Carver C S, Pozo-Kaderman C, Price A A, Noriega V, Harris S D, Derhagopian R P, Robinson D S, Moffat F L
Department of Psychology, University of Miami, Coral Gables, Florida 33124-2070, USA.
Psychosom Med. 1998 Mar-Apr;60(2):168-74. doi: 10.1097/00006842-199803000-00010.
Several authors have suggested that patients adjust more poorly to breast cancer if they are heavily invested in body image as a source of their sense of self-worth. This prospective study examined this possibility, looking at two aspects of concern about body image as predictors of several indices of adjustment over the first postoperative year.
At diagnosis (and again a year later) 66 women with early stage breast cancer reported how much they valued a) a sense of body integrity (or intactness) and b) a good physical appearance. The day before surgery, a week afterward, and at 3-month, 6-month, and 12-month follow ups, they reported on their mood. At presurgery and at follow ups they also rated their attractiveness and sexual desirability and reported on frequency of sexual interaction. At follow-ups they also indicated how much their illness and treatment were interfering with social and recreational activities.
Initial investment in appearance was related to distress across the postsurgical year. In contrast, investment in appearance made women more resilient against deterioration in their perceptions of attractiveness. Concern about body integrity did not strongly predict emotional distress, but it related to adverse impact on social and recreational activities in the follow-up period, to deterioration in feelings of sexual desirability, and to feelings of alienation from the self (feeling "not like yourself anymore").
Body image is often thought of in terms of physical appearance, but there is also a body image pertaining to integrity, wholeness, and normal functioning. People who are greatly concerned about either aspect of their body image are vulnerable to poorer psychosocial adjustment when confronting treatment for breast cancer. The poorer adjustment takes a different form, however, depending on the nature of the patient's body-image concern.
几位作者提出，如果患者过度将身体形象视为自我价值感的来源，那么他们对乳腺癌的适应情况会更差。这项前瞻性研究考察了这种可能性，研究了对身体形象的两方面关注，将其作为术后第一年几个适应指标的预测因素。
66名早期乳腺癌女性在确诊时（以及一年后）报告了她们对以下两方面的重视程度：a）身体完整性（或完好无损）的感觉，b）良好的外表。在手术前一天、术后一周、3个月、6个月和12个月的随访中，她们报告了自己的情绪。在手术前和随访时，她们还对自己的吸引力和性吸引力进行了评分，并报告了性互动的频率。在随访时，她们还指出自己的疾病和治疗对社交和娱乐活动的干扰程度。
术前对外表的重视程度与术后一整年的痛苦程度相关。相比之下，对外表的重视使女性在对自身吸引力的认知下降时更具恢复力。对身体完整性的关注并不能强烈预测情绪困扰，但它与随访期间对社交和娱乐活动的负面影响、性吸引力的下降以及自我疏离感（感觉“不再像自己”）有关。
身体形象通常被认为是指外表，但也存在与完整性、整体性和正常功能相关的身体形象。在面对乳腺癌治疗时，非常关注身体形象任何一个方面的人在心理社会适应方面更容易出现问题。然而，适应不良的形式不同，这取决于患者对身体形象关注的性质。
