A fear avoidance model in facial burn body image disturbance.

The quality of life of burn-injured patients can be impaired physically and psychologically. Burn patients who experience facial disfigurement have psychological, social, and economic difficulties living with their appearance in addition to difficulties associated with their medical treatment. The aim of this review was to investigate, within a cognitive behavioural framework, the effect of facial disfigurement on body image and social integration in burn patients. Body image is a complex concept used to express the mental image of a person's physical self. Newell offered a cognitive-behavioural model which drew on clinical studies of phobic disorders, assuming that many of the psychological difficulties in patients who have suffered a threat to their body image are mediated primarily by fear and avoidance. The model proposes two ends of a continuum for disturbed body image: confrontation leading to social integration, and avoidance leading to social isolation. The literature suggests that many of the confrontational and adaptive processes described in the model are likely to be important in addressing facial disfigurement issues in burn patients. However, the conclusions drawn may be entirely speculative until they are confirmed by sufficient robust research evidence.