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Phobic nature of social difficulty in facially disfigured people

School of Healthcare Studies, University of Leeds, Leeds

ISAAC MARKS, FRCPsych

Institute of Psychiatry, London

Declaration of interest R. N. was initially supported by the University of Hull and by the University of Leeds thereafter.

Correspondence: R. Newell, School of Healthcare Studies, University of Leeds, 22 Hyde Terrace, Leeds LS2 9LN

Background Over 390 000 people in the UK are disfigured. Facial disfigurement distresses sufferers markedly but has been studied little.

Aims To compare fearful avoidance of people with a facial disfigurement with that of a group of patients with phobia.

Method Comparison of Fear Questionnaire agoraphobia, social phobia and anxiety depression sub-scale scores of 112 facially disfigured people (who scored high on Fear Questionnaire problem severity in three survey studies) with those of 66 out-patients with agoraphobia and 68 out-patients with social phobia.

Results Facially disfigured people and patients with social phobia had similar Fear Questionnaire scores. In contrast, facially disfigured people scored lower on the agoraphobia sub-score but higher on the social phobia sub-score than did patients with agoraphobia.

Conclusions Facially disfigured people with psychological difficulties resembled people with social phobia on Fear Questionnaire social phobia, agoraphobia and anxiety/depression sub-scores but were less agoraphobic and more socially phobic than were people with agoraphobia. Facially disfigured people thus appeared to be socially phobic and to deserve the cognitive—behavioural therapy that is effective for such phobias.

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