Perceived Stigmatization and Fear of Negative Evaluation: Two Distinct Pathways to Body Image Dissatisfaction and Self-Esteem in Burn Survivors
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OBJECTIVE: Scars resulting from burn injury can pose social and psychological problems that may affect body image and self-esteem. This study aimed to investigate whether burn severity, age and female gender are associated with body image dissatisfaction and self-esteem, through an association with perceived stigmatization and fear or negative evaluation. DESIGN & MAIN OUTCOME MEASURES: Burn survivors (N = 224) completed the Fear of Negative Evaluation scale (FNE) and the Perceived Stigmatization Questionnaire (PSQ) at 3 months post-burn, and the Rosenberg Self-Esteem scale (RSE) and the Satisfaction with Appearance scale (SWAP) at 6 months post-burn. Path analysis was used to test the relationships. RESULTS: Body image dissatisfaction and self-esteem were moderately associated. Burn severity was directly and indirectly associated with body image dissatisfaction through perceived stigmatization. Female gender and age were indirectly associated with body image dissatisfaction though fear of negative evaluation. Age was indirectly associated with both perceived stigmatization and fear of negative evaluation. Perceived stigmatization and fear of negative evaluation were associated with self-esteem through body image dissatisfaction, the first indirectly and the latter both directly and indirectly. CONCLUSIONS: Findings highlight that both burn-specific factors and psychological vulnerability should be taken into account to deal with social challenges that may affect body image and self-esteem after burns.
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Fostering community-wide dialogues about body image, challenging stigmatizing behaviors, and promoting acceptance can contribute to a cultural shift toward greater body positivity.
“Moreover, fostering community-wide dialogues about body image, challenging stigmatizing behaviors, and promoting acceptance can contribute to a cultural shift toward greater body positivity [213,214,215].”
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- Authors
- Willemse, H., Geenen, R., Egberts, M. R., Engelhard, I. M., & Van Loey, N. E.
- Affiliations
- Utrecht University (NL)
- Department of Behavioural Research, Association of Dutch Burn Centres, Beverwijk, The Netherlands
- Venue
- Psychology & Health
- Publisher
- Informa UK Limited
- Published
- 2021-08-26
- Volume
- 38
- Issue
- 4
- Pages
- 445-458
- ISSN
- 0887-0446 (ISSN-L)
- 1476-8321
- OpenAlex
- W3193623090
- Cited by
- 33
- References
- 44
- Citations by year
- 2026: 5 · 2025: 10 · 2024: 11 · 2023: 7
- FWCI
- 3.24
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Psychology and Health (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Utrecht University Repository (Utrecht University) (submittedVersion, other-oa)
- Funders
- Dutch Burns Foundation (12.105, 17.102)
- Nederlandse Brandwonden Stichting
- Topics
- Health Sciences › Medicine › Epidemiology › Burn Injury Management and Outcomes
- Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
- Social Sciences › Psychology › Clinical Psychology › Eating Disorders and Behaviors
- Keywords
- burn scars, burn survivors, body dissatisfaction, self-esteem, perceived stigma, fear of negative evaluation, burn severity, gender differences, age differences, psychological vulnerability, appearance satisfaction
- MeSH terms
- Body Dissatisfaction, Fear, Female, Humans, Self Concept, Stereotyping, Survivors
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