer reality. Socio-cultural ideals for body appearance illustrate that repeated exposure to media would have an effect on women measure of self-worth. The western culture has recently endorsed thin female body an issue that affects women. Similarly, the ideal male body is a tall, lean, and muscular figure. Granatino & Haytko (2013) finds that girls begin to have a desire to become thin at the age of seven and boys are aware of their body size at the age of nine. Most of the researchers agree that at a young age, both boys and girls are awar.
Running head INFLUENCE OF THE MEDIA ON BODY IMAGE1INFLUENCE .docxcharisellington63520
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INFLUENCE OF THE MEDIA ON BODY IMAGE 14
Influence of the Media on Body Image
Tiffany King
Argosy University
February 10, 2016
Influence of the Media on Body Image
Abstract
Media images of the ideal body are prevalent in the contemporary society. These images are seen in ads, commercials, billboards, and magazines. For the longest time, there has been a continued interest in women’s body image. Their eating habits, self-esteem and how these two aspects are affected by what a female sees in the media have been researched. Such a line of research is essential because discovering the link between the media’s portrayal and poor image could allow for successful interventions to be implemented and evaluated (Harper & Tiggemann, 2008). In this regards, an intervention might lead to fewer cases of bulimia and anorexia and could also increase self-esteem and a sense of a more positive body image among females.
Majorly, this study aimed at substantiating the media’s influence on body image. Forty-three Argosy University undergraduate students participated in the study voluntarily. The control subjects participated through filling out the BISS (Body Image States Scales). The experimental subjects showed 120-second power point presentation revealing media images of women followed by completing the BISS. The BISS included six questions that were rated on a Likert scale type, which inquired about the subject’s feelings concerning their physical appearance. The study used data analysis from independent sample t-tests.
The analysis revealed that people who viewed the media images of females felt less physically attractive than those who were not exposed to the media presentation. Additionally, individuals who saw the media presentation felt worse regarding their looks compared with those that did not view the presentation. Additional findings suggested that attractiveness, satisfaction with their body and looks were not found to be significantly different. The questions that never revealed significant findings addressed more specific aspects of the body. For instance, body weight, shape and size.
Introduction
TV advertisements, magazines, and movies have always revealed the unattainable images of women’s body. Many studies have indicated that the ways in which a female’s eating habits, body image, and self-esteem are affected negatively by what they see and hear from the media. According to Spitzer, Henderson & Zivian (1999), social endorsements in the media portraying an ideal body have escalated image disturbances among women and influenced the development of eating disorders. Moreover, Kasey (n.d) found that women who are exposed to appearance-related media seem less satisfied with their shapes compared with those exposed to non-appearance related media.
Many magazines tend to advise women to concentrate on their physical, outside attributes but fail to mention the significance o.
1Running head MEDIA INFLUENCE ON BODY IMAGE MEDIA INFLUEN.docxfelicidaddinwoodie
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Running head: MEDIA INFLUENCE ON BODY IMAGE
MEDIA INFLUENCE ON BODY IMAGE
8
Media's influence on body image
Janet Hernandez
Introduction
The media and body image advertisement are two close concepts specifically; the body image advertising displays affects our body image. Despite other elements like parenting, education, intimate relationship influencing body image, media has the greatest impact. According to Diedrichs, (2012) Americans spends 250billion hours watching TV annually. Also, advertising occupies 30 % of all television airtime. Normal child watches 20,000 televisions commercial annually. In the print media, some magazines are filled with ads. In addition, social media has the highest of users compared to any other media globally. Anything seen for many hours influence us. As a result, media and body images are closely interrelated due to the numerous image we see in the media.
Wykes, M., & Gunter, B. (2015). The Media and Body Image: If Looks Could Kill. doi:10.4135/9781446215395
This article fits in the research topic because it covers the influence of advertisement in girls’ looks. It pinpoints that girls who like magazines, TVs are more likely to change and look like the persons in the magazines.
The article further discusses that the available applications have made it easy for persons to edit photos. This includes clearing blemishes, whitening of teeth, even to shaving off few pounds. For some users especially ladies, there is real problem in their body image. Additionally, this article postulates that notable percentage of people are changing their body images to match the ones in the media (Wykes & Gunter, 2015).
Levine, M. (2012). Media Influences on Female Body Image. Encyclopedia of Body Image and Human Appearance, 540-546. doi:10.1016/b978-0-12-384925-0.00085-7
As the title alludes, the article perfectly fits in this topic. This is because it covers how the female body image has been significantly influenced by the media. Also, it addresses how the females’ models have altered their body image. It provides an example where normal American woman is 5feet and 4inches and 166 pounds .In disparity, most model women are 5 feet and 11 inches in the media. The major question is how this disparity emerges. According to an interview conducted the major factor that influences this changes is the social media. This different stature and size is seen in the social media (Levine, 2012) .
Tiggemann, M. (2014). The Status of Media Effects on Body Image Research: Commentary on Articles in the Themed Issue on Body Image and Media. Media Psychology, 17(2), 127-133. doi:10.1080/15213269.2014.891822
This article is relevant as it pinpoints the media effects on body image. Again, it covers the how media has influenced the persons in different ways. One of the most notable topic covered in the article is the how girls in Fiji are affected by media. One survey in Fiji has shown that one in every ten girls have reported to have ...
Running head MEDIA INFLUENCE ON BODY IMAGE .docxMARRY7
Running head: MEDIA INFLUENCE ON BODY IMAGE 1
MEDIA INFLUENCE ON BODY IMAGE 2
Media Influence on Body Image
Michele
Argosy University
Media Influence on Body Image
RQ-Does Reality TV influenced perceived body image in the adolescent child?
Null (HO) Reality TV does not influenced perceived body image in the adolescent child.
Research (H1)-Reality TV does influence perceived body image in the adolescent child.
Outline
Annotated Bibliography
Cusumano, D. K. (2001). Media influence and body image in 8-11-year-old boys and girls: a preliminary report on the multidimensional media influence scale. International journal of eating disorders, 29(1), 37-44.
Research conducted by Cusumano on influence of body image from the media used a total of 182 participants; 75 boys and 107 girls, 69% of the boys and girls were white, 18% African American, and 12% were from other races. The participants were given a packet to fill out during regular school hours in a classroom setting. The questionnaire used a three point Likert Scale (1- disagree, 2- Not sure, 3-Agree) the questions were developmentally appropriate for the subjects ages and grade level, large font was used to minimize distractions, and the test consisted of a total of 29 questions to minimize fatigue. The questionnaire consisted of a practice question to warm the children up, as well as to confirm that they understood how to answer the questions. The findings of the research concluded that females have a higher score confirming that girl’s body image is influenced by the media. The research is very pertinent in proving my hypothesis that adolescent girl’s body images are influenced by the media.
Lawrie, Z., Sullivan, E. A., Davies, P. W., & Hill, R. J. (2006). Media influence on the body image of children and adolescents. Eating disorders, 14(5), 355-364.
Lawrie, Sullivan, Davies, and Hill conducted a study using 925 students; 634 girls and 291 boys from both private and public schools. Ages ranging from nine years of age to 14 years of age using a “Sociocultural Influence Questionnaire” a five section questionnaire consisting of 62 questions filled out by students during class time. Three main questions were “do the media give the idea that you should be slimmer? Do the media give the idea that you should gain weight? Do the media give the idea that you should be more muscular? Answers were assessed using a Likert-type scare with five responses: strongly agree, agree, unsure, disagree and strongly disagree. The answers were then transformed into a score ranging from one to five; a score of one equals to strongly agree, five strongly disagree. An overall low test score would indicates greater agreement that the media does influence, a high score would indicate that there is minimal agreement that the media influences adolescents. Conclusion of this stud ...
Running head SECONDARY SOURCE INTEGRATION1SECONDARY SOURCE I.docxtodd521
Running head: SECONDARY SOURCE INTEGRATION 1
SECONDARY SOURCE INTEGRATION 2
Secondary Source Integration
Stereotypes are confirmation that certain specific roles are specifically designed for a particular gender or group of people. Stereotype play a critical role in the process of elimination of personal choices in various matters of interest. Living to the standards of the stereotypes caused a lot of physical and emotional damage to self since most of the expectations are usually unrealistic. The women's body image has experienced a lot of stereotypes because of the general quest for acceptance in society. Different scholars and authors share different views on the subject of women body's image. The women’s body image issue is strongly related to both physical aspect of the matter and the psychological aspect which is related to the attitude.
Most of the cultures in the world reveal that women are greatly obsessed by the existing myth of beauty. The acceptance of these myths is influenced by the existence of various media influence that is consumed from television and social media (Stice et al., 2014). The effect of social media on behaviour and character is indisputable due to the fact that most trends in various parts of the world have been as a result of the power of social media. Therefore, most of the stereotypes on the state of the women body emanate from trending believes in the media.
Over the years, the media has fuelled the belief that slim women are more attractive than those with a lot of body flesh. Additionally, the media has always hailed the light skinned women as beautiful and looked down upon the women with dark skins (Stice et al., 2014). The repercussion of these media influences has been great and contributed to some life-threatening decisions among the women. For instance, most dark skinned women have been taking different therapies and medication with the intention of making themselves beautiful in the eyes of society.
Similarly, it is reported that most of the women who enrol in the gym program are pushed by the societal demand to slim in order to be accepted as beautiful (Stice et al., 2014). The gym programs and cosmetic industries have been booming recently due to the push from these beliefs in myths about women body. The infiltration of these myths into the hearts of the youths has been pushed mainly through social media and electronic media. The fitness programs are blended by the dieting process to achieve the desired body. It is a fact that most women strain in a quest to please the society.
The quest for acceptance in the society makes the myths about women body seem true despite the fact that they are misguided. Most of the women fight for acceptance in society and this leads to extreme measures of changing their body to suit the needs of the society. It is generally reported that most women have suffered while trying to please society.
The stereotype about women sends an unhealthy message to both men .
Introduction to Psychology - Proposal for research on eating disorders and ho...Sarah Lee
Introduction to Psychology - Proposal for research on eating disorders and how they are caused by the sustained high prevalence of the media depicting the ideal female body as excessively thin
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Representations of individuals with facial disfigurements in newspaper
articles: A Thematic Analysis
By Zulekha Nurein
Student ID: 10168439
Faculty of Health, Psychology & Social Care
Unit Code: 2F6Z000515169Z2F
A dissertation submitted to the
Department of Psychology
Manchester Metropolitan University
in part fulfilment for the degree of
BSc (HONS) PSYCHOLOGY/COMBINED HONOURS
Supervised by: Dr Carly Jim Date 19th August 2016
Student Declaration: By submitting this document I confirm that the material
contained in this assignment is all my own work; when the work of others has
been adopted/paraphrased (e.g. books, articles, handouts, conference reports
etc.) it has been acknowledged according to appropriate academic convention.
Direct quotes from other works are clearly identified
I have read and understand the University’s statements concerning
plagiarism
I have included all aspects of the assignment
If applicable I have paid the resubmission fee
I am aware of the penalties for exceeding coursework limits
Total Word Count : [6390].Excluding numerical tables, figures, references
section and appendices.
2. 2 | P a g e
Representations of individuals with facial disfigurements in newspaper articles:
A Thematic Analysis
ABSTRACT
Existing research into facial disfigurement suggests a bias towards
facial disfigurement. The present research used a thematic analysis
to investigate representations towards those with facial
disfigurements in six newspaper articles. From the data emerged a
set of themes which demonstrated that there is a bias towards those
with facial disfigurements. The research examined the role of the
media in influencing public perceptions and the way in which
behaviour towards facially disfigured individuals occurs through
social learning theory. The research provides some in depth
understanding through thematic analysis and can be considered in
addition to previous research, however further empirical research is
encouraged and necessary to provide further understanding into
facial disfigurements.
KEY
WORDS:
FACIAL
DISFIGUREME
NTS
SOCIAL
INTERACTION
MEDIA
REPRESENTA
TION
THEMATIC
ANALYSIS
MEDIA
INFLUENCE
3. 3 | P a g e
Introduction
We live in a society which is dictated by cultural and social expectations, behaviours
and rules (Brown, 2010). The way we look plays an important role in social
relationships (Gilbert & Miles, 2014) and is an issue which affects many people
during the course of their lives (Gilbert & Thompson, 2002). For those who have a
facial disfigurement, this means that there is a significant impact on their self-
confidence and self-esteem (Feragen et al, 2010). Contemporary notions of beauty,
as exemplified by the mass media’s depiction of beauty, are unrealistic and
unattainable, often resulting in anxiety and depression, as well as encouraging body
dysmorphic belief and disordered eating behaviour (Schwitzer et al, 1998; Stice &
Whitenton, 2002). Such pressures will inevitably affect those with a facial
disfigurement (Dittar et al, 2000) as when it is seemingly not enough to be
comfortable in your own skin when you are deemed as ‘normal’ by others, it is
inevitable that those deemed as ‘abnormal’ or ‘disfigured’ will face enormous
pressures.
The media has become an influential institution in shaping public attitudes and
opinions around various topics including beauty standards. Social Learning Theory
(Bandura, 1977) suggests that people learn new behaviours by observing others and
argues that people construct their realities based on their experiences and the
knowledge acquired from social interplay. In this instance, the media acts as an
agent of socialisation, thereby reinforcing, revealing and shaping cultural beliefs,
values and myths. Pollack and Kubrin (2007) found that the social constructionist
approach emphasised the significance of representation and meaning in the media
and argue that the constructed meaning could affect perception. One could argue
that social learning theory explains how the relationship between media and society
reinforces perceptions concerning people with facial disfigurements.
Wardle, Boyce & Barron (2009) studied television portrayals of disfigurement and
audience reception. They reported that disfigurement was rarely shown on television,
especially in everyday roles and that representations of disfigurement on television
tend to be based on stereotypes and assumptions instead of facts. This research
shows TV representation and portrayal of disfigurement is generally far from
balanced, accurate or fair and is in danger of infringing some of the industry’s
guiding codes of practice.
According to Changing Faces, over one million people in the UK alone have a
significant disfigurement from diverse causes. They report that those who contact
Changing Faces state that current depictions of disfigurements in the media can
convey a distorted and uninformed view of disfigurement (often negative) leading to
prejudice and discrimination. A public attitudes survey found that nine out of ten
people found it difficult to attribute positive characteristics to people who have facial
disfigurements (Goode et al, 2008) however there was no actual bias towards those
with disfigurements. This might be, however, because there is no appropriate scale
to measure for bias, not that a bias did not occur.
A visible disfigurement can have a profound psychological impact on individuals.
Body image, quality of life and self-esteem can be deeply impacted (Millard &
4. 4 | P a g e
Richman, 2001; Feragen et al, 2010; Harcourt & Rumsey, 2008). Social encounters
can present many challenges, however, many individuals adapt to the demands
placed upon them and appear relatively unaffected by their visible difference. Body
image is the perception that an individual holds of their body and physical
appearance, as well as the thoughts and feelings that result from this perception.
These thoughts and feelings may be positive, negative or both and are influenced by
the individual and environmental factors. This becomes problematic when an
individual displays disturbed or severe body dissatisfaction. Body dissatisfaction is
defined as a negative subjective evaluation of the weight and shape of one’s own
body image. Body dissatisfaction predicts the onset, severity and treatment
outcomes of eating disorders (Joseph & Shiffrar, 2011). A negative body image can
often involve a distorted perception of size or shape, including more global feelings
of shame, awkwardness and anxiety about the body. People with negative body
image tend to feel that their size or shape is a sign of personal failure, and that it is
an important indicator of worth.
Research indicates that body image disturbance (BID) affects many people of all
ages, genders and different ethnic backgrounds (Thompson & Heinberg, 1999 cited
in Thompson, Roehrig & Heinberg, 2005). Individuals who hold dysfunctional beliefs
and cognitions about their physical appearance are at a greater risk of displaying
disturbed body image (Butters & Cash, 1987). This shows a link between body
dissatisfaction and appearance-related cognitions rather than physical reality.
Research has shown that women experience dissatisfaction with their physical
appearance more than their male counterparts (Striegel-Moore & Franko, 2002) and
that women of all ages and sizes display body image disturbance. However, more
recent studies suggest that males also experience body-image issues such as the
negative psychological impact through exposure to images of idealised male bodies
and exhibiting body related attentional biases towards other men. (Dittmar et al,
2000; Pope, Philip & Olivardia, 2000; Joseph & Shiffrar, 2011; Pope et.al, 1999;
Blond, 2008; Lait, Gray & Pope, 2002; Griffiths et. al, 2016; Gough, Seymour-Smith
& Matthews, 2016; Cordes et al, 2016)
Children are highly perceptible to exposure, particularly with regards to appearance
and body image. Dittmar, Halliwell & Ive (2006) suggest that exposure to Barbie dolls
increases body dissatisfaction in girls ages five to eight years old. Their study was
replicated by Jellinek, Myers & Keller (2016) who also found that girls who were
exposed to thin Barbie dolls expressed a desire for thinner body shapes compared to
those in the control groups. Those who were exposed to dolls with a fuller body type
expressed no desire towards thinner body shapes. Additionally, Pope et al (1999)
explored the developing ideals of male body image through action toys and found
that the male body in toys had become much more muscular than in previous years.
This research indicates that cultural expectations may contribute to body image
disorders in both genders. Moreover, it suggests that children are significantly
influenced by what they are exposed to, and if they are presented with such
unrealistic body beauty ideals then it will affect their attitudes towards those who are
deemed less than perfect in society such as those with disfigurements.
5. 5 | P a g e
Kleck & Strenta (1998) found that people with disfigurements are often victims of
stigmatisation. Experimenters were made to appear as though they had a facial
disfigurement in order to record the public’s reaction to them when they had an
unblemished face as opposed to when they had an artificial scar applied on the
cheek. Results showed that people perceived the experimenter’s behaviour
negatively when the scar was visible (Kleck & Strenta, 1998). Previous studies also
found similar results: Rumsey et al (1982) also used actors and recorded people’s
reactions at a pedestrian crossing, where the actor had either no blemishes on their
face, a port-wine on one side of their face or a bandage (indicating they were in an
accident). They found that people stood the furthest away when the actor had a port-
wine stain and less likely to stand on the bandage side. Similarly, Houston & Bull
(1994) found that people avoided sitting next to someone who appeared to have a
port-wine stain.
Although these studies do provide some insight into the stigmatisation of people with
facial disfigurements, they have their limitations. Due to the facial disfigurements
being artificial, it could be argued that the representation of the “facially disfigured”
was inaccurate. Additionally, research like this suggests that people with facial
disfigurements appear to be socially avoided and this exclusion has a behavioural
and cognitive impact on those affected therefore they would exhibit different body
language to people who do not have not have a facial disfigurement. Moreover,
these studies do not provide an explanation as to why people avoid those with a
facial disfigurement, nor do they suggest how to improve the current situation. Social
Learning Theory suggests that if the avoidance and exclusion of people with facial
disfigurements is viewed as “normal” then they will continue to be avoided by others
(Rumsey & Bull, 1994).
Coping is a term used to describe the different approaches used to manage
stressors and pressures. Thompson, Kent & Smith (2002) explored coping
mechanisms in vitiligo patients as a strategy regarding their appearance. Results
showed that social support facilitated the development of coping methods associated
with different maintaining acceptance struggle. Macgregor (1979) examined the
social and psychological impact in individuals with facial disfigurement, observing
that the “primary challenges encountered by individuals with a facial disfigurement is
the social response in the non-disfigured,” (Macgregor, 1979). However, recent
research suggests that the level of “social disability” is influenced by a number of
social and individual factors. Additionally, individuals with disfigurements are at risk
of experiencing psychological distress, however the level of this distress is only
marginally associated with clinical severity (Gilbert & Thompson, 2002). Moreover,
the emotions, thoughts and behaviours expressed by those with facial
disfigurements echoes that of non-facially disfigured individuals who are dissatisfied
with their appearance (Rumsey & Harcourt, 2004). Moos & Schaefer (1984) found
that dealing with a chronic disease involves developing a variety of strategies in
order to regain equilibrium. Further research is needed to examine whether these
experiences apply to other disfiguring conditions such as facial disfigurements.
Newell & Marks (2000) conducted a study on the phobic nature of social difficulty in
people with facial disfigurements. They compared fearful avoidance of people with a
6. 6 | P a g e
facial disfigurement with that of patients with phobia and found that facially disfigured
individuals and patients with social phobia had similar fear questionnaire scores,
agoraphobia and anxiety/depression; however they scored lower on the agoraphobia
sub-score and higher on the social phobia sub-score. Therefore, individuals with a
facial disfigurement appear to be more socially phobic. Newell & Marks (2000)
suggest that cognitive behavioural therapy would be appropriate for facially
disfigured individuals as it is effective for social phobias.
Rumsey et al (2004) examined the effectiveness of cognitive-behavioural
interventions on disfigured individuals and reported significant improvements on
individuals’ social anxiety, appearance-related stress, general anxiety and
depression. They also found that individuals recalled improvements in positive affect
and life satisfaction, feeling more confident with strangers and meeting new social
situations. Results also showed that perceptions of their facial disfigurement had
changed and the noticeability of their condition, both to themselves and others, had
been significantly reduced (Rumsey et al, 2004). This research supports Newell &
Marks’ (2000) research suggesting that cognitive-behavioural interventions could
benefit those with facial disfigurements.
While research indicates that people are able to adapt to their disfigurements, many
still struggle to cope and demonstrate major psychological and physical distress
(Walker & Papadopoulos, 2005) and the use of strategies is reactive and may not
work on a larger scale. Although experiencing negative reactions may be inevitable
for those with a facial disfigurement, perhaps the best way to tackle this issue is to
educate the public through such means as mass-media campaigns (Krishna, 2009)
in order to change people’s perceptions of those with disfigurements.
There is little research regarding children’s attitudes towards those with
disfigurements (Bull, Rumsey & Gahagan, 1986; Rutter, 2009; Feragen et al, 2010)
however evidence suggests that facial stereotyping towards deformed people occurs
in children by the age of eleven (Bull & Rumsey, 2012) suggesting that facial
attractiveness is a significant factor in stereotyping behaviour. However, there are
many factors which could contribute to stereotyping in children including parental
disposition as well as societal and media influence. On the other hand, educating
children and schools about facial disfigurements has been found to be effective in
reducing bullying, improving the self-confidence of children with disfigurements and
improving both educators’ and children’s understanding and acceptance of those
with visible differences (Rumsey & Harcourt, 2012 cited in Casalme, 2016).
The above body of research focuses on primary school children’s attitudes towards
those with facial disfigurements and further research into a wider age range is
required to gain deeper insight into the attitudes of non-adults towards those with
facial disfigurements. Dittmar et al (2000) conducted two studies examining English
adolescents’ images of ideal bodies for same and other-gender individuals.
Participants in the first study were fifty eight pupils aged between twelve to sixteen
years and were asked to discuss photographs of “good looking” media personalities
of both genders and then choose descriptors for “ideal” men and women. The
second study used a quantitative approach and asked 458 pupils from the same age
7. 7 | P a g e
category to answer a questionnaire about body image and “ideal” beauty. Dittmar et
al (2000) concluded that body-image ideals are “multi-dimensional, showing
systematic gender differences and becoming more conventional with age (closer to
culture ideals)”. Participants’ own body mass linked systematically to body-image
preferences. However, with regard to the “ideal woman” body image, both female
and male participants with higher BMIs were found to distance themselves from
traditional notions of female beauty.
The reliability of the results for these studies is questionable: the descriptors for
“ideal” men and women in the first study could be said to have been influenced by
the previous discussion where participants were shown photographs of “good-
looking” media personalities. This may have created a pre-existing notion of “ideal”
beauty in the participants before the next task. Additionally, the choice of participants
in the study (white Caucasians from a middle-class and working-class background)
suggests ethnocentric bias and limits the universal application of the study.
Furthermore, research has shown that there is an attentional bias towards the body
of thin women (Glauert et al, 2010) and that this is linked to body dissatisfaction
(Joseph & Shiffrar, 2011). However, this attentional bias only occurs when the
observer can identify with the observed subject and more interestingly, does not
generally tend to occur across genders. Therefore, Dittmar et al’s (2000) research
suggests that these “heavier” individuals either do not possess higher body
dissatisfaction as their peers, or that they do not identify with the bodies of thin
women. If the latter is true, then it would allow these adolescents to challenge the
unrealistic beauty ideals incited by mass-media and society. By challenging these
preceding notions of beauty, it would enable topics such as facial disfigurements to
be brought to light, and become less stigmatised in society.
Overall, research demonstrates that there is an unequivocal bias against people with
facial disfigurements. It could be argued that it is a case of a lack of understanding
and knowledge on the part of the public, in conjunction with society’s unattainable
image of beauty which is incited by mass-media and internalised by the public
through Social Learning Theory. It appears that those with facial disfigurements are
isolated from the rest of society, which has detrimental effects on their psychological
well-being. This means that these individuals require an emotional strategy in order
to cope with other’s attitudes towards them. There a serious issue of unawareness in
society about people with facial disfigurements and this segregation is a result of
society’s expected body image ideals and fuelled by the media. The reasons,
however, could be ruled as mere speculation without further research as there is not
enough existing research, particularly qualitative, on facial disfigurements. The
present study used a thematic analysis to gain a clear understanding of the way in
which the media portrays people with disfigurements. The study aimed to explore the
following research questions: Are people with disfigurements presented in a
particular way in the media? What are the attitudes towards people with
disfigurements in the media? Is there a social stigma towards people with
disfigurements? If so, why is this? The explored body of research has already
suggested some themes, which was considered in the thematic analysis.
8. 8 | P a g e
Method
Participants
This study does not use human participants. Data will be collected from six
newspaper articles featuring individuals with disfigurements.
Materials
There are various forms of media but newspapers are the main source of presenting
social and national issues as well as forming ideologies (Lotz, 1991). Six newspaper
articles reporting about people with facial disfigurements will be used in this study
and be subjected to critical analysis as they are the relevant materials necessary in
order to answer the research questions. Gamson et al (1992) found that newspaper
articles contain layers of meanings or “meta-messages” presented to readers in the
form of stereotypes that readers do not always understand, thereby shaping public
opinion. It will be interesting to see whether this influence of opinion and stereotype
is evident in the data set. Due to the popularity of social media and the ever-
changing widened target audience that online journalism receives, it seemed only
appropriate to use online articles as it is pertaining to contemporary society.
Procedure
The newspaper articles were read numerous times in order to become familiarised
with and fully digest the data. Initial codes were generated by writing down ideas and
any themes which were relevant at first glance were noted. The data was then re-
read in order to revise these themes. Similarities and differences across the data
sets were considered and a final set of themes were noted. A thorough analysis was
carried out in order to gain an insightful understanding of the data. Finally, a full
analysis was created in the form of a report.
A qualitative research method called thematic analysis was conducted in this study
in order to gain a clear understanding concerning the perception of people with
disfigurements and the reason behind these attitudes and representations towards
individuals with facial disfigurements and the facially disfigured community in
general. Thematic analysis is the most appropriate method for this study as it
involves identifying, analysing and reporting patterns (themes) within the dataset
(Braun & Clarke, 2006) allowing for the emergence of a developed set of themes to
be explored thoroughly in relation to the research question. Thematic analysis allows
for a condensed overview of a lengthy text in that key points are easily extracted,
whilst still providing a deep insight into the topic at hand and offer a social
interpretation as well as a psychological analysis (Braun & Clarke, 2006). Thematic
analysis is simple, easy to use and allows for flexibility in the researcher’s choice of
theoretical framework. While other research methods are linked to specific theories,
thematic analysis can be used with any theory the researcher chooses. Through this
flexibility, thematic analysis allows for the emergence of rich, detailed and complex
descriptions of data. However, as with other research methods, thematic analysis
does have its disadvantages. One disadvantage is that it is reliant on the
9. 9 | P a g e
competence of the researcher to conduct a good analysis, as well as choosing an
appropriate research question. Additionally, because thematic analysis has limited
interpretive powers, it allows for a wider scope for the researcher which makes it
difficult to focus on one particular topic.
Discussion and Analysis
Through examination of the data sets, six themes emerged from the experiences of
the facially disfigured individuals. The thematic structure of the results is illustrated in
table 1. The themes are all interlinked and this connection will be more apparent
during the analysis.
Table 1: Structure of themes
Acceptance Levels of Facial Disfigurement (Table 1: Code 1.)
Acceptance is a major theme as it examines not only the level of self- acceptance of
an individual with a facial disfigurement, both also the reactions encountered by said
individual from the public.
While day-to-day encounters with strangers brought the same hurtful stares and
comments, Loker was used to it. (Lines 264-265, Penny)
Living with a facial disfigurement, in a busy city like London, means I am rarely
invisible. Even something as simple as a train journey can turn into a gauntlet of
stares, pointing and whispers. (Lines 366-368, Adam)
Pointing and staring can quickly progress into name-calling, particularly on nights out
when alcohol is added to the equation. (Lines 383-384, Adam)
As a teenager, I used to get angry, but that doesn’t do any good to you or the person
staring. It just reinforces the stereotype that people with disfigurements must be
angry, tragic or scary. (Lines 183-185, Victoria)
Thematic
level
Code Theme 1 Code Theme 2 Code Theme 3 Code Theme 4
Primary
theme
1. Acceptance
level of
disfigurement
2. Media
influence
3. Education 4. Isolation
Sub-
theme
1.1 Perceived
acceptance
level
2.1 Stereotype(s) 3.1 Experience in
education /
school
4.1 Psychological
effects of
living with a
disfigurement
Sub-
theme
1.1.1 Actual
acceptance
level of
2.1.2 Power 3.1.1 Educating others
/ Lack of
education
4.1.1 Support
network(s)
Sub-
theme
1.2 Attitudes 2.1.3 Influence on
public
behaviour
3.1.2 Preconception(s)
Sub-
theme
1.1.2 Prejudice(s) 3.1.3 Children
10. 10 | P a g e
'People point and stare and Simon often gets funny looks when he walks around the
village with Alice’. (Lines 554-555, Simon)
I have grown up being stared at because of the way I look…I remember thinking all
adults were angry, because of the way they used to look me. (Lines 327–330, Lucas)
…James applied to be a residence hall adviser, someone who assists other students
in navigating dorm life. The supervisor who rejected him candidly told him that his
odd-looking ear could put others off. (Lines 62-64, Randy)
The data suggests that general public attitudes (Code 1.2) towards the facially
disfigured are negative. This unacceptance and prejudice (Code 1.1.2) is
demonstrated through others’ reactions to those with a facial disfigurement. They are
subjected to stares and judgement based on the way they look and are socially
avoided. Even then, they must keep up appearances and become or put on an act of
resilience in order to carry on. It is often assumed that because others are
unaccepting of people with disfigurements, that they themselves do not accept their
disfigurements. However, as demonstrated by the data, this assumption is a
stereotypical misrepresentation:
I’m happy with my face most days. After all, I’m a woman, and no woman is
completely happy with the way she looks. (Line 177-178, Victoria)
“I try not to take it too personally. We all stare, even me," she says. (Line 182,
Victoria)
“All people with facial disfigurements should be as proud as I am.” (Line 320, Lucas)
The exterior doesn't necessarily reflect the beauty that often lives inside. (Line 301,
Penny)
There is an assumption that those with a facial disfigurement are uncomfortable or
unaccepting of their own disfigurement, however the dataset demonstrates that the
individuals are accepting of their disfigurements as well as others’ reactions and
understand why they are subjected to such treatment from the public. They also
understand that although there are reasons as to why people stare, something
should be done to change the public’s understanding and treatment of those
perceived as different. The data illustrates both the perceived acceptance (Code 1.1)
of having a facial disfigurement and the implications of having a facial disfigurement
as well as the actual level of acceptance (Code 1.1.1) by those who have a
disfigurement.
Media influence (Table 1: Code 2.)
The media acts as an influence (Code 2.1.3) of people’s perceptions of those who
look different or do not conform to society’s standards in terms of appearance.
Although there was not much direct discussion of addressment of the media, there
were some issues which emerged throughout the data sets.
Disfigurement is so widely unrepresented in our media heavy culture it is little
wonder people don't know how to react to it. (Lines 371-372, Adam)
11. 11 | P a g e
When people get drunk, they like to call me names. I have been called "spastic",
"elephant man" and "deformed mutant". (Lines 387-388, Adam)
“With the rise of social media, you can be an anonymous bully. If you're not
attractive, in many ways you're not going to be successful in society”. (Lines 117-
119, Randy)
…when I ask James if I could take a picture of him wearing his new ear, he
refuses… worried… that it might later be lifted and included in some online "hall of
monsters". (Lines 138-141, Randy)
Victoria has been falsely portrayed in the media as being anti-cosmetic surgery
because of her decision not to have the size of her jaw reduced. (Lines 170-173,
Victoria)
Disfigurement is a topic which is generally unrepresented in our “media heavy
culture” therefore people are unsure of how to react when they encounter those who
have a disfigurement. Adam mentions some names he has been called – “spastic”,
“elephant man” and “deformed mutant”. These slurs are heavily influenced (Code
2.1.3) by popular culture. “Elephant man” refers to Joseph Carey Merrick, an
Englishman in the 19th century who suffered from a disfigurement similar to Adam’s,
neurofibromatosis, and who was exhibited as a human curiosity due to his severe
disfigurement and labelled the ‘elephant man’. People with disfigurements are often
presented in a stereotypical (Code 2.1) manner, if at all, in the media. They are
rarely shown in “normal” circumstances, taking part in day to day activities, rather
they are depicted in roles such as “shock docs” and subjected to and exhibited in
extraordinary circumstances and labelled or referred to in such a way as to receive
shocking reactions from the public (Wardle, Boyce & Barron, 2009). It is not
surprising then than Randy refuses to have his photograph taken, fearing that his
photo will be put in an exhibit where he will be ridiculed. This portrayal of disfigured
people reinforces the notion that they should be seen as different and excluded from
society except when publicised as a subject of entertainment or to be studied by
curious individuals. Additionally, it illustrates the power (Code 2.1.2) of suggestion
that the media holds over people as well as their prejudices (Code 1.1.2) and beliefs
about those who do not conform to cultural norms. Victoria experiences this
prejudice (Code 1.1.2) through the expectation to conform to altering her appearance
to make her appear more “normal” and then questioned for not doing so. This
ideology is worrying as it conforms to the notion that different equals wrong and
therefore anyone who looks different should not be accepted. Stereotyping appears
to be an issue which people with facial disfigurements encounter on a daily basis. It
also develops in the theme of “education” (Code 3.).
Education (Table 1: Code 3.)
Education (Code 3.) is an imperative and ambiguous theme which comes in two-fold
in the data set: the experiences in education (Code 3.1) and educating others (Code
3.1.1).
12. 12 | P a g e
When it was time to start school, she discovered how different she actually was…
She had no friends. She accepted the name-calling as part of her life and seemed to
understand that crying or fighting back only made it worse. (Lines 253-256, Penny)
She has been called names like fat chin, Buzz Lightyear and Desperate Dan. At
school, a girl threatened to punch her eyeball "back into place". (Lines 148-159,
Victoria)
My friend Lucas also has a facial disfigurement. Growing up, he was also ridiculed,
spat at and even had his head stood on. In both of our cases the schools we
attended didn't do anything about it. (Lines 391-393, Adam)
I have been bullied at school (Lines 327-328, Lucas)
At school, in an environment where children (Code 3.1.3) are taught not only
vocational skills but social skills and what is deemed appropriate behaviour, these
facially disfigured individuals endured the most cruelty. This is a serious issue as
although bullying is a common occurrence in most schools, it does have detrimental
effects on the children’s wellbeing and development. Children (Code 3.1.3) with
disfigurement are more likely to be bullied as a result of their disfigurement.
What is more disturbing about the experiences described the individuals, is the
indifference expressed by the teachers to the situation as well as the prejudice
(Code 1.1.2) shown to students with disfigurements. Ignoring or not taking action
when a child who has a disfigured or even disability is being treated as such only
reinforces this type of behaviour from other children (Code 3.1.3). This then
becomes a chain of negative behaviour and attitudes (Code 1.2) towards those who
are different or who are disfigured – and a perfect example of social learning theory.
Moreover, while there are stricter regulations and training provided to educators in
schools to detect and help students with learning difficulties in this day and age,
there are still occurrences of preconceptions (Code 3.1.2) regarding children (Code
3.1.3) and adults with a disfigurement. The data suggests that the perceptions and
judgements of facially-disfigured individuals appears to be very assumptive; and that
there is a lack of education (Code 3.1.1) regarding disfigurements:
"The teachers assumed I must be stupid," says James, who was put in a class with
children who had learning disabilities… (Lines 55-56, Randy)
I'm often thought of as having learning difficulties and I'm treated differently to other
kids. (Lines 328-329, Lucas)
'They think because of the way he looks he can't, or shouldn't be able to, cope with a
baby. (Line 556, Simon)
'Children are the worst because they just say what they see and don't realise how
mean they can be…' (Lines 562-563, Simon)
13. 13 | P a g e
She's quick to point out she has no interest in visiting a theme park geared toward
children, where she'd likely be subjected to stares as parents attempt to answer
questions about her. (Lines 292-294, Penny)
It appears that societal perceptions align with the ideology those who look different,
or ‘abnormal’ must have special needs. James, Lucas and Simon all experienced
discrimination regarding their intellectual capability due to their disfigurements. Their
physical appearance seems to be a basis of their mental capacity, to those without a
disfigurement. With regards to children’s attitudes (Code 3.1.3) towards facially
disfigured individuals, research shows that children (Code 3.1.3) are highly
impressionable and will replicate the actions of those around them, particularly role
models. This could be a parent, guardian, teacher, even media personalities.
Therefore it is vital that a good example is set for children (Code 3.1.3) and that they
are taught about disfigurement from an early age so that they can learn to accept
those who appear different.
Isolation (Table 1: Code 4.)
People with facial disfigurements often feel isolated due to others’ reactions to their
disfigurement:
“Sometimes you can feel isolated, especially if you have a rare condition. It’s difficult
if you don’t see anybody else in the street like you. Getting peer support is so
important.” (Lines 200 -202, Victoria)
I felt utterly alone and unsupported. (Lines 402-403, Adam)
It's in the pub, when I'm having a pint of beer after a hard week of work that I feel at
my most vulnerable and exposed. (Lines 385-386, Adam)
There are many adventures in life that she is hesitant to embrace, even though she
is physically able. (Lines 284-285, Penny)
"When I go out to dinner with my friends and no one stares at me or asks to be
moved to a table further away from me, that's a good day," (Lines 311-312, Penny)
The data suggests that isolation (Code 4.) is a normal part of life for those with
disfigurements, it is also insinuated that the severe the disfigurement, the more an
individual will isolate themselves. Adam finds it difficult to fully immerse himself in
social situations. He describes feeling “exposed” and “vulnerable”, a common feeling
for those with a facial disfigurement. Research has shown that those with
disfigurements can suffer cognitively and emotionally due to the social impact of
living with a facial disfigurement (Code 4.1). They can also tend to avoid social
encounters so that they do not feel uncomfortable or out of place. This is true for
Penny, who is cautious about straying past her comfort zone. It is likely that her
previous negative social encounters have impacted her psychological well-being and
development (Code 4.1). She is much happier to be ignored than acknowledged in
public. However, Penny does have a great support network (Code 4.1.1) in her
group of girl friends and family, as well as a job which provide her with a great deal
14. 14 | P a g e
of joy. It is imperative to have a good strong support network (Code 4.1.1) in order to
not feel isolated or abandoned.
The data illustrates the naïve misconceptions and assumptions held by those without
disfigurements towards those with disfigurements. It also highlights the serious
implications of these ideologies. Again, social learning theory suggests that if people
react in a negative manner towards those with disfigurements or actively avoid them,
then others will eventually imitate this behaviour and segregate facially disfigured
people even more.
Through the exploration of facial disfigurements, various key issues around the topic
emerged. Four core themes were identified and analysed thoroughly. The themes
included acceptance levels of those with a facial disfigurement (Code 1); the
influence of the media (Code 2); education (Code 3); and isolation (Code 4).
Throughout the analysis it was clear that the themes were all connected. For
example, the influence of the media had an impact on the preconceptions of those
with a disfigurement which in turn affected the way in which others perceived and
behaved with those who had a disfigurement. This behaviour or reaction to those
with disfigurements has an impact on the way people with disfigurements feel, often
causing psychological detriments which could affect the way in which they choose to
integrate with society. Additionally, the lack of education about disfigurements
shapes people’s behaviours and attitudes towards disfigurement.
The existing study aimed to examine the representations of individuals with facial
disfigurements in the media, focusing on newspaper articles. A thematic analysis
revealed a broad set of themes which explored the various factors that impacted
those with facial disfigurements in their daily lives. Although the use of qualitative
research methods can be viewed as limiting, the current research provides a clear
and profound understanding from a research perspective of those with facial
disfigurements using real life experiences, thus adding to the existing research on
facial disfigurements. While there have been numerous studies exploring the effects
of social attitudes towards those with disfigurements, the research thus far has been
inconclusive and insufficient due to the nature of facial disfigurements. There has
also been a lack of evidence providing an in-depth analysis of the potential reasons
as to why those with facial disfigurements struggle to integrate within society and its
implications for the future. There have been studies which have explored the
personal implications of facial disfigurement (Rumsey & Harcourt, 2007) however, it
has been found that many of the issues which arise surrounding facial
disfigurements transpire due to the way in which others react to and perceive those
with a facial disfigurement (Harcourt & Rumsey, 2008). The present study not only
explores these issues but offers further actions which can be implemented by society
in order to cease the isolation of those with a facial disfigurement so that they feel
less stigmatised and can assimilate into society without prejudice.
The qualitative research method used offers a deeper understanding into the issues
discussed above and may be used in relation to previous research, allowing for
further knowledge into the topic. The findings of the current research integrates the
use of behavioural and cognitive theories in relation to the way in which facially
15. 15 | P a g e
disfigured individuals are treated. Social Learning Theory (Bandura, 1977) suggests
that people learn through social observations and imitate the behaviour of others
within a similar environment to them. The results of the study indicate that there is a
bias toward individuals with facial disfigurements, perpetuated by the media and
resulting in the avoidance and isolation of individuals with facial disfigurements.
The influence of the media was also highlighted. The data found that the media
constantly disseminates the expectations of today’s beauty and body conscious
society. The media has an authoritative and prevailing power over public opinion and
successfully persuades consumers’ ideologies through the constant evocations in
many different types of media. There has been a plethora of research linking
negative body image to psychological well-being; and as research suggests, this is a
particular concern with those who have a facial disfigurement. Facial disfigurement
leads to lower self-esteem, anxiety, depression and general low satisfaction with life
(Millard & Richman, 2001; Feragen et al, 2010). It could be argued that the media is
a perpetrator due to the high and often unobtainable standards of beauty portrayed
in conjunction with the unflattering and pejorative portrayal of those with
disfigurements. This representation of those with disfigurements could be said to
lead to further isolation and alienation from society. This notion is supported by
previous research (Millard & Richman, 2001; Feragen et al, 2010; Harcourt &
Rumsey, 2008).
Whilst thematic analysis does have its benefits, it also have its limitations. The
results of the study, due to the method of data collection and analysis, cannot be
generalised as it is not representative of the population. However, the subjects in the
study did have facial disfigurements therefore it does offer an outlook of life and
perspective through their experiences (Rumsey & Harcourt, 2004). On the other
hand, it would be interesting to see the results of a focus group who have a facial
disfigurement and their discussions around this topic as it would offer more insight
into their subjective experiences. Alternatively, a focus group of participants without
disfigurements would also provide an interesting scope, to observe the attitudes of
the perceiver instead of the perceived. Further research surrounding the topic of
facial disfigurement is encouraged by the present research. Similarly, it would be
interesting to observe the results that a discourse analysis would extract from the
same dataset. Perhaps an analysis of the way in which the newspaper articles were
written or an examination of the attitudes of the writers as opposed to the
experiences of the subjects as was explored in the present research.
To summarise, existing research and literature into facial disfigurement has
illustrated that there is a bias towards those with a disfigurement. The present
research used a thematic analysis to examine representations of those with
disfigurements in newspaper articles and has found that those with disfigurements
are discriminated against due to their disfigurements. The research also suggests
that the media has a great influence and power over its consumers and that through
social learning theory this results in negative stereotypical behaviour towards those
with a disfigurement from the rest of society.
Reflexive Analysis
16. 16 | P a g e
Although the researcher has attempted to remain objective throughout this research,
it would be naïve to assume that this is entirely possible. Due to the researcher’s
own ethnic background and feminist ideology, the researcher understands that a
preconceived notion of discrimination against individuals exists within her and that
this may be present in this research.
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facially disfigured?’ European Journal of Social Psychology, 24(2), pp.279-284.
Joseph, C. and Shiffrar, M. (2011) ‘Do Observers' Negative Self-Evaluations of Their
Own Bodies Mediate Their Visual Attention Towards Other Bodies?’ Vision Science
Society, Naples, FL. [Online] [Accessed on 18th July 2016]
http://nwkpsych.rutgers.edu/roar/EatingDisorders.html
Jellinek, R.D., Myers, T.A. and Keller, K.L. (2016) ‘The impact of doll style of dress
and familiarity on body dissatisfaction in 6-to 8-year-old girls.’ Body Image, 18,
pp.78-85.
Kent, G. and Thompson, A.R. (2002) ‘The development and maintenance of shame
in disfigurement.’ Body shame: Conceptualisation, research and treatment, pp.103-
116.
Kleck, R.E. and Strenta, A. (1980) ‘Perceptions of the impact of negatively valued
physical characteristics on social interaction.’ Journal of Personality and Social
Psychology, 39(5), p.861.
Kleve, L., Rumsey, N., Wyn‐Williams, M. and White, P. (2002) ‘The effectiveness of
cognitive‐behavioural interventions provided at Outlook: a disfigurement support
unit.’ Journal of Evaluation in Clinical Practice, 8(4), pp.387-395.
Krishna, S. (2009) ‘Disfigurement: psychosocial impact and coping.’ Open
Dermatology Journal, 3, pp.54-57.
18. 18 | P a g e
Leit, R.A., Gray, J.J. and Pope, H.G. (2002) ‘The media's representation of the ideal
male body: A cause for muscle dysmorphia?’ International Journal of Eating
Disorders, 31(3), pp.334-338.
Lotz, R.E. (1991) Crime and the American press (Vol. 91). New York: Praeger.
Macgregor, F.M.C. (1979) After plastic surgery: adaptation and adjustment. Praeger
Publishers.
Millard, T. and Richman, L.C. (2001) ‘Different cleft conditions, facial appearance,
and speech: relationship to psychological variables.’ The Cleft palate-craniofacial
journal, 38(1), pp.68-75.
Moos, R.H. and Schaefer, J.A. (1984) ‘The crisis of physical illness.’ Coping with
physical illness, pp. 3-25.
Newell, R. and Marks, I. (2000) ‘Phobic nature of social difficulty in facially disfigured
people.’ The British Journal of Psychiatry, 176(2), pp.177-181.
NHS. (2014) Cherubism and Me. 2nd October [Online] [Accessed on 2nd November
2015] http://www.nhs.uk/Livewell/facialdisfigurement/Pages/VictoriaWright.aspx
Parry, L. (2015) ‘Father born with severe facial disfigurement is branded ‘cruel’ after
he and his wife decide to keep baby daughter who also has the condition- and insists
‘I’ll tell her she’s beautiful every day’’. Daily Mail Online. [Online] 28th April [Accessed
on 2nd November 2015] http://www.dailymail.co.uk/health/article-3058890/Father-
born-severe-facial-deformity-branded-cruel-wife-decide-baby-daughter-condition-
insists-ll-tell-s-beautiful-day.html
Pearson, A. (2015) ‘What Makes a Disability Hate Crime?’ BBC News. [Online] 23rd
July [Accessed on 2nd November 2015] http://www.bbc.co.uk/news/blogs-ouch-
33623011
Pollak, J. and Kubrin, C.E. (2007) ‘Crime in the News: How Crimes, offenders and
victims are portrayed in the media.’ Journal of Criminal Justice and Popular
Culture, 14, pp.59-83.
Pope, H., Philips, K., & Olivardia, R. (2000). The adonis complex: the secret crisis of
male body obsession. Simon & Schuster.
Pope, H.G., Olivardia, R., Gruber, A. and Borowiecki, J. (1999) ‘Evolving ideals of
male body image as seen through action toys.’ International Journal of Eating
Disorders, 26(1), pp.65-72.
Public, J. (2010) ‘All people with facial disfigurements should be as proud as I am’.
The Guardian. [Online] 5th March [Accessed on 2nd November 2015]
https://www.theguardian.com/society/joepublic/2010/mar/05/changing-faces-my-life-
equality
Rumsey, N., Bull, R. and Gahagan, D. (1986) ‘A developmental study of children's
stereotyping of facially deformed adults.’ British Journal of Psychology, 77(2),
pp.269-274.
19. 19 | P a g e
Rumsey, N. and Harcourt, D. (2004) ‘Body image and disfigurement: issues and
interventions’. Body image, 1(1), pp.83-97.
Rumsey, N. and Harcourt, D. (2005) The psychology of appearance. McGraw-Hill
Education (UK).
Rumsey, N. and Harcourt, D. (2007) ‘Visible difference amongst children and
adolescents: issues and interventions.’ Developmental neurorehabilitation,10(2),
pp.113-123.
Schwitzer, A.M., Bergholz, K., Dore, T. and Salimi, L. (1998) ‘Eating disorders
among college women: Prevention, education, and treatment responses.’ Journal of
American College Health, 46(5), pp.199-207.
Steinberg, N. (2015) ‘Facial Discrimination: Living With a Disfigured Face.’ CNN.
[Online] 23rd June [Accessed on 2nd November 2015]
http://edition.cnn.com/2015/06/23/health/facial-discrimination-disfigured-face/
Stice, E. and Whitenton, K. (2002) ‘Risk factors for body dissatisfaction in adolescent
girls: a longitudinal investigation.’ Developmental psychology,38(5), p.669.
Striegel-Moore, R.H. and Franko, D.L. (2002) ‘Body image issues among girls and
women.’ Body image: A handbook of theory, research, and clinical practice, pp.183-
191.
Thompson, J.K., Roehrig, M., Cafri, G. and Heinberg, L.J. (2005) ‘Assessment of
body image disturbance.’ Assessment of eating disorders, pp.175-202.
Thompson, A.R., Kent, G. and Smith, J.A. (2002) ‘Living with vitiligo: dealing with
difference.’ British journal of health psychology, 7(2), pp.213-225.
Walker, C. and Papadopoulos, L. (2005) Psychodermatology: The psychological
impact of skin disorders. Cambridge University Press.
Wardle, C., Boyce, T. and Barron, J. (2009) ‘Media coverage and audience reception
of people with disfigurement or visible loss of function.’ The Healing Foundation.
Wynn, D. (2013) ‘A Beauty Beyond Skin Deep.’ CNN. [Online] 17th April [Accessed
on 2nd November 2015] http://edition.cnn.com/2013/04/14/health/loker-profile/
22. 22 | P a g e
Appendix 2: Application for Ethics Form
Application for Ethics Approval Form (AEAF)
(This form includes the University Ethics Check List and a Risk Assessment)
Introduction
Undergraduate projects must have ethical approval before participants are
contacted and the study is conducted.
Before completing this form, please refer to the Dissertation Unit Handbook which
provides information and advice about the ethical approval process. You must also
consult the University’s Academic Ethical Framework and the University’s Guidelines
for Good Research Practice, both of which can be found at:
http://www2.mmu.ac.uk/rke/ethics-forms/
Accessed 25th August, 2015
In addition, you must comply with the British Psychological Society’s conduct and
ethics guidelines, which can be found at:
http://www.bps.org.uk/the-society/code-of-conduct/code-of-conduct_home.cfm
Accessed 25th August, 2015
No data collection, or contact with prospective participants can take place
before ethical approval has been given.
Please note that it is the student’s responsibility to follow the University’s
Guidelines on Good Research Practice and any relevant academic or
professional guidelines in the conduct of their study. This includes providing
appropriate information sheets a consent form and a debrief sheet, and
ensuring anonymity in the storage and use of data.
Once approval is granted any change in the questions, design or conduct of
your research will require ethical approval from your supervisor and will
require the submission of a “Request for Amendment” form.
If you answer Yes to any of the questions in Section 3 (Ethical Issues and Risk
Assessment) on this form, you must give a full explanation of what the risks are, and
what steps you will take to minimise those risks. Note that even if you answer ‘No’
or ‘Not applicable’ to any of the questions, this does not absolve you from
responsibility if a risk is found when the research begins. You should
therefore still discuss the issue on this form to demonstrate why the answer is
“No” or Not applicable”.
23. 23 | P a g e
Section 1) Project and Applicant Details
To be completed by student
Final Year Research Project | Research Practical | Other (please circle)
Final Year Research Project
Name of applicant:
Zulekha Nurein
Email address:
10168439@stu.mmu,ac,uk
Programme of study:
Combined (Hons) BSc Psychology
Name of supervisor:
Dr Carly Jim
Name of Unit Leader:
Dr Gillian Marks
Department:
Department of Psychology
Title of proposed research:
Representations of individuals with facial disfigurements in newspaper
articles: A Thematic Analysis
Summary of project
1. Give a brief overview of your project including [150 words max.]
i. Broad aims
The aim of this project is to explore representations of disfigurements in the media –
focusing on newspaper articles and the way in which people with disfigurements are
portrayed.
ii. Brief summary of background literature citing key sources/journal articles
1. Media Coverage and Audience Reception of Disfigurement on Television
(Boyce, Wardle & Kitzenger, 2006)
24. 24 | P a g e
2. Changing Faces (Charity for people with disfigurements) *Millstone (2008)
combats the “beauty” myths e.g. the notion that good looking people are more
successful etc
3. ‘Women With Facial Disfigurements: Impact of Media-Constructed Images of
Beauty’ Papadopoulos (2010)
4. Bandura’s Social Learning Theory
iii. Research question(s) and/or hypothesis/hypotheses
1. Are people with disfigurements presented in a particular way in the media?
2. What are the attitudes towards people with disfigurements in the media?
3. Is there a social stigma towards people with disfigurements? Why is this?
Section 2) Method
1. Provide a clear description of the method to be used including [150 words
max.]
i. Number of participants and how they will be recruited
This study does not use human participants. Data will be collected from 6 newspaper
articles which feature individuals with disfigurements will be used instead to highlight
important themes and the texts will be carefully analysed.
ii. Brief outline of procedure
A qualitative research method called thematic analysis will be used. It is a ‘method
for identifying, analysing and reporting patterns (themes) within data’. (Braun &
Clarke, 2006). Thematic analysis allows for a condensed overview of a lengthy text
in that key points are easily extracted, whilst still providing a deep insight into the
topic at hand and offer a social interpretation as well as a psychological analysis.
(Braun & Clarke, 2006)
The thematic analysis will involve:
Familiarising myself with the data
Generating initial codes (by jotting down ideas)
Looking for key themes
Revising these themes
Defining and naming thee themes
Producing a final and full analysis in the form of a report
iii. Identify any material / apparatus to be used
Pencil/pen, highlighters
iv Outline questionnaires/interview schedule to be used and include full copy
in an appendix
25. 25 | P a g e
v. Make it clear whether you need permission to use anything identified in (iii)
and (iv) or provide evidence that you have gained permission in an appendix
n/a
Section 3) Ethical Issues and Risk Assessment
Please provide a discussion for all the questions to support your answer
1. Vulnerability: Could your study involve participants who may be classed as
vulnerable and may need assistance to give informed consent?
[Tick the relevant box]
Yes No X N/a
Discuss [150 words max.]
2. Consent & Deception: Will participants be deceived or will it be necessary
for participants to take part in the study without their knowledge and consent
at the time?
[Tick the relevant box]
Yes No X N/a
2. 1 Deception: Describe the arrangements for briefing or de-briefing
potential participants [note that briefing must ensure that participants are
aware of their right to withdraw from the study within a stated time period]
[150 words max.] N/A
2.2 Consent: Describe the arrangements for obtaining participants’ consent.
[150 words max.] N/A
3. Recruitment & Sampling: Have you or will you obtain permission from a
gatekeeper (e.g. an external ethics committee) to access data, texts or
participants?
[Tick the relevant box]
26. 26 | P a g e
Yes No X N/a
Discuss [150 words max.]
4. Data Storage & Protection: Will you collect and store personal information
that would require you to abide by the Data Protection Act (1998)?
[Tick the relevant box]
Yes No X N/a
Discuss [150 words max.]
For example, explain: How you will keep raw data secure? Will raw data, recordings,
or hard copy questionnaires be kept in a locked cabinet? Will raw data be kept on a
password protected computer? When will you transform raw data into anonymised
data? Make it clear that, on completion of your degree the anonymised data will
either be destroyed or passed to your supervisor for safekeeping if it is to be used for
publication.
5. Harm: Could your study subject harm to participants’ psychological well-
being, physical health, personal values or dignity, beyond that which they face
in their normal lifestyles?
[Tick the relevant box]
Yes No X N/a
Discuss [150 words max.]
6. Invasiveness: Are drugs, placebos or other substances (e.g. food
substances, vitamins) to be administered to participants or will the study
involve invasive, intrusive or potentially harmful procedures of any kind?
[Tick the relevant box]
Yes No X N/a
Discuss [150 words max.]
27. 27 | P a g e
7. Coercion: Will inducements be offered to participants in a way that could lead
to or be perceived as a form of coercion?
[Tick the relevant box]
Yes No X N/a
Discuss [150 words max.]
8. Risk: Is there any possible risk to the researcher (e.g. working alone with
participants, interviewing in secluded or dangerous settings)?
[Tick the relevant box]
Yes No X N/a
Discuss [150 words max.]
9. Other: Are there any other ethical issues for your project?
[Tick the relevant box]
Yes No X N/a
Discuss [150 words max.]
Section 4) Anonymity, Confidentiality & Dissemination/Publication
1). Will the data on every individual/source be treated as anonymous?
[Tick the relevant box]
Yes No N/a X
Discuss [150 words max.]
28. 28 | P a g e
If the answer is ‘no’, explain briefly why the data cannot, or will not, be anonymous
and what steps have been taken to warn participants before they take part in the
study: If the answer is yes, how will you do this?
2). Will the data provided by every individual/source be treated as confidential?
[Tick the relevant box]
Yes No N/a X
Discuss [150 words max.]
NB: Research data cannot be treated as confidential because it must be available for
discussion with your supervisor and will be reported in your research write up and
might subsequently be published. What steps have been taken to warn participants
before they take part in the study? If your research involves analysis of non-public
documents, what are the implications of making those documents public? Should
you ask permission to make those documents public?
3). Are your results likely to be of interest to your participants?
[Tick the relevant box]
Yes No N/a X
Discuss [150 words max.]
If you have answered ‘yes’, please explain how your research findings will be
communicated to your participants. For example, if participants want to know about
the research findings when can they apply for this? You should provide them with a
specified time period. It is recommended that this is simply a brief, anonymised
summary of your results. You must not supply individual feedback on
response/performance.
The study will be of interest to other people with disfigurements.
29. 29 | P a g e
Section 5) University Ethics Check List
ETHICS CHECK LIST
This checklist must be completed before commencement of any research
project. This includes projects undertaken by staff and by students as part of a UG, PGT
or PGR programme. Please attach a Risk Assessment*.
Please also refer to the University's Academic Ethics Procedures and the University's
Guidelines on Good Research Practice
* See section 3 above
Full name and title of applicant: Miss Zulekha Nurein
University Telephone Number: n/a
University Email address: 10168439@stu.mmu.ac.uk
Status: (delete as appropriate) Undergraduate Student
Department/School/Other Unit: Faculty of Health, Psychology & Social Care
Programme of study (if applicable): Combined (Hons) BSc Psychology
Name of DoS/Supervisor/Line manager: Dr Carly Jim
Project Title: Representations of individuals with
disfigurements in newspaper articles: A
Thematic Analysis
Start & End date of project: Dec 2015 – May 2016
Number of participants (if applicable): n/a
Funding Source: n/a
Brief description of research project activities (300 words max):
The aim of this project is to explore representations of disfigurements in the media – focusing
on newspaper articles and the way in which people with disfigurements are portrayed.
ii. Brief summary of background literature citing key sources/journal articles
5. Media Coverage and Audience Reception of Disfigurement on Television (Boyce,
Wardle & Kitzenger, 2006)
30. 30 | P a g e
6. Changing Faces (Charity for people with disfigurements) *Millstone (2008) combats the
“beauty” myths e.g. the notion that good looking people are more successful etc
7. ‘Women With Facial Disfigurements: Impact of Media-Constructed Images of Beauty’
Papadopoulos (2010)
8. Bandura’s Social Learning Theory
iii. Research question(s) and/or hypothesis/hypotheses
4. Are people with disfigurements presented in a particular way in the media?
5. What are the attitudes towards people with disfigurements in the media?
6. Is there a social stigma towards people with disfigurements? Why is this?
Method
1. Provide a clear description of the method to be used including [150 words max.]
i. Number of participants and how they will be recruited
This study does not use human participants. Data will be collected from 6 newspaper articles
which feature individuals with disfigurements will be used instead to highlight important themes
and the texts will be carefully dissected.
ii. Brief outline of procedure
A qualitative research method called thematic analysis will be used. It is a ‘method for
identifying, analysing and reporting patterns (themes) within data’. (Braun & Clarke, 2006).
Thematic analysis allows for a condensed overview of a lengthy text in that key points are
easily extracted, whilst still providing a deep insight into the topic at hand and offer a social
interpretation as well as a psychological analysis. (Braun & Clarke, 2006)
The thematic analysis will involve:
Familiarising myself with the data
Generating initial codes (by jotting down ideas)
Looking for key themes
Revising these themes
Defining and naming thee themes
Producing a final and full analysis in the form of a report
iii. Identify any material / apparatus to be used
Pencil/pen, highlighters
Does the project involve NHS patients or resources? NO
If ‘yes’ please note that your project may need NHS National
Research Ethics Service (NRES) approval. Be aware that research
carried out in a NHS trust also requires governance approval.
31. 31 | P a g e
Click here to find out if your research requires NRES approval
Click here to visit the National Research Ethics Service website
To find out more about Governance Approval in the NHS click here
Does the project require NRES approval? NO
If yes, has approval been granted by NRES?
Attach copy of letter of approval. Approval cannot be granted without a
copy of the letter.
YES NO
NB Question 2 should only be answered if you have answered
YES to Question 1. All other questions are mandatory.
YES NO
1. Are you are gathering data from people? ☐ ☐
For information on why you need informed consent from your participants please click here
2. If you are gathering data from people, have you: n/a
a. attached a participant information sheet explaining your
approach to their involvement in your research and maintaining
confidentiality of their data?
☐ ☐
b. attached a consent form? ☐ ☐
Click here to see an example of a participant information sheet and consent form and note that
there are templates on Moodle which you should adjust to make them appropriate for your
study.
3. Are you gathering data from secondary sources such as websites,
archive material, and research datasets?
☒ ☐
Click here to find out what ethical issues may exist with secondary data
4. Have you read the guidance on data protection issues? ☒ ☐
a. Have you considered and addressed data protection issues
– relating to storing and disposing of data?
☐ ☒
b. Is this in an auditable form? (can you trace use of the data
from collection to disposal)
☐ ☒
5. Have you read the guidance on appropriate research and consent
procedures for participants who may be perceived to be vulnerable?
☐ ☒
32. 32 | P a g e
a. Does your study involve participants who are particularly
vulnerable or unable to give informed consent (e.g. children,
people with learning disabilities, your own students)?
☐ ☒
6. Will the study require the co-operation of a gatekeeper for initial
access to the groups or individuals to be recruited (e.g. students at
school, members of self-help group, nursing home residents)?
(please note that “gatekeeper does not refer to the University ethics
procedure)
☐ ☒
Click for an example of a Participant Information Sheet and information about gatekeepers
7. Will the study involve the use of participants’ images or sensitive
data (e.g. participants personal details stored electronically, image
capture techniques)?
☐ ☒
Click here for guidance on images and sensitive data
8. Will the study involve discussion of sensitive topics (e.g. sexual
activity, drug use)?
☒ ☐
Click here for an advisory distress protocol
9. Could the study induce psychological stress or anxiety in participants
or those associated with the research, however unlikely you think
that risk is?
☐ ☒
Click here to read about how to deal with stress and anxiety caused by research procedures
10. Will blood or tissue samples be obtained from participants? ☐ ☒
Click here to read how the Human Tissue Act might affect your work
11. Is your research governed by the Ionising Radiation (Medical
Exposure) Regulations (IRMER) 2000?
☐ ☒
Click here to learn more about IRMER
12. Are drugs, placebos or other substances (e.g. food substances,
vitamins) to be administered to the study participants or will the study
involve invasive, intrusive or potentially harmful procedures of any
kind?
☐ ☒
Click here to read about how participants need to be warned of potential risks in this kind of
research
13. Is pain or more than mild discomfort likely to result from the study?
Please attach the pain assessment tool you will be using.
☐ ☒
Click here to read how participants need to be warned of pain or mild discomfort resulting from
the study and what do about it.
14. Will the study involve prolonged or repetitive testing or does it include
a physical intervention?
☐ ☒
Click here to discover what constitutes a physical intervention and here to read how any
prolonged or repetitive testing needs to managed for participant wellbeing and safety
33. 33 | P a g e
15. Will participants to take part in the study without their knowledge and
informed consent? If yes, please include a justification.
☐ ☒
Click here to read about situations where research may be carried out without informed
consent
16. Will financial inducements (other than reasonable expenses and
compensation for time) be offered to participants?
☐ ☒
Click here to read guidance on payment for participants
17. Is there an existing relationship between the researcher(s) and the
participant(s) that needs to be considered? For instance, a lecturer
researching his/her students, or a manager interviewing her/his staff?
☐ ☒
Click here to read guidance on how existing power relationships need to be dealt with in
research procedures
18. Have you undertaken Risk Assessments for each of the procedures
that you are undertaking?
☐ ☒
19. Is any of the research activity taking place outside of the UK? ☐ ☒
PLEASE APPEND BELOW ALL REQUIRED INFORMATION (labelled Appendix
1, Appendix 2, etc.)
All students must append:
the full briefing information
An example of the informed consent form
the full debriefing information.
Students must also append as appropriate to their particular study:
any interview schedule;
any self-constructed questionnaires in full;
any permission to use established questionnaires with the questionnaire in
full;
any self-constructed materials in full;
any permission to use established materials with an outline/example of the
materials;
an outline of any apparatus being used.
I understand that if granted, this approval will apply to the current project protocol and timeframe
stated. If there are any changes I will be required to review the ethical consideration(s) and this will
include completion of a ‘Request for Amendment’ form.
☐I have attached a Risk Assessment
Name of Applicant: Zulekha Nurein Date: 02/11/2015
34. 34 | P a g e
All students, whether they have early ethical approval or not, should include the
AEAF and accompanying documentation, in their
a. Research Proposal submission.
and
b. Journal Report submission
Appendix 3: Newspaper articles
Facial discrimination: Living with a disfigured face1
(CNN)"Take your ear off for me, please," Rosie Seelaus says to Randy James, who2
is sitting on a black exam chair in a special room designed for viewing colors in3
the Craniofacial Center on the Near West Side of Chicago.4
He reaches up and detaches his right ear, which she created for him out of silicone5
seven years before. The ear is shabby, stained from skin oil and mottled by daily6
use. Viewed under various lights in the neutral, gray-walled room -- daylight,7
incandescent, fluorescent -- it remains a pasty beige.8
James is a doctor with the Department of Veterans Affairs in Las Vegas -- the fierce9
desert sunlight is also tough on his prosthetic ear. Seelaus is an anaplastologist, a10
clinician who sculpts artificial body parts for people who have lost them through11
injury or disease or, as with James, who never had them to begin with.12
He was born 58 years ago with Goldenhar syndrome, a genetic condition that13
distorts the fetal face, sometimes severely. Some children with Goldenhar, like14
James, are born missing an ear or part of an ear (he had only the right lobe). Some15
have bulging eyes, or no eyes at all. James's jaw was undersized and skewed. He16
underwent 35 surgeries, including one to construct his right cheekbone using bone17
shaved from his ribs. He pulls up his shirt to show off slashing scars across his18
ribcage.19
I used to tell bullies I was mauled by a tiger at the zoo.20
Randy James, doctor21
"I used to tell bullies I was mauled by a tiger at the zoo," he says.22
The first time I walked through the corridors of the Craniofacial Center, on the23
University of Illinois at Chicago's medical campus, I had to sit down. Not that I was24
going to faint, but the immediate possibility occurred to me. So I filled a paper cup25
with water and carefully lowered myself into a chair.26
And that was before meeting any patients. Seeing the mute plaster molds of cleft27
faces, the blindly staring glass eyes and the little pyramids of false noses was28
enough. A baby's hand, made of silicone, grasped at the air.29
That was 15 years ago. I'm not sure whether I was more or less scared of people30
with disfigurements than is average. As a child I had been terrified. Even of the small31
square picture on page 289 in the American Heritage Dictionary illustrating32
"contortionist," an early-20th-century photograph of a circus acrobat, her chin33
35. 35 | P a g e
propped against the back of a chair, her body twisted impossibly above it, a foot34
planted on either side of her disembodied head. I would turn the pages of the Cs35
very slowly, steeling myself.36
Most frightening of all, Cynthia Cowles, in Mrs Farmer's first grade class at Fairwood37
School, her eyes set too far apart, her nose flattened. We boys teased her38
relentlessly, so much that her mother phoned my mother, asking her to make me39
stop.40
"I felt helpless," my mother told me, years later. "The things you were upset about,41
you'd open your mouth about."42
School days43
Randall H James was born in Ohio in 1956. His first surgeries were done over the44
next couple of years at Cincinnati Children's Hospital by Dr Jacob Longacre, a45
pioneer in modern plastic surgery.46
The teachers assumed I must be stupid.47
Randy James, doctor48
"He was like a second father to me because I saw him so much," says James, who49
didn't celebrate a Christmas at home between the ages of 3 and 13. School holidays50
were for operations. Summers too.51
When little Randy began school, his teachers in the city of Hamilton made a common52
mistake, the sort of automatic connection between inner person and outer53
appearance that has been the default assumption since history began.54
"The teachers assumed I must be stupid," says James, who was put in a class with55
children who had learning disabilities -- until teachers realized that he was actually56
very bright, only shy, and missing an ear, which made it harder for him to hear. He57
was allowed to sit in the front of the room, where he could hear the teacher, and his58
grades soared.59
Doctors constructed him a large, puffy, vaguely earish appendage. It looked like a60
coil of dough, like a boxer's cauliflower ear. It wasn't much help.61
As a student at the University of Kentucky, James applied to be a residence hall62
adviser, someone who assists other students in navigating dorm life. The supervisor63
who rejected him candidly told him that his odd-looking ear could put others off.64
"'You might make the students nervous,'" James recalls him saying, then paused,65
the pain still obvious after 40 years. "These were my classmates."66
Survivors67
"So Randy, can I take your bar off?" says Rosie Seelaus. James has a white gold C-68
shaped armature permanently fixed to the side of his head, anchored to his skull with69
gold screws. The prosthetic ear snaps onto the bar. "I'll take your bar off so I can70
make the substructure. At lunch we can look at images we have."71
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If this were fitting well we could use the same mold and just replace the silicone, but72
since it's not fitting well, we're going to be starting from scratch and redesigning ...73
Tomorrow will be mostly sculpting his ear.74
Rosie Seelaus, anaplastologist75
It is Monday. James is in Chicago for the entire week, having his new ear created.76
Seelaus removes the screws and lifts the metal structure from the side of his head,77
the first time it has been taken off in seven years, since he decided to replace the78
crude ear surgeons had created for him with a prosthetic.79
"If this were fitting well we could use the same mold and just replace the silicone,"80
she says of James, who has lost 24 pounds, which threw off the fit of his ear. "But81
since it's not fitting well, we're going to be starting from scratch and redesigning ...82
Tomorrow will be mostly sculpting his ear."83
This involves a range of high-tech gear. A CT scan is taken of his left ear. A84
computer then creates a mirror image of that scan, which a milling machine uses to85
carve a right ear out of a block of dense blue wax. Seelaus takes this prototype and86
makes a second, skin-toned ear from softer dental wax, which she puts on James to87
adjust its form and fit. A colorimeter and a spectrophotometer are used to gauge88
exact color values.89
"Color is essential to having a successful prosthesis outcome," says Seelaus, who90
spends hours matching shades, then fitting James's ear to his head -- even the most91
perfect, natural looking ear will fail if there's a gap between it and the wearer's head.92
When she's done, the ear is then pressed into dental stone to create a mold that she93
fills with silicone to make the final ear. She mixes liquid pigments into splashes of94
clear silicone, colors she dabs into clear plastic, which she holds against James's95
head, trying to match his skin tone. Seelaus doesn't pour the colored silicone into the96
mold; she paints it in, layer by layer. To imitate tiny veins, she uses strands of red97
and purple yarn.98
Matching the appearance of each individual is crucial. She has, for instance, created99
ears that were partially burned, to match scarring on a burned face.100
"This is a full-life journey for these patients," says Seelaus, who has done this work101
for 16 years. "I'm still learning from patients about what their life experience is and102
how it changes. Being born with a facial difference becomes a life journey that has a103
lot to do with acceptance. I've learned with patients who are burn survivors -- not104
victims, survivors -- initially their relationship with the prosthesis changes, too,105
throughout their lives ... What I try to tell them is, they've been through a lot already,106
it will also take adapting to the new way they look."107
How people fare on this journey generally depends on what they start with. "It's108
about your self-perception before the incident," Seelaus says.109
People who sit in this chair are survivors. They don't come to me in this chair without110
having survived something, and often it's a lot.111
Educating the public112
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Randy James is not optimistic. As someone who not only wears an artificial ear and113
has sprays of scars under his jaw, but also is a doctor working with veterans whose114
faces have been damaged by war or illness, he doesn't see much improvement in115
how society views people with facial disfigurements.116
"In some ways it's worse," James says. "With the rise of social media, you can be an117
anonymous bully. If you're not attractive, in many ways you're not going to be118
successful in society.119
A matter of perception120
On Friday, Seelaus heats James's new ear in an Imperial V Laboratory Oven, then,121
wearing light green oven mitts, removes the cylindrical mold. After it has cooled, she122
pries the sections of the mold apart. "Look at that," she says, brushing away excess123
silicone, then almost sings, "I think that looks pretty goooood."124
She lifts out a startlingly human-looking ear. With a few trims and a touch of color125
here and there, she attaches it to James's head. From two feet away you can't tell it126
isn't a natural human ear. James is delighted. "It looks a lot better, huh hon?" he127
says to his wife, who has come to see the final result. She later pronounces the new128
ear "sexy".129
Seelaus gives him some practical care tips. Keep away from solvents, small children130
and pets -- animals like to chew silicone. The ear will sink. "If you go swimming, if131
you're in the ocean, wear your old ear," she says. "Don't put it on top of a radiator or132
toaster oven."133
I estimate the ear costs $10,000 -- its fabrication took up most of Seelaus's working134
week -- and she does not contradict me. I also observe that Seelaus must be one of135
the few artists who hopes that her work goes entirely unnoticed by the public, and136
she doesn't contradict me about that, either.137
Happy though he is with his improved appendage, when I ask James if I could take a138
picture of him wearing his new ear, he refuses. He says he is worried, not about the139
photo's appearance on Mosaic, but that it might later be lifted and included in some140
online "hall of monsters". I ask several times in several ways, reassuring him that in141
my view this is highly unlikely. His answer is always the same: No. A reminder that142
looks are always relative, always only part of the story, and that our reaction to them143
fills in the rest.144
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'Cherubism and me'145
"For every person who stares, there are a hundred others who don’t, and who will146
like and respect you for who you are."147
She has been called names like fat chin, Buzz Lightyear and Desperate Dan. At148
school, a girl threatened to punch her eyeball "back into place".149
Yet, despite the difficult years she has had growing up with her condition, her self-150
assurance is clear. Victoria Wright speaks engagingly and with humour about living151
with a facial disfigurement.152
“A girl used to draw pictures of me in class and share them around,” says Victoria,153
from London.154
The tormenting only made her more determined to stand up for herself. “I have a155
very strong sense of who I am and how I want to live my life,” she says.156
“I don’t want to hide at home, afraid to go out and afraid of other people. If they have157
issues about how I look it’s their problem, not mine.”158
First signs159
Victoria was about four years old when the first signs of cherubism appeared. “My160
mum was brushing my teeth and she noticed they weren’t in the right place.”161
Cherubism, named after the chubby-cheeked, angelic figures in Renaissance art,162
runs in Victoria’s family, although in a much milder form.163
It was thought that Victoria's condition would regress after puberty, but it didn’t.164
Instead, her jaw grew larger and it began affecting her eyes.165
She had surgery to relieve the pressure on her eyes, which saved her eyesight, but166
she still suffers from headaches due to her impaired vision.167
“Cherubism isn’t a painless condition,” she says. “I do get twinges of pain. My head168
is very heavy. Doctors say it’s as heavy as a bowling ball.169
“I’ve been offered surgery on my jaw to make it smaller, but I don’t think it would170
improve my appearance,” she says. “I’m used to the way I look.”171
Victoria has been falsely portrayed in the media as being anti-cosmetic surgery172
because of her decision not to have the size of her jaw reduced.173
She is not against surgery and says: “I’m certainly not against people with174
disfigurements having surgery, but I’m fine with the way I look. Why should I have175
the surgery for other people?176
“I’m happy with my face most days. After all, I’m a woman, and no woman is177
completely happy with the way she looks. But I’m not going to change myself to178
make other people happy.”179
Unsettling stares180
39. 39 | P a g e
Victoria has never got used to the stares, although she understands that it’s a natural181
human reaction. “I try not to take it too personally. We all stare, even me," she says.182
“As a teenager, I used to get angry, but that doesn’t do any good to you or the183
person staring. It just reinforces the stereotype that people with disfigurements must184
be angry, tragic or scary.185
“If I find myself being stared at in an aggressive way, it can be unsettling. But I don’t186
let it get to me. That’s because I’ve got a good sense of who I am.187
“If someone’s staring out of curiosity, I just smile and nod to show them I’m a human188
being and there’s nothing to be scared of.189
"Most of the time, people smile back. That’s a good feeling, because I know I’ve190
made a small connection with them.”191
The support she’s received throughout her life from family, friends, teachers and192
Changing Faces, the disfigurement charity, has been crucial.193
The charity recently launched a website called iface for young people to discuss194
disfigurement, offer and receive advice, and share personal stories.195
“There are fantastic role models at Changing Faces,” she says. “Lots of staff196
members there of all ages have a facial disfigurement.197
“As a teenager meeting them, I felt, 'Wow, you can have a career, and be happy and198
confident with a disfigurement’.199
“Sometimes you can feel isolated, especially if you have a rare condition. It’s difficult200
if you don’t see anybody else in the street like you. Getting peer support is so201
important.”202
Changing perceptions203
Victoria is studying law part-time and plans to be a solicitor, perhaps representing204
people who have experienced discrimination.205
She says that 50 years ago, the world was a much harder place for people with206
disfigurements. “Now we have people with disfigurements with successful careers,207
and we are no longer hidden away.”208
Legal protection through the Disability Discrimination Act and awareness campaigns209
led by Changing Faces are helping to change public perceptions.210
“I would strongly encourage anyone with a disfigurement who feels they need211
support to get in touch with Changing Faces,” says Victoria.212
“I know it can feel as though life is hard if you have an unusual appearance. You just213
have to be brave and take that first step out of the door.214
“For every person who stares, there are a hundred others who don’t and who will like215
and respect you for who you are.”216
40. 40 | P a g e
A beauty beyond skin deep217
By Debbi Wynn, CNN218
Updated 1819 GMT (0119 HKT) April 17, 2013219
220
Surrounded by love – Penny Loker, 31, was born with two birth defects --221
hemifacial microsomia and Goldenhar Syndrome -- that left her with a disfigured222
face.223
Growing up, she endured cruel treatment from others224
She wishes she could open the dialogue and educate others about225
malformations226
Loker wants to be a wife and mother, but accepts that may never happen227
As a little girl, she never got a valentine at school parties.228
As a teenager, she never had a best friend, a boyfriend or a date.229
As a woman, she's never had a relationship. She's never been kissed.230
Her dream to one day become a wife and mother is fading as she grapples with the231
reality that it may never happen.232
Penny Loker, 31, was born with hemifacial microsomia andGoldenhar Syndrome,233
two birth defects that left her with a disfigured face. Hemifacial microsomia causes a234
malformation of the ear and/or the structure of the lower jaw. Goldenhar Syndrome is235
a congenital condition that produces abnormalities of the head and the bones of the236
spinal column. It usually affects the appearance of eyes, ears, facial bones and the237
mouth.238
Both conditions are complex, as are their names. But for a little girl facing a big239
world, the names were simple: Monster. Ugly. Freak.240
Loker was raised in Waterloo, Ontario, Canada, in a home where love and241
acceptance were given freely.242
Her father died soon after Loker's first birthday. Her mother, a strong, loving woman,243
readily took on the challenge of raising Loker and her sisters. That included244
arranging for multiple surgeries at hospitals far from home.245
Loker's recoveries were lengthy and painful, recalls older sister Crystal Loker. "But246
even then Penny had a positive attitude. She was a trouper who kept her smile and247
didn't complain."248
'Impaired Perceptions': Photographer rejects first impressions249
At home, Loker's looks were not an issue and she was treated the same as her250
sisters. She knew she looked a bit different, and she knew it caused her to be in the251
hospital a lot, but she had a child's innocence and accepted it as normal.252
41. 41 | P a g e
When it was time to start school, she discovered how different she actually was. She253
spent a lonely childhood excluded from nearly everything. She had no friends. She254
accepted the name-calling as part of her life and seemed to understand that crying255
or fighting back only made it worse. So she quietly endured it.256
She remembers that pain and humiliation well. "As an adult, it's hard to stand by257
silently when you know what these kids are going through," Loker says. "But it's258
equally difficult to speak out when you don't feel empowered to do so."259
As she got older, the name-calling was more often behind her back than to her face.260
By the time she reached high school, she had learned there would be no friends,261
parties or dates for a girl who looked like a freak.262
"It hurt, but there was nothing I could do to change it," she says.263
While day-to-day encounters with strangers brought the same hurtful stares and264
comments, Loker was used to it. Then came a day with such cruelty it remains a265
vivid memory.266
"For graduation my sister gave me a gift certificate for a manicure and pedicure. I'd267
never had one before, and it was a wonderful experience. I left the spa feeling truly268
pretty for the first time in my adult life."269
But less than a block from the salon, she encountered a carload of boys who slowed270
to look at her and began pointing and calling her names.271
Distraught, she walked as quickly as she could to get away from them, thinking all272
the while that she was not beautiful after all.273
"The pretty nails made no difference at all. Shamed and humiliated, I realized I was274
still the same girl that everyone made fun of," she recalls. "I remember that day as275
one of the worst."276
But time can ease all wounds, and her determined spirit taught her to find the good277
around her.278
She has a core group of girlfriends and relatives who cherish her as she is. She279
speaks proudly of being able to provide for herself, thanks to her job at Rogers280
Communications, where she spends her days handling customer requests. The281
company was recognized this year as a diversity leader corporation, a recognition282
that only adds to Loker's pride.283
There are many adventures in life that she is hesitant to embrace, even though she284
is physically able. She prefers not to shop alone. She has never been on a true285
vacation, saying the thought of one is scary.286
Yet it's a feat she is determined to accomplish. She is saving now for a trip to287
California to visit either BlizzCon or Comic-con.288
"I'm kind of a geek and play the online MMO World of Warcraft with my sister and289
her husband, and we always talk about how cool it would be to go there," she says.290
"People dress up so I would feel 'normal', not out of place."291
42. 42 | P a g e
She's quick to point out she has no interest in visiting a theme park geared toward292
children, where she'd likely be subjected to stares as parents attempt to answer293
questions about her.294
She wishes she could open the dialogue about individuals with malformations by295
educating people, especially children, whose natural curiosity can eventually become296
cruelty if left unaddressed.297
"Educating them early on would help them learn to be more tolerant of others who298
are different. The ability to love, share, bring happiness and help others is the real299
beauty of a person," she says.300
"The exterior doesn't necessarily reflect the beauty that often lives inside. And when301
people fail to remember that, they can miss out on the love and friendship of a truly302
special person."303
Crystal Loker agrees. "Penny is truly beautiful. She's always seeing the best in304
others and never has an unkind word for anyone. In Penny's world, others always305
come first. She's full of laughter and smiles. When you spend a day with her, you go306
home feeling good about yourself."307
Loker welcomes the opportunity to teach all of us to see beyond the surface. But308
until then, she continues to hope for good days in her own life, which for her means309
days when she is ignored.310
"When I go out to dinner with my friends and no one stares at me or asks to be311
moved to a table further away from me, that's a good day," she says.312
In spite of it all, Loker is quick to point out her many blessings: Being able to share a313
home with her family, having a job she loves, having good friends and a good health314
care system to help with the cost of a lifetime of surgeries.315
Her only regret?316
"I have so much love to give and I would love to share that with a family of my own. I317
understand it will probably never happen, and I'm learning to accept it. But I am sad318
about it," she says. "It feels like the one great loss in my life."319
43. 43 | P a g e
'All people with facial disfigurements should be as proud as I am'320
Lucas Hayward is a Billboard Kid, one of the stars of a BBC documentary and a321
national poster campaign to challenge prejudice against facial disfigurement.322
Photograph: Adam Broomberg and Oliver Chanarin BBC Two/Public Domain323
Friday 5 March 2010 12.10 GMTLast modified on Wednesday 11 June324
201420.30 BST325
I was born with a facial disfigurement and look different from most people.326
I have grown up being stared at because of the way I look. I have been bullied at327
school, I'm often thought of as having learning difficulties and I'm treated differently328
to other kids.329
I remember thinking all adults were angry, because of the way they used to look me.330
One day in my village primary school (I was nine years old) I'd had enough, so I just331
got up and went home.332
That caused a quite a stir, and it was soon after that my parents got in touch with the333
charity Changing Faces for help and advice.334
Someone from the charity came to my school to help the teachers and thankfully335
things got much better from there on.336
That's why I decided, along with Harry, Max and Lauren, to get involved with the337
Changing Faces children's campaign for Face Equality.338
I want to help other children like me by changing people's unconscious attitudes339
towards disfigurement, and by showing people that I am happy with the way I look340
and I would like them to be happy too.341
The BBC was interested in what was happening and wanted to follow the four of us,342
and film a documentary of our involvement with the poster campaign, which turned343
out to be a lot of fun as the cameras shadowed us over the course of a few months.344
First we went to an advertising agency. They asked us what we wanted to say to the345
world, and then we went to the photographer's studio where we had our portraits346
made for the posters.347
They filmed me at home and around and about with my brother, but the most348
exciting bit was when the posters were up in the London Underground and we went349
to see who's poster was in which station.350
The most impressive part of that day's filming, for all of us, was when we came out of351
one station, just as it was getting dark, and we saw ourselves on this giant352
illuminated display, it was bigger than a double decker bus.353
I never dreamt I would see myself up in lights in the middle of London.354
We all felt like film stars!355