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Two-Year Gender Differences in Satisfaction With Appearance After Burn Injury and Prediction of Five-Year Depression: A Latent Growth Curve Approach

      Highlights

      • A model for dissatisfaction with appearance after burn injury is proposed.
      • After an initial increase, dissatisfaction with appearance follows a stable path for 2 years postdischarge.
      • Women and individuals with larger burns are more dissatisfied with their appearance.
      • Dissatisfaction with appearance predicts 5-year postdischarge depression scores.

      Abstract

      Objectives

      To use latent growth curve and longitudinal structural equation modeling to examine the 2-year trajectory of satisfaction with appearance in adults with burn injury, and that trajectory's effect on depression 5 years after burn injury.

      Design

      Data were collected at discharge after burn injury hospitalization and at 6 months, 1 year, 2 years, and 5 years postdischarge.

      Setting

      The Burn Model Systems (BMS) program consisted of a data center and 5 participating burn centers.

      Participants

      The sample consisted of adults (N=720) who were hospitalized for a burn injury, enrolled in the BMS database, and completed measures at least once throughout the 5-year study duration.

      Interventions

      Not applicable.

      Main Outcome Measures

      Satisfaction With Appearance Scale and Patient Health Questionnaire-9 (depression).

      Results

      Women with burn injury reported higher levels of dissatisfaction with their appearance in comparison to their male counterparts over the 2 years after discharge. Individuals with a larger total body surface area (TBSA) affected by a burn also reported greater body dissatisfaction across the postdischarge 2-year period. Results did not support significant gender or TBSA differences in the rate of change of body dissatisfaction trajectories across these 2 years. Individuals with greater body dissatisfaction at 6 months postdischarge tended to have higher depressive symptoms at 5 years. Six month postdischarge, body dissatisfaction scores also mediated the effects of gender and TBSA on depressive symptoms 5 years later.

      Conclusions

      It is recommended that individuals with heightened body image dissatisfaction after a burn, particularly women and those with larger TBSA, participate in evidence-based psychosocial interventions to improve long-term adjustment.

      Keywords

      List of abbreviations:

      BMS (Burn Model Systems), CFI (comparative fit index), CI (confidence interval), RMSEA (root-mean-square error of approximation), SWAP (Satisfaction With Appearance Scale), TBSA (total body surface area), TLI (Tucker-Lewis Index)
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      1. American Burn Association. Burn incidence fact sheet. American Burn Association. 2015. Available at: http://www.ameriburn.org/resources_factsheet.php. Accessed February 6, 2016.

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