Polivy J
J Nerv Ment Dis. 1977 Feb;164(2):77-87. doi: 10.1097/00005053-197702000-00001.
Previous literature on mastectomy indicates that the operation may be perceived by the patient as a threat to her feminity. Accordingly, the present study attempted to measure changes in body image, self-concept, and total self-image in mastectomy patients and two control groups (biopsy and surgical controls). Patients were given a questionnaire measuring the concepts in question three times: 1 day before surgery; 6 days after surgery; and 6 to 11 months later. There were distinctly different patterns of results for the three groups. Mastectomy patients did indeed evince a decline in body image and total self-image, but not until months after surgery. This was not unexpected in light of previous findings of massive denial in mastectomy patients. Immediately after surgery, this denial would be at its strongest, and it is feasible that it would take some months of reality testing until the denial is no longer a necessary defense. Biopsy patients showed a decline in body image and total self-image immediately after surgery, when their denial was no longer needed. Surgical control patients showed little overall change. Thus, mastectomy patients do appear to react to the operation with a decline in self-image, although this does not appear until some time after the operation.
以往关于乳房切除术的文献表明，患者可能会将该手术视为对其女性特质的一种威胁。因此，本研究试图测量乳房切除患者以及两个对照组（活检对照组和手术对照组）的身体意象、自我概念和整体自我意象的变化。患者在三个时间点接受了一份测量上述概念的问卷：手术前1天；手术后6天；以及6至11个月后。三组的结果模式明显不同。乳房切除患者确实在身体意象和整体自我意象方面出现了下降，但这直到手术后数月才出现。鉴于之前在乳房切除患者中发现的大量否认现象，这并不意外。手术后即刻，这种否认最为强烈，可能需要数月的现实检验，否认才不再是一种必要的防御机制。活检患者在手术后即刻，当他们不再需要否认时，身体意象和整体自我意象就出现了下降。手术对照组患者总体变化不大。因此，乳房切除患者似乎确实会因手术而出现自我意象下降，尽管这在手术后一段时间才会显现。
