Psychometric properties of a Romanian translation of the Acceptance of Cosmetic Surgery Scale (ACSS): An examination using bifactor exploratory structural equation modelling

Impact of Gender-Role Attitudes and Mental Health on Hostile Sexism and Acceptance of Cosmetic Surgery

BACKGROUND

Each year, tens of thousands of people worldwide choose to undergo cosmetic surgery in order to alter their appearance. In recent years, young people have gradually emerged to comprise the main driving force behind the increasing demand for cosmetic surgery. Previous studies have found that sexism may motivate young people to undergo such surgeries. However, few studies have been conducted to determine if this psychological mechanism influences the acceptance of cosmetic surgery among Chinese university students.

METHODS

A total of 579 Chinese university students (280 girls and 299 boys, 17-20 years) volunteered to participate in the online survey. They completed a questionnaire containing the Ambivalent Sexism Inventory, the 12-item General Health Questionnaire, the Gender-Role Attitudes Questionnaire and the Acceptance of Cosmetic Surgery Scale. We firstly evaluated the underlying factor structure of the Acceptance of Cosmetic Surgery Scale using exploratory and confirmatory factor analyses, and exploring pattern of associations between the constructs was analyzed via path analysis.

RESULTS

According to the findings, hostile sexism was associated with greater levels of acceptance toward cosmetic surgery. Moreover, gender-role attitudes mediated the link between hostile sexism and the acceptance of cosmetic surgery, and this mediation was positively influenced by general mental health.

CONCLUSION

Our study contributes to a deeper understanding of Chinese university students' attitudes toward cosmetic surgery, hostile sexism may contribute to normalizing traditional gender stereotypes and encourage cosmetic surgery acceptability among Chinese university students.

LEVEL OF EVIDENCE V

This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Translation and validation of a Romanian version of the Breast Appreciation Scale (BrAS)

The 9-item Breast Appreciation Scale (BrAS; Swami et al., 2022) is a recently developed instrument that assesses a woman's positive breasted experiences. To date, however, the psychometric properties of the BrAS have only been investigated in English-speaking women. Here, we report on the translation and validation of a novel, Romanian version of the BrAS. A total of 555 cisgender women from Romania completed a Romanian translation of the BrAS along with additional measures of body image and psychological well-being. Exploratory and confirmatory factor analysis identified a stable unidimensional model of the BrAS, with all nine items retained. Additionally, the Romanian BrAS evidenced complete invariance (i.e., through to latent mean invariance) across mothers and non-mothers, though mothers had higher observed scores than non-mothers. Evidence of convergent, concurrent, and incremental validity was very strong when based on observed BrAS scores, but slightly weaker when based on latent BrAS scores. In particular, greater latent breast appreciation was significantly associated with higher body appreciation, lower breast size dissatisfaction, and higher self-esteem. Overall, these results suggest that the psychometric properties of the Romanian BrAS are robust and that the instrument can be effectively deployed in this linguistic context.

A guide to exploratory structural equation modeling (ESEM) and bifactor-ESEM in body image research

Traditionally, assessments of factor validity of body image instruments have relied on exploratory or confirmatory factor analysis. However, the emergence of exploratory structural equation modeling (ESEM), a resurgence of interest in bifactor models, and the ability to combine both models (bifactor-ESEM) is beginning to shape the future of body image research. For these analytic approaches to truly advance body image research, scholars will need to have a deep understanding of their use and application. To facilitate such understanding, we describe ESEM and bifactor-ESEM models for body image researchers and provide them with the tools they need to apply these methods in their own work. Specifically, we provide an overview of ESEM and bifactor-ESEM models, and describe their broad applicability to body image research. Next, we describe how ESEM and bifactor models can be used and, using an existing dataset of responses to the Acceptance of Cosmetic Surgery Scale, demonstrate how ESEM and bifactor-ESEM models can be deployed. To facilitate wider application of these ideas, we provide our Mplus syntax (inputs) in Supplementary Materials. Through this manuscript, we hope to assist researchers to better understand the strengths ESEM and bifactor models, and to use these approaches in their own work.

The relationship between personality traits and willingness to undergo cosmetic surgery in the non-clinical population - a systematic review and meta-analysis

Objective

Conducting a systematic review and meta-analysis to synthesize previously obtained results regarding the relationship between interest in cosmetic surgery and personality traits.

Methodology

A series of criteria were applied (at the level of design, independent variables, dependent variable, participants) in order to decide which existing studies could be considered eligible for inclusion in the meta-analytic procedure. The identification of research that met the eligibility criteria was carried out with the help of the electronic search function in the following databases: ScienceDirect, PsycInfo, Web of Science, Scopus, Springer, and PubMed. Following this approach left 13 studies that were then subjected to the final analysis and included in the meta-analysis.

Results

The researchers' expectations were partially supported by the results of the analyses, thus demonstrating the existence of a significant relationship between perfectionism (socially prescribed perfectionism; perfectionistic self-promotion), appearance-based rejection sensitivity, and interest in pursuing esthetic surgery.

Discussions

Identifying these relationships will allow cosmetic surgeons to understand both the mechanisms underlying this decision and the need for psychological assessment/counseling before patients undergo such procedures. It will also allow psychologists to develop best practice guidelines for how they relate to the patient before they perform cosmetic surgery. At the same time, psychotherapists will be able to devise targeted and personalized interventions for each personality profile, so that the decision to undergo an esthetic operation is not made based on a dispositional trait (fear of rejection, stress caused by body dissatisfaction).