THE QUEST FOR PERFECT APPEARANCE: AN EXAMINATION OF THE ROLE OF

OBJECTIVE SELF-AWARENESS THEORY AND EMOTIONS

Atefeh Yazdanparast Ardestani, B.S., M.S.

Dissertation Prepared for the Degree of

DOCTOR OF PHILOSOPHY

UNIVERSITY OF NORTH TEXAS

August 2012

APPROVED:

Nancy Spears, Major Professor

Kenneth Thompson, Committee Member
Nicholas Evangelopoulos, Committee
Member
Jeffrey Sager, Committee Member and
Chair of the Department of
Marketing and Logistics
Audhesh Paswan, PhD Coordinator for
Marketing and Logistics
O. Finley Graves, Dean of the College of
Business
Mark Wardell, Dean of the Toulouse
Graduate School
 Yazdanparast Ardestani, Atefeh. The Quest for Perfect Appearance: An

Examination of the Role of Objective Self-Awareness Theory and Emotions. Doctor of

Philosophy (Marketing), August 2012, 142 pp., 40 tables, 3 figures, references, 163 titles.

Quality of appearance is important in nature and individuals have a basic need to

establish the normality of appearance to confirm their acceptability to others. In daily

inter-relationships of the same species, for instance, normal-appearing members of a

species group reject or kill other members who appear abnormal. In human society,

appearance is considered as one of the most direct sources of information about other

people, and unattractiveness is often accompanied by negative judgments, which can

cause emotional distress and isolation. Accordingly, humans tend to pay great attention to

their personal appearance and make improvements to enhance their self-representations.

The growth of the beauty and cosmetic surgery industries is an indication of an

increasing willingness to enhance physical appearance. However, despite the growing

demand for cosmetic procedures, the consumer research literature on this topic is

extremely sparse. In fact, little is known about the attitudinal and motivational drivers

that facilitate undergoing such procedures. This dissertation enriches our understanding

of factors that affect consumers’ motivation to pursue cosmetic procedures and examines

the role of emotions in such decisions. To that end, objective self-awareness (OSA)

theory is applied and the interplay between the state of public OSA, beauty standards, and

self-conscious emotions of shame and pride is explored.

 The results of two experimental studies indicate that access to beauty standards

coupled with the state of public OSA generates self-standard comparison thoughts that

may yield self-standard discrepancies. Negative emotions experienced due to such

discrepancies move individuals into a self-regulatory cycle with the purpose of

discrepancy reduction and impact their motivation to undergo cosmetic procedures. Pride

and shame, two central self-conscious emotions, influence self-regulatory strategies and

differently impact the approach to discrepancy reduction.

These findings contribute to the research advocating the role of emotions in

decision making and provide more insights about self-conscious emotions and their role

in regulating goal pursuit behavior. The findings provide practical implications for

marketers of cosmetics products and services, social marketers trying to encourage or

discourage certain behaviors, and public policy makers. Moreover, the results have wide-

ranging implications for structuring programs designed to contribute to consumer

welfare.
 Copyright 2012

by

Atefeh Yazdanparast Ardestani

ii
 ACKNOWLEDGEMENTS

It is not easy to express how grateful I am for the infinite support and love I have

received throughout these years in the Ph.D. program, without which, I would have not

been able to reach this stage successfully.

I would like to express my heartfelt appreciation for the patience, guidance, and

support provided by my major professor, Dr. Nancy Spears. I would also like to express

my gratitude to my dissertation committee members, Dr. Jeffrey Sager, Dr. Kenneth

Thompson, and Dr. Nicholas Evangelopoulos, for their precious insights and guidance

throughout this endeavor.

I am grateful to Dr. Ila Manuj for mentoring and encouraging me during my first

year as a doctoral student. I would also like to thank all the other faculty members in the

Department of Marketing and Logistics for their mentorship and stewardship during my

time at the University of North Texas.

Many thanks go to my colleagues, whose support, friendship, and encouragement

made the Ph.D. journey an enjoyable and unforgettable experience for me.

Last, but not least, I would like to thank my amazing family and my dear Mehran

for their unconditional love and support, for always being there for me, listening to me,

and always making me smile. I am grateful for having them in my life and I thank God

for this blessing.

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 TABLE OF CONTENTS

Page

ACKNOWLEDGMENTS ................................................................................................. iii

LIST OF TABLES ............................................................................................................ vii

LIST OF FIGURES ........................................................................................................... ix

CHAPTER 1: INTRODUCTION ........................................................................................1

Overview ..................................................................................................................1
Research Goals.........................................................................................................7
Managerial and Academic Contributions ................................................................8
Overview of the Research Design............................................................................9

CHAPTER 2: LITERATURE REVIEW AND THEORETICAL BACKGROUND........10

Overview ................................................................................................................10
Literature Review...................................................................................................10
Physical Attractiveness ..............................................................................10
Cosmetic Surgery: A Self-Enhancement Tool ...........................................16
Objective Self-Awareness (OSA) ..............................................................24
Public vs. Private Self-Awareness .................................................27
Self-Standard Comparison .............................................................29
Self-Awareness and Self-Regulation .............................................30
Self-Awareness and Emotions .......................................................33
Self-Conscious Emotions ...............................................................35
Self-Conscious Emotions and Self-Monitoring .............................38
Self-Conscious Emotions and Self-Regulation ..............................39
Model and Hypotheses Development ....................................................................42

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CHAPTER 3: STUDY 1 ....................................................................................................45
Overview ................................................................................................................45
Methodology ..........................................................................................................46
Pre-Test 1 ...................................................................................................46
Procedure .......................................................................................47
Results ............................................................................................47
Pre-Test 2 ...................................................................................................49
Procedure .......................................................................................50
Results ............................................................................................51
Study 1 Design ...........................................................................................52
Sample............................................................................................53
Procedure .......................................................................................55
Data Collection Instrument ............................................................57
Analysis and Results ..............................................................................................60
Measurement Assessment ..........................................................................60
Manipulation Checks .................................................................................70
Public OSA Manipulation Check...................................................70
Standards Manipulation Check ......................................................71
Test of Hypotheses .....................................................................................75
Supplementary Analyses ............................................................................81
Other Appearance Enhancing Procedures .....................................81
Body-Esteem and Objective Self-Awareness ................................83
Discussion of Study 1 Findings .............................................................................85

CHAPTER 4: STUDY 2 ....................................................................................................89

Overview ................................................................................................................89
Methodology ..........................................................................................................89
Pre-Test 3 ...................................................................................................90
Procedure .......................................................................................90
Results ............................................................................................91
Study 2 Design ...........................................................................................94

v
 Sample............................................................................................94
Procedure .......................................................................................95
Data Collection Instrument ............................................................96
Analysis and Results ..............................................................................................97
Measurement Assessment ..........................................................................97
Manipulation Checks ...............................................................................103
Public OSA Manipulation Check.................................................103
Pride and Shame Manipulation Check .........................................105
Test of Hypothesis ...................................................................................106
Discussion of Study 2 Findings ...........................................................................114

CHAPTER 5: GENERAL DISCUSSION AND IMPLICATIONS ................................116

General Discussion ..............................................................................................116
Theoretical Contributions ....................................................................................117
Practical Contributions.........................................................................................119
Limitations and Future Research .........................................................................122

REFERENCE LIST .........................................................................................................129

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 LIST OF TABLES

Page

1. Demographic Profile of Respondents-Study 1 ......................................................53

2. Situational Self-Awareness Exploratory Factor Analysis and Reliability-Study 161

3. Body Image State Dissatisfaction Exploratory Factor Analysis and Reliability-

Study 1 ...................................................................................................................62

4. Positive and Negative Affect Exploratory Factor Analysis and Reliability-Study 163

5. Acceptance of Cosmetic Surgery Factor Analysis and Reliability-Study 1 ..........64

6. Propensity for Appearance Enhancement Factor Analysis and Reliability ...........65

7. Body-Esteem Factor Analysis and Reliability .......................................................66

8. Body Resource Needs Factor Analysis and Reliability-Study 1 ...........................67

9. Self-Esteem Factor Analysis and Reliability-Study 1 ...........................................67

10. Fear of Cosmetic Surgery Factor Analysis and Reliability ...................................68

11. Measurement Model Assessment of Discriminant Validity-Study 1 ....................70

12. Manipulation Check for Public Objective Self-Awareness- Study 1 ....................71

13. Manipulation Check for Private Objective Self-Awareness-Study 1 ....................71

14. Emotions Index Comparison for Individuals in OSA Condition ...........................72

15. Emotions Index Comparison for Individuals in No-OSA Condition.....................72

16. Body Image State Dissatisfaction for Irrelevant Standards Groups ......................73

17. Motivations and Likelihood to Undergo Cosmetic Procedures for Irrelevant

Standards Groups ...................................................................................................74

18. ANCOVA Results for Test of H1and H2 ..............................................................77

19. ANCOVA Results for Test of H1and H2 after Removing the Control Group ......78

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20. Mediation Analysis Results for Test of H3............................................................82

21. Factor Loadings and Cronbach’s Alpha Values for Pride and Shame...................92

22. Manipulation Check for Pride/Shame-Pre-Test 3 ..................................................93

23. Manipulation Check for External Shame-Pre-Test 3 .............................................93

24. Demographic Profile of Respondents-Study 2 ......................................................95

25. Situational Self-Awareness Exploratory Factor Analysis and Reliability-Study 297

26. Pride and Shame Exploratory Factor Analysis and Reliability-Study 2 ................98

27. Body Image State Dissatisfaction Exploratory Factor Analysis and Reliability-
Study 2 ...................................................................................................................99

28. Positive and Negative Affect Exploratory Factor Analysis and Reliability-Study 2100

29. Acceptance of Cosmetic Surgery Factor Analysis and Reliability-Study 2 ........101

30. Body Resource Needs Factor Analysis and Reliability-Study 2 .........................102

31. Self-Esteem Factor Analysis and Reliability-Study 2 .........................................102

32. Measurement Model Assessment of Discriminant Validity-Study 2 ..................103

33. Manipulation Check for Public Objective Self-Awareness-Study 2 ...................104

34. Manipulation Check for Private Objective Self-Awareness-Study 2 ..................104

35. Manipulation Check for Pride/Shame-Study 2 ....................................................105

36. Manipulation Check for External Shame-Study 2 ...............................................106

37. Body Image State Dissatisfaction for OSA Vs. No-OSA Groups .......................107

38. Multivariate Analysis of Variance for Cosmetic Surgery Motivation and

Likelihood ............................................................................................................110

39. Mediation Relationships When Shame is Induced ..............................................111

40. Mediation Relationships When Pride is Induced .................................................112

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 LIST OF FIGURES

Page

1. Research Model .....................................................................................................44

2. Interaction Between Objective Self-Awareness and Standards on Body Image

State Dissatisfaction ...............................................................................................78

3. Interaction Between OSA and Body Esteem-Appearance on Intrapersonal

Motivation for Cosmetic Surgery ..........................................................................84

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 CHAPTER 1

INTRODUCTION

Overview

In children’s fairytales, physical appearance accurately predicts moral virtue and

the allocation of rewards. Cinderella, for example, was a lovely young maiden who, in

addition to her generous nature, had a beautiful face and a shapely figure. As we all

know, eventually, good things happened to her; she married the prince, and lived happily

ever after. This simple story is just an example of the logic in most children’s tales in

which the hero is often an attractive young individual, while the antagonist is a witch or

possesses a variety of undesirable physical characteristics (Surawski and Ossoff 2006).

Most people embrace the fairytale notion that our appearance reveals who we are

and what we deserve (Regan 2011). Social psychological research provides strong

evidence for the existence of a pervasive physical attractiveness stereotype, commonly

illustrated by the phrase what is beautiful is good (Dion, Bersceid, and Walster 1972;

Regan 2011). For instance, previous research indicates that physically attractive

individuals are believed to have more socially desirable personality traits and

characteristics (e.g., kindness, sensitivity, intelligence, and warmth) compared to their

less attractive counterparts (Hatfield and Spercher 1986; Eagly et al. 1991; Langlois et al.

2000). Attractive people are also expected to obtain prestigious jobs, have successful

marriages, and experience happy and satisfying lives (Hatfield and Spercher 1986; Eagly

et al. 1991; Langlois et al. 2000). Moreover, physically attractive individuals are more

1
likely to receive help from others (Sarwer, Magee, and Clark 2003) and get better job

offers, promotions, and salary rates (e.g., Frieze, Olson, and Russell 1991; Robins,

Homer, and French 1994).

Research has indicated that personal appearance may be the most direct source of

information about other people (Shevlin et al. 2003). In many professions (e.g., personal

selling, help desk, and reception) attractiveness is among the most important factors that

consumers rely on for evaluating employees’ competence (Gronroos 2000). Although

service encounters usually comprise short interactions with service employees, customers

generally form a first impression based on their brief exposure to employees’ appearance

(Verhoeven, Van Ropmay, and Pruyn 2009). In addition to service encounters, the

presence of a strong attractiveness halo effect has also been established in other contexts

such as perceived competence of athletic coaches (Thelwell et al. 2010), and politicians

(Lodge and Steenbergen 1995; Surawski and Ossoff 2006).

Regan’s (2011) study provides evidence that a person’s physical attractiveness

serves as a powerful social cue that elicits behavior from others. Overall, the external

image of individuals appears to have a strong influence on their behavior as well as their

personal and professional lives. Consequently, many individuals pay great attention to

their physical appearance as they move through different stages of life – particularly their

work life – and try to improve their self-representation, a behavior referred to as

impression management (Foustanos, Pantazi, and Zavrides 2007).

Cosmetic procedures contribute in an effective way to the improvement of

physical attractiveness, and are defined as surgical and non-surgical procedures that

2
reshape structures of the body in order to improve appearance (American Society of

Plastic Surgeons: ASPS 2011). Invasive and non-invasive cosmetic procedures are

receiving higher acceptability and desirability, and are becoming increasingly routine in

the contemporary society (Pentina, Taylor, and Voelker 2009). According to the

American Society of Plastic Surgeons (ASPS), 13.1 million cosmetic surgery procedures

were performed in the United States in 2010, a 77% increase over the last decade.

According to the president of the American Academy of Cosmetic Surgery (AACS),

Mark Berman, MD, “The cosmetic surgery industry continues to grow at a rate many

people never thought it would reach” (AACS 2010, p. 1).

One reason for this upward trend is an increase in the knowledge of the body,

coupled with an increase in technical and surgical procedures that continually offer new

solutions to individuals dissatisfied with their appearance (Henderson-King and

Henderson-King 2005). Plastic surgery permits people to change their inherited bodies

and move them closer to their desired self-images of themselves (Suissa 2008). The

increased demand for cosmetic procedures can also be attributed to lower costs and

higher disposable incomes, as well as increased emphasis on physical appearance due to

existing social standards of the ideal body promulgated by mass media (Henderson-King

and Henderson-King 2005). The standards depicted in advertising messages through

models and movie stars, Hollywood spokespeople, and fashion models reflect the modern

values of personal responsibility for one’s health and appearance, ability to control and

shape one’s body, and superiority of youthfulness and agility over aging and inertia

(Davis 2002; Pentina, Taylor, and Voelker 2009).

3
 The cumulative effect of these promotional efforts contributes to a variety of

harmful consequences including depression, loss of self-esteem, unhealthy diets, eating

disorders, and elective cosmetic surgery (Pentina, Taylor, and Voelker 2009). As an

example, the emergence and popularity of TV reality shows such as Extreme Makeover

and The Swan may explain the increase in the number of people going under the knife

and allowing their bodies to be sculpted and reengineered. These issues predominantly

arise among females (Martin and Gentry 1997; Green and Pritchard 2003). Young

women compare themselves to advertising models in terms of their perceptions of

physical attractiveness rather than their financial success, while males do the opposite

(Gulas and McKeage 2000).

Previous research indicates that there is a strong relationship between media

influence and the level of reported body image dissatisfaction, and that women have

lower levels of body satisfaction (Green and Pritchard 2003). It is noteworthy, though,

that while women show lower body satisfaction than men, men are also dissatisfied with

their body image, and usually want to be either thinner or more muscular (Vartanian and

Giant 2001). Similarly, Askegaard, Gertsen, and Langer (2002) mentioned that cosmetic

surgery is purchased mostly by women and that generally speaking, most women

probably feel the need to look good more strongly than do most men. However, they

further argued that there seems to be a more and more unisexual beauty myth in the

society and that currently, more men undergo cosmetic surgery compared to previous

decades. Vartanian and Giant (2001) also found that media influence is the most

important predictor of overall body dissatisfaction in college women and that the

4
influence of media is beginning to affect men as well. In the 1940s and ’50s, the ideal

man portrayed in movies and other media was far less toned and muscular; but today’s

young men who grew up playing with action figures, looking at men’s magazines, and

seeing widespread mass use of gyms and weight training, are under much more pressure

to have a masculine face and body (Landro 2011). A recent article in the Wall Street

Journal (Landro 2011) indicated that although women still account for the majority of

cosmetic procedures, more men are opting for plastic surgery and other enhancements to

make themselves more attractive, look younger, etc.

Despite the growing popularity of cosmetic surgery, the consumer research

literature on this topic is extremely sparse (Askegaard, Gertsen, and Langer 2002).

Morgan (1991, p. 26) referred to this topic as a “silent” topic and Schouten (1991) called

for more research about motivators of cosmetic surgery. After almost two decades,

Slevec and Tiggemann (2010) noted that we do not have an exhaustive understanding of

people’s motivations for aesthetic surgery. In fact, socially responsible marketers,

particularly those active in the cosmetics industry, may wish to consider the emotional

vulnerability of their target market and the socio-psychological processes underlying

consumption choice and experiences with cosmetic procedures. This requires a better

understanding of the target segment’s motivational mechanisms leading them to make the

decision to receive cosmetic procedures. Yet, little is known about the attitudinal and

motivational drivers that facilitate cosmetic surgery (Henderson-King and Henderson-

King 2005; Judge and Barish-Wreden 2009; Pentina, Taylor, and Voelker 2009).

5
 Emotions (both positive and negative) can impose a motivating influence and

affect attitudes and behavioral intentions (Baumgartner, Pieters, and Bagozzi 2008).

Indeed, many of life’s important events (i.e., pivotal decision making situations such as

new career choices) are filled with a mix of emotions, both positive and negative (Aaker,

Drolet, and Griffin 2008). However, no previous research has addressed the question of

how emotions are experienced and how emotions motivate individuals to have a cosmetic

procedure or other appearance enhancing procedures. Overall, this dissertation aims to

address the following research questions:

1- What motivates consumers to pursue cosmetic procedures?

2- What is the role of emotions in decision making about cosmetic procedures?

To that end, this research explores the role of emotions and their relationship with

objective self-awareness (OSA; Duval and Wicklund 1972) in the context of cosmetic

surgery. OSA theory is one of the earliest self theories (Silvia and Duval 2001) and holds

that just as people can apprehend the existence of environmental stimuli, they can be

aware of their own existence. “When attention is directed inward and the individual’s

consciousness is focused on himself, he is the object of his own consciousness, hence

objective self-awareness” (Duval and Wicklund 1972, p. 2).

OSA theory assumes that people have representations of the self’s features as well

as representations of standards that specify features the self ought to have (Duval and

Silvia 2001). OSA, as a state of attention focused on the self, initiates a self-standard

comparison process in which people evaluate the self in relation to relevant standards.

Discrepancies from standards generate negative affect which motivates consequent

6
behavior to change the self, change the standard, or avoid the situation (Duval and

Lalwani 1999). In fact, the motivational influence of affect has always been assumed to

function in discrepancy reduction, while there is surprisingly little research that actually

tests this mechanism (Duval and Silvia 2001; Boldero and Francis 2002). Previous

research has called for more research on this area to address these uncertainties, and to

provide more insights on the dynamics of self-awareness (Morin 2006). Phillips and

Silvia (2005) called for finding moderating variables, interactive processes, and boundary

conditions to enrich this theory and enhance our understanding of the dynamics of

psychological processes described by this theory.

Research Goals

In order to address the identified gaps in the literature, this dissertation builds

upon and extends previous literature on OSA theory to achieve three main objectives.

The first goal is to examine the role of exposure to beauty standards in intensifying the

self-standard discrepancies experienced by self-aware individuals. Thus, the focus of the

first objective is to identify the boundary condition for the effect of self-awareness on

self-standard discrepancies. In other words, the moderating role of OSA on having access

to standards of appearance is examined to identify the condition under which individuals

engage in self-standard comparisons and consequently, experience self-standard

discrepancies. The second goal is to examine the emotional consequences of the state of

objective self-awareness and its interplay with beauty standards to identify the underlying

process for the role of emotions in motivating individuals to undergo cosmetic

procedures. The third goal is to identify boundary conditions that affect the proposed

7
underlying process, hampering or enhancing the motivation to undergo appearance

enhancing procedures. To that end, the moderating role of two self-conscious emotions

(i.e., pride and shame) is examined.

Managerial and Academic Contributions

The present research applies objective self-awareness theory from social

psychology to consumer research and expands the domain of this theory to the context of

physical attractiveness. The findings contribute to the research advocating the role of

emotions in decision making and provide more insights about self-conscious emotions

and their role in regulating individuals’ goal pursuit behavior. These findings have

important implications for advertising and persuasive communication tactics, guiding the

choice of emotional appeals as well as message framing approaches to encourage or

discourage specific targeted behaviors.

Furthermore, this study provides additional insights about the motivating factors

affecting cosmetic surgery decision making, and contributes to this stream of research by

enhancing our understanding of this understudied topic. The identification of factors

influencing individuals’ engagement in possibly health threatening beauty procedures is

important to marketers and public policy makers (Mowen, Longoria, and Sallee 2009).

The results highlight the emotional vulnerability of individuals toward the ever-

increasing number of TV shows, advertisements, etc. (representing contemporary

standards of appearance) promoting cosmetic procedures, and call for proper regulatory

control over media and advertising practices.

8
 Overview of the Research Design

The present research follows an experimental design approach to examine the

aforementioned relationships and achieve the stated research objectives. Two

experiments are conducted to test the interplay between beauty standards and objective

self-awareness and its consequent impact on individuals’ emotions as well as appearance

enhancement attitudes and intentions. In both experiments, the state of objective self-

awareness is manipulated using a full length mirror, a well-established method in the

literature (Carver and Scheier 1978) which is widely used in contemporary research

(Dijksterhuis and Van Knippenberg 2000; Govern and Marsch 2001; Mullen, Migdal,

and Rozell 2003; Phillips and Silvia 2005) and the affective reactions (experienced

emotions) are captured using validated scales.

In the first study, the significance of the impact of access to relevant beauty

standards on situational body image dissatisfaction is tested and compared to the

situations in which irrelevant standards or no standards are provided to individuals. The

second study manipulates two self-conscious emotions (i.e., pride and shame) and

examines their influence on regulating the experienced affective reactions to self-standard

discrepancies as well as the motivations and likelihood to undergo cosmetic procedures.

The major dependent variables in both studies are measured using previously validated

scales borrowed from psychology literature. Several factors are measured throughout the

experiments to control for their potential impact on focal relationships.

9
 CHAPTER 2

LITERATURE REVIEW AND THEORETICAL BACKGROUND

Overview

This chapter provides a review of the theoretical background and relevant

literature leading to the development of research hypotheses. The literature review

includes four parts. First, a brief review of the extant research on physical attractiveness

and impression management is provided. The second section reviews the research on

cosmetic surgery (as one of the approaches for appearance enhancement and impression

management) in social psychology, medical psychology, feminist studies, and marketing.

The third section comprises a review of the theoretical basis of the present research

followed by a review of literature on social self-conscious emotions. The last section

provides the research theoretical framework and leads to the development of a research

model and hypotheses.

Literature Review

Physical Attractiveness

Quality of appearance is important in nature, and every individual has a basic

need to establish the normality of his or her own appearance to confirm its acceptability

to others (Harris 1982). In fact, Darwin’s work (1900) had a significant influence on our

understanding of the role of appearance in evolutionary theory. According to Sarwer,

Magee, and Clark (2003), Darwin’s explanation of the development of physical

characteristics that make a given animal attractive to another promoting reproduction,

10
was about sexual selection rather than survival advantage. Indeed, the significance of

appearance in nature could be observed in daily inter-relationships of a group of the same

species. Many species have the ability to discriminate quality of appearance amongst

group membership. For instance, normal appearing members of a species group will

reject or kill other members who appear abnormal relative to their group (Harris 1982).

In human society, quality of appearance is subject to aesthetic judgments which

vary from one person to another according to their perceptions. Unattractiveness is often

accompanied by negative judgment and treatment of others and may lead to the

perception of external constraints leading to isolation (Judge, Hurst, and Simon 2009).

Unattractive individuals may experience negative consequences in their interpersonal

relationships and activities, suffer from emotional distress, and have restricted lifestyles

(Harris 1982). This is because in human societies, appearance is considered one of the

most direct sources of information about other people (Shevlin et al. 2003).

The social attractiveness stereotype may be learned through cultural messages that

associate beauty with good things and ugliness with bad things (Surawski and Ossoff

2006). In children’s stories, for example, the heroine is often a beautiful young woman,

while the antagonists are witches, giants, or other disgusting creatures. Caricatures

criticizing politicians often depict them in ugly form, while media praising them often

depict very attractive images of them. Added to these examples is the constant influence

of advertisements into everyday life that depict attractive people receiving attention and

rewards for their looks (Surawski and Ossoff 2006).

11
 Social psychological research conducted over the past four decades provides

robust evidence for the existence of a pervasive physical attractiveness stereotype

(Holahan and Stephan 1981), commonly illustrated by the phrase what is beautiful is

good (Dion, Bersceid, and Walster 1972). Eisenmann-Klein (2010) found that individuals

with more attractive faces were assessed to be more successful, contended, pleasant,

intelligent, sociable, exciting, creative, and diligent. In general, attractive individuals

were considered to be better human beings. These results indicate that physical

attractiveness means an enormous competitive advantage in private, social, and

professional life. For instance, attractive looking children get more attention from their

parents and teachers and their intelligence is estimated to be higher than that of non-

attractive children (Eisenmann-Klein 2010). Judge and Barish-Wreden (2009) also

argued that attractive children benefit from more resources supporting their academic

achievement, making them more likely to finish high school and go to college.

Recent evidence indicates that this bias for beauty operates below the threshold of

conscious awareness. In fact, even when distracted and not paying conscious attention to

another person’s appearance, attractiveness elicits positive evaluative responses from

both men and women (Van Leeuwen and Neil 2004; Regan 2011).

An individual’s personal appearance is composed of physical features, makeup

(cosmetic items directly applied to the face or body), and wardrobe (clothes, jewelry, and

other adornments that are worn on, or physically secured to the person). Although

impressions following from zero-acquaintance seem to be primarily based on faces

(Berry and Wero 1993), a number of other appearance attribute cues such as clothing,

12
posture, and locomotion may also be influential. These latter elements are considered to

be neither peripheral aspects of physical identity nor a disguise of the real self, but rather

are viewed as central elements of a goal-directed performance in which people declare a

particular identity, communicate with others in the social environment, and increase their

likelihood of attaining certain rewards (Mangum et al. 1997).

In many services (such as sales and customer service), competence appears to be

among the most important traits that consumers use when they evaluate employees

(Gronroos 2000; Verhoeven, Van Ropmay, and Pruyn 2009). Even though service

encounters usually comprise rather short interactions with service employees who are

usually unknown to the customer, customers are generally quite capable of forming a first

impression based on brief exposures to employee appearance (Gronroos 2000).

Thelwell et al. (2010) conducted a study and examined the impact of the coach’s

physical attractiveness on the impressions formed of them by male and female athletes

and non-athletes. Participants viewed four photographs that depicted different

combinations of build and clothing (lean build/large build and sport clothing/academic

clothing) and rated their perceived competence of the coach. The results showed a

significant difference across the photographs and revealed that initial impression can

influence the judgments made of an individual.

Masip, Garrido, and Herrero (2004) examined the impact of facial maturity on

impressions of truthfulness as well as the influence of age on perceptions of individuals.

Participants viewed a series of photographs and rated them on traits such as honesty,

truthfulness, strength, dominant, intelligence, and warmth. The photographs were baby-

13
faced, intermediate, and mature-faced versions of the same individual at three different

ages and were computer-manipulated to create different versions. Results supported the

existence of a baby-face overgeneralization effect. Overall, in this experiment higher

ratings of perceived attractiveness were associated with higher attributions of positive

qualities such as warmth, intelligence, honesty, and sincerity. The findings were

consistent with the attractiveness halo effect and indicated that physically attractive

individuals are believed to possess positive personal characteristics.

Surawski and Ossoff (2006) found support for the attractiveness halo effect

(higher ratings for highly attractive targets) in a different setting. This bias was witnessed

when subjects rated photographs of target politicians for competency, trustworthiness,

qualification, and leadership ability. The results were in line with those of another study

by Efran and Patterson (1974) which found that physically attractive candidates won a

greater number of elections than candidates judged to be unattractive. Even though it is

unlikely that voters only use candidates’ physical attractiveness to make voting decisions,

studying the implications of the attractiveness halo effect in politics is of prominent

value.

Petty, Cacioppo, and Schumann (1983) argued that people seem to be cognitive

misers, preferring the peripheral route of information processing that does not entail

much thinking or critical evaluation to the central route, which requires motivated

cognitive effort. Even when making important decisions such as those about politics,

Lodge and Steenbergen (1995) found that voters are likely to rely on social cognitive

heuristics.

14
 Surawski and Ossoff (2006) argued that in the absence of any other information

about the target, participants attribute more favorable personality traits and more

successful life outcomes to the pictured individuals to the extent that they were physically

attractive. Overall, physical attractiveness of the candidate was significantly correlated

with the proportion of the votes obtained. Efran and Patterson’s (1974) results suggest

that the level of attractiveness of candidates may influence how the public votes. As a

result, it has been argued that physical attractiveness should be added to the list of other

characteristics such as age, race, and emotional expression which can be detected with a

single, brief glance at another person (Surawski and Ossoff 2006).

Overall, it seems that the external image of individuals has a decisive influence on

their behavior and personal choices regarding both their personal and professional lives.

The influence of physical attractiveness on the choice of a partner is just one example

(Eisenmann-Klein 2010). Moreover, it could be assumed that appearance influences

professional choices and development. Accordingly, individuals do place particular

importance on and pay great attention to their personal appearance in all aspects of their

lives, especially their work life, and try to improve their self-representations, an approach

called management of impressions or impression management (Foustanos, Pantazi, and

Zavrides 2007).

The growth of the beauty and cosmetic surgery industries is an indication of

people’s increasing willingness to enhance their physical appearance. Cosmetic

procedures contribute in an effective way to the improvement of physical attractiveness

15
(Foustanos, Pantazi, and Zavrides 2007) and are considered to be part of the individual’s

reflexive construction of self-identity (Askegaard, Gertsen, and Langer 2002).

Cosmetic Surgery: A Self-Enhancement Tool

Cosmetic surgery is first and foremost about identity… Identity and

appearance go hand in hand.
–Davis

Cosmetic procedures are defined as surgical and non-surgical procedures that

reshape structures of the body in order to improve appearance (ASPS 2011). Thus, any

alteration of a person’s physical appearance, as a form of self-improvement or self-

enhancement is considered as a cosmetic procedure (Domzal and Kernan 1993).

Cosmetic surgery is a branch of plastic surgery, but in contrast to plastic surgery that is

dedicated to reconstruction of facial and body defects due to birth, disorder, disease, or

accident, is entirely elective in nature and is dedicated to appearance enhancement

(Haiken 2000). The history of cosmetic surgery traces back to hundreds of years B.C.E.

in India where members of a brickmaker caste tried to reconstruct noses cut off as

punishment for infidelity. Also, during the sixteenth century in Italy, attempts were made

to repair facial scars resulted from frequent duels. Despite its long existence, the history

of cosmetic surgery is essentially a twentieth century story (Haiken 2000) when

industrialization, urbanization, and migration transformed the United States from a

primarily rural nation, in which identity was based on family and region, to an

increasingly urban nation, in which identity was based on self-presentation and

appearance defects were considered as problems to be conquered (Haiken 2000).

16
 Today, cosmetic surgery is one of the fastest-growing medical practices in the

world. Invasive and non-invasive cosmetic procedures are receiving higher acceptability

and desirability and becoming increasingly routine in contemporary society (Pentina,

Taylor, and Voelker 2009). Dr. Peter Schmid who runs a cosmetic surgery practice in

Longmont, Colorado, said “cosmetic surgery has become table talk at home” referring to

the ever increasing acceptability of these procedures (Crary 2011). The beauty industry is

growing at a faster rate than the gross domestic product of most developed countries

(Economist 2003). Globally, around $45 billion is spent on cosmetics and toiletries each

year (Sarwer, Magee, and Clark 2003). In the United States, cosmetic procedures tripled

from 1997 to 2003 (Judge, Hurst, and Simon 2009). More recent statistics on the number

of people who undergo these procedures is striking. According to the American Society

of Plastic Surgeons (ASPS), 13.1 million cosmetic surgery procedures were performed in

the United States in 2010, indicating a 5% increase over 2009 and a 77% increase over

the last decade. The report specifies that more than $10 billion were spent on cosmetic

procedures in the United States in 2010.

Due to the growing popularity of cosmetic surgery and the increasing demand for

these procedures, it is extremely important to understand what motivates individuals to

undergo these procedures (Eisenmann-Klein 2010). The review of the extant literature on

this area reveals that two approaches to investigating possible reasons and motives to

undergo cosmetic procedures have been pursued (Pentina, Taylor, and Voelker 2009).

The macro-level perspective, advocated by medical sociologists, anthropologist, and

feminists, focuses on how society influences culturally constructed meaning of the human

17
body, while psychology and marketing literature have a micro-level perspective focusing

on the self-body relationships.

The macro-level approach holds that in Western societies women are subject to

cultural and interpersonal experiences in which the female body is constructed primarily

as an object that exists for the pleasure and use of others to be inspected and evaluated

(Davis 2002). As a result of such influences, women and girls are gradually socialized

and adopt an observer’s perspective of their physical selves (Fredrickson and Roberts

1997) and treat themselves as an object to be looked at and evaluated on the basis of

appearance (Fredrickson and Roberts 1997; Citrin, Roberts, and Fredrickson 2004). Such

frequent monitoring of appearance produces a number of negative experiential

consequences for women such as body-based feelings of shame and anxiety since few

women can match current societal body ideals (Tiggemann and Boundy 2008).

Sociocultural pressure to be thin and/or attractive has been considered as a

significant factor affecting negative body image (Markley Rountree and Davis 2011).

Such pressures can lead to a growing and widespread decline in self-esteem among both

men and women. As Davis (1997) asserted, “[W]e are still in the thrall of the cultural

dictates of beauty and cannot bear to imagine women’s bodies are ugly” (p. 33). Thus, the

act of undergoing a cosmetic procedure involves conforming to the dictates of the

Western beauty system and a refusal to suffer beyond a certain point (i.e., suffer from

not being just like anybody else in the society; Davis 1997). Similarly, Adamas (2010)

argued that cosmetic surgery has become a medium through which individuals can better

18
align themselves, specifically their physical appearance, with normative expectations and

standards of attractiveness.

Following the perspective of social construction of body standards, Thompson

and Hirschman (1995) proposed a framework based on McCracken’s (1986) meaning

transfer model of a culturally constituted world. They argued that body image is the

perceptions a person has of his/her body, and that these perceptions are conditioned by a

network of social relationships, cultural ideals, normative prescriptions (i.e., which

characteristics are to be regarded as appropriate and which aspects of one’s life should be

controlled), and moralistic meanings of self-control and discipline. The social world in

which each consumer is embedded operates to enforce and reinforce this system of bodily

meanings and practices. The result is a form of socialization that inspires a deeply

internalized duty to exercise control over one’s body to be thinner, less gray, and less

wrinkled, and to hide a variety of bodily imperfections that may deviate from valued

cultural norms of appearance. Thus, the person becomes an observer of his/her own self.

Under such conditions, a tendency to regard one’s body as a socially visible object (i.e.,

social body) that should be worked on, reconstructed, and improved to convey preferred

social meanings might naturally follow (Thompson and Hirschman 1995). Although the

body is a priori a physical object, the social body is the result of the “social gaze,” the

determining factor of the process of judging what is acceptable and what is less so

(Suissa 2008, p. 620).

Belk’s (1988) conceptualization of possessions as extended self provides more

insights about body objectification with a micro-level perspective. This view maintains

19
that body and body parts are the most valued possessions central to individuals’

conceptions of self, and are strongly charged with emotional energy, explaining greater

use of grooming products and services. Self-improvement and social body image

satisfaction are important psychological and psychosocial processes including emotions,

wishes, and beliefs about self that may lead to decisions to undergo cosmetic procedures.

As Hesse-Biber (2007, p. 97) mentioned, “[cosmetic] surgery as self–improvement is an

increasing option, even a mandate, with an expanding market.”

Domzal and Kernan (1993) had a similar view about self-body relationships and

argued that the body-as-object is the most visible expression of a person’s self through

which individuals express their psychological selves. In fact, everybody’s sense of self

incorporates some form of bodily consideration since corporality influences processes

such as self-identity, self-presentation, and self-evaluation. Based on this notion, Domzal

and Kernan (1993) proposed a corporal theory maintaining that people regard their bodies

in different ways and that these conceptions affect how people deploy their bodies. They

further proposed a corporal taxonomy, identifying four body types based on two

dimensions that address what people do with their bodies and why, and described the

susceptibility of these body types to beauty-related products and services.

The first dimension, associatedness, refers to a person’s sense of how much he or

she is represented by his/her body. Individuals low on this dimension regard themselves

as a great deal more than their bodies, while those high on this dimension do the opposite.

According to this theory, associatedness suggests the need to enhance the body. The

second dimension, inner- or outer-directedness, refers to the focus of individuals and

20
whether they experience their bodies independent of or in relation to other people’s

bodies. Inner-focus represents self-contained bodily experience and is a private self-

focus, while outer-focus represents a bodily experience that is mutually constituted with

other bodies and thus is a public self-focus. Overall, according to this taxonomy, pursuit

of beauty is not uniformly distributed across society and individuals with different bodily

experience (according to the two dimensions) have different motivations for self-

enhancement. However, these differences have not been tested empirically.

Following the self-body perspective, Joy and Venkatesh (1994) differentiated

between the inner body and outer body. They mentioned that the inner body refers to

concerns with health and functioning of the body. Outer body, on the other hand, refers to

appearance, aesthetics of the body, and bodily movement in social space. They argued

that the primary motive for maintaining the inner body is to enhance the outer body and

further emphasized the increasing importance of appearance for the maintenance of self-

concept which naturally leads to ever increasing significance of conformance to the

accepted cultural standard of body and beauty.

Askegaard, Gertsen, and Langer (2002) conducted interviews with 15 women

who had cosmetic operations and examined their motivations for surgery via the

theoretical lens of Giddens’ view of self-identity and human relationships in late

modernity. They argued that cosmetic surgery is considered to be part of the individual’s

reflexive construction of self-identity, and leads to a focus on issues such as self-esteem

and relationship between body and identity.

21
 Thorpe and Steer (2004) conducted a retrospective study to explore reasons for

undergoing elective plastic surgery. Following semi-structured interviews with female

postoperative participants, they found that in all cases, removing the perceived

discrepancy between the actual-self and ideal-self resulted in an improvement in

participants’ moods which were lower before the surgery than after.

Pentina, Taylor, and Voelker (2009) also examined the motivating role of self-

concept discrepancy in young women seeking cosmetic procedures and assessed the

moderating role of different types of social support on the relationship between self-

discrepancy and choice of cosmetic procedures. The results revealed that a perceived

discrepancy between an individual’s actual and ideal self-image can influence the choice

of cosmetic procedure as a coping mechanism to reduce the discomfort associated with

lower self-esteem and act as a motivator for body modifications.

Following a different approach, Mowen, Longoria, and Sallee (2009) identified

and compared the trait predictors of the propensity to undergo cosmetic surgery and

obtain a sun tan (two appearance enhancing procedures) based on the 3M model of

motivation and personality (Mowen 2000). The results indicated that body needs,

emotional instability, vanity concerns, and vanity view are predictive traits of both

appearance enhancing tools.

Adams (2010) conducted 13 in-depth interviews with individuals (11 women and

two men) who had undergone, or in once case had scheduled, a minimum of one invasive

cosmetic procedure, and explored their motivations for having cosmetic surgery as well

as their expectations and assessments of the surgery experience and outcomes. The

22
results revealed that motivations for cosmetic surgery are often articulated in both

physical and psychosocial terms. Many respondents believed that there is a strong social

pressure to embody certain beauty standards and expected the physical alterations to

facilitate social or emotional changes in their lives.

Using a survey methodology, Slevec and Tiggemann (2010) investigated factors

that influence attitudes toward cosmetic surgery in middle-aged women and found that

appearance investment, aging anxiety, and television exposure are unique predictors of

social motivations for cosmetic surgery. They further argued that media has a direct

effect on attitudes toward cosmetic surgery.

Following a social network perspective, Voelker and Pentina (2011) examined

cosmetic surgery intentions among Generation Y consumers and found that the social

structure surrounding individuals may influence their perceptions of the beauty norms. In

other words, individuals’ access to others who have utilized cosmetic procedures

increases positive attitudes toward these procedures.

Markley Rountree and Davis (2011) followed a dimensional qualitative research

approach to understand motivations for unnecessary cosmetic surgeries. The results of in-

depth interviews with patients between the ages of 19 and 40 indicated that improving

self-esteem and eliminating negative body-related image were major motivators. They

also found that negative emotions from low self-esteem are perceived as creating

inescapable feelings of not being good enough and/or not fitting in enough. Interview

respondents mentioned difficulties in coping with their feelings of inadequacy and body

dissatisfaction. These results indicated that socio-cultural pressures for looking better in

23
order to find more satisfactory and lasting relationships as well as better jobs also affect

the motivation to pursue appearance enhancing procedures. Content analysis of plastic

surgery stories found via a search on Google web site identified self-criticism, feelings of

nostalgia, and self-dissatisfaction as major factors. The results of four focus groups with

college students confirmed the motivational role of low self-esteem and dissatisfaction

with self, and identified competition with others as a common issue across all age groups

and genders to be another influential factor.

Overall, social/interpersonal motives (to please one’s partner or to look younger

for social or business reasons) and intrapersonal desires (to feel better about oneself) are

considered as generic reasons to have a cosmetic procedure (Henderson-King and

Henderson-King 2005). Yet, as Askegaard, Gertsen, and Langer (2002) mentioned, the

consumer research literature on cosmetic surgery is extremely sparse. The present

research aims to provide more insights about the underlying processes for decisions to

pursue cosmetic procedures. As the review of extant research on cosmetic surgery

decision making reveals, self-perceptions and social pressures are important factors

affecting such decisions. Accordingly, objective self-awareness (OSA) theory (Duval and

Wicklund 1972), one of the earliest modern self theories, developed to better understand

the reasons why people conform their beliefs and behaviors to the larger society

(Phemister and Crewe 2004), is the theoretical basis for this research.

Objective Self-Awareness (OSA)

Objective self-awareness theory (Duval and Wicklund 1972) is one of the first

modern theories to consider how discrepancies affect emotions. This theory focuses on

24
the self-reflexive quality of consciousness (Phillips and Silvia 2005). According to OSA

theory, just as people can apprehend the existence of environmental stimuli, they can be

aware of their own existence. “When attention is directed inward and the individual’s

consciousness is focused on himself, he is the object of his own consciousness-hence

objective self-awareness” (Duval and Wicklund 1972, p. 2). “This is contrasted with

subjective self-awareness which results when attention is directed away from the self and

the person experiences himself as the source of perception and action” (Duval and

Wicklund 1972, p. 3). OSA provides a very broad definition of the self as the person’s

knowledge of him/herself.

OSA assumes that people have representations of the self’s features as well as

representations of standards that specify features the self ought to have (Duval and Silvia

2001). A standard is “a mental representation of correct behavior, attitudes, and traits”

and “all of the standards of correctness taken together define what a correct person is”

(Duval and Wicklund 1972, pp. 3, 4). Standards for the self are diverse and idiosyncratic;

they are often vague, perfectionistic, unattainable, and inconsistent with other standards

(Duval and Silvia 2001).

Objective self-awareness, a state of attention focused on the self, initiates a self-

standard comparison process in which people evaluate the self in relation to relevant

standards. This is consistent with social learning theory (Bandura 1982) maintaining that

individuals can adopt new goals by observing and imitating actions of models or

standards of being. Such goal pursuits motivate individuals to take new actions in order

to achieve the positive end states associated with performing those actions. In fact,

25
focusing attention on the self greatly heightens the accessibility of self-relevant

information and the accessibility of self-standard comparisons (Carver and Scheier 1978;

Ickes, Layden, and Barnes 1978; Gibbons 1990). Congruity between self and standards

generates positive affect, which rewards the action that established congruity (Duval and

Silvia 2001), while discrepancy between self and standards generates negative affect,

which motivates a different series of actions.

OSA theory predicts that discrepancies covary more strongly with emotions when

self-awareness is high (Phillips and Silvia 2005). As a consistency theory, OSA assumes

that inconsistency between self and standards creates general negative affect (Duval and

Silvia 2001). This is similar to the notions of negative affect asserted by balance theory

(Heider 1958) and cognitive dissonance theory (Festinger 1957). This discrepancy

motivates changing the self (actively changing the actions, attitudes, or traits to be more

congruent with the representations of the standard), changing the standard (Duval and

Lalwani 1999), or avoiding the situation (avoiding the self-focusing stimulus and its

circumstances). This simple system consisting of self, standards, and attentional focus is

assumed to operate according to gestalt consistency principles (Heider 1960).

OSA theory has stimulated a great deal of research, most of which has been

supportive. It has been applied to basic issues in social psychology such as attribution

(Duval and Lalwani 1999), attitude-behavior consistency (Gibbons 1983), self-standard

comparison (Duval and Lalwani 1999), prosocial behavior (Froming, Nasby, and

McManus 1998), deindividuation (Ickes, Layden, and Barnes 1978), self-assessment

(Duval and Silvia 2002), social interactions (Alden, Teschuk, and Tee 1992), and terror

26
management (Silvia 2001), as well as customer satisfaction of service providers (Pham,

Goukens, and Stuart 2010).

Despite the widespread application of OSA, researchers have called for

investigating moderating variables, interactive processes, and boundary conditions to

enrich this theory (Phillips and Silvia 2005) in order to better examine the self-awareness

concept (Morin 2006). Moreover, despite its relevance, prior research has not examined

this theory in the context of physical attractiveness (Domzal and Kernan 1993).

Public vs. Private Self-Awareness

It is commonly agreed that human self-focus has both a public and a private

dimension (e.g., Carver and Scheier 1981; Govern and Marsch 2001). Public self-focus is

characterized by attention to those features of one’s self that are presented to others such

as physical features and mannerisms. Public self-focus pertains to aspects of behavior in

which the needs, desires, or reactions of others are acknowledged and taken into account

(Mor and Winquist 2002). These are goals colored by a desire for social consensus or by

a desire to consider the impact that an action may have on others’ impressions of oneself

(Carver and Scheier 1987). Private self-focus, on the other hand, involves attentiveness to

the internal and personal aspects of one’s self such as memories and feelings of physical

pleasure or pain (Mor and Winquist 2002). Private self-focus “reflects private,

autonomous, egocentric goals. These are goals that do not necessarily require one to

consider others’ reactions to what one is doing” (Carver and Scheier 1987, p. 527).

Self-focus, whether public or private, can be dispositional or situational.

Dispositional self-focus is often referred to as self-consciousness, whereas situational

27
self-focus is labeled self-awareness (Carver and Scheier 1981; Govern and Marsch 2001).

Thus, public and private self-consciousness (i.e., the consistent tendency to direct

attention outward or inward) are assumed to be relatively stable traits or elements of

one’s personality (Fenigstein, Scheier, and Buss 1975; Carver and Glass 1976; Govern

and Marsch 2001). In contrast, public and private self-awareness are thought to be

transient states that are susceptible to manipulation (Carver and Glass 1976). For

example, public self-awareness can be induced in the laboratory by exposing participants

to a full-length mirror (e.g., Webb et al. 1989; Phillips and Silvia 2005) or a video camera

(e.g., Insko et al. 1973; Alden, Teschuk, and Tee 1992). Private self-awareness can be

induced by instructions to focus on personal thoughts and feelings (e.g., Silvia 2001) or

by exposing participants to a small mirror that reveals only the their head and shoulders

(e.g., Govern and Marsch 2001).

The ability to differentiate between public and private self-awareness is important

because the psychological underpinnings and behavioral effects of these two states are

distinctive (Govern and Marsch 2001). A state of private self-awareness serves to clarify

and intensify whatever affects, motives, or personal standards are currently salient to the

individual. Thus, the private aspects of one’s self (e.g., values and current mood) become

magnified, and one’s behavior is likely to reflect the increased attention to these factors.

In contrast, individuals in a state of public self-awareness generally experience some

level of discomfort and evaluation apprehension because they see themselves as the

subject of others’ appraisal. In order to reduce this negative state, they may attempt to

28
modify their behavior to meet the perceived expectations of others, even if this behavior

is not consistent with their internal standards (Govern and Marsch 2001).

Self-Standard Comparison

As discussed previously, OSA theory illustrates the fundamental connection

between self-awareness and self-evaluation and assumes that gaps between the self and

standards create negative affect (Phillips and Silvia 2005). Thus, when a discrepancy is

experienced, reducing the gap (i.e., approach behavior) or avoiding self-focus (i.e.,

avoidance behavior) are equally effective ways of reducing the negative affect resulting

from the discrepancy (Silvia and Duval 2001). According to OSA, the decision to pursue

which approach depends on two factors: 1) whether individuals feel they can effectively

reduce the discrepancy, and 2) whether the discrepancy is small or large.

Similarly, Carver, Blaney, and Scheier (1979b; 1979a) stated that expectancies

regarding outcome favorability determine approach versus avoidance behavior. When a

self-standard discrepancy is recognized, individuals implicitly assess their likelihood of

reducing the gap. If discrepancy reduction is perceived as possible, they will try to

achieve the standard. When expectations regarding improvement are unfavorable,

however, people will try to avoid self-focus.

Later research and theory (Duval, Duval, and Mulilis 1992) refined Duval and

Wicklund’s (1972) speculations and the notion of outcome favorability and argued that a

person’s rate of progress in discrepancy reduction relative to the magnitude of the

discrepancy is the determining factor. More specifically, individuals’ attempt to reduce a

discrepancy depends on the extent they believe that their rate of progress is sufficient

29
relative to the magnitude of the problem. Consequently, if they believe their rate of

progress is insufficient, they will avoid the self-focus (Silvia and Duval 2001).

Furthermore, it has been suggested that when people are discrepant from a

standard, they make attributions for the cause of the discrepancy and appraise the

likelihood that the discrepancy could be rapidly reduced. If the discrepancy can be

reduced, people will attribute failure internally and attempt to change the self. If the

discrepancy cannot be reduced, people will attribute failure externally to a similar

possible cause, such as a standard or another person (Duval and Silvia 2001). This will

promote attempts to avoid self-awareness and reminders of the discrepancy between self

and standards.

OSA theory originally assumed that people will reduce discrepancies by changing

self to match standards. However, Dana, Lalwani, and Duval (1997) suggested that when

people focus attention on the standard, they may opt to change the standard. In fact, when

people are discrepant, focusing on the standard should lead to a negative evaluation of the

standard which in turn, may lead to a change in the standard toward self instead of

attempts to change self toward the standard. Overall, as extant research indicates, there

are several views regarding the behavioral consequences of experiencing self-standard

discrepancies. Next section provides an alternative approach which provides a clear

explanation of such consequences.

Self-Awareness and Self-Regulation

Carver and Scheier (1981) developed a model integrating self-awareness theory

and self-regulation to better explain the behavioral consequences of experiencing a self-

30
standard discrepancy. Generally, “the term self-regulation refers to the processes by

which the self alters its own responses or inner states in a goal-directed manner” (Finkel

and Fitzsimons 2011, p. 391). Keeping the fundamental components of OSA theory,

Carver and Scheier (1981) conceptualized self-focus as part of a self-regulatory negative

feedback cycle with the purpose of keeping the individual on track in the pursuit of

important goals (Pyszczynski and Greenberg 1987). According to this model, when

attention is focused on the self and a behavioral standard is salient, the person compares

his or her current state with that standard. If the person meets or exceeds the standard, he

or she exists the cycle and self-focus is terminated. However, if the person falls short of

the standard, he or she enters an operate phase, in which he or she engages in some

behavior to become closer to the standard. Thus, the individual makes further

comparisons with the standard.

If a negative discrepancy is detected as a result of the comparison, the individual

will attempt to conform to the standard, while if the discrepancy is eliminated during the

operate phase, the individual will exit from the regulatory cycle. Based on Carver and

Scheier’s (1981) model of self-regulation, discrepancy reduction is the preferred

consequence of self-focus when a negative discrepancy exists. If, however, the person’s

attempt to match the standard is hampered or disrupted, an assessment of the likelihood

of successful discrepancy reduction will be made. If the perceived probability of

successful discrepancy reduction is low, further self-focus is avoided and the person

withdraws from further efforts. Disengagement from the self-regulatory cycle is adaptive

in such situations, since it protects the individual from the negative affect created by the

31
negative discrepancy and prevents him or her from ineffective persistence in pursuit of an

unattainable goal. A high probability, on the other hand, leads to taking actions aimed at

reducing the discrepancy.

During different stages of life, individuals encounter numerous irreducible

discrepancies. In most instances, individuals are able to abandon attempts to reduce these

discrepancies without great difficulty, either through the pursuit of substitute goals or the

derogation of the unattainable goal. These self-regulating strategies (i.e., pursuit of

alternative goals or derogation from the unachievable goal) make the absence of the

desired objective more tolerable and thus, facilitate one’s exit from the self-regulatory

cycle. In some cases, however, the person may be unable or unwilling to give up the

desired, but unattainable goal.

These strategies (i.e., willingness to purse or inability to abandon the unattainable

goal) will prevent disengagement from the self-regulatory cycle and, as a result, the

person will persist in focusing on the irreducible discrepancy (Pyszczynski and

Greenberg 1987). Such ineffective persistence may occur when what is lost or

unattainable is of central importance to the person. To the extent that the desired state

(objective) is an important source of identity or self-worth, engagement in the regulatory

cycle will be pursued.

In other words, when primary motivational commitments are linked to the desired

goal and few alternative commitments remain, the individual would be willing to stay in

the regulatory cycle. In such cases, the goal is so essential that the person is unable to

deny the significance of not achieving it and cannot think of other goals that are

32
accessible but have similar levels of desirability and value. Hence, when the goal or

standard is too central or valuable to let go of, the individual may persist in self-focusing

regardless of the probability of successful reduction of the discrepancy (Pyszczynski and

Greenberg 1987).

Self-Awareness and Emotions

According to appraisal theory, emotions are caused by a person’s interpretation of

a given situation and its relevance to his or her goals (MacInnis and de Mello 2005).

Traditional literature on decision making typically does not involve emotions. Rather, the

literature views decisions as rational processes that involve weighing pros and cons of

different options, and maintains that choices are based on calculations of maximizing

benefits and minimizing losses. However, more recent literature suggests that emotions

have powerful effects on our decisions (Chen and Ma 2009). Research in

neuroeconomics has also emphasized that the interplay of emotion and decision making

is important in situations that include risk and uncertainty (Heilman et al. 2010). The fact

that specific emotions and their corresponding characteristics may have differential

effects on individuals’ evaluations and behavior (Winterich and Haws 2011) highlights

the significance of the need to study how emotions influence decision making.

Emotions have been assumed to have a motivating function in discrepancy

reduction. However, as Silvia and Duval (2001) and Boldero and Francis (2002)

mentioned and the review of recent literature revealed, there is surprisingly little research

that actually tests this. As Carver and Scheier (2011) mentioned, affects pertain to

individuals’ desires and whether they are being met. Three general positions exist

33
regarding the interrelations between self-awareness and emotions. The first position,

found in the original OSA theory, assumes that the negative affect created by self-

standard discrepancies has a motivational character. This perspective is consistent with

gestalt views of motivation (Heider 1960) and past consistency theories (Festinger 1957;

Heider 1960), and maintains that the affect provides the energy and the incentive for the

restoration of the preferred state of self-standard identity. The second view is based on

cybernetic models of how action is controlled by online performance feedback and

assumes that affect has an informational or monitoring function (Carver and Scheier

1998). The third perspective is the view that discrepancies create affect but the affect has

no implications for later discrepancy reduction (Silvia and Duval 2001).

The well-known position, however, is the first perspective maintaining that

emotions motivate actions (Silvia and Duval 2001). The view that emotions have

motivational properties has been advocated by other researchers of emotion (e.g., Lazarus

1991; Prinz 2004; Herzberg 2009) arguing that emotions provide the energetic drive

toward a single action and motivate individuals to pursue that rather than other possible

actions. Carver and Scheier (2011) also referred to a natural link between emotions and

actions and mentioned that affect has a direct influence on actions; but this link was not

empirically tested.

Phillips and Silvia (2005) mentioned that emotions are experienced more strongly

when individuals are self-aware. They found that high self-awareness strengthens the

relationship between self-discrepancies and emotions. In a low self-awareness condition,

discrepancies between the actual and ideal selves had weak relations to emotions, while

34
under the condition of high self-awareness, such discrepancies strongly predicted

emotional experience and further actions to decrease the discrepancy. They mentioned

that it would be beneficial if OSA research moves toward greater specificity in its

predictions about the types of experienced emotions and their roles in individuals’

actions, given that much has been learned about emotions since the original OSA theory

was developed (Duval and Wicklund 1972).

Self-Conscious Emotions

Over the past two decades, interest in self-conscious emotions such as shame and

pride has grown dramatically (Tracy and Robins 2007a; Orth, Robins, and Soto 2010).

Self-conscious emotions guide individuals’ behavior by forcing them to act in a way that

is socially valued and to avoid actions that cause social disapproval (Tracy and Robins

2004a). These emotions are important due to their significant influence on moral

judgment, social behavior, and subjective well-being of individuals (Tracy et al. 2009) as

well as their fundamental role in motivating and regulating people’s thoughts (Tracy and

Robins 2004a). Scheff’s (1988, p. 399) argument that individuals are “virtually always in

a state of either pride or shame” highlights the importance of these emotions. Despite

their centrality to psychological functioning, pride and shame have received considerably

less attention from researchers than other emotions such as joy and sadness (Tracy and

Robins 2004a).

Shame is an unpleasant emotion that individuals experience when they fail to

meet internalized social standards such as standards of morality, competence, or

aesthetics (Tracy and Robins 2004b). Shame often involves evaluations that the self is

35
flawed or bad in some way, alongside evaluations and expectations that others are

looking down on the self. Gilbert (1998) suggested that these two evaluative processes

(i.e., what I think others think about me and what I think about myself) involve different

attentional foci and processing systems, and labeled these different evaluation systems as

internal and external shame.

Internal shame relates to inner experiences, self-evaluations and sense of self as

flawed, inadequate, inferior, powerless and personally unattractive. It is often associated

with intense self-criticism and even self-hatred (Goss and Allan 2009). In other words,

internal shame refers to self as judged by self. Thus, one sees oneself as bad, flawed,

worthless, or unattractive. In internal shame, the focus of attention is directed inward,

processing information about or from within the self. Intense internal shame is an inner

experience of the self as an unattractive social agent, under pressure to limit possible

damage to the self via escape or conciliation (Gilbert 1998). It is the pain of not seeing

oneself as being worthy of love.

External shame is focused on believing that the other looks down on the self in

some way, and is usually defined and measured in terms of the negative beliefs that one

creates in the mind of the other. In other words, external shame refers to self as seen and

judged by others. In external shame, attention is focused outward, processing information

about what is going on in the minds of others about the self. Thus, the person believes

that others see the self as flawed, inadequate, worthless, and unattractive. Often, the

primary anxiety is that one will be exposed to others, leading to social diminishment,

36
devaluation, or rejection. This can lead to motivations to conceal unattractive aspects of

the self from others (Goss and Allan 2009).

Internal and external shame are often highly correlated, but this need not be the

case always. A person can have socially unacceptable traits, such as being severely obese,

and experience negative comments without a sense of internal shame. Another person

may feel severe shame even though he or she receives great acceptance and assurance

from others.

Previous research has shown that shame is linked to low psychological well-being

and dysfunctional interpersonal behaviors and loss of self-esteem (McMurrich and

Johnson 2009; Orth, Robins, and Soto 2010). For instance, in clinical literature, shame is

considered as a central phenomenon in eating disorders (Goss and Allan 2009). In fact,

eating disorders are rooted in the context of a general sense of an unattractive self. There

are several case reports of individuals with eating disorder describing emotions and

cognitions that fit the definition of shame (Skarderud 2007).

Pride, however, is a pleasant emotion in response to meeting internalized social

standards (Orth, Robins, and Soto 2010). Pride is often viewed as the opposite of shame

and is considered as a powerful social, as well as psychological process. Pride is the

affect associated with social success and feeling approved of or admired by others

(Skarderud 2007) and plays a critical role in many domains of psychological functioning.

In contrast to self-love which is a natural sentiment, pride is a relative artificial sentiment

born in the society (Tracy and Robins 2007b).

37
 Feelings of pride reinforce prosocial behaviors such as altruism and adaptive

behaviors such as achievement (Tracy and Robins 2007b). Pride has been considered as

the most important human emotion motivating social behavior (Tracy and Robins 2007a).

However, despite its centrality to social behavior, relative to other self-conscious

emotions, pride has received little attention in the social-personality literature (Tracy and

Robins 2007b). Accordingly, studies should examine the social outcomes of this emotion

(Tracy and Robins 2004b). Recent research suggests that there are two forms of pride,

namely authentic and hubristic (Tracy et al. 2009; Orth, Robins, and Soto 2010). In both

forms of pride, the attributional focus is on internal causes. However, whereas authentic

pride implies attributions to unstable and specific causes such as specific

accomplishments or prosocial behaviors (e.g., I did a good thing), hubristic pride results

from attributions to stable and global aspects of the self (e.g., I am a good person).

Authentic pride has been proposed as the affective core of self-esteem, while hubristic

pride is theorized to be the affective core of narcissism (Orth, Robins, and Soto 2010).

Self-Conscious Emotions and Self-Monitoring

The same context that is self’s perception of the evaluation of self by other(s) as a

result of a continuous social monitoring of the self from the stand point of others, has

been suggested for pride and shame (Scheff 1988). In fact, pride and shame are the

primary social emotions, generated by constant monitoring of the self in relation to

others. Such monitoring, happens in social interaction, and, more covertly, in solitary

thoughts.

38
 Goffman (1967) mentioned that the emotion of shame or anticipation of

embarrassment plays a prominent role in every social encounter. In presenting ourselves

to others, we risk rejection. Depending on its intensity and obviousness, rejection usually

leads inevitably to the painful emotions of embarrassment, shame, or humiliation. On the

other hand, when we are accepted as we present ourselves, we usually feel rewarded by

the pleasant emotions of pride.

Cooley (1922), considered pride and shame as the crucial social self-feelings.

This idea is sustained in the concept of the looking-glass self, which is the description of

the social nature of the self. According to Cooley, we see our face, body, and dress in the

glass, and are interested in them because they are ours, and pleased or disappointed with

them as they do or do not conform to what we would like them to be. Similarly, in our

imagination we perceive in another’s mind some thought of our appearance, manners,

aims, actions, character, and so on, and are variously influenced by our thoughts. Thus,

self-monitoring process consists of our imagination of our appearance to the other person,

the imagination of others’ judgments of that appearance, and its consequent self-feelings

(such as pride or shame).

Self-Conscious Emotions and Self-Regulation

Recall that according to the Carver and Scheier’s (1981) model of self-regulation,

an individual who experiences a discrepancy between the self and desired standards feels

the need to take actions toward reducing the discrepancy. Generally, negative or

discrepancy-reducing feedback loops move individuals toward a goal aimed at decreasing

the gap between present condition and intended condition. There are also discrepancy-

39
enlarging loops, in which deviations from the comparison point are increased rather than

decreased. Sometimes individuals can avoid something they find aversive by approaching

something else. This strategy is called active avoidance (Carver and Scheier 2011). Thus,

one strategy to exit the self-regulatory cycle is to pursue a substitute goal (Carver and

Scheier 1981).

In the context of cosmetic surgery decision making, the discrepancy between

one’s appearance and standards of beauty may motivate the individual to pursue cosmetic

procedures in order to close the experienced gap. One substitute goal to pursue could be

an activity or achievement that induces pride in the individual. As already mentioned,

pride is experienced after successes or achievements. Over time, this experience may

promote positive feelings and thoughts about the global self and informs individuals of

their social value (Tracy and Robins 2007a). Thus, being proud of one’s

accomplishments and qualifications rather than the physical attractiveness, and the desire

to pursue those pride inducing behaviors may help the individual disengage from the

regulatory cycle and disregard the pursuit of cosmetic procedures. As an example, a

young female student might think I am not physically as attractive as the models in

fashion shows. However, I am a successful student and can have a bright future even if I

don’t undergo a cosmetic procedure. Thus, in this case, pride can introduce (or remind

the individual of) a substitute goal to pursue.

In fact, pride may serve important adaptive functions. The subjective experience

of pride might reinforce the behaviors that generate proud feelings, boost self-esteem, and

communicate to the individual that she or he merits increased status (Tracy and Robins

40
2007b). Pride in one’s achievements might promote positive behaviors in the

achievement domain help the individual develop self-esteem (Tracy and Robins 2007b).

Consequently, following a socially valued success, pride might function to maintain and

promote an individual’s social status and group acceptance and thus, help him or her exit

the regulatory cycle and the negative feelings of not meeting beauty standards.

This argument is supported by Carver (2003) suggesting that positive emotions

promote shifting of focus to other things that need attention and consequently, can reduce

the priority of other goals by creating an experience of threat dissipation. Thus, pride as a

positive feeling reminds individuals that they are doing well, and can reduce the priority

of cosmetic procedure pursuits by shifting the focus from the need to undergo such

procedures to behaviors that generate pride feelings in the individual.

On the other hand, an individual with feelings of shame and flaw would

experience loss of self-esteem and would not be able to think of substitute activities. Such

a person will be unable to disengage from the regulatory cycle and will persist in focus on

the irreducible discrepancy. In the context of this study, such an individual would persist

in focusing on the discrepancy and may consider undergoing a cosmetic procedure. This

is consistent with Simon’s (1967) position that negative emotions call for higher priority.

That is, such emotions will demand the pursuit of the focal goal rather than shifting focus

to a substitute objective.

Overall, “given the ubiquity of self-regulation efforts in everyday life, and the fact

that many acts of self-regulation occur within social contexts, the consequences of self-

regulation likely extend beyond self-directed accomplishments to social and interpersonal

41
relationships as well” (Finkel and Fitzsimons 2011, p.407). Since pride and shame are

social emotions, generated as a result of self-monitoring behaviors in social interaction,

linking these two emotions to the study of self-regulatory strategies could contribute to

self-regulation research.

Model and Hypotheses Development

As describe in previous sections, the theoretical framework for the present

dissertation is objective self-awareness theory as linked with self-regulation. OSA theory

is relevant to the context of cosmetic procedure decision making due to its focus on

comparison of self with relevant social standards and the motivation to reduce the

potential experience gaps (see Duval and Wicklund 1972). According to this theory,

when individuals are self-aware, they follow a self-evaluation process in which they

compare their view of themselves with salient standards. Under conditions of public self-

awareness, this comparison is directed toward physical features that are presented to

others. Thus, one can argue that any discrepancy between individuals’ physical

appearance and salient attractive standards of appearance can lead to a discrepancy, and it

is hypothesized that:

H1: Individuals who are self-aware will experience more body image state

dissatisfaction (discrepancy) compared to those who are not self-aware.

H2: Objective self-awareness and standards should interact such that when

relevant appearance standards are accessible, self-aware individuals

experience significantly more body image state dissatisfaction compared to

irrelevant standards. Individuals who are not self-aware do not experience a

42
 significantly different body image state dissatisfaction regardless of their

access to relevant or irrelevant standards.

Such discrepancies create negative emotions that motivate further courses of

action to reduce the discrepancy. In other words, negative emotions act as the underlying

process in the relationship between experienced discrepancy and motivation to take

action. Therefore, it is hypothesized that:

H3: Negative emotions (experienced as a result of self-standard discrepancy) will

mediate the impact of body image state dissatisfaction on (a) interpersonal

motivation, (b) intrapersonal motivation, and (c) likelihood to purse cosmetic

procedures.

When the individual feels the negative affect resulted from the discrepancy,

he/she enters the self-regulatory cycle to reduce the discrepancy. As Carver and Scheier

(1981) argue, depending on what regulating strategy is taken, the individual may

disengage from or remain in the cycle. Feelings of pride can help the individual exit the

regulatory cycle by reminding the individual of alternative goals to pursue. However,

shame will keep the individual in the regulatory cycle since the individual cannot find a

substitute goal to purse. Thus, feeling of shame may increase self-aware individuals’

motivation and likelihood to pursue cosmetic surgery, while pride may have an opposite

effect. Thus, it is hypothesized that:

H4: The indirect effect of body image state dissatisfaction (discrepancy) on (a)

interpersonal motivation, (b) intrapersonal motivation, and (c) likelihood to

43
 undergo cosmetic procedures is moderated by individuals’ state of pride or

shame.

These relationships and are illustrated in the research model (see Figure 1).

FIGURE 1
Research Model

44
 CHAPTER 3

STUDY 1

Overview

The first study was a 2 (OSA vs. no-OSA) x 3 (relevant vs. irrelevant standard vs.

control) between subjects factorial design in which objective self-awareness and

standards were manipulated and body image state dissatisfaction was measured as the

dependent variable. Overall, the purpose of this study was to establish the effect of

objective self-awareness and access to relevant standards of beauty on creating self-

standard discrepancy and its consequent impact on motivation and likelihood to pursue

cosmetic procedures. More specifically, this experiment assessed the following research

hypotheses:

H1: Individuals who are self-aware will experience more body image state

dissatisfaction (discrepancy) compared to those who are not self-aware.

H2: Objective self-awareness and standards should interact such that when

relevant beauty standards are accessible, self-aware individuals experience

significantly more body image state dissatisfaction compared to irrelevant

standards. Individuals who are not self-aware do not experience a

significantly different body image state dissatisfaction regardless of their

access to relevant or irrelevant standard.

45
 H3: Negative emotions mediate the impact of body image state dissatisfaction on

(a) interpersonal motivation, (b) intrapersonal motivation, and (c) likelihood

to undergo cosmetic procedures.

Methodology

Prior to conducting the main experiment, two pre-tests were conducted for several

reasons. The first reason was to gain a better understanding of the relevance and

importance of the topic of the study (undergoing cosmetic procedures) for a student

sample (addressed in pre-test 1). Second, it was essential to ascertain the importance of

emotions in cosmetic surgery decision making and identify those emotions that could be

influential in this process (addressed in pre-test 1). The third reason was to ensure the

soundness of the elected approach to manipulate beauty standards and its impact on

individuals as opposed to the irrelevant standards (addressed in pre-test 2).

Pre-Test 1

The first pre-test was an exploratory study to gain a better understanding of the

cosmetic surgery decision making. It was important to conduct the exploratory phase to

identify the relevance of the topic under investigation to the population of the study.

Moreover, such an understanding was necessary to assure that important aspects of the

cosmetic surgery decision making phenomenon are studied. Overall, this pre-test pursued

two major purposes. First and foremost, the objective was to query the opinions and

attitudes of students about cosmetic procedures generally as a social phenomenon and

specifically for themselves. Second, the pre-test was conducted to identify whether

emotions are important factors affecting decisions to undergo cosmetic procedures.

46
Procedure

The pre-test used a convenience sample of 20 undergraduate students at a large

public university in the Southwestern United states who received course credit for

participation. Because the sample for the main studies was to drawn from the same

population, the demographic profile of this sample was similar to that of the main study.

The questionnaire, containing eight open-ended questions and four demographic

questions (age, gender, ethnicity, and income), was distributed in the classroom and

collected after five days. Students were asked about their opinions regarding cosmetic

surgery, the outcomes of having a cosmetic procedure, motivators of such decisions, as

well as their feelings about having a cosmetic procedure. Moreover, participants

mentioned whether they had considered undergoing a cosmetic procedure, and/or had

already had a cosmetic procedure. The collected responses were entered into an Excel

sheet and used for further analyses.

Results

The open-ended responses were coded based on the emerging patterns in the data.

The results indicated that the student sample (mean age = 26.3 years old) believes in

undergoing cosmetic procedures for the purpose of self-improvement. For instance, one

participant (female, 29 years old) stated “I think you can't place a price on self-

improvement. And if it will make you feel better then go for it. Cosmetic surgery is not

what it used to be. It is now more favorable and everyone from different social

backgrounds is getting it done.” Another participant (male, 27 years old) mentioned “a

great achievement in the science and technology field. The use of cosmetic surgery in the

47
field of fashion and media is increasing each and every day and some people don’t realize

that they are over doing it.”

Beliefs about the results of cosmetic surgery were mixed. A group of participants

stated positive outcomes such as increased confidence, better self-feelings, and improved

social interactions. On the other hand, other participants stated negative outcomes such as

surgery failure, addiction to surgery, infection, and pain.

Similarly, evoked emotions relevant to such surgical procedures were also mixed.

Positive feelings associated with desires to be happier, more successful, and more

confident were mentioned alongside negative emotions of fear of surgical failure, pain,

and uncertainties about the results. A few respondents, however, were indifferent about

cosmetic procedures.

At least half of the respondents had considered having a cosmetic procedure in the

future. The motivating factors, according to the results, included being viewed by others

as more attractive, being happier, and being more confident. Important themes emerging

from the data was the importance of social norms encouraging individuals to look a

certain way, the desire to enhance one’s self-esteem, and to improve others’ attitudes.

One respondent (male, 22 years old) explained the motivation to undergo a cosmetic

surgery as “if there is a physical feature that hinders your ability to function within your

everyday life or there is something that you wish to fix superficially.” A female

respondent (23 years old) mentioned “if you are totally unhappy with a body part that

would be a motivation. Also if people you know comment on something you already

don’t like about yourself then you are more likely to get the surgery.” These responses

48
highlight the impact of the society and judgments of others on individuals’ emotions

motivating them to take action to reduce the negative comments or to enhance their

appearance-related confidence.

Overall, the results of this preliminary test indicated that the study of cosmetic

surgery employing a student sample is viable (ten respondents expressed positive views

about undergoing cosmetic surgery, six reported such procedures as being unviable, and

four were indifferent). Also, the results revealed that emotions play an important part in

such decisions as 12 respondents express emotional reactions of some kind (referring to

hope, fear, anxiety, shame, and pride) about cosmetic procedures, while six did not report

any emotions in this regard and two did not provide any answers. Despite the limited

sample size, this qualitative inquiry yielded valuable initial insights about the research

topic.

Pre-Test 2

The second pretest was conducted for the purpose of identifying relevant and

irrelevant beauty standards for the main experiments. According to objective self-

awareness theory (Duval and Wicklund 1972), standards are representations of

characteristics to which individuals compare themselves. Thus, this pre-test was designed

to capture students’ views of representations of physical attractiveness in society. More

specifically, the objective of this study was to select images of fashion models that were

considered to be attractive by research participants. These images constituted the relevant

beauty standard in main experiments.

49
 Images of plants and flowers were selected as irrelevant images to be used for the

main study because they are not related to personal appearance. Thus, a second objective

of the study was to ensure that plants and flowers do not induce thoughts about beauty

standards and physical attractiveness and could be considered as irrelevant to beauty and

appearance standards.

Procedure

The first step was to select images of fashion models and attractive individuals in

beauty and fashion magazines for the purpose of the pre-test. Several issues of magazines

such as Allure, People, Gentlemen’s Quarterly, etc. were reviewed for selecting images

of models with no product/brand endorsement. Care was taken to include images of

models with different ethnic identities and skin colors. The plant and flower images were

selected from magazines such as House & Garden, Home, and Garden Design.

Scanned color images of all chosen images were embedded in an online survey

using Qualtrics. Participants were asked to measure the attractiveness of each image on a

scale of 1 to 7 (1 = not attractive at all; 7 = extremely attractive). Participants were

undergraduate students who participated in the study in an exchange for course credit.

Based on gender, participants were randomly assigned to either rate the attractiveness of

the images of plants and flowers or fashion models of the same gender as the participant

(each group of images contained 20 pictures). The last question asked participants to state

their thoughts and feelings at that moment.

50
Results

Sixty-seven students rated the attractiveness of the images (i.e., about 17 ratings

per group of images). Only those images that were rated to be above average (greater

than 3.5) were selected to be used in the main study. Twelve to 15 images were selected

from the pool of images in each group (female models, male models, and flowers) and

the hard copies of those images were kept for the main experiments. Thus, based on the

ratings, images of flowers and plants as well as those of male and female beauty models

were selected for the main study.

The review of the cognitive responses about thoughts and feelings after viewing

the images indicated that plants and flowers induced thoughts and feelings that were not

related to physical appearance, social norms and standards of beauty, or bodily feelings.

For instance, one female participant mentioned “I don't have any thoughts about myself. I

just want to be somewhere that nice.” Another participant wrote “These pictures just

made me feel indifferent really.” On the other hand, the images of fashion models created

thoughts related to appearance and attractiveness. As an example, one female participant

mentioned “I thought that the pictures were very beautiful. The women were very vibrant

and of all ethnicities. Not only that but I love fashion.” A male respondent stated “I

thought that a lot of the pictures showed a resemblance of culture and fashion desires but

I am not very interested in these.” Another male respondent mentioned “I wish I was built

like the men on the pictures. I’m ok with how I look though.”

Overall, the results of this pre-test indicate that using the images of flowers and

plants as irrelevant beauty standards would be appropriate as participants did not mention

51
any thoughts or feelings related to their appearance, personal beauty, and fashion.

According to the results, the images of fashion and beauty models of both genders were

considered to be representative of the contemporary beauty culture toward which many

individuals aspire. Moreover, attractive images of plants and flowers as well as male and

female fashion models were selected for the purpose of main study.

Study 1 Design

This section outlines the methodology for exploring the research questions and

hypothesized relationships in study 1. A 2 x 3 full factorial between subjects

experimental design was conducted to test the interplay between objective self-awareness

and accesses to beauty standard and the consequent impact on body image state

dissatisfaction. The first factor consisted of two levels of objective self-awareness (i.e.,

OSA vs. no-OSA). The second factor consisted of three levels of standards (i.e., relevant

standards of beauty, irrelevant standards of beauty consisting of images of plants and

flowers, and the control group with no images). Although the results of the second pre-

test indicated that viewing the images of plants and flowers does not create thoughts and

feelings related to appearance and beauty, one could argue that viewing images of plants

and flowers (i.e., irrelevant standards) could induce emotions that may have confounding

effects. To address this concern, a third control condition was employed to further

examine the differences in the impact of viewing pictures of flowers and plants versus no

picture on participants’ emotions and feelings.

Subsequent to examining the above relationships, a mediation analysis was

conducted to assess the ability of body image state dissatisfaction to evoke negative

52
 affect and, ultimately, appearance enhancement motivations and likelihood of pursuing

cosmetic procedures.

Sample

One hundred sixty-two undergraduate students at a large public university in the

Southwestern United states participated in the study in exchange for course credit.

Overall, 152 usable responses were collected (60.5% female). Respondents ranged in age

from 18 to 35 years, with a mean age of 22.14 (SD = 2.70). Only 16.4% had prior

cosmetic procedures. Almost 89.5% were single and never married, 3.3% were married,

5.3% were living with a partner, and 1.3% were separated. Demographic statistics are

summarized in Table 1.

TABLE 1
Demographic Profile of Respondents-Study 1
Gender No (%) Personal No (%) Family No (%)
Annual Annual
Income Income
Male 59 (38.8%) Less than 100 (68.5%) Less than 8 (5.3%)
$20K $20K
Female 92 (60.5%) $20K-29K 31 (20.4%) $20K-29K 15 (9.9%)
Not reported 1(.7%) $30K-39K 8 (5.3%) $30K-39K 9 (5.9%)
$40K-49K 2 (1.3%) $40K-49K 5 (3.3%)
$50K-59K 2 (1.3%) $50K-59K 9 (5.9%)
$60K-69K 2 (1.3%) $60K-69K 16 (10.5%)
$70K-79K 1 (.7%) $70K-79K 11 (7.2%)
Ethnicity No (%) $80K-89K 7 (4.6%)
White/Caucasian 87 (57.2%) $90K-99K 6 (3.9%)
Hispanic 17 (11.2%) $100K-109K 14 (9.2%)
Black/African 18 (11.8%) $110K-119K 7 (4.6%)
American
Asian 14 (9.2%) $120K-129K 5 (3.3%)
Other 14 (9.2%) $130K and 33 (21.7%)
more
Not reported 2 (1.3%) Not reported 7 (4.6%)

53
 A student sample is appropriate for this research since as the results of the first

pre-test indicate, students consider cosmetic procedures as mechanisms of self-

enhancement and many of them have considered undergoing such procedures. Also,

previous research indicates that half of American college students are anxious about at

least one aspect of their physical appearance (Suissa 2008). Furthermore, information

from the American Society for Aesthetic Plastic Surgery (ASAPS) in 2008 revealed that

individuals aged 19-34 years, most of whom are women, are highly concerned about their

appearance and aging symptoms and, thus, could be potential purchasers of cosmetic

surgery services.

Moreover, as Calder, Phillips, and Tybout (1981) have mentioned, when the goal

of research is theory application, it is ideal to employ maximally homogeneous

respondents such as students samples. Homogenous respondents permit more accurate

theoretical predictions than heterogeneous samples since the greater variability in the

latter sample makes precise predictions more difficult and weakens the test of theory.

Using homogenous samples in theory application studies reduces the chance of making

false conclusions about the presence (or absence) of covariation between the variables

under study (i.e. reduces the likelihood committing a Type II statistical error). Contrary to

homogeneous samples, heterogeneous respondents impose a greater threat to statistical

conclusion validity and enhance the possibility of making a Type II error by increasing

the error variance (Calder, Phillips, and Tybout 1981). Overall, homogeneous samples

provide a stronger test of the theory and are preferable in theory application studies.

Therefore, a student sample was deemed appropriate for the present research as many

54
social background factors could be considered relatively homogenous across the sample,

making it appropriate for the present research.

Procedure

Public OSA was manipulated using a full length mirror (36”x48”) following the

procedures in previous research (e.g., Webb et al. 1989; Phillips and Silvia 2005). This

manipulation procedure is well-established in the social psychology literature and is

widely used in contemporary research (Dijksterhuis and Van Knippenberg 2000; Govern

and Marsch 2001; Mullen, Migdal, and Rozell 2003; Phillips and Silvia 2005). Data

collection was conducted on an individual basis. Participants were randomly assigned to

the mirror or no-mirror condition. In the mirror condition, participants were seated on the

only available chair in the experiment room which faced the mirror. A few boxes, chairs,

and a table on top of which were newspapers and paper copy boxes were placed in the

room to make the presence of the mirror in the room less noticeable. The experimenter

said “I’m sorry for the clutter in the room, but someone else was kind enough to let me

use their room. I really shouldn’t move things around in here because they aren’t mine.”

Then the experimenter left the room and waited for two minutes to let the participant look

at him/herself in the mirror.

Next, the experimenter entered the room with a pamphlet containing select images

from the second pre-test. These pamphlets contained images of the plants and flowers

(irrelevant standard) or the male or female fashion models (relevant standard). The

assignment of the pamphlet containing images of fashion models was according to the

participants’ gender to make sure that participants view images of beauty standards

55
pertaining to their gender to possibly induce body-standard comparison thoughts. In the

control group, no picture was shown to the participants. Overall, the assignment of

relevant, irrelevant, or no standard was random (note that the control group did not

receive any images). In those conditions that the images were shown to participants, the

experimenter explained “please look at these images while I print the questionnaire for

you. These are collected for another study and I would like to ask your ideas about them

before I use them in my study. Please tell me your opinions about these pictures after you

complete the questionnaire.” After two minutes, participants were provided with the

questionnaire, which took about twenty minutes to complete, on average.

When each participant submitted the questionnaire to the experimenter, he or she

was asked “what do you think the purpose of this experiment was?” to assure that the

purpose of the presence of mirror in the experiment room was not guessed. Except one

participant (whose responses were removed from the pool of collected data), no one

guessed that the presence of the mirror in the room was related to the purpose of the

study. Participants were also asked to share their thoughts and opinions about the images.

Consistent with the results of pre-test 1, those who had seen the images of flower and

plants mentioned that the images were unrelated to the study questionnaire and made

comments about the flowers and variety of colors in the collection. Those who had

viewed the images of beauty models, however, mentioned that the collection of images

was representative of different ethnicities and was similar to what is seen on fashion

magazines, and that viewing the images made them think about themselves.

56
 In order to assure that participants in the OSA condition faced the mirror while

sitting on the chair, small tapes were placed on the carpet in the experiment room at the

exact location of chair legs. After each participant assigned to the mirror condition left

the room and submitted the questionnaire, the experimenter checked whether the chair

had been relocated to avoid facing the mirror, but no instances of such relocation were

witnessed.

Data Collection Instrument

The data collection instrument was divided into several sections. The first section

consisted of the six items intended to measure public and private situational self-

awareness (public- and private-OSA). These items were adopted from items developed

by Govern and Marsch (2001). Govern and Marsch demonstrated that differences in both

public and private situational self-awareness induced by laboratory manipulations can be

detected by this scale. The results of five studies conducted by these researchers

supported the use of this instrument as a valid, reliable, and efficient means of

quantifying situational fluctuations in both public and private self-awareness.

Self-awareness manipulation check measures were followed by an open-ended

question that asked participants to describe their thoughts and feelings about themselves

at that moment. Next, positive and negative emotions were measured using the positive

and negative affect schedule (PANAS) developed and validated by Watson, Clark, and

Tellegen (1988). The next set of questions measured the body image state dissatisfaction

(BISDS) of participants. This 9-point scale consists of six questions developed by Cash

et al. (2002) and anchored from 1 to 9.

57
 A list of 36 cosmetic procedures (14 minimally-invasive and 22 surgical

procedures) adapted from the Web site of the American Society of Plastic Surgeons

(ASPS) was provided next, and participants were asked to choose the specific procedures

they may personally consider for the future. Next, they indicated, via an open-ended, item

the dollar amount they were willing to pay for their selected cosmetic procedure(s).

Those who did not choose any cosmetic procedure were asked to explain the reason for

not being interested in them.

Dependent variables were measured next. Interpersonal (social) and intrapersonal

motivation for cosmetic surgery as well as the likelihood of having a cosmetic procedure

were measured using the fifteen questions (five questions for each construct) of the

acceptance of cosmetic surgery scale (ACSS) developed and validated by Henderson-

King and Henderson-King (2005), and one item was developed and added to the

likelihood of having a cosmetic procedure scale. All items were assessed via 7-point

Likert-type scales from 1 to 7 (1 = strongly disagree; 7 = strongly agree). Henderson-

King and Henderson-King (2005) have provided evidence of this scale’s reliability,

convergent, and discriminant validity.

These questions were followed by four items measuring cosmetic surgery

propensity (Mowen, Longoria, and Sallee 2009) as well as tanning propensity (Mowen,

Longoria, and Sallee 2009). Propensity for cosmetics tattoos (such as eyebrows, eye line,

lip line tattoos) was also captured using the measure adapted from the tanning propensity

scale. The propensity items are surface traits identified by Mowen, Longoria, and Sallee

(2009) and are defined as enduring dispositions to act within category-specific contexts.

58
Surface traits result from the influence of elemental, compound, and situational traits that

operate jointly with more context-specific environmental pressures (Mowen 2000). Since

surface traits have a strong behavioral component (Mowen 2000), they were considered

important in the present study and were measured.

Body-esteem was also measured due to its relevance to the topic of the study.

Body-esteem assesses individuals’ attitudes about their bodies and appearance. The scale

to measure body-esteem was developed and validated by Mendelson, Mendelson, and

White (2001). Body-esteem has three dimensions namely, appearance (related to general

feelings about one’s appearance), attribution (related to evaluations attributed to others

about one’s body and appearance), and weight (related to satisfaction with one’s weight)

that could be considered independently. The discriminant validity of the body-esteem

subscales has been confirmed (Mendelson, Mendelson, and White 2001). Self-esteem

was also measured using the ten measurement items developed by Rosenberg (1965). The

trait self-esteem is traditionally conceptualized as an individual’s personal assessment of

his/her achievement of personal goals or standards (Leary and Guadagno 2011) and has

been linked to perceived regard from others (Lemay and Ashmore 2006).

Body resource (physical) needs (Mowen 2000), a personality characteristic about

the need to protect and enhance one’s body, was also measured to control for its potential

influence. This individual trait affects a number of other characteristics and behaviors

such as health motivation, sports interest, healthy-diet life style, vanity, and eating

disorders (Mowen and Minor 2006), and thus it was assumed that it could be an

influential factor in this research. Fear of surgery was also measured as it may impact

59
decisions to undergo surgical procedures. The items for fear of pain (Sullivan, Bishop,

and Pivik 1995) and fear of failure (adapted from Conroy 2001) were adapted to better

match the context of the study.

Finally, demographic information were collected. Information about age, gender,

marital status, ethnicity, country of origin, number of years spent in the United States (for

those who were not born in the United States), personal annual income, family annual

income, household size, and major were gathered. The last question asked whether the

participants had undergone a cosmetic procedure before, as well as the type of those

procedures.

Analysis and Results

Measurement Assessment

In order to assess the psychometric properties of the measures used in the study

and test the hypothesized relationships, accepted procedures from the extant literature

were followed. Frist, reliability and validity were established for all measurement scales

(Churchill 1979; Gerbing and Anderson 1988) using exploratory factor analysis (EFA),

confirmatory factor analysis (CFA), and calculation of Cronbach’s alpha as well as

composite reliability (CR). Next, the hypothesized relationships were examined using

multivariate analysis of covariance and mediation analysis.

The first step in the data analysis was to establish reliability and validity for the

measurement scales using the two-step process recommended by Anderson and Gerbing

(1988). An exploratory factor analysis with principal component extraction and Varimax

60
rotation was conducted on each measurement scale followed by calculating the

Cronbach’s alpha to assess the reliability.

Table 2 shows the results of EFA on situational self-awareness scale used for

manipulation check as well as the Cronbach’s alpha values. As expected, the six items

loaded on two factors, public and privates self-awareness, with no cross-loadings. Body

image state dissatisfaction items yielded one factor and had loadings of above .6 and the

Cronbach’s alpha was .901(See Table 3).

TABLE 2
Situational Self-Awareness Exploratory Factor Analysis and Reliability-Study 1
Item Factor Loadings
Public Private
Right now, I am conscious of my inner feelings. -.053 .787
Right now, I am reflective about my life. .209 .770
Right now, I am aware of my innermost thoughts. .019 .826
Right now, I am concerned about the way I present myself. .798 .058
Right now, I am self-conscious about the way I look. .840 -.048
Right now, I am concerned about what other people think of .787 .143
me.

Cronbach’s Alpha .719 .713

The result of the EFA for positive and negative affect schedule scale was also

satisfactory (see Table 4) as the items loaded under two factors (positive and negative

affect) and showed acceptable reliability (Cronbach’s alphas were above .8).

61
 TABLE 3
Body Image State Dissatisfaction Exploratory Factor Analysis and Reliability-Study 1
Item Factor Loadings
Body Image State
Dissatisfaction
Right now, I feel extremely dissatisfied with my physical .853
appearance.
Right now, I feel extremely dissatisfied with my body size and .882
shape.
Right now, I feel extremely dissatisfied with my weight. .844
Right now, I feel extremely physically unattractive. .878
Right now, I feel a great deal worse about my looks than I .686
usually feel.
Right now, I feel I look a great deal worse than the average .804
person looks

Cronbach’s Alpha .901

The dependent variables were also factor analyzed and yielded discriminant

factors with high reliability (see Table 5). Other potentially related and influential

variables (not included in the research model) were also factor analyzed.

Propensity items produced three factors (i.e., cosmetic surgery propensity, tanning

propensity, and tattooing propensity) with Cronbach’s alphas above .8 (Table 6).

62
 TABLE 4
Positive and Negative Affect Exploratory Factor Analysis and Reliability-Study 1
Item Factor Loadings
Negative Affect Positive Affect
Interested .148 .461
Excited .029 .672
Strong -.149 .768
Enthusiastic -.061 .760
Proud -.168 .714
Alert .005 .536
Inspired .153 .722
Determined .091 .717
Attentive .008 .580
Active .039 .685
Distressed .632 -.002
Upset .613 .056
Guilty .683 .114
Scared .787 .156
Hostile .609 -.109
Irritable .718 -.143
Ashamed .709 -.048
Nervous .711 .090
Jittery (stressed out) .697 -.014
Afraid .769 .086

Cronbach’s Alpha .877 .862

After eliminating items with low loadings on factors or high loadings on more

than one factor (cross loading), body-esteem items produced three factors consistent with

previous research (Mendelson, Mendelson, and White 2001) each capturing a different

aspect of body-esteem. Table 7 provides item loadings on each factor, and the reliability

values.

63
 TABLE 5
Acceptance of Cosmetic Surgery Factor Analysis and Reliability-Study 1
Item Factor Loadings
Surgery Intrapersonal Interpersonal
Likelihood Motivation Motivation
Intrapersonal Motivation Items
It makes sense to have minor cosmetic surgery
.392 .753 .132
rather than spending years feeling bad about the
way you look.
Cosmetic surgery is a good thing because it can
.319 .833 .152
help people feel better about themselves.
People who are very unhappy with their physical
appearance should consider cosmetic surgery as .270 .775 .313
one option.
If cosmetic surgery can make someone happier
.180 .821 .275
with the way they look, then they should try it.
Cosmetic surgery can be a big benefit to
.256 .768 .215
people’s self-image.
I would seriously consider having cosmetic
.291 .438 .675
surgery if my partner thought it was a good idea
I would think about having cosmetic surgery in
.569 .246 .548
order to keep looking young.
If it would benefit my career I would think about
.290 .167 .772
having plastic surgery.
I would seriously consider having cosmetic
surgery if I thought my partner would find me .235 .207 .864
more attractive.
If a simple cosmetic surgery procedure would
make me more attractive to others, I would think .328 .221 .804
about trying it.
In the future, I could end up having some kind of
.795 .275 .392
cosmetic surgery.
If I could have a surgical procedure done for free
.717 .339 .421
I would consider trying cosmetic surgery.
If I knew there would be no negative side effects
.742 .391 .390
or pain, I would like to try cosmetic surgery.
I have sometimes thought about having cosmetic
.798 .321 .207
surgery.
I would never have any kind of plastic surgery. .604 .153 .174
If I have the money someday, I would get a
.843 .363 .257
cosmetic procedure.
.932 .918 .906
Cronbach’s Alpha

64
 TABLE 6
Propensity for Appearance Enhancement Factor Analysis and Reliability
Item Factor Loadings
Tattoo Tanning Cosmetic
Propensity Propensity Surgery
Propensity
I like the idea of having plastic surgery to .010 .147 .919
improve my appearance.
I envision myself having plastic surgery to .039 .094 .900
make me look better.
If the opportunity arises, I would have -.070 .077 .799
cosmetic surgery on my face.
Overall, I believe that elective surgery can .085 .204 .818
be a good thing.
For me, tan skin is more attractive than pale .015 .855 .088
skin.
I feel more attractive when my skin is tan. -.018 .948 .146
A suntan enhances my physical appearance. .005 .927 .165
I enjoy the experience of obtaining a suntan. .076 .821 .128
I think tattoo makes your appearance more .886 .066 .020
attractive.
I feel more attractive when I have a tattoo on .938 .044 -.035
my body.
A tattoo enhances my physical appearance. .950 .033 -.044
I enjoy the experience of obtaining a tattoo. .837 -.055 .104

Cronbach’s Alpha .921 .920 .893

Self-esteem yielded one factor with an acceptable reliability (above .8). Other

control variables (i.e., body resource needs, fear of surgery failure, and fear of pain) were

also factor analyzed. The results are provided in Tables 8 to 10, respectively. After

eliminating the items with cross-loading, fear of pain produced one factor, and fear of

surgery failure yielded more than one factor (i.e., social fear, outcomes fear, and fear of

future consequences).

65
 TABLE 7
Body-Esteem Factor Analysis and Reliability
Item Factor Loadings
Appearance Attribution Weight

I wish I looked like someone else. (R) .793 .104 .106

My looks upset me. (R) .766 .285 .280
There are lots of things I’d change about my .815 .246 .140
looks if I could. (R)
I wish I looked better. (R) .793 .197 .237
I feel ashamed of how I look. (R) .613 .459 .240
I worry about the way I look. (R) .702 .186 .233
I’m as nice looking as most people. .259 .799 .276
My looks help me to get dates. .151 .839 .176
People of my own age like my looks. .194 .844 .226
I think my appearance would help me get a job. .192 .803 .050
Other people consider me good looking. .219 .884 .160
I am satisfied with my weight. .263 .370 .797
I really like what I weigh. .248 .351 .816
I am preoccupied with trying to change my .368 -.171 .588
body weight.
Weighing myself depresses me. .527 .112 .604
My weight makes me unhappy. .529 .178 .702
I feel I weigh the right amount for my height. -.022 .296 .750

Cronbach’s Alpha .898 .926 .889

66
 TABLE 8
Body Resource Needs Factor Analysis and Reliability-Study 1
Item Factor Loadings
Self-Esteem
I feel that I’m a person of worth, at least on an equal basis with .511
others.
I feel that I have a number of good qualities. .664
All in all, I am inclined to feel that I am a failure. (R) .748
I am able to do things as well as most people. .441
I feel I do not have much to be proud of. (R) .739
I take a positive attitude toward myself. .752
On the whole, I am satisfied with myself. .809
I wish I could have more respect for myself. (R) .701
I certainly feel useless at times. (R) .767
At times I think I am no good at all. (R) .747

Cronbach’s Alpha .872

TABLE 9
Self-Esteem Factor Analysis and Reliability-Study 1
Item Factor Loadings
Body Resource Needs
I focus on my body and how it feels. .818
I devote time each day to improving my body. .869
I feel that making my body look good is important. .752
I work hard to keep my body healthy. .847

Cronbach’s Alpha .837

67
 TABLE 10
Fear of Cosmetic Surgery Factor Analysis and Reliability
Item Factor Loadings
Fear of Social Outcomes Fear of
Pain Fear Fear Future
If the procedure fails, I will still feel good about .146 -.001 .696 .218
myself. (R)
If the procedure fails, my appearance will be .054 .269 .715 .098
embarrassing.
If the procedure fails, others will think I am not .035 .414 .726 .182
looking good anymore.
I hate the fact that I am not in control of the .179 .190 .648 .009
outcome of the procedure.
If the procedure fails, my future plans will change. .171 .383 .051 .614
When I decide to undergo a cosmetic surgery I am .023 -.037 .223 .711
not worried about its outcomes affecting my future
plans. (R)
If the procedure fails, it disturbs my plans for the .109 .335 .220 .723
future.
If the procedure fails, I won’t lose my hope because .092 .315 .024 .613
I know that I can still achieve the results I want to
achieve. (R)
If the procedure fails, I will lose great opportunities .076 .722 -.017 .453
in my life.
If the procedure fails, people will be less interested .062 .811 .254 .230
in me.
If the procedure fails, my significant other may .038 .815 .126 .202
tend to leave me.
If the procedure fails, some people may avoid me. .099 .860 .207 .111
If the procedure fails, some people will not be .115 .841 .241 .092
interested in me anymore.
If the procedure fails, important people will think .019 .770 .114 .055
less of me.
I keep thinking about how badly I will feel pain .807 .137 .098 -.029
after a cosmetic procedure.
The pain of the cosmetic procedure is something .894 .074 .027 .020
that I cannot keep it out of my mind.
I keep thinking about how much it will hurt. .903 .133 .065 .024
I feel I can't tolerate the pain of the cosmetic .848 .048 .016 .188
surgery.
Post-surgery pain is terrible. .755 -.035 .221 .029
The pain of cosmetic surgery worries me a lot. .935 .013 .025 .092
I think the pain of cosmetic surgery is awful. .841 .035 .192 .017
I think I won’t be able to stand the pain of the .856 .085 .021 .241
cosmetic surgery.

Cronbach’s Alpha .952 .751 .922 .717

68
 Confirmatory factor analysis was then performed using LISREL software, during

which composite reliability (CR) and average variance explained (AVE) were examined

for all variables in the model. The CFA indicated an acceptable fit between the model and

the data (χ2 = 1023.16, df = 454, p < .00, RMSEA = .08, NFI = 90, NNFT =.93, CFI =

.94). Reliability was assessed by examining item and construct reliability (Peter 1981).

All item loadings were significant (t-values above 1.96) and exceeded the recommended

.5 parameter value. Both composite reliability (CR) and average variance explained

(AVE) exceeded their recommended threshold of .7 and .5, respectively, indicating

acceptable reliability (Bagozzi and Yi 1988) with the exception of negative affect which

had an AVE of .427 (see Table 11).

Discriminant validity was checked following the recommended method of Fornell

and Larcker (1981) that is the squared correlations between constructs were less than the

values of AVE for each construct in the correlated pair. Table 11 provides the

discriminant validity results.

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 TABLE 11
Measurement Model Assessment of Discriminant Validity-Study 1
Body Image
Negative State Intrapersonal Interpersona Surgery
Affect Dissatisfaction Motivation l motivation Likelihood CR
Negative Affect .427 .040 .026 .044 .019 .761
Body Image
State .200 .616 .002 .017 .026 .856
Dissatisfaction
Intra-Personal
Motivation
.160 .050 .700 .436 .547 .891
Inter-Personal
.210 .130 .660 .661 .624 .865
motivation
Likelihood .140 .160 .740 .790 .729 .922
The numbers below the diagonal represent correlations. The numbers on the diagonal are the average
variance extracted (AVE) by each variable. The numbers above the diagonal are the squared correlations
between the variables.

Manipulation Checks

Public OSA Manipulation Check

To determine whether the manipulation of public objective self-awareness via

full length mirror was successful, situational objective self-awareness was measured

using the six items of the situational self-awareness scale (SSAS) and the two groups

(assigned to the mirror condition vs. no-mirror condition) were compared based on their

self-awareness scores. Scores on the three items of each subscale of the SSAS (i.e., public

and private) were averaged to provide one score for each subscale. The results of the

univariate analysis of variance indicated that participants in the mirror condition (public

objective self-awareness) reported significantly higher scores on the public self-

awareness subscale (M = 4.614) than did participants in the no-mirror condition (M =

4.12), F (1,150) = 4.911, p = .030, η2 = .031 (see Table 12). However, as shown in Table

13, the differences in private self-awareness (which was not intended to be manipulated)

70
was not significant for the two groups (F(1, 150) = .278, p = .599, η2 = .002; M = 5.329

and 5.226 for mirror and no-mirror conditions, respectively). Overall, the results indicate

that the manipulation of public objective self-awareness was successful.

TABLE 12
Manipulation Check for Public Objective Self-Awareness-Study 1
Type III Sum Mean Eta
Source of Squares df Square F Sig. Squared
Corrected Model 9.299 1 9.299 4.811 .030 .031
Intercept 2898.720 1 2898.720 1499.677 .000 .909
OSA vs. NO-OSA 9.299 1 9.299 4.811 .030 .031
Error 289.934 150 1.933
Total 3202.778 152
Corrected Total 299.233 151

TABLE 13
Manipulation Check for Private Objective Self-Awareness-Study 1
Type III Sum Mean Eta
Source of Squares df Square F Sig. Squared
Corrected Model .398 1 .398 .278 .599 .002
Intercept 4233.310 1 4233.310 2953.004 .000 .952
OSA vs. NO-OSA .398 1 .398 .278 .599 .002
Error 215.034 150 1.434
Total 4450.556 152
Corrected Total 215.432 151

Standards Manipulation Check

To check whether there was a difference in the emotions induced by images of

plants and flowers versus the control condition (both irrelevant standards for beauty), a

univariate analysis of variance with condition as the fixed factor and emotion index as the

dependent variable was run for each experimental group (i.e., OSA and no-OSA). An

emotion index was calculated by subtracting the average of negative emotions from that

of positive emotions, both measured by PANAS (Watson, Clark, and Tellegen 1988). For

71
 the OSA condition, the results indicated that there is no difference in the emotions of

individuals who viewed images of flowers and plants (M = 2.352) and those who viewed

no images (M = 2.544); F(1,52) = .291, p = .592, η2 = .006. When individuals were

assigned to the no-OSA condition, the results were similar (F(1,49) = 2.371, p = .130, η2

= .046), indicating that there was no significant difference in the emotions of those

individuals who viewed flowers and plants (M = 2.929) and those who did not see any

pictures (M = 2.218). Tables 14 and 15 provide these results

TABLE 14
Emotions Index Comparison for Individuals in OSA Condition
Type III Sum Mean Eta
Source of Squares df Square F Sig. Squared
Corrected Model .501 1 .501 .291 .592 .006
Intercept 323.645 1 323.645 188.136 .000 .783
Irrelevant vs. No-Standard .501 1 .501 .291 .592 .006
Error 89.454 52 1.720
Total 413.600 54
Corrected Total 89.955 53

TABLE 15
Emotions Index Comparison for Individuals in No-OSA Condition
Type III Sum Mean Eta
Source of Squares df Square F Sig. Squared
Corrected Model 6.417 1 6.417 2.371 .130 .046
Intercept 336.689 1 336.689 124.427 .000 .717
Irrelevant vs. No-Standard 6.417 1 6.417 2.371 .130 .046
Error 132.590 49 2.706
Total 471.400 51
Corrected Total 139.007 50

Moreover, there was no difference in the body image state dissatisfaction between

those individuals who had seen the pictures of plants and flowers (M = 5.44) and those

72
who had not seen any images (M = 5.63; F(1, 103) = .333, p = .565, η2 = .003; see Table

16). Similarly, there were no significant differences between these individuals in their

intrapersonal and interpersonal motivation as well as their likelihood to undergo cosmetic

procedures as the multivariate test was insignificant (Wilks’ Lambda F(3, 101) = .213, p

= .887, η2 = .006). The test of between subjects effects indicated that respondents did not

have different interpersonal motivations (F(1, 103) = .142, p = .707, η2 = .001; M = 2.88

vs. 2.75 for those who saw images of plants and flowers vs. no images, respectively).

Intrapersonal motivation of these respondents to undergo cosmetic procedures was not

significant as well (F(1, 103) = .587, p = .445, η2 = .006; M = 4.466 vs. 4.230 for those

who saw images of plants and flowers vs. no images, respectively). Similar results were

achieved for likelihood to undergo cosmetic procedures (F(1, 103) = .345; p = .558,

partial η2 = .003; M = 3.373 vs. 3.518 for those who saw images of plants and flowers vs.

no images, respectively). These results are shown in Table 17.

TABLE 16
Body Image State Dissatisfaction for Irrelevant Standards Groups
Type III Sum Mean Eta
Source of Squares df Square F Sig. Squared
Corrected Model .995 1 .995 .333 .565 .003
Intercept 3214.540 1 3214.540 1074.539 .000 .913
Irrelevant vs. No-Standard .995 1 .995 .333 .565 .003
Error 308.130 103 2.992
Total 3529.528 105
Corrected Total 309.125 104

73
 TABLE 17
Motivations and Likelihood to Undergo Cosmetic Procedures for Irrelevant Standard
Groups
Dependent Type III Sum Mean Eta
Source Variable of Squares df Square F Sig. Squared
Corrected Intrapersonal 1.462 1 1.462 .587 .445 .006
Model Motivation
Interpersonal .422 1 .422 .142 .707 .001
Motivation
Likelihood 1.255 1 1.255 .345 .558 .003
Intercept Intrapersonal 1983.973 1 1983.973 796.915 .000 .886
Motivation
Interpersonal 833.702 1 833.702 281.151 .000 .732
Motivation
Likelihood 1380.836 1 1380.836 379.913 .000 .787
Irrelevant Intrapersonal 1.462 1 1.462 .587 .445 .006
vs. No- Motivation
Standard Interpersonal .422 1 .422 .142 .707 .001
Motivation
Likelihood 1.255 1 1.255 .345 .558 .003
Error Intrapersonal 256.425 103 2.490
Motivation
Interpersonal 305.427 103 2.965
Motivation
Likelihood 374.365 103 3.635
Total Intrapersonal 2240.403 105
Motivation
Interpersonal 1139.160 105
Motivation
Likelihood 1755.204 105
Corrected Intrapersonal 257.888 104
Total Motivation
Interpersonal 305.849 104
Motivation
Likelihood 375.620 104

Overall, the manipulation of standards was deemed successful since viewing the

images of flowers and plants did not create a confounding effect on the feelings of the

74
respondents and the results indicated that viewing pictures of flowers vs. no pictures did

not impact participants’ expressed levels of affect, as well as other dependent variables.

Test of Hypotheses

In order to test H1, an ANCOVA was run with OSA vs. no-OSA and relevant

beauty standards vs. irrelevant beauty standard and the control group as fixed factors and

body image dissatisfaction as dependent variable while controlling for the effect of self-

esteem and body resource needs. A requirement for covariance analysis is that covariates

correlate with the dependent variables. The results of the correlation between self-esteem

and body image state dissatisfaction suggested that self-esteem should be considered as a

covariate (r = -.565, p < .001). Similarly, there was a significant correlation between body

resource needs and body image state dissatisfaction (r = .206, p = .011).

As expected, the results of the ANCOVA indicated that self-esteem was a

significant covariate (F(1,144) = 64.739, p < .001, η2 = .310). Body resources needs

showed marginal significance (F(1, 144) = 3.498, p = .053, η2 = . 024) and thus, both

control variables were kept for the test of hypotheses. It is noteworthy that the results of

the analyses with gender, fear of pain, and fear of surgery failure as covariates indicated

that they were not significant factors (p > .1). The Levene test for equality of the

homogeneity of regression was not significant (F(5, 146) = .409, p = .842), indicating that

the assumption of homoscedasticity was met and that the variance-covariance matrices

for the covariates were equal across levels of the fixed factors.

The results of the analysis revealed that the main effect of objective self-

awareness was not significant (F(1, 144) = .146, p = .703, η2 = .001) and thus, H1 was

75
not supported. Moreover, as expected, the main effect of standards was not significant

(F(1, 144) = .200, p = .819, η2 = .003).

In support of H2, a significant interaction was found between OSA and standards

(F(1, 144) = 3.313, p = .039, η2 = .044; see Table 18). The interaction is graphically

illustrated in Figure 2. Test of simple effects indicated that when individuals were self-

aware (i.e., faced the mirror) and were assigned to the relevant standards (i.e., images of

beauty models), they showed significantly higher levels of body image state

dissatisfaction (M = 6.181) than when they were self-aware and saw irrelevant standards

(M = 5.111; F(1, 48) = 5.356, p = .025, η2 = .100). There was a marginally significant

difference between individuals who saw relevant beauty standards (M = 6.181) and no

standards (M = 5.598; F(1, 47) = 3.511, p = .067, η2 = .070). Furthermore and as

expected based on the results of the standards manipulation check, there was no

significant difference on the body image state dissatisfaction of those individuals who

were self-aware and had seen irrelevant standards (M = 5.111) compared to those who

had seen no standards (M = 5.599; F(1, 52) = 1.057, p = .309, η2 = .020).

However, when individuals were not self-aware (i.e., did not face the mirror) and

viewed relevant standards, their body image state dissatisfaction (M = 5.090) was not

significantly different from those participants who saw irrelevant standards (M = 5.805;

F(1, 46) = 2.289, p = .137, η2 = .047) or saw no standards (M = 5.666; F(1, 48) = 1.425, p

= .239, η2 = .029).

76
 TABLE 18
ANCOVA Results for Test of H1 and H2
Type III Sum Mean Eta
Source of Squares df Square F Sig. Squared
Corrected Model 160.970 7 22.996 12.091 .000 .370
Intercept 1.324 1 1.324 .696 .406 .005
Body Resource Needs 6.652 1 6.652 3.498 .063 .024
Self-Esteem 123.123 1 123.123 64.738 .000 .310
OSA vs. NO-OSA .277 1 .277 .146 .703 .001
Relevant vs. Irrelevant .760 2 .380 .200 .819 .003
Standards vs. No
Standard
Interaction between 12.604 2 6.302 3.313 .039 .044
OSA and Standards
Error 273.866 144 1.902
Total 5141.639 152
Corrected Total 434.836 151

To further assess the interaction relationship, the control group was removed and

the analysis was run as a 2 (OSA vs. No-OSA) x 2 (relevant standard vs. irrelevant

standard) since the control group did not have any significant difference with the

irrelevant standard group.

The results indicated that body resource needs is not a significant factor while

self-esteem is a significant covariate (Table 19). The results supported the two-way

interaction between OSA and standards (F(1, 93) = 6.681, p = .011, η2 = .067; see Table

19), indicating that body image state dissatisfaction is significantly higher for self-aware

individuals who viewed relevant beauty standards compared to those who viewed

irrelevant standards. However, for those individuals who were not self-aware, the body

image state dissatisfaction was not significantly different for those who had viewed

beauty standard images compared to irrelevant plants and flowers images.

77
 FIGURE 2
Interaction between Objective Self-Awareness and Standards on Body Image State
Dissatisfaction

TABLE 19
ANCOVA Results for Test of H1 and H2 after Removing the Control Group
Type III Sum Mean Eta
Source of Squares df Square F Sig. Squared
Corrected Model 104.108 4 26.027 14.438 .000 .383
Intercept .366 1 .366 .203 .653 .002
SE 83.156 1 83.156 46.128 .000 .332
Relevant vs. Irrelevant .386 1 .386 .214 .645 .002
Standard
OSA vs. NO-OSA 2.142 1 2.142 1.188 .278 .013
Interaction between 12.044 1 12.044 6.681 .011 .067
OSA and Standards
Error 167.653 93 1.803
Total 3265.667 98
Corrected Total 271.761 97

H3 suggests a mediating role for negative affect in the relationship between

individuals’ body image state dissatisfaction and their motivations and likelihood to

undergo cosmetic procedures. In order to examine these relationships, the Baron and

78
Kenny (1986) procedure was followed. This procedure requires several steps to establish

the effects of mediation. The first step is to examine whether the variation in the predictor

variable significantly accounts for variation in the mediator variable (i.e., to regress the

mediator on the predictor variable). The second step is to regresses the outcome variable

on the predictor to establish a significant relationship between the predictor and outcome

variable in the absence of the mediator. The final step regress the outcome variable on

both the mediator and the predictor variable to establish that the mediator affects the

outcome in the presence of the predictor. If the effect of the predictor on the outcome is

not significant in the third step, the mediator fully mediates the effect of predictor

variable on the dependent variable.

To test the mediation effect on interpersonal motivation (H3a), first, the path from

body image state dissatisfaction to negative affect was assessed which was significant (b

= .129, t = 2.511, p = .013). The second step was to assess the direct effect of body image

state dissatisfaction on interpersonal motivation. This path was also significant (b = .163,

t = 1.950, p = .053). However, when the direct effect was assessed while controlling for

negative affect as another predictor (third step), the relationship became non-significant

(b = .122, t = 1.433, p = .154), providing support for H3a (see Table 20). The pattern of

these relationships indicates that, in the case of interpersonal motivation, negative affect

completely mediates the effect of body image state dissatisfaction on the dependent

variable. Based on the casual steps approach of Baron and Kenny (1986), mediation

relationship was not established for H3b since the path from body image state

79
dissatisfaction to intrapersonal motivation was not significant (p = .507). However, H3c

was supported.

Prior to making conclusions based on these findings, though, it is important to

consider that modern thinking about mediation analysis recommends bootstrapping the

confidence intervals for indirect effect to assess mediation relationships (e.g., Preacher,

Rucker, and Hayes 2007; Cerin and MacKinnon 2009; Hayes 2009). In fact, recent

literature (MacKinnon et al. 2002; Preacher and Hayes 2004) has recommended the use

of bootstrapping over the Sobel test (Sobel 1982) or the causal steps approach advocated

by Baron and Kenny to assess mediation relationships. The Sobel test has been criticized

due to its normal theory assumptions (e.g., MacKinnon et al. 2002; Preacher and Hayes

2004; Preacher, Rucker, and Hayes 2007). In addition, Baron and Kenny’s causal steps

method has been criticized on two fronts. It may suffer from low power (increasing the

likelihood of committing a Type II error) and may not directly address the research

hypothesis of interest (MacKinnon et al. 2002; Preacher, Rucker, and Hayes 2007).

Consequently, a growing literature advocates the use of bootstrapping for assessing

indirect effects (e.g., MacKinnon et al. 2002; Preacher and Hayes 2004; Preacher,

Rucker, and Hayes 2007). In contrast to the Sobel test, bootstrapping does not impose the

assumption of normality of the sampling distribution (as in most cases this assumption is

not met for small samples). Rather, the technique repeatedly samples from the data set

and directly estimates the indirect effect in each resampled data set (Preacher and Hayes

2004).

80
 Thus, the bootstrapping technique was pursued to test the mediation relationships.

The 95% bias corrected confidence interval with 5000 bootstraps supported the mediation

relationship of H3a as zero was not in the confidence interval (see Table 20). The

bootstrapping approach also supported the mediation relationship hypothesized by H3b.

However, the results of the bootstrapping did not support H3c as the 95% confidence

interval did include zero. Overall, according to the results of the bootstrapping technique,

H3a and H3b were supported and H3 received partial support.

Supplementary Analyses

Other Appearance Enhancing Procedures

The mediation role of negative affect was examined for the relationship between

body image state dissatisfaction and tanning and tattooing propensity as other potential

appearance enhancing procedures. These relationships were insignificant as the 95% bias

corrected confidence interval with 5000 bootstraps for these indirect effects (from body

image state dissatisfaction through negative affect) contained zero.

81
 TABLE 20
Mediation Analysis Results for Test of H3
Path Coefficient t Sig. Sobel 95% 95% Test of
Z Bootstrap Bootstrap Hypothesis
(Sig.) CI (LL) CI (UL)
Body Image State .129 2.511 .013
Dissatisfaction 
Negative Affect
Negative Affect .270 2.062 .041
Interpersonal
Motivation
Body Image State .163 1.950 .053
Dissatisfaction 
Interpersonal
Motivation
Body Image State .122 1.433 .154 1.732 .008 .102 H3a
Dissatisfaction (.083) Supported
Negative Affect
 Interpersonal
Motivation
Body Image State .129 2.511 .013
Dissatisfaction 
Negative Affect
Negative Affect .238 2.025 .045
Intrapersonal
Motivation
Body Image State .049 .6646 .507
Dissatisfaction 
Intrapersonal
Motivation
Body Image State .019 .251 .802 1.585 .004 .084 H3b
Dissatisfaction (.113) Supported
Negative Affect
 Intrapersonal
Motivation
Body Image State .129 2.545 .013
Dissatisfaction
Negative Affect
Negative Affect .2094 1.429 .155
Likelihood
Body Image State .187 2.028 .044
Dissatisfaction
Likelihood
Body Image State .160 1.706 .090 1.249 -.087 .009 H3c Not
Dissatisfaction (.211) Supported
Negative Affect
Likelihood

82
Body-Esteem and Objective Self-Awareness

Since body-esteem (BE) is defined as individuals’ attitudes about their bodies and

appearance, it would be interesting to examine the interplay between this individual

predisposition towards one’s body and appearance and the state of objective self-

awareness and the consequent impact of such interaction on acceptance of cosmetic

surgery. Therefore, the relationship between different dimensions of body-esteem and

objective self-awareness impacting motivations and likelihood to undergo cosmetic

procedures was assessed. The regression procedure recommended by Aiken and West

(1991) was followed and the effect of BE-appearance was examined at one standard

deviation above and below the mean since the median split approach has been criticized

(Fitzsimons 2008).

The results indicated that there is a significant interaction between BE-appearance

and OSA on intrapersonal motivation to undergo cosmetic procedures (b = .374, t =

2.335, p = .021) controlling for self-esteem and body resources need as covariates. Test

of simple effects indicated that when body-esteem appearance was one standard deviation

below the mean, there was a significant difference for the self-aware and not self-aware

individuals (b = - .834, t = -2.461, p = .015; bootstrap 95% confidence interval: -1.504, -

.164) in their intrapersonal motivation for cosmetic surgery, while no significant

difference was found for those with body-esteem appearance at one standard deviation

above the mean (b = .288, t = .848, p = .398; bootstrap 95% confidence interval: -.383,

.959). Figure 3 depicts this interaction. The interaction between BE-attribution and BE-

83
weight with objective self-awareness was also tested and the results indicated that there

was no significant interaction (p > .1).

Further analysis indicated that the interaction (moderation) relationship between

BE-appearance and OSA is mediated by individuals’ cosmetic surgery propensity.

Mediated moderation happens only when moderation occurs (Muller, Judd, and Yzerbyt

2005) and implies that the interaction between two variables affects a mediator, which

then affects a dependent variable (Baron and Kenny 1986; Morgan-Lopez 2006).

FIGURE 3
Interaction between OSA and Body Esteem-Appearance on Intrapersonal Motivation for
Cosmetic Surgery

The mediated moderation analysis was performed consistent with Martin, Gnoth,

and Strong’s (2009) approach. The first step was met since there was a significant

interaction on intrapersonal motivation as already reported. Second, there was a

marginally significant interaction between OSA and body–esteem appearance on

cosmetic surgery propensity (b = .301, t = 1.811, p = .072). Third and fourth, when

84
controlling for cosmetic surgery propensity, there was no significant interaction between

OSA and body-esteem appearance on intrapersonal motivation (b = .171, t = 1.473, p =

.143) while cosmetic surgery propensity was a significant predictor (b = .679, t = 11.813,

p < .001). These results supported the mediated moderation effect on intrapersonal

motivation for undergoing cosmetic procedures. However, there were no significant

results for interpersonal motivation to undergo cosmetic procedures (b = .190, t = 1.046,

p = .297) as well as likelihood to pursue a cosmetic procedures (b = .319, t = 1.577, p =

.117) when controlling for self-esteem and body resources need as covariates (p < .05).

Discussion of Study 1 Findings

The results of study 1 demonstrate the boundary influence that access to relevant

beauty and appearance standards imposes on self-aware individuals with respect to self-

standard discrepancies. This finding is not surprising in light of the fact that when self-

features are compared to a reference value, a discrepancy is experienced which in turn

creates affect, while self-awareness per se does not create such effect (Carver and Scheier

2011). These arguments provide further support for the lack of a main effect of self-

awareness on body image state dissatisfaction and support Duval and Lalwani’s (1999)

argument that increased self-awareness coupled with access to standards results in

awareness of self-standard discrepancies.

From a methodological standpoint, according to Baron and Kenny (1986),

discovering interaction effects while there is no main effect for predictor and moderator

variables is more desirable and indicates that the moderator variable is uncorrelated with

the dependent variable. Thus, no significant main effect for either OSA or standards, adds

85
to the strength of the interaction between these two factors on body image state

dissatisfaction.

The results also indicate the mediating role that negative affect plays in the

relationship between body image state dissatisfaction and interpersonal and intrapersonal

motivation to pursue cosmetic procedures. According to Watson, Clark, and Tellegen

(1988), high levels of negative affect indicate anxiety and agitation. Such tension is

experienced when individuals face self-standard discrepancies, and motivates them to

take actions to close the experienced gap. Thus, the results of the mediation provide

additional insight to the underlying mechanism for the relationship between self-standard

comparison (as a result of OSA), self-standard discrepancy, and motivation to take action

in order to reduce the experienced discrepancy.

Generally, motivation to engage in a pattern of behavior could be examined by

focusing on external and internal motivations. External motivation refers to the extrinsic

impetus that arises from the desire to attain (avoid) an externally imposed reward

(punishment), or the control motivation that stems from the desire to please others (Deci

and Ryan 1985). Thus, one could argue that the interpersonal or social motivation to

pursue cosmetic procedures is an extrinsic motivation to create a more positive

impression on others and possibly achieve more successful relationships. Internal or

intrinsic motivation, on the other hand, refers to the desire to obtain internally imposed

rewards or the motivation to engage in a behavior aimed at satisfying one’s needs (Deci

and Ryan 1985). Intrapersonal motivations for undergoing cosmetic procedures, thus, are

86
individuals’ intrinsic motivations associated with feeling better about themselves or

approaching their internalized ideals.

Investigators have traditionally asserted that people are more likely to sustain a

pattern of behavior over time if it is based on intrinsic motivation compared to extrinsic

motivation (Deci and Ryan 1985). The results of this study, however, indicate that in the

context of appearance enhancement, external motivations are also important as the

negative affect experienced due to discrepancy between ones’ appearance and relevant

beauty standards leads to such motivations.

Finally, the supplementary analysis suggested that individuals’ general feelings

and attitudes about their appearance (i.e., body-esteem appearance) interact with their

state of objective self-awareness and that individuals’ enduring dispositions to pursue

cosmetic procedures have a strong behavioral impact that links the influence of this

interaction to intrapersonal motivation to undergo cosmetic procures. More specifically,

the interaction analysis revealed that for those individuals with low body-esteem,

increased focus on their appearance (as a result of objective self-awareness) will lead to

higher intrapersonal motivation to pursue cosmetic procedures. When such individuals

with low body-esteem are not self-aware and thus their attention is not directed towards

their appearance, their motivation to purse cosmetic procedures is significantly lower. In

contrast to low body-esteem individuals, those with high regard about their appearance

are not motivated to pursue such procedures as they do not feel bad about their

appearance. Since body-esteem appearance refers to one’s feelings and attitudes about

his/her look, the intrinsic motivation to pursue appearance enhancing procedures is

87
increased as a result of the interplay between this individual factor and state of self-

awareness.

Overall, the results of study 1 indicate that discrepancy with appearance standards

and beauty ideals can indirectly impact the motivation to pursue appearance enhancing

procedures via negative affect. One interesting question raises that under what conditions

this relationship will be fortified or diminished. Study 2 attempts to address this question.

88
 CHAPTER 4

STUDY 2

Overview

Study 2 was a 2 (OSA vs. no-OSA) x 2(shame vs. pride) between subjects

factorial design in which both OSA and emotions of shame and pride were manipulated.

The purpose of this experiment was to examine the role of two self-conscious emotions

(i.e., shame and pride) in regulating individuals’ motivations and likelihood to undergo

cosmetic procedures. It is expected that when shame is induced, self-aware individuals

who are experiencing discrepancy and negative emotions will have greater motivation

and likelihood to pursue cosmetic procedures compared to when pride is induced. More,

specifically, this study examined the following hypothesis:

H4: The indirect effect of body image state dissatisfaction (discrepancy) on (a)

interpersonal motivation, (b) intrapersonal motivation, and (c) likelihood to

undergo cosmetic procedures is moderated by individuals’ state of pride or

shame.

Methodology

The results of the first pre-test (reported in chapter 3) revealed that individuals’

motivation to pursue cosmetic procedures could be due to the emotions they experience

as a result of judgments of others about their appearance. The results highlight the role of

emotions such as pride and shame. However, the impact of these fundamental self-

conscious emotions on moral judgment, social behavior, and subjective well-being of

89
individuals has been the focus of limited prior research (Tracy et al. 2009). This created

the motivation to conduct study 2 which required manipulation of these emotions. Pre-

test 3 was conducted to assess the validity of the experimental manipulation. Measures of

shame and pride were used to check the accuracy of the manipulations.

Pre-Test 3

The purpose of this pre-test was to validate the manipulation intended to induce

the emotions of pride and shame. Additionally, the scales intended as manipulation

checks to measure these emotions were examined to ascertain their validity and

reliability.

Procedure

Participants were 81 undergraduate students (mean age = 23.01 years old, SD =

2.68) who completed the survey for course credit. Participants were randomly assigned to

one of the two writing tasks intended to induce feelings shame or pride. The writing tasks

were developed based on the previous approaches reported in extant literature (Williams

and Desteno 2008; Williams and Desteno 2009). This task is a version of the well-

established relived emotion task which has been shown to manipulate emotional

experiences and to produce emotion-typical subjective feelings and physiology

(Levenson et al. 1992; Tracy and Robins 2007b). The pride inducing task read:

Think about a time when you felt very proud of yourself. Describe the events that
led up to your feeling this way and the feelings and emotions you had at that
moment in as much detail as you can remember.
Now, think about yourself and write about something that makes you feel proud.
It could be anything from a personal characteristic/feature, academic
achievement, professional achievement, family achievement, or status that makes
you feel proud and receive praise from others.

90
 The shame inducing task read:

Think about a time when you felt very ashamed of yourself. Describe the events
that led up to your feeling this way and the feelings and emotions you had at that
moment in as much detail as you can remember.
Now, think about yourself and write about something that makes you feel
ashamed and embarrassed. It could be anything from a personal
characteristic/feature, academic failure, professional failure, family failure, or
status that makes you feel embarrassed and receive negative feedback from
others.

According to the Tracy and Robins (Tracy and Robins 2004a) theoretical model

of self-conscious emotions, pride and shame are elicited when individuals direct their

focus on the self by appraising emotion-eliciting events. Thus, the writing tasks used for

manipulating the emotions shame and pride were expected to elicit these targeted

emotions in participants. Next, participants answered a series of questions that measured

external shame (Goss, Gilbert, and Allan 1994) and general pride/shame feelings

(Williams and Desteno 2009) followed by demographic questions.

Results

The first step in analyzing the data was to check the validity and reliability of the

scales borrowed from previous research. Exploratory factor analysis (EFA) was

conducted to assess the factor structures. Reliability of measures was examined via

Cronbach’s alpha. The nine items representing pride/shame (7-point semantic

differential) loaded on a single factor (Table 21). External shame loaded under two

factors referring to ‘being seen as inferior’ and ‘how others behave when they see one’s

mistakes.’ This factor structure is similar to the previous research (Goss, Gilbert, and

Allan 1994).

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 TABLE 21
Factor Loadings and Cronbach’s Alpha Values for Pride and Shame
Items Factor Loadings
How
Pride/ Being seen others
Shame as inferior react
I feel satisfied/ dissatisfied. .827 .294 .195
I feel fulfilled/ unfulfilled right. .847 .256 .192
I feel confident/ unsure right. .769 .386 .199
I feel proud/ ashamed right. .778 .341 .274
I feel accomplished/ relinquished. .820 .192 .225
I feel I am successful/ unsuccessful. .811 .050 .133
I feel like I am an achiever/ not an achiever. .855 .021 .144
I feel I am productive/ unproductive. .810 .001 .183
I feel I am full of self-worth/ empty of self-worth .808 .292 .193
Other people see me as not measuring up to .184 .694 .103
them.
I think that other people look down on me. .238 .836 .241
I feel other people see me as not good enough. .249 .763 .330
Other people see me as small and insignificant. .080 .782 .329
People see me as unimportant compared to .122 .826 .345
others.
Other people see me as a defective person. .210 .673 .465
Others see me as empty and unfulfilled. .275 .664 .432
I feel insecure about others opinion of me. .451 .280 .604
Others are critical or punishing when I make a .120 .217 .759
mistake.
Other people always remember my mistakes. .306 .282 .732
People distance themselves from me when I .280 .329 .761
make mistakes.
Other people look for my faults. .184 .216 .832
Other people put me down a lot. .109 .295 .785
I think others are able to see my defects. .283 .344 .687

Cronbach’s Alpha .956 .930 .920

Next, the manipulation of pride and shame was checked by running separate one-

way ANOVAs with scenario as the fixed factor and external shame and pride/shame as

dependent variables. The results indicated that the manipulation of pride/shame was

92
successful as there was a significant difference in feelings of pride/shame and external

shame between those individuals in the shame and pride conditions. The individuals

assigned to the shame condition experienced less pride (M = 4.172) compared to those

who were assigned to the pride condition (M = 4.994); (F(1,79) = 10.195; p = .002, η2 =

.114; see Table 22). Similarly, as shown in Table 23, external shame was more

experienced by individuals assigned to the shame condition compared to the pride

condition individuals (M = 2.68 vs. 2.14; F(1,79) = 4.77; p = .003, η2 = .057). According

to the results, it can be concluded that the writing tasks employed to manipulate pride and

shame were successful.

TABLE 22
Manipulation Check for Pride/Shame-Pre-Test 3
Type III Sum Mean Eta
Source of Squares df Square F Sig. Squared
Corrected Model 13.692 1 13.692 10.195 .002 .114
Intercept 472.964 1 472.964 352.172 .000 .817
Pride vs. Shame 13.692 1 13.692 10.195 .002 .114
Error 106.096 79 1.343
Total 590.840 81
Corrected Total 119.789 80

TABLE 23
Manipulation Check for External Shame-Pre-Test 3
Type III Sum Mean Eta
Source of Squares df Square F Sig. Squared
Corrected Model 5.851 1 5.851 4.777 .032 .057
Intercept 472.391 1 472.391 385.630 .000 .830
Pride vs. Shame 5.851 1 5.851 4.777 .032 .057
Error 96.774 79 1.225
Total 573.791 81
Corrected Total 102.625 80

93
Study 2 Design

A 2 x 2 between subjects, full factorial design experiment was conducted to test

the conditional indirect effect of body image state dissatisfaction on motivations and

likelihood to purse cosmetic procedures impacted by pride/shame. In other words, this

study examined the moderating effect of shame and pride on the relationship between

negative affect (created as a result of body image state dissatisfaction) and intrapersonal

motivation, interpersonal motivation, and likelihood to pursue cosmetic procedures.

Sample

Participants were 203 undergraduate students at a large public university in the

Southwestern United states who participated in the study in exchange for course credit.

Overall, 191 usable responses were collected (51.8% female). Respondents ranged in age

from 19 to 55 years, with a mean age of 23.30 years (SD = 5.71). 8.9% had prior

cosmetic procedures. 80.1% were single and never married, 8.4% were married, 8.4%

were living with a partner, and 1.6% were separated. Demographic summary statistics are

provided in Table 24.

94
 TABLE 24
Demographic Profile of Respondents-Study 2
Gender No (%) Personal No (%) Family
Annual Annual
Income Income
Male 90 (47.1%) Less than 139 Less than 12 (6.3%)
$20K (72.8%) $20K
Female 99 (51.8%) $20K-29K 21 (11%) $20K-29K 10 (5.2%)
Not reported 2 (1%) $30K-39K 9 (4.7%) $30K-39K 6 (3.1%)
$40K-49K 8 (4.2%) $40K-49K 20 (10.5%)
$50K-59K 3 (1.6%) $50K-59K 11 (5.8%)
$60K-69K 2 (1%) $60K-69K 13 (6.8%)
$70K-79K 1 (.5%) $70K-79K 9 (4.7%)
Ethnicity No (%) $110K-119K 1(.5%) $80K-89K 12 (6.3%)
White/Caucasian 107 (55.8%) $90K-99K 8 (4.2%)
Hispanic 26 (13.4%) $100K-109K 10 (5.2%)
Black/African 25 (13.1%) $110K-119K 5 (2.6%)
American
Asian 15 (7.8%) $120K-129K 11 (5.8%)
Other 14 (7.3%) $130K and 31 (16.2%)
more
Do not know 29 (15.2%)
Not reported 4 (2%)

Procedure

Public OSA was manipulated using a full length mirror (36”x48”) and as in study

1, data collection was conducted on an individual basis. Participants were randomly

assigned to the mirror or no-mirror condition. The same setting and procedure were

followed as in the first study. However, in contrast to study 1 in which participants were

randomly assigned to view relevant standards (images of beauty models) or not, in this

study, all participants viewed the images of male or female beauty models depending on

their gender (i.e., each participant viewed images of models of similar gender). The same

95
collections of images were shown to participants and the same fake story regarding the

purpose of showing those images was repeated for each individual.

After two minutes, the experimenter provided the questionnaire to the participant

which took about thirty minutes to complete. Participants were randomly assigned to

receive one of the two versions of the questionnaire which contained the pride or shame

manipulation tasks. Similar to the first study, when each participant submitted the

questionnaire to the experimenter, he or she was asked “what do you think the purpose of

this experiment was?” to assure that the purpose of the presence of mirror in the

experiment room was not guessed. Only one male participant was suspicious about the

presence of mirror in the room and thus his responses were removed from the pool of

collected data.

Data collection instrument

For the most part, the data collection instrument was similar to the one used in

study 1. However, the instrument contained the manipulation procedure for shame or

pride (depending on the version of questionnaire) using a writing task (as described in

pre-test 3) as well as measures of these emotions employed in the manipulation check.

All other measures were similar to study 1. Tanning propensity, and tattoo propensity

measures were not included in the data collection instrument since no significant impact

was detected for these factors in the first study.

96
 Analysis and Results

Measurement Assessment

As in Study 1, the psychometric properties of the measures were assessed using

exploratory factor analysis (EFA), confirmatory factor analysis (CFA), and calculation of

Cronbach’s alpha as well as composite reliability (CR). First an exploratory factor

analysis was conducted on each measurement scale followed by calculating the

Cronbach’s alpha to assess the reliability.

Table 25 shows the results of the EFA on situational self-awareness scale used for

the OSA manipulation check, as well as values of Cronbach’s alpha. As expected, the six

items loaded on two factors, public and private self-awareness, with low cross-loadings.

Table 26 provides the results of the EFA for pride/sham manipulation check items.

Similar to pre-test 3, three factors emerged. The nine items of the pride/shame scale

loaded under one factor and external shame items loaded under two factors pertaining to

being seen as inferior and how others react to one’s mistakes.

TABLE 25
Situational Self-Awareness Exploratory Factor Analysis and Reliability-Study 2
Item Factor Loadings
Public Private
OSA OSA
Right now, I am conscious of my inner feelings. .005 810
Right now, I am reflective about my life. .186 .584
Right now, I am aware of my innermost thoughts. .057 .820
Right now, I am concerned about the way I present myself. .702 .258
Right now, I am self-conscious about the way I look. .840 -.057
Right now, I am concerned about what other people think of me. .826 .104

Cronbach’s Alpha .717 .607

97
 TABLE 26
Pride and Shame Exploratory Factor Analysis and Reliability-Study 2
Items Factor Loadings
How
Pride/ Being Seen Others
Shame as Inferior React
I feel satisfied/ dissatisfied. .805 .109 .162
I feel fulfilled/ unfulfilled right. .786 .185 .112
I feel confident/ unsure right. .815 .092 .247
I feel proud/ ashamed right. .815 .131 .096
I feel accomplished/ relinquished. .859 -.014 -.016
I feel I am successful/ unsuccessful. .806 .167 -.042
I feel like I am an achiever/ not an achiever. .812 .213 -.074
I feel I am productive/ unproductive. .707 .265 -.044
I feel I am full of self-worth/ empty of self-worth .714 .227 .171
Other people see me as not measuring up to them. .191 .762 .201
I think that other people look down on me. .228 .727 .451
I feel other people see me as not good enough. .279 .712 .445
Other people see me as small and insignificant. .212 .719 .402
People see me as unimportant compared to others. .193 .682 .382
Other people see me as a defective person. .169 .836 .222
Others think there is something missing in me. .125 .736 .376
Others see me as empty and unfulfilled. .207 .753 .256
Other people think I have lost control over my .195 .663 .239
body and feelings.
I feel insecure about others opinion of me. .314 .226 .611
Others are critical or punishing when I make a -.029 .406 .681
mistake.
Other people always remember my mistakes. -.010 .307 .810
People distance themselves from me when I make -.042 .462 .631
mistakes.
Other people look for my faults. -.025 .338 .765
Other people put me down a lot. .087 .462 .685
I think others are able to see my defects. .161 .210 .786

Cronbach’s Alpha .956 .930 .920

Body image state dissatisfaction yielded one factor as expected. All the items had

loadings above .6 and the Cronbach’s alpha was .878 (See Table 27).

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 TABLE 27
Body Image State Dissatisfaction Exploratory Factor Analysis and Reliability-Study 2
Item Factor Loadings
Body Image State
Dissatisfaction
Right now, I feel extremely dissatisfied with my .864
physical appearance.
Right now, I feel extremely dissatisfied with my body .887
size and shape.
Right now, I feel extremely dissatisfied with my weight. .810
Right now, I feel extremely physically unattractive. .844
Right now, I feel a great deal worse about my looks than .607
I usually feel.
Right now, I feel I look a great deal worse than the .729
average person looks

Cronbach’s Alpha .878

Results of the EFA on the positive and negative affect schedule (PANAS) scale

was satisfactory (Table 28) as the items loaded as expected on the two intended factors

(i.e., positive and negative affect) and showed acceptable reliability. The dependent

variables were also factor analyzed, yielding the three anticipated distinct factors with

associated high reliabilities (Cronbach’s alphas above .9) as expected (Table 29).

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 TABLE 28
Positive and Negative Affect Exploratory Factor Analysis and Reliability-Study 2
Item Factor Loadings
Negative affect Positive Affect
Interested -.081 .580
Excited .133 .649
Strong -.054 .696
Enthusiastic .017 .756
Proud -.005 .746
Alert -.083 .554
Inspired .045 .749
Determined .008 .757
Attentive -.098 .631
Active .034 .640
Distressed .624 .093
Upset .713 -.161
Guilty .564 .087
Scared .762 -.081
Hostile .544 .064
Irritable .623 -.202
Ashamed .581 -.066
Nervous .635 .112
Jittery (stressed out) .709 -.051
Afraid .720 -.011

Cronbach’s Alpha .870 .841

Self-esteem and body resource needs were significant control variables in the first

study. Thus, these factors were included in this study. Tables 30 and 31 provide the

outcomes of the EFA for these variables.

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 TABLE 29
Acceptance of Cosmetic Surgery Factor Analysis and Reliability-Study 2
Item Factor Loadings
Surgery Intrapersonal Interpersonal
Likelihood Motivation Motivation
It makes sense to have minor cosmetic surgery
rather than spending years feeling bad about the .351 .736 .301
way you look.
Cosmetic surgery is a good thing because it can .260 .846 .213
help people feel better about themselves.
People who are very unhappy with their .216 .808 .289
physical appearance should consider cosmetic
surgery as one option.
If cosmetic surgery can make someone happier .268 .774 .243
with the way they look, then they should try it.
Cosmetic surgery can be a big benefit to .290 .756 .191
people’s self-image.
I would seriously consider having cosmetic .364 .352 .699
surgery if my partner thought it was a good idea
I would think about having cosmetic surgery in .427 .243 .681
order to keep looking young.
If it would benefit my career I would think .298 .239 .727
about having plastic surgery.
I would seriously consider having cosmetic .160 .187 .887
surgery if I thought my partner would find me
more attractive.
If a simple cosmetic surgery procedure would .243 .292 .812
make me more attractive to others, I would
think about trying it.
In the future, I could end up having some kind .724 .277 .437
of cosmetic surgery.
If I could have a surgical procedure done for .709 .340 .409
free I would consider trying cosmetic surgery.
If I knew there would be no negative side .701 .432 .377
effects or pain, I would like to try cosmetic
surgery.
I have sometimes thought about having .819 .231 .271
cosmetic surgery.
I would never have any kind of plastic surgery. .709 .228 .086
If I have the money someday, I would get a .768 .352 .383
cosmetic procedure.

Cronbach’s Alpha .931 .918 .913

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 TABLE 30
Body Resource Needs Factor Analysis and Reliability-Study 2
Item Factor Loadings
Body Resource
Needs
I focus on my body and how it feels. .839
I devote time each day to improving my body. .879
I feel that making my body look good is important. .804
I work hard to keep my body healthy. .903

Cronbach’s Alpha .872

TABLE 31
Self-Esteem Factor Analysis and Reliability-Study 2
Item Factor Loadings
Self-Esteem
I feel that I’m a person of worth, at least on an equal basis .685
with others.
I feel that I have a number of good qualities. .745
All in all, I am inclined to feel that I am a failure. (R) .731
I am able to do things as well as most people. .542
I feel I do not have much to be proud of. (R) .661
I take a positive attitude toward myself. .738
On the whole, I am satisfied with myself. .731
I wish I could have more respect for myself. (R) .562
I certainly feel useless at times. (R) .689
At times I think I am no good at all. (R) .727

Cronbach’s Alpha .858

Similar to study 1, confirmatory factor analysis for a measurement model that

included body image state dissatisfaction, negative affect, interpersonal motivation,

intrapersonal motivation, and likelihood to pursue cosmetic procedures was performed

using LISREL software. The results indicated an acceptable fit between the model and

the data (χ2 = 866.16, df = 454, p < .001, RMSEA = .069, NFI = .92, NNFT =.95, CFI =

.96). Reliability was assessed by examining item and construct reliabilities (Peter 1981).

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 All items loadings were significant (t-values above 1.96) and exceeded the recommended

.5 parameter value. Both composite reliability (CR) and average variance explained

(AVE) exceeded their recommended threshold of .7 and .5, respectively, indicating

acceptable reliability and convergent validity (Bagozzi and Yi 1988) with the exception

of negative affect which had an AVE of .438 (see Table 32). Discriminant validity was

checked and established following the recommended method of Fornell and Larcker

(1981) since is the squared correlation between constructs was less than the AVE for each

construct. Table 12 provides the discriminant validity results.

TABLE 32
Measurement Model Assessment of Discriminant Validity-Study 2
Body Image
Negative State Intrapersonal Interpersonal Surgery
Affect Dissatisfaction Motivation motivation Likelihood CR
Negative Affect .438 .022 .008 .090 .044 .753
Body Image
State .150 .585 .000 .032 .022 .824
Dissatisfaction
Intrapersonal
.090 .010 .694 .476 .578 .887
Motivation
Interpersonal
.300 .180 .690 .680 .640 .878
Motivation
Surgery
.210 .160 .760 .800 .655 .899
Likelihood
Note. The numbers below the diagonal represent correlations. The numbers on the diagonal are the average
variance extracted (AVE) by each variable. The numbers above the diagonal are the squared correlations
between the variables.

Manipulation Checks

Public OSA Manipulation Check

Similar to the first study, to determine whether the manipulation of public

objective self-awareness via full length mirror was successful, the two groups (assigned

to the mirror condition vs. no-mirror condition) were compared based on their situational

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self-awareness scores (public and private) measured by the six items of the situational

self-awareness scale. The results of the univariate analysis of variance indicated that

participants in the mirror condition (i.e., public self-awareness) reported significantly

higher scores on the public self-awareness subscale (M = 4.533) than did participants in

the no-mirror condition (M = 3.990), F (1, 189) = 7.972, p = .005, η2 = .040 (see Table

33). Moreover, as expected, the two groups did not differ significantly in their reported

level of private self-awareness (F(1, 189) = .230, p = .632, η2 = .001; M = 5.304 and

5.383 for mirror and no-mirror conditions, respectively), providing additional support for

the accuracy of the manipulation of public objective self-awareness. Table 34

summarizes these results.

TABLE 33
Manipulation Check for Public Objective Self-Awareness-Study 2
Type III Sum Mean Eta
Source of Squares df Square F Sig. Squared
Corrected Model 14.044 1 14.044 7.972 .005 .040
Intercept 3457.479 1 3457.479 1962.673 .000 .912
OSA vs. No-OSA 14.044 1 14.044 7.972 .005 .040
Error 332.946 189 1.762
Total 3790.556 191
Corrected Total 346.990 190

TABLE 34
Manipulation Check for Private Objective Self-Awareness-Study 2
Type III Sum Mean Eta
Source of Squares df Square F Sig. Squared
Corrected Model .298 1 .298 .230 .632 .001
Intercept 5435.067 1 5435.067 4194.552 .000 .957
OSA vs. No-OSA .298 1 .298 .230 .632 .001
Error 244.896 189 1.296
Total 5703.000 191
Corrected Total 245.194 190

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Pride and Shame Manipulation Check

To check the accuracy of the pride/shame manipulation, a univariate analysis of

variance was run with pride/shame as the fixed factor and pride as the dependent

variable. As shown in Table 35, the results indicated that there was a significant

difference in the reported feelings of pride between the two groups (F(1, 189) = 17.097, p

< .001, η2 = .083). More specifically, those individuals who had received the pride

manipulation reported experiencing more pride (M = 5.409) than those who were in the

shame condition (M = 4.706). Moreover, the results of the univariate analysis of variance

comparing these experimental groups based on their experienced feelings of external

shame revealed that individuals in the shame condition experienced more shame (M =

2.631) than those in the pride condition (M = 2.089; F(1, 189) = 10.529, p = .001, η2 =

.053; see Table 36). Overall, the results indicate that the manipulation of pride/shame was

successful.

TABLE 35
Manipulation Check for Pride/Shame-Study 2
Type III Sum Mean Eta
Source of Squares df Square F Sig. Squared
Corrected Model 23.598 1 23.598 17.097 .000 .083
Intercept 4879.250 1 4879.250 3535.008 .000 .949
Pride vs. Shame 23.598 1 23.598 17.097 .000 .083
Error 260.870 189 1.380
Total 5145.407 191
Corrected Total 284.469 190

105
 TABLE 36
Manipulation Check for External Shame-Study 2
Source Type III Sum Mean Eta
of Squares df Square F Sig. Squared
Corrected Model 13.990 1 13.990 10.526 .001 .053
Intercept 1062.809 1 1062.809 799.640 .000 .809
Pride vs. Shame 13.990 1 13.990 10.526 .001 .053
Error 251.202 189 1.329
Total 1338.398 191
Corrected Total 265.191 190

Test of Hypothesis

The design of study 2 assumed an interaction between OSA and relevant

standards. Since all individuals viewed the images of fashion models (relevant standards),

it was expected that the two groups randomly assigned to the mirror vs. no-mirror

condition (i.e., OSA vs. no-OSA) would vary significantly on their body image state

dissatisfaction. The Levene test for equality of the homogeneity of the variance-

covariance matrices was not significant (F(1, 189) = .853, p = .357), indicating that the

assumption of homoscedasticity was met. The results of the analysis of variance indicated

that there is a significant difference between the two groups (M = 4.672 vs. 4.218 for the

mirror and no-mirror condition, respectively) on their body image state dissatisfaction

(F(1, 189) = 4.210, p = .042, η2 = .022; see Table 37). It is noteworthy that as in study 1,

gender and fear of surgery failure were not significant covariates.

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 TABLE 37
Body Image State Dissatisfaction for OSA vs. No-OSA Groups
Type III Sum Mean Eta
Source of Squares df Square F Sig. Squared
Corrected Model 9.827 1 9.827 4.210 .042 .022
Intercept 3761.303 1 3761.303 1611.542 .000 .895
OSA vs. No-OSA 9.827 1 9.827 4.210 .042 .022
Error 441.122 189 2.334
Total 4202.583 191
Corrected Total 450.949 190

H4 suggested a moderated mediation relationship in which the indirect effect of

body image state dissatisfaction on interpersonal and intrapersonal motivation, as well as

likelihood to pursue cosmetic procedures via negative affects was moderated by

individuals’ feelings of pride/shame. Moderated mediation models aim to explain how

and when a given effect occurs (Preacher, Rucker, and Hayes 2007). Moderated

mediation occurs when the strength of an indirect effect (mediation relationship) depends

on the level another variable which is the moderator (Muller, Judd, and Yzerbyt 2005). In

other words, if the mediating process that intervenes between the independent and

dependent variables is different at different levels of the moderator variable, a moderated

mediation model exists Thus, in moderated mediation models, the effect of the mediator

on the outcome variable depends on the level of the moderator variable (Muller, Judd,

and Yzerbyt 2005).

According to Muller, Judd, and Yzerbyt (2005), this type of relationship can be

observed when there is no interaction between the independent variable and the

moderator because a mediator operates at some levels of the moderator but not at other

levels. In fact, moderated mediation is best defined in cases where there is no interaction

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of the independent variable and moderator to dependent variable. This condition was

established in the case of this study. There was no significant interaction between body

image state dissatisfaction and pride/shame for interpersonal motivation (b = .153, t =

1.03, p = .304), intrapersonal motivation (b = -.085, t = -.555, p = .583), and likelihood to

undergo cosmetic procedures (b = -.003, t = -.019, p = .985). Also, as shown in Table 38,

there was no interaction between OSA and pride/shame on dependent variables.

One way to test moderated mediation relationships is to test the mediation effect

at each level of the moderator variable and show a significant simple mediation at one

level of the moderator but no such relationship at the other level (Muller, Judd, and

Yzerbyt 2005). Table 39 provides the results of the simple mediation analysis for those

individuals who experienced shame. The most popular strategies to gauge the extent and

significance of indirect effects are the causal steps strategy of Baron and Kenny (1986),

products of coefficients strategies, and bootstrapping strategies. The causal steps strategy

suffers from low power and does not directly address the hypothesis of interest

(MacKinnon et al. 2002). The products of coefficients strategy requires the assumption

that the product of the coefficients is normally distributed while this distribution is

usually positively skewed and kurtotic. As a result, the products coefficient strategy also

suffers from power problems. The bootstrapping strategy, however, requires no

assumptions about the shape of the sampling distribution. Accordingly, the use of

bootstrapping to assess the significance of indirect effects continues to grow in popularity

(MacKinnon et al. 2002; Preacher and Hayes 2004; Preacher, Rucker, and Hayes 2007).

Bootstrapping techniques are also recommended for use in testing moderated mediation

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hypotheses (Preacher and Hayes 2004). Thus, the mediation relationships for individuals

assigned to the shame condition was assessed using bootstrapping technique. The results

indicated that the mediation relationship was established for all three dependent variables

when individuals were in the shame condition (Table 39).

Similarly, mediation effect was examined for those individuals who were

experiencing pride. The results are shown in Table 40 and indicate that, in contrast to the

shame condition, the indirect effect of body image state dissatisfaction on all dependent

variables via negative affect is not significant. The 95% bootstrapped confidence interval

of 5000 bootstraps contained zero indicating that the indirect effect is not established.

These results provide support for the fact that the hypothesized indirect effect is

moderated by pride/shame as the mediation effect is significant at one level of the

moderator (i.e., shame) and insignificant at the other level (i.e., pride). However,

according to Muller, Judd, and Yzerbyt (2005), test of interaction between moderator and

mediator variables is also required to demonstrate that the magnitude of any simple

mediation effects depends on the moderator.

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 TABLE 38
Multivariate Analysis Of Variance for Cosmetic Surgery Motivation and Likelihood
Type III Partial
Sum of Mean Eta
Source Dependent Variable Squares df Square F Sig. Squared
Corrected Intrapersonal Motivation 6.352 3 2.117 .802 .494 .013
Model Interpersonal Motivation 4.330 3 1.443 .576 .632 .009
Likelihood 10.074 3 3.358 .965 .410 .015
Body Image State 16.333d 3 5.444 2.342 .075 .036
Dissatisfaction
Intercept Intrapersonal Motivation 3053.218 1 3053.218 1156.815 .000 .861
Interpersonal Motivation 1291.514 1 1291.514 515.097 .000 .734
Likelihood 2207.929 1 2207.929 634.572 .000 .772
Body Image State 3743.959 1 3743.959 1610.895 .000 .896
Dissatisfaction
OSA vs. No- Intrapersonal Motivation .623 1 .623 .236 .628 .001
OSA Interpersonal Motivation 3.789 1 3.789 1.511 .220 .008
Likelihood 7.863 1 7.863 2.260 .134 .012
Body Image State 10.260 1 10.260 4.415 .037 .023
Dissatisfaction
Pride vs. Intrapersonal Motivation 1.568 1 1.568 .594 .442 .003
Shame Interpersonal Motivation .605 1 .605 .241 .624 .001
Likelihood 2.245 1 2.245 .645 .423 .003
Body Image State 6.406 1 6.406 2.756 .099 .015
Dissatisfaction
OSA vs. No- Intrapersonal Motivation 4.480 1 4.480 1.698 .194 .009
OSA x Pride Interpersonal Motivation .038 1 .038 .015 .902 .000
vs. Shame Likelihood .218 1 .218 .063 .803 .000
Body Image State .207 1 .207 .089 .766 .000
Dissatisfaction
Error Intrapersonal Motivation 493.555 187 2.639
Interpersonal Motivation 468.870 187 2.507
Likelihood 650.647 187 3.479
Body Image State 434.616 187 2.324
Dissatisfaction
Total Intrapersonal Motivation 3568.720 191
Interpersonal Motivation 1766.440 191
Likelihood 2869.361 191
Body Image State 4202.583 191
Dissatisfaction
Corrected Intrapersonal Motivation 499.907 190
Total Interpersonal Motivation 473.199 190
Likelihood 660.721 190
Body Image State 450.949 190
Dissatisfaction

110
 TABLE 39
Mediation Relationships When Shame Is Induced
Path Coefficient t Sig. Sobel Z 95% 95% Mediation
(Sig.) Bootstrap Bootstrap
CI (LL) CI (UL)
Body Image State .127 2.151 .034
Dissatisfaction  Negative
Affect
Negative Affect  .616 3.508 .001
Interpersonal Motivation
Body Image State .233 2.158 .033
Dissatisfaction 
Interpersonal Motivation
Body Image State .155 1.479 .142 1.846 .009 .202 Established
Dissatisfaction  Negative (.065)
Affect Interpersonal
Motivation
Body Image State .127 2.151 .034
Dissatisfaction Negative
Affect
Negative Affect .411 2.122 .036
Intrapersonal Motivation
Body Image State .023 .203 .839
Dissatisfaction
Intrapersonal Motivation
Body Image State .076 .655 .514 1.52 .002 .158 Established
Dissatisfaction Negative (.128)
Affect Intrapersonal
Motivation
Body Image State .127 2.151 .034
Dissatisfaction  Negative
Affect
Negative Affect .692 3.409 .001
Likelihood
Body Image State .159 1.277 .204
Dissatisfaction
Likelihood
Body Image State .071 .587 .558 1.831 .009 .213 Established
Dissatisfaction Negative (.067)
Affect Likelihood

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 TABLE 40
Mediation Relationships When Pride Is Induced
Path Coefficient t Sig. Sobel Z 95% 95% Mediation
(Sig.) Bootstrap Bootstrap
CI (LL) CI (UL)
Body Image State .080 1.226 .223
Dissatisfaction 
Negative Affect
Negative Affect  .307 1.907 .059
Interpersonal Motivation
Body Image State .080 .794 .429
Dissatisfaction 
Interpersonal Motivation
Body Image State .056 .555 .581 1.039 -.011 .110 Not
Dissatisfaction  (.299) Established
Negative Affect
Interpersonal Motivation
Body Image State .080 1.226 .223
Dissatisfaction 
Negative Affect
Negative Affect  -.060 -.361 .719
Intrapersonal Motivation
Body Image State .062 .605 .547
Dissatisfaction 
Intrapersonal Motivation
Body Image State .067 .643 .522 -.350 -.064 .014 Not
Dissatisfaction  (.726) Established
Negative Affect 
Intrapersonal Motivation
Body Image State .080 1.226 .223
Dissatisfaction 
Negative Affect
Negative Affect  .158 .784 .435
Likelihood
Body Image State .162 1.304 .196
Dissatisfaction 
Likelihood
Body Image State .149 1.189 .237 .667 -.012 .097 Not
Dissatisfaction Negative (.505) Established
Affect  Likelihood

In support of H4a, the interaction between pride/shame and negative affect on

interpersonal motivation was marginally significant (b = .152, t = 1.817, p = .071). A

statistically significant interaction between the moderator (pride/shame) and mediator

112
(negative affect) variables implies that the indirect effect of body image state

dissatisfaction on motivation and likelihood to pursue cosmetic procedures through

negative affect is moderated by pride/shame. Given the interaction, the indirect effect was

further probed by estimating conditional indirect effects at the levels of the moderator

(i.e., pride vs. shame). The results indicated that the conditional indirect effect of body

image state dissatisfaction on intrapersonal motivation is significant when shame is

induced (95% bootstrap CI: .0124, .156), while this effect is not significant when pride is

induced (95% bootstrap CI: -.001, .094).

A similar approach was followed to test H4b. The results indicated that the

conditional indirect effect of body image state dissatisfaction on intrapersonal motivation

is significant for the shame condition (95% bootstrap CI: .002, .112), while there is no

such effect for the pride condition (95% bootstrap CI: -.058, .021). These results in

conjunction with the marginally significant interaction for the indirect effect (b = .458, t

= 1.839, p = .067) provide support for H4b.

H4c was also supported as the interaction between pride/shame and negative

affect on likelihood was significant (b = .213, t = 1.937, p = .054). The indirect effect of

body image state dissatisfaction on likelihood to pursue cosmetic procedures was further

probed by estimating conditional indirect effects for shame and pride conditions. The

results indicated that the indirect effect was significant when shame was induced (95%

bootstrap CI: .017, .169), while there was no such indirect effect for the pride condition

(95% bootstrap CI: -.021, .074). Overall, the results support H4 and maintain that the

indirect effect of body image state dissatisfaction on intrapersonal motivation,

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interpersonal motivation, and likelihood to undergo cosmetic procedures is moderated by

individuals’ state of pride or shame.

Discussion of Study 2 Findings

The results of study 2 provide further support for the interplay between objective

self-awareness and relevant standards and its consequent impact on self-standard

discrepancy as indicated by body image state dissatisfaction. Moreover, the results

answer the question raised in study 1 regarding the boundary conditions for the identified

underlying mechanism for self-standard discrepancy and the motivation to reduce the

experienced gap. Study 2 examined the conditions under which the mediating role of

negative affect in the relationship between body image state dissatisfaction and

motivations and likelihood to undergo cosmetic procedures is reinforced or diminished.

When individuals experienced shame, an indirect effect of body image state

dissatisfaction via negative affect to interpersonal and intrapersonal motivation to pursue

cosmetic procedures as well as the likelihood to undergo such procedures was identified.

However, no such mediation relationship was established when individuals experienced

pride.

Overall, these results indicate that pride and shame, two self-conscious emotions,

can differently impact the self-regulatory strategies of individuals. Pride can help

individuals disengage from the self-regulatory cycle by shifting their focus to a substitute

goal and thus protecting them from the negative affect created due to self-standard

discrepancy. Shame, on the other hand, will keep the individuals in the regulatory cycle

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focusing on the irreducible discrepancy and making them unable to think of possible

substitute goals.

In summary, objective self-awareness theory maintains that awareness of self-

standard discrepancies impacts behavior not because it represents a challenge to an

existing self-identity but because it disrupts the preferred state of self-standard identity

(Dana, Lalwani, and Duval 1997). When individuals are aware of a self-standard

discrepancy, their attempt to deal with this challenge can take the form of self-regulation

and self-reconstruction. “Specific activities such as self-esteem maintenance, attention to

self-affirming domains of self-identity, reinterpretation of threat, and loss of a feature of

self are mentioned as ways in which the person regulates and reconstructs self-identity”

(Dana, Lalwani, and Duval 1997, p. 377). The results of this study indicate that pride can

also work as factors to help individuals regulate their negative emotions experienced due

to the discrepancy. In fact, by shifting the focus from appearance related deficiencies to

pride inducing qualities and capabilities, what one ought and ought not to feel, think, and

do is redefined. These results have implications for priority management as indeed,

individuals usually pursue many goals simultaneously while only one can have top

priority at a given moment. Thus, individuals manage their many goals by shifting among

them (Carver and Scheier 2011). The results of this study indicate that emotions,

specifically pride and shame, can influence the process of priority management and alter

self-regulatory strategies pursued by individuals.

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 CHAPTER 5

GENERAL DISCUSSION AND IMPLICATIONS

General Discussion

The present research was aimed at addressing two main questions pertaining to

identifying factors that motivate consumers to pursue cosmetic procedures, and

examining the role of emotions in cosmetic surgery decision making. More specifically,

three goals were pursued. The first goal was to examine the role of exposure to beauty

standards in intensifying the self-standard discrepancies experienced by self-aware

individuals. Thus, the focus of the first objective was to identify the effect of self-

awareness on self-standard discrepancies. The results of two studies revealed that access

to relevant standards, coupled with a state of public self-awareness, generates self-

standard comparisons that lead to self-standard discrepancies.

The second goal was to examine the emotional consequences of the state of

objective self-awareness and its interplay with beauty standards to identify the underlying

process for the role of emotions in motivating individuals to undergo cosmetic

procedures. The results of the first study indicated that negative affect mediates the

relationship between body image state dissatisfaction (as the indicator of self-standard

discrepancy) and motivations to undergo cosmetic procedures.

The third goal was to identify boundary conditions that affect the proposed

underlying processes that hamper or enhance the motivation and likelihood to undergo

appearance enhancing procedures. To that end, study 2 examined the moderating role of

116
 two self-conscious emotions (i.e., pride and shame) and assessed the underlying

mechanism more closely by introducing a boundary condition created via feelings of

pride and shame. The results of study 2 revealed that pride and shame can influence

individuals’ self-regulatory strategies differently, such that while pride helps individuals

exit the self-regulatory cycle aimed at reducing the gap, shame keeps them engaged in the

cycle and eliminates the pursuit of possible substitute goals. These results hold theoretical

and practical implications examined in subsequent sections of this chapter.

Theoretical Contributions

The present research applies objective self-awareness theory from social

psychology to consumer research and empirically tests its application in the specific case

of cosmetic surgery decision making. The findings expand the domain of OSA theory to

the context of physical attractiveness and enrich its foundations via empirically testing

the interplay of public OSA and standards and identifying the underlying mechanism for

the impact of such interplay on motivations to take actions. In fact, the results of two

studies revealed that exposure to relevant standards even for a short period of time can

move self-aware individuals into the phase of self-standard comparison and self-standard

discrepancy identification. The findings provide support for the OSA theory assumption

that negative affect created by self-standard discrepancies has a driving force, motivating

individuals to take actions, and thus contribute to the research advocating the role of

emotions in decision making. The findings address the call by Morin (2006) and Phillips

and Silvia (2005) for investigating moderating variables, interactive processes, and

boundary conditions of OSA theory.

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 Moreover, by providing a better understanding of the underlying mechanism for

individuals’ motivation to undergo cosmetic procedures, the present research strived to

add to the body of knowledge on cosmetic surgery decision making (e.g., Askegaard,

Gertsen, and Langer 2002; Slevec and Tiggemann 2010). The results strongly suggest

that a state of public objective self-awareness is the first critical stage in cosmetic surgery

decision making. As publicly self-aware individuals focus on their features presented to

others, including physical appearance and mannerisms (Mor and Winquist 2002), their

exposure to standards for such features moves them into a state of self-standard

comparison which then may yield perceptions of self-standard discrepancies. Having

experienced such discrepancies, individuals take actions to move their current appearance

state closer to the standard.

The results also add to the extant knowledge on self-regulatory strategies (Carver

and Scheier 1981) and provide support for the essential role of emotions in disengaging

(or keeping) individuals from (in) regulatory cycles. More specifically, by examining the

influence of two central self-conscious emotions (i.e., pride and shame) on the self-

regulation of behavior, the present research addressed the call by Tracy and Robins

(2004a) for more investigation on the role of self-conscious emotions. Investigating the

intense emotions of pride and shame contributes substantially to understanding the

mechanisms underlying self-esteem regulation (Tracy and Robins 2004a). Indeed, one

accepted definition of self-esteem focuses on “the balance between pride and shame

states in a person’s life, taking into account both duration and intensity”(Scheff 1988, p.

399). In fact, the emotions of shame and pride work opposite from one another to affect

118
self-esteem – shame diminishes self-esteem while pride enhances self-esteem. Prior

studies have shown that following an ego threat, low self-esteem individuals tend to

experience shame and withdraw from the task they were pursuing (e.g., Tracy and Robins

2004a). Interestingly, the results of the present investigation provide a different

perspective of the effect of shame on goal-directed behavior. The experience of shame

can increase the importance attached to a certain goal that results from a self-standard

discrepancy, motivating the individual even more to achieve the desired goal state. In

contrast, feelings of pride can result in disengagement from the regulatory cycle and

focus the individual’s attention to substitute goals.

Practical Contributions

The findings provide practical contributions for marketers of cosmetics products

and services, social marketers trying to encourage or discourage certain behaviors, and

public policy makers, as well as social counselors, psychiatrists, and psychologists.

Moreover, the results have wide-ranging implications for structuring programs designed

to contribute to consumer welfare.

The results of the two studies help marketers of cosmetics products and services

better understand their target markets and the emotional vulnerabilities that affect

decision making. The results also provide insights into the factors affecting individuals’

motivations to undergo cosmetic procedures. These motivations are both intrinsic and

extrinsic to the consumer and the emotions emanating from both sources can be essential

when making cosmetic surgery decisions.

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 In addition, the findings indicate that college students are a representative target

market for physical appearance enhancement or, more specifically, cosmetic procedures

and call attention to the emotional vulnerabilities of this group. The results of the present

research are consistent with past research suggesting that the motivation to undergo self-

enhancement procedures is not gender specific. Vartanian and Giant’s (2001) observed

that the increasing pressure on men for physical attractiveness, and the cultural

socialization processes affecting gender-based differences in concerns and perceptions

about appearance, were changing (see Burton, Netemeyer, and Lichtenstein 1995 for

contrasting results). This pattern of change seems unabated. If anything, the rate of

change may be accelerating – both sexes show increasing acceptance of self-

enhancement procedures.

Moreover, the results of the two studies indicate that the mere presence of relative

beauty standards does not create body image dissatisfaction. Only when access to such

standards of physical appearance is coupled with the state of public OSA will individuals

compare themselves with desired standards. The implication here is that marketers should

attempt to direct the consumer’s attention to his or her appearance-related features. Such

an effort could be accomplished by following the several methods used in OSA research

to situationally manipulate public OSA. Full length mirrors and video cameras have been

successfully employed to initiate a state of public OSA in past research (Dijksterhuis and

Van Knippenberg 2000; Govern and Marsch 2001; Mullen, Migdal, and Rozell 2003;

Phillips and Silvia 2005). Similarly, reflective surfaces and mirrors could be employed in

retail settings to induce states of public OSA. Alternatively, consumers can be given

120
instructions in some manner, or be encouraged, to view their old pictures and videos in

order to activate their state of public OSA. Such tactics could be used in selling clothes,

cosmetics, etc. and benefit marketers in retail settings.

The results of study 2 indicate that shame and pride are important emotions

impacting individuals’ self-regulatory strategies by encouraging or discouraging them to

take certain actions and behave in certain ways. Thus, advertising and other forms of

persuasive communications can deliver pride- or shame-inducing appeals that encourage

or discourage specific targeted behaviors. For example, social marketing campaigns can

be directed at decreasing individuals’ levels of felt depression and anxiety by

encouraging them to focus on past personal achievements and qualifications in which

they take pride. Similarly, public service announcements (PSAs) initiated by health

organizations ranging from nonprofit to governmental organizations, such as Anxiety and

Depression Association of America (ADAA) and the United States Department of Health

and Human Services (HHS), can help shape societal standards of success and pride. Such

pride-inducing advertising efforts can lift individuals’ self-esteem and discourage them

from taking actions such as undergoing unnecessary cosmetic procedures, engaging in

unsafe dieting practices, or spending excessively on costly clothing tied to peer

acceptance. For instance, these advertisements can couple ordinary appearance with high

levels of success, and television and movies can provide more instances of average

appearance associated with social power and rewards. This amounts to changing the

relevant standards of appearance (or behavior). Over time, such efforts may shift some

121
consumers away from the current emphasis on appearance-related qualities to other

pride-inducing qualities.

Social relationships offer another significant avenue for enhancing perceptions of

pride in individuals. A growing research stream suggests that social relationships have

strong effects on individuals’ self-regulatory strategies or even bolster the strength of

such strategies. In fact, a relationship partner can have such an impact by providing social

support, influencing one’s psychological resources and motivation, changing one’s goal-

pursuit strategies, or even fostering appropriate disengagement from one’s goal (Finkel

and Fitzsimons 2011). Socially supportive relationships, specifically with significant

others, could be considered as a means to remind individuals of their achievements,

successes, and unique qualifications. Since pride is strongly associated with social

success and feeling approved of or admired by others (Skarderud 2007), the role of

significant others in inducing this emotion should not be underestimated. This argument

requires further examination and promises significant contributions to consumer welfare.

Limitations and Future Research

Despite the theoretical and practical contributions, the present research is subject

to a number of limitations. First, a student sample was employed, encompassing all of the

requisite caveats regarding representativeness and generalizability. In addition,

respondents were geographically concentrated in the Southwestern United States and

were younger than the general population at large. Thus, it would be fruitful to examine

these relationships in samples that are drawn from additional age and ethnic groups, as

well as from added geographical locations. However, it is noteworthy that students of the

122
age group included in this study do indeed represent a distinct segment targeted by the

cosmetics industry (Suissa 2008), making them representatives of at least a portion of the

population of interest. Moreover, the experimental design employed in this study was

intended primarily to maximize internal validity, entailing sacrificing some degree of

eternal validity. When the focus of research is on theory application, the use of controlled

experimental settings and more homogenous samples (such as student samples) is

desirable (Calder, Phillips, and Tybout 1981).

With an eye toward examining the role of social relationships in self-regulatory

strategies, additional future researcher should examine the ways in which interpersonal

relationships (rather than writing tasks) can be employed to manipulate emotions, such as

pride and shame. Also, it would be interesting to compare the impact of access to images

of models who are average looking as opposed to the ones who are above average in

terms of attractiveness, and assess whether the consequent self-standard discrepancy will

be reduced. If such results are achieved, the findings could have implications for public

policy. For instance, public service announcements should be encouraged to use average

looking celebrities and models.

Finally, future research should examine the possible influence of other emotions

in self-regulatory behaviors. One promising extension is the role of anticipatory

emotions. According to Markus and Nurius (1986), the individual’s current behavior is,

in part, motivated by our desire to become our hoped-for possible selves (to achieve an

ideal private- or social-self) and our attempts to avoid becoming our feared possible

selves. This emphasizes the role of emotions as motivators of behavior (Markus et al.

123
1987) since hope and fear are typical anticipatory emotions (Ortony, Clore, and Collins

1988) that can influence individuals’ behaviors. Anticipatory emotions are experienced

due to the prospect of a desirable or undesirable future event (Baumgartner, Pieters, and

Bagozzi 2008). Therefore, uncertainty about what is going to happen constitutes a subset

of anticipatory emotions in the sense that feelings of uncertainty, per se, partially cause

the emotion (i.e., anticipatory hope in the case of desired events and anticipatory fear in

the case of undesired events).

Anticipatory emotions are experienced, real affective responses to possible future

events that have positive or negative implications for the self. Positive anticipatory

emotions encourage the formation of behavioral intentions aimed at bringing about

desirable future states, while negative anticipatory emotions lead to the formation of

behavioral intentions aimed at avoiding undesirable future states (Baumgartner, Pieters,

and Bagozzi 2008). Bagozzi, Baumgartner, and Pieters (1998) examined the role of

positive and negative anticipatory emotions, elicited by the prospect of goal success and

goal failure, and mentioned that these context-related emotions influence motivation to

pursue the goal. They found that both positive and negative anticipatory emotions

motivate people to (1) form intentions and plans with respect to behaviors instrumental in

bringing about a desired goal; and, (2) expend the energy necessary to achieve their

goals. The anticipatory emotions responsible for initiating goal pursuit are labeled goal-

directed emotions (Bagozzi, Baumgartner, and Pieters 1998).

Likewise, Leon, Perugini, and Bagozzi (2005) argued that although positive and

negative emotions have motivational content, the motivational forces they convey follow

124
different paths and serve different purposes. The effects of anticipatory emotions on

behavior derive from the motivational tendencies associated with hope and fear. Hope is

a positive emotion that arises from environments or outcomes characterized as goal

congruent and uncertain, but still possible to achieve (MacInnis and de Mello 2005).

Thus, outcomes regarded as certain will not evoke hope. In contrast, individuals will feel

hopeless if faced with the certainty that a goal-congruent outcome will not occur. Hope

reflects pleasure about the prospect of a desired future event. It is the prospect of good

things ahead, looking forward to positive circumstances, future optimism, wishes, and

desires. Hope’s specific emotional facets include excitement and feelings of optimism,

confidence, or relaxation.

In contrast, fear indicates displeasure about the prospect of an undesired future

event and creates a desire to escape from or avoid an aversive state (Lazarus 1991). It is

associated with apprehension, dread, and nervousness about bad outcomes. Specific

facets of fear include worry, anxiety, nervousness, and tension or stress (Baumgartner,

Pieters, and Bagozzi 2008). Relevant to this study, when making decisions about

cosmetic surgery, hope and fear may have different motivational influences on

individuals since one may experience hope (fear) when thinking about the positive

(negative) consequences that may happen as a result of having (or not having) a cosmetic

procedure. Darisi, Throne, and Iacobelli (2005) found that cosmetic surgery patients often

report extra-physical benefits from cosmetic surgery ranging from higher self-esteem to

an improved sex life. More than half of their research participants reported psychological

benefits (e.g., happiness, self-confidence, and self-esteem) and some others mentioned

125
social benefits (e.g., more acceptance and attractiveness) as the results of cosmetic

surgery, all-encompassing emotional elements (Darisi, Thorne, and Iacobelli 2005).

Intense levels of hope increase perceptions that positive outcomes will occur and

reduce perceptions that negative consequences may happen to the self (MacInnis and de

Mello 2005). Thus, according to the self-regulatory model of Carver and Scheier (1981),

one can argue that hopefulness about the prospect of positive outcomes makes the

individual willing to engage in the actions that may lead to discrepancy reduction. In

other words, hope will make the individual unwilling to give up the regulatory cycle. In a

cosmetic surgery decision making context, the hope to look more attractive, be more

favorably perceived, and experience improved social and economic status may influence

individuals’ willingness and motivation to pursue cosmetic surgery. The consumer is

motivated to reduce his or her level of felt discrepancy between his or her current state of

appearance and any desired state.

In fact, when the individual feels the negative affect resulted from the

discrepancy, he/she enters the self-regulatory cycle to reduce the discrepancy. As Carver

and Scheier (1981) argue, depending on what regulating strategy is taken, the individual

may disengage from or remain in the cycle. Hope will encourage the individual to pursue

the discrepancy reduction goal since it provides the individual with the prospect of

positive outcomes of such behavior.

In contrast, fear increases perceptions that negative outcomes will occur and

reduces perceptions that positive consequences will accrue. Thus, fear of the prospect of

negative outcomes associated with actions taken at the present time, may make the

126
individual willing to disengage from the regulatory cycle and possibly derogate from

what is perceived to be an unattainable goal. In the context of decision to undergo a

cosmetic procedure to reduce the gap between self and beauty standards of the society,

the fear of failure of the surgery and its irreversible consequences, or the risk of being

teased, and discriminated against if the surgery fails may motivate the individual to avoid

the comparison and ignore or dismiss the discrepancies. Therefore, fear discourages the

individual by highlighting the prospect of negative outcomes and the undesirable

consequences of the targeted behavior.

The latter argument is supported by Carver and Scheier’s (1998) statement that

sufficient doubt about goal attainment results in an impetus to disengage from efforts to

reach the goals, and even to abandon the goal itself which is a decrease in priority for that

goal. More specifically, if the situation involves loss, movement forward is precluded

because the incentive is gone. Generally, when failure is anticipated or assured,

individuals will feel despondent and hopeless. This may be the case with respect to fear

of surgery failure in which the individual disengages from further effort directed toward

the goal. Fear of the negative consequences or doubts about positive outcomes of an

action (such as undergoing cosmetic procedures) can thus yield goal abandonment.

Overall, the present research began with the intention to shed more light on our

understanding of the factors that motivate individuals to undergo appearance enhancing

procedures. The results indicated that emotions play a central role in such decisions and

identified the motivating role of negative emotions as well as the strategic impact of self-

conscious emotions of pride and shame on directing individuals’ behavior. Further

127
studies in this area can be productive as researches explore the nuances of the interplay of

emotions and decision making and implement these findings in crafting effective public

policy, consumer welfare, and healthcare initiatives.

128
 REFERENCE LIST

AACS, American Academy of Cosmetic Surgery (2010), "New Survey Indicates More
Than 17 Million Cosmetic Procedures Performed Last Year in U.S.," (accessed October
25, 2010), [available at [Link]

Aaker, Jennifer, Aimee Drolet, and Dale Griffin (2008), "Recalling Mixed Emotions,"
Journal of Consumer Research, 35 (2), 268-78.

Adams, Josh (2010), "Motivational Narratives and Assessments of the Body After
Cosmetic Surgery," Qualitative Health Research, 20 (6), 755-67.

Aiken, Leoan S. and Stephen G. West (1991), Multiple Regression: Testing and
Interpreting Interactions. Newbury Park, CA: Sage.

Alden, Lynn E., Michael Teschuk, and Karen Tee (1992), "Public Self-Awareness and
Withdrawal from Social Interactions," Cognitive Therapy and Research, 16 (3), 249-67.

ASAPS, American Society for Aesthetic Plastic Surgery (2008), "National Data Bank
Statistics," (accessed October 25, 2010), [available at
[Link]

Askegaard, Søren, Martine Cardel Gertsen, and Roy Langer (2002), "The Body
Consumed: Reflexivity and Cosmetic Surgery," Psychology and Marketing, 19 (10), 793-
812.

ASPS, American Society of Plastic Surgeons (2011): (accessed October 25, 2010),
[available at [Link]

Bagozzi, Richard P., Hans Baumgartner, and Rik Pieters (1998), "Goal-Directed
Emotions," Cognition and Emotion, 12 (1), 1-26.

Bagozzi, Richard P. and Youjae Yi (1988), "On the Evaluation of Structural Equation
Models," Journal of the Academy of Marketing Science, 16 (1), 74-94.

Bandura, A. (1982), "Self-Efficacy Mechanisms in Human Agency," American

Psychologist, 37, 122-47.

Baron, Reuben M. and David A. Kenny (1986), "The Moderator-Mediator Variable

Distinction in Social Psychological Research: Conceptual, Strategic, and Statistical
Considerations," Journal of Personality and Social Psychology, 51 (6), 1173-82.

129
Baumgartner, Hans, Rik Pieters, and Richard P. Bagozzi (2008), "Future-oriented
emotions: conceptualization and behavioral effects," European Journal of Social
Psychology, 38 (4), 685-96.

Belk, Russell W. (1988), "Possessions and the Extended Self," Journal of Consumer
Research, 15 (2), 139-68.

Berry, Diane S. and Julia L. Finch Wero (1993), "Accuracy in Face Perception: A View
from Ecological Psychology," Journal of Personality, 61 (4), 497-520.

Boldero, Jennifer and Jill Francis (2002), "Goals, Standards, and the Self: Reference
Values Serving Different Functions," Personality and Social Psychology, 6 (3), 232-41.

Burton, Scot, Richard G. Netemeyer, and Donald R. Lichtenstein (1995), "Gender

Differences for Appearance-Related Attitudes and Behaviors: Implications for Consumer
Welfare," Journal of Public Policy and Marketing, 14 (1), 60-75.

Calder, Bobby J., Lynn W. Phillips, and Alice M. Tybout (1981), "Designing Research
for Application," Journal of Consumer Research, 8 (2), 197-207.

Carver, Charles S. (2003), "Pleasure as a Sign You Can Attend to Something Else:
Placing Positive Feelings within a General Model of Affect," Cognition and Emotion, 17
(2), 241-61.

Carver, Charles S., Paul H. Blaney, and Michael F. Scheier (1979a), "Focus of Attention,
Chronic Expectancy, and Responses to a Feared Stimulus," Journal of Personality and
Social Psychology, 37 (7), 1186-95.

---- (1979b), "Reassertion and Giving Up: The Interactive Role of Self-Directed
Attention and Outcome Expectancy," Journal of Personality and Social Psychology, 37
(10), 1859-70.

Carver, Charles S. and David C. Glass (1976), "The Self-Consciousness Scale: A

Discriminant Validity Study," Journal of Personality Assessment, 40 (2), 169.

Carver, Charles S. and Michael F. Scheier (1987), "The Blind Men and the Elephant:
Selective Examination of the Public-Private Literature Gives Rise to a Faulty
Perception," Journal of Personality, 55 (3), 525-41.

---- (1998), On the Self-Regulation of Behavior. New York, NY: Cambridge University
Press.

130
---- (1978), "Self-Focusing Effects of Dispositional Self-Consciousness, Mirror Presence,
and Audience Presence," Journal of Personality and Social Psychology, 36 (3), 324-32.

---- (2011), "Self-Regulation of Action and Affect," in The Relationship of Social

Approval Contingency to Trait Self-Esteem: Cause, Consequence, or Moderator?,
Kathleen D. Vohs and Roy F. Baumeister, eds. New York, NY: The Guilford Press, 3-21.

Carver, Charles S. and Michael F. Scheier (1981), Attention and Self-Regulation. New
York, NY: Springer-Verlag.

Cash, Thomas F., Emily C. Fleming, Jenny Alindogan, Laura Steadman, and Abigail
Whitehead (2002), "Beyond Body Image as a Trait: The Development and Validation of
the Body Image States Scale," Eating Disorders, 10 (2), 103-13.

Cerin, Ester and David P. MacKinnon (2009), "A Commentary on Current Practice in
Mediating Variable Analysis in Behavioral Nutrition and Physical Activity," Public
Health and Nutrition, 12 (8), 1182-88.

Chen, Yiwei and Xiaodong Ma (2009), "Age Differences in Risky Decisions: The Role
of Anticipated Emotions," Educational Gerontology, 35 (7), 575-86.

Churchill, Gilbert A. Jr (1979), "A Paradigm for Developing Better Measures of

Marketing Constructs," Journal of Marketing Research, 16 (1), 64-73.

Citrin, L. B., T. A. Roberts, and B. L. Fredrickson (2004), Objectification Theory and

Emotions: A Feminist Psychological Perspective on Gendered Affect. Cambridge:
Cambridge University Press.

Conroy, David E. (2001), "Progress in the Development of a Multidimensional Measure

of Fear of Failure: The Performance Failure Appraisal Inventory (PFAI)," Anxiety, Stress
and Coping, 14 (4), 431.

Cooley, Charles Horton (1922), Human Nature and the Social Order. New York:
Scribners.

Crary, David (2011), "Boomers Flock to Stay Forever Young," in the Dallas Morning
News, August 21.

Dana, Edward R., Neal Lalwani, and T. Shelley Duval (1997), "Objective Self-
Awareness and Focus of Attention Following Awareness of Self-Standard Discrepancies:
Changing Self or Changing Standards of Correctness," Journal of Social and Clinical
Psychology, 16 (4), 359-80.

131
Darisi, Tanya, Sarah Thorne, and Carolyn Iacobelli (2005), "Influences on Decision-
Making for Undergoing Plastic Surgery: A Mental Models and Quantitative Assessment,"
Plastic and Reconstruction Surgery, 116 (3), 907-16.

Darwin, Charles (1900), The Origin of Species. New York, NY: Books, Inc.

Davis, Kathy (2002), "A Dubious Equality: Men, Women and Cosmetic Surgery," Body
and Society, 8 (1), 49-65.

---- (1997), "My Body is My Art: Cosmetic Surgery as Feminist Utopia?," European
Journal of Women's Studies, 4 (1), 23-37.

Deci, Edward L. and Richard M. Ryan (1985), Intrinsic Motivation and Self-
Determination in Human Behavior: New York, NY: Plenum Press.

Dijksterhuis, Ap and Ad Van Knippenberg (2000), "Behavioral Indecision: Effects of

Self-Focus on Automatic Behavior," Social Cognition, 18 (1), 55-74.

Dion, Karen, Ellen Bersceid, and Elaine Walster (1972), "What is Beautiful is Good: A
Meta-Analytic Review of Research on the Physical Attractiveness Stereotype," Journal
of Personality and Social Psychology, 24 (3), 285-90.

Domzal, Teresa J. and Jerome B. Kernan (1993), "Variations on the Pursuit of Beauty:
Toward a Corporal Theory of the Body," Psychology and Marketing, 10 (6), 495-511.

Duval, T. Shelley, Virginia Hensley Duval, and John-Paul Mulilis (1992), "Effects of
Self-Focus, Discrepancy Between Self and Standard, and Outcome Expectancy
Favorability on the Tendency to Match Self to Standard or to Withdraw," Journal of
Personality and Social Psychology, 62, 340-48.

Duval, T. Shelley and Neal Lalwani (1999), "Objective Self-Awareness and Causal
Attributions for Self-Standard Discrepancies: Changing Self or Changing Standards of
Correctness," Personality and Social Psychology Bulletin, 25 (10), 1220-29.

Duval, T. Shelley and Paul J. Silvia (2001), Self-Awareness and Causal Attribution: A
Dual Systems Theory. Dordrecht, Netherlands: Kluwer Academic Publishers.

Duval, T. Shelley and Robert A. Wicklund (1972), A Theory of Objective Self-

Awareness. Oxford: Academic Press.

Duval, Thomas Shelley and Paul J. Silvia (2002), "Self-Awareness, Probability of

Improvement, and the Self-Serving Bias," Journal of Personality and Social Psychology,
82 (1), 49-61.

132
Eagly, Alice H., Richard D. Ashmore, Mona G. Makhijani, and Laura C. Longo (1991),
"What is Beautiful is Good, but…: A Meta-Analytic Review of Research on the Physical
Attractiveness Stereotype," Psychological Bulletin, 110 (1), 109-28.

Economist (2003), "Pots of Promise: The Beauty Business, an Industry Driven by Sexual
Instinct Will Always Thrive " Vol. 367, 69-71.

Efran, Michael G. and E. W. J. Patterson (1974), "Voters Vote Beautiful: The Effect of
Physical Appearance on a National Debate," Canadian Journal of Behavioral Science, 6
(4), 352-56.

Eisenmann-Klein, M (2010), Sociopsychological Issues and Research on Attractiveness.

London: Springer.

Fenigstein, Allan, Michael F. Scheier, and Arnold H. Buss (1975), "Public and private
self-consciousness: Assessment and theory," Journal of Consulting nad Clinical
Psychology, 43 (4), 522-27.

Festinger, Leon (1957), A Theory of Cognitive Dissonance. Stanford, CA: Stanford

University Press.

Finkel, Eli J. and Grainne M. Fitzsimons (2011), "The Effects of Social Relationships on
Self-Regulation," in Handbook of Self-Regulation: Research, Theory, and Applications,
Kathleen D. Vohs and Roy F. Baumeister, eds. (2nd ed.). New York, NY: The Guilford
Press, 390-406.

Fitzsimons, Gavan J. (2008), "Death to Dichotomizing," Journal of Consumer Research,

35 (June), 5-8.

Foustanos, A., L. Pantazi, and H. Zavrides (2007), "Representations in Plastic Surgery:

The Impact of Self-Image and Self-Confidence in the Work Environment," Aesthetic
Plastic Surgery, 31 (5), 435-42.

Fredrickson, B. L. and T. Roberts (1997), "Objectification Theory: Toward

Understanding Women's Lived Experiences and Mental Health Risks," Psychology of
Women Quarterly, 21, 173-206.

Frieze, Irene Hanson, Josephine E. Olson, and June Russell (1991), "Attractiveness and
Income for Men and Women In Management," Journal of Applied Social Psychology, 21
(13), 1039-57.

Froming, William J., William Nasby, and John McManus (1998), "Prosocial Self-
Schemas, Self-awareness, and Children's Prosocial Behavior," Journal of Personality and
Social Psychology, 75 (3), 766-77.

133
Gerbing, D. W. and J. C. Anderson (1988), "An Updated Paradigm for Scale
Developemnt Incorporating Unidimensionality and its Assessment," Journal of
Marketing Research, 25 (2), 186-92.

Gibbons, Frederick, X. (1990), "Self-Attention and Behavior: A Review and Theoretical

Update," Advances in Experimental Social Psychology, 23, 249-303.

Gibbons, Frederick X. (1983), "Self-Attention and Self-Report: The 'Verdicality'

Hypothesis," Journal of Personality, 51 (3), 517-42.

Gilbert, P. ed. (1998), What is Shame? Some Core Issues and Controversies. Oxford:
Oxford University Press.

Goffman, Erving (1967), Interaction Ritual. New York, NY: Anchor.

Goss, K., P. Gilbert, and S. Allan (1994), "An Exploration of Shame Measures: I. The
Other As Shamer Scale," Personality and Individual Differences, 17 (5), 713-17.

Goss, Kenneth and Steven Allan (2009), "Shame, Pride and Eating Disorders," Clinical
Psychology and Psychotherapy, 16 (4), 303-16.

Govern, John and Lisa A. Marsch (2001), "Development and Validation of the
Situational Self-Awareness Scale," Consciousness and Cognition, 10, 366-78.

Green, Sharin Palladino and Mary E. Pritchard (2003), "Predictors of Body Image
Dissatisfaction in Adult Men and Women," Social Behavior and Personality: An
International Journal, 31 (3), 215-22.

Gronroos, Christian (2000), Service Management and Marketing: A Customer

Relashionship Management Approach. New York, NY: Wiley.

Gulas, Charles S. and Kim McKeage (2000), "Extending Social Comparison: An

Examination of the Unintended Consequences of Idealized Advertising Imagery,"
Journal of Advertising, 29 (2), 17-28.

Haiken, Elizabeth (2000), "The Marketing of the Modern Face: Cosmetic Surgery,"
Social Research, 67 (1), 81-97.

Harris, David L. (1982), "Cosmetic Surgery-Where Does it Begin?," British Journal of

Plastic Surgery, 35 (3), 281-86.

Hatfield, Elaine and Susan Spercher (1986), Mirror, Mirror: The Importance of Looks in
Everyday Life. New York, NY: State University of New York Press.

134
Hayes, Andrew F. (2009), "Beyond Baron and Kenny: Statistical Mediation Analysis in
the New Millennium," Communication Monographs, 76 (4), 408-20.

Heider, Fritz ed. (1960), The Gestalt Theory of Motivation. Lincoln, NE: University of
Nebraska Press.

---- (1958), The Psychology of Interpersonal Relations. Mahwah, NJ: Lawrence Erlbaum
Associates Publishers.

Heilman, Renata M., Liviu G. Crisan, Daniel Houser, Mircea Miclea, and Andrei C. Miu
(2010), "Emotion Regulation and Decision Making Under Risk and Uncertainty,"
Emotion, 10 (2), 257-65.

Henderson-King, Donna and Eaaron Henderson-King (2005), "Acceptance of Cosmetic

Surgery: Scale Development and Validation," Body Image, 2 (2), 137-49.

Herzberg, Larry A. (2009), "Direction, Causation, and Appraisal Theories of Emotion,"

Philosophical Psychology, 22 (2), 167-86.

Hesse-Biber, Sharlene Nagy (2007), The Cult of Thinness (2nd ed.). New York, NY:
Oxford University Press.

Holahan, Carole Kovalic and Cookie White Stephan (1981), "When Beauty isn't Talent:
The Influence of Physical Attractiveness, Attitudes Toward Women, and Competence on
Impression Formation," Sex Roles, 7 (8), 867-76.

Ickes, William, Mary Anne Layden, and Richard D. Barnes (1978), "Objective Self-
Awareness and Individuation: An Empirical Link," Journal of Personality, 46 (1), 146-
61.

Insko, Chester A., Stephen Worchel, Elaine Songer, and Susan E. Arnold (1973), "Effort,
Objective Self-Awareness, Chice, and Dissonance," Journal of Personality and Social
Psychology, 28 (2), 262-69.

Joy, Annamma and Alladi Venkatesh (1994), "Postmodernism, Feminism, and the Body:
The Visible and the Invisible in Consumer Research," International Journal of Research
in Marketing, 11 (4), 333-57.

Judge, Kay and Maxine Barish-Wreden (2009), Cosmetic Surgery: Think First, in the
Sacramento Bee, March 13.

Judge, Timothy A., Charlice Hurst, and Lauren S. Simon (2009), "Does it Pay to Be
Smart, Attractive, or Confident (or All Three)? Relationships among General Mental

135
Ability, Physical Attractiveness, Core Self-Evaluations, and Income," Journal of Applied
Psychology, 94 (3), 742-55.

Landro, Laura (2011), "More Men Seek out Cosmetic Surgery," in the Wall Street
Journal, May 24.

Langlois, Judith H., Lisa Kalakanis, Adam J. Rubenstein, Andrea Larson, Monica
Hallam, and Monica Smoot (2000), "Maxims or Myths of Beauty? A Meta-Analytic and
Theoretical Review," Psychological Bulletin, 126 (3), 39-423.

Lazarus, Richard S. (1991), Emotion and Adaptation: New York, NY: Oxford University
Press.

Leary, Mark R. and Jennifer Guadagno (2011), "The Sociometer, Self-esteem, and the
Regulation of Interpersonal Behavior," in Handbook of Self-Regulation: Research,
Theory, and Applications, Kathleen D. Vohs and Roy F. Baumeister, eds. New York,
NY: The Guilford Press, 339-54.

Lemay, Edward P., Jr. and Richard D. Ashmore (2006), "The Relationship of Social
Approval Contingency to Trait Self-Esteem: Cause, Consequence, or Moderator?",
Journal of Research in Personality, 40 (2), 121-39.

Leone, Luigi, Marco Perugini, and Richard P. Bagozzi (2005), "Emotions and Decision
Making: Regulatory Focus Moderates the Influence of Anticipated Emotions on Action
Evaluations," Cognition and Emotion, 19 (8), 1175-98.

Levenson, Robert W., Paul Ekman, Karl Heider, and Wallace V. Friesen (1992),
"Emotion and Autonomic Nervous System Activity in the Minangkabau of West
Sumatra," Journal of Personality and Social Psychology, 62 (6), 972-88.

Lodge, Milton and Marco R. Steenbergen (1995), "The Responsive Voter: Campaign
Information and the Dynamics of Candidate Evaluation," American Political Science
Review, 89 (2), 309-26.

MacInnis, Deborah J. and Gustavo E. de Mello (2005), "The Concept of Hope and Its
Relevance to Product Evaluation and Choice," Journal of Marketing, 69 (1), 1-14.

MacKinnon, David P., Chondra M. Lockwood, Jeanne M. Hoffman, Stephen G. West,

and Virgil Sheets (2002), "A Comparison of Methods to Test Mediation and Other
Intervening Variable Effects," Psychological Methods, 7 (1), 83-104.

Mangum, S., C. Garrison, C. Lind, and H. G. Hilton (1997), "First Impressions of the
Nurse and Nursing Care," Journal of Nursing Care Quality, 11 (5), 39-47.

136
Markley Rountree, Melissa and Lenita Davis (2011), "A Dimensional Qualitative
Research Approach to Understanding Medically Unnecessary Aesthetic Surgery,"
Psychology and Marketing, 28 (10), 1027-43.

Markus, Hazel and Paula Nurius (1986), "Possible Selves," American Psychologist, 41
(9), 954-69.

Markus, Hazel, Paula Nurius, Krysia Yardley, and Terry Honess (1987), "Possible
Selves: The Interface Between Motivation and the Self-Concept," in Self and Identity:
Psychosocial Perspectives. Oxford, England: John Wiley & Sons, 157-72.

Martin, Brett A. S., Juergen Gnoth, and Carolyn Strong (2009), "Temporal Construal in
Advertising," Journal of Advertising, 38 (3), 5-19.

Martin, Mary C. and James W. Gentry (1997), "Stuck in the Model Trap: The Effects of
Beautiful Models in Ads on Female Pre-Adolescents and Adolescents," Journal of
Advertising, 26 (2), 19-33.

Masip, Jaume, Eugenio Garrido, and Carmen Herrero (2004), "Facial Appearance and
Impressions of Credibility: The Effects of Facial Babyishness and Age on Person
Perception," International Journal of Psychology, 39 (4), 276-89.

McCracken, Grant (1986), "Culture and Consumption: A Theoretical Account of the

Structure and Movement of the Cultural Meaning of Consumer Goods," Journal of
Consumer Research, 13 (1), 71-84.

McMurrich, Stephanie L. and Sheri L. Johnson (2009), "The Role of Depression, Shame-
Proneness, and Guilt-Proneness in Predicting Criticism of Relatives towards People with
Bipolar Disorder," Behavior Therapy, 40 (4), 315-24.

Mendelson, Beverley K., Morton J. Mendelson, and Donna R. White (2001), "Body-
Esteem Scale for Adolescents and Adults," Journal of Personality Assessment, 76 (1), 90-
106.

Mor, Nilly and Jennifer Winquist (2002), "Self-Focused Attention and Negative Affect:
A Meta-Analysis," Psychological Bulletin, 128 (4), 638-62.

Morgan-Lopez, Antonio A. MacKinnon David E. (2006), "Demonstration and Evaluation

of a Method for Assessing Mediated Moderation," Behavior Research Methods, 38 (1),
77-87.

Morgan, Kathryn Pauly (1991), "Women and the Knife: Cosmetic Surgery and the
Colonization of Women's Bodies," Hypatia, 6 (3), 25-53.

137
Morin, Alain (2006), "Levels of Consciousness and Self-Awareness: A Comparison and
Integration of Various Neurocognitive Views," Consciousness and Cognition, 15, 358-
71.

Mowen, John C. (2000), The 3M Model of Motivation and Personality: Theory and
Empirical Application to Consumer Behavior: Boston, MA: Kluwer Academic
Publishers.

Mowen, John C. , Adelina Longoria, and Amy Sallee (2009), "Burning and Cutting:
Identifying the Traits of Individuals with an Enduring Propensity to Tan and to Undergo
Cosmetic Surgery," Journal of Consumer Behaviour, 8 (5), 238-51.

Mowen, John C. and Michael S. Minor (2006), Understanding Consumer Behavior.

Mason, OH: Thompson.

Mullen, Brian, Michael J. Migdal, and Drew Rozell (2003), "Self-Awareness,

Deindividuation, and Social Identity: Unraveling Theoretical Paradoxes by Filling
Empirical Lacunae," Personality and Social Psychology Bulletin, 29 (9), 1071-81.

Muller, Dominique, Charles M. Judd, and Vincent Y. Yzerbyt (2005), "When Moderation
is Mediated and Mediation is Moderated," Journal of Personality and Social Psychology,
89 (6), 852-63.

Orth, Ulrich, Richard W. Robins, and Christopher J. Soto (2010), "Tracking the
Trajectory of Shame, Guilt, and Pride across the Life Span," Journal of Personality and
Social Psychology, 99 (6), 1061-71.

Ortony, Andrew, Gerald L. Clore, and Allan Collins (1988), The Cognitive Structure of
Emotions. New York, NY: Cambridge University Press.

Pentina, Iryna, David G. Taylor, and Troy A. Voelker (2009), "The Roles of Self-
Discrepancy and Social Support in Young Females' Decisions to Undergo Cosmetic
Procedures," Journal of Consumer Behaviour, 8 (4), 149-65.

Peter, J. Paul (1981), "Construct Validity: A Review of Basic Issues and Marketing
Practices," Journal of Marketing Research, 18 (2), 133-45.

Petty, Richard E., John T. Cacioppo, and David Schumann (1983), "Central and
Peripheral Routes to Advertising Effectiveness: The Moderating Role of Involvement,"
Journal of Consumer Research, 10 (2), 135-46.

Pham, Michel Tuan, Caroline Goukens, Lehmann, Donald R., and Jennifer Ames Stuart
(2010), "Shaping Customer Satisfaction Through Self-Awareness Cues," Journal of
Markeing Research, 47 (6), 920-32.

138
Phemister, Andrew A. and Nancy M. Crewe (2004), "Objective Self-Awareness and
Stigma: Implications for Persons with Visable Disabilities," Journal of Rehabilitation, 70
(2), 33-37.

Phillips, Ann G. and Paul J. Silvia (2005), "Self-Awareness and the Emotional
Consequences of Self-Discrepancies," Personality and Social Psychology Bulletin, 31
(5), 703-13.

Preacher, Kristopher J. and Andrew F. Hayes (2004), "SPSS and SAS Procedures for
Estimating Indirect Effects in Simple Mediation Models," Behavior Research Methods,
Instruments, and Computers, 36 (4), 717-31.

Preacher, Kristopher J., Derek D. Rucker, and Andrew F. Hayes (2007), "Addressing
Moderated Mediation Hypotheses: Theory, Methods, and Prescriptions," Multivariate
Behavioral Research, 42 (1), 185-227.

Prinz, Jesse J. (2004), Gut Reactions: A Perceptual Theory of Emotion: New York, NY:
Oxford University Press.

Pyszczynski, Tom and Jeff Greenberg (1987), "Self-Regulatory Perseveration and the
Depressive Self-Focusing Style: A Self-Awareness Theory of Reactive Depression,"
Psychological Bulletin, 102 (1), 122-38.

Regan, Pamela C. (2011), "Cinderella Revisited: Women's Appearance Modificatio as

Functio of Target Audience Sex and Attractiveness," Social Behavior and Personality, 39
(4), 563-76.

Robins, Philip K., Jenny F. Homer, and Michael T. French (1994), "Beauty and the Labor
Market: Accounting for the Additional Effects of Personality and Grooming," Labour, 25
(2), 228-51.

Rosenberg, Milton (1965), Society and the Adolescent Self-Image: Princeton, NJ:
Princeton University Press.

Sarwer, David B., Leanne Magee, and Vicki Clark (2003), "What is Beauty? Physical
Appearance and Cosmetic Medical Treatments: Physiological and Socio-Cultural
Influences," Journal of Cosmetic Dermatology, 2, 29-39.

Scheff, Thomas J. (1988), "Shame and Conformity: The Deference-Emotion System,"

American Sociological Review, 53 (3), 395-406.

139
Schouten, John W. (1991), "Selves in Transition: Symbolic Consumption in Personal
Rites of Passage and Identity Reconstruction," Journal of Consumer Research, 17 (4),
412-25.

Shevlin, Mark, Stephanie Walker, Mark N. O. Davies, Philip Banyard, and Christopher
Alan Lewis (2003), "Can You Judge a Book by its Cover? Evidence of Self-Stranger
Agreement on Personality at Zero Acquaintance," Personality and Individual
Differences, 35 (6), 1373-83.

Silvia, Paul J. (2001), "Nothing or the Opposite: Intersecting Terror Management and
Objective Self-Awareness," European Journal of Personality, 15 (1), 73-82.

Silvia, Paul J. and T. Shelley Duval (2001), "Objective Self-Awareness Theory: Recent
Progress and Enduring Problems," Personality and social Psychology, 5 (3), 230-41.

Simon, Herbert A. (1967), "Motivational and Emotional Controls of Cognition,"

Psychological Review, 74 (1), 29-39.

Skarderud, Finn (2007), "Shame and Pride in Anorexia Nervosa: A Qualitative

Descriptive Study," European Eating Disorders Review, 15 (2), 81-97.

Slevec, Julie and Marika Tiggemann (2010), "Attitudes toward Cosmetic Surgery in
Middle-Aged Women: Body Image, Aging Anxiety, and the Media," Psychology of
Women Quarterly, 34 (1), 65-74.

Sobel, Michael E. (1982), "Asymptotic Confidence Intervals for Indirect Effects in

Structural Equestions Models," in Sociological Methodology, Leinhart S., ed. San
Fransisco, CA: Jossey-Bass, 290-312.

Suissa, Amnon Jacob (2008), "Addiction to Cosmetic Surgery: Representations and

Medicalization of the Body," International Journal of Mental Health and Addiction, 6
(4), 619-30.

Sullivan, Michael J., Scott R. Bishop, and Jayne Pivik (1995), "The Pain Catastrophizing
Scale: Development and Validation," Psychological Assessment, 7 (4), 524-32.

Surawski, Melissa K. and Elizabeth P. Ossoff (2006), "The Effects of Physical and Vocal
Attractiveness on Impression Formation of Politicians," Current Psychology, 25 (1), 15-
27.

Thelwell, Richard C., Neil J. V. Weston, Iain A. Greenlees, Jenny L. Page, and Andrew J.
Manley (2010), "Examining the Impact of Physical Appearance on Impressions of
Coaching Competence," International Journal of Sport Psychology, 41 (3), 277-92.

140
Thompson, Craig J. and Elizabeth C. Hirschman (1995), "Understanding the Socialized
Body: A Poststructuralist Analysis of Consumers' Self-Conceptions, Body Images, and
Self-Care Practices," Journal of Consumer Research, 22 (2), 139-53.

Thorpe, S. J., B. Ahmed, and K. Steer (2004), "Reasons for Undergoing Cosmetic
Surgery: A Retrospective Study," Sexualities, Evolution and Gender, 6 (2/3), 75-96.

Tiggemann, Marika and Michelle Boundy (2008), "Effect of Environment and

Appearance compliment on College Women's Self-Objectification, Mood, Body Shame,
and Cognitive Performance," Psychology of Women Quarterly, 32 (4), 399-405.

Tracy, Jessica L., Joey T. Cheng, Richard W. Robins, and Kali H. Trzesniewski (2009),
"Authentic and Hubristic Pride: The Affective Core of Self-esteem and Narcissism," Self
and Identity, 8 (2/3), 196-213.

Tracy, Jessica L. and Richard W. Robins (2007a), "Emerging Insights into the Nature and
Function of Pride," Current Directions in Psychological Science, 16 (3), 147-50.

---- (2007b), "The Psychological Structure of Pride: A Tale of Two Facets," Journal of
Personality and Social Psychology, 92 (3), 506-25.

---- (2004a), "Putting the Self into Self-Conscious Emotions: A Theoretical Model,"
Psychological Inquiry, 15 (2), 103-25.

---- (2004b), "Show Your Pride: Evidence for a Discrete Emotion Expression,"
Psychological Science, 15 (3), 194-97.

Van Leeuwen, Matthijs L. and Macrae C. Neil (2004), "Is Beautiful Always Good?
Implicit Benefits of Facial Attractiveness," Social Cognition, 22 (6), 637-49.

Vartanian, Lesa Rae and Carrie L. Giant (2001), "Ally Mcbeal vs. Arnold
Schwarzenegger: Comparing Mass Media, Interpersonal Feedback and Gender as
Predictors of Satisfaction with Body Thinness and Muscularity," Social Behavior and
Personality: An International Journal, 29 (7), 711-23.

Verhoeven, Joost W.M., Thomas Van Ropmay, and Ad Pruyn (2009), "At Face Value:
Visual Antecedents of Impression Formation in Servicescapes," Advances in Consumer
Research, 36, 223-37.

Voelker, Troy A. and Iryna Pentina (2011), "Cosmetic Surgery Intent among Generation
Y Consumers: A Social Network Perspective," Health Marketing Quarterly, 28 (1), 38.

141
Watson, David, Lee Anna Clark, and Auke Tellegen (1988), "Development and
Validation of Brief Measures of Positive and Negative Affect: The PANAS Scales,"
Journal of Personality and Social Psychology, 54, 1063-70.

Webb, William M., Kerry L. Marsh, William Schneiderrnan, and Bob Davis (1989),
"Interaction between Self-Monitoring and Manipulated States of Self-Awareness,"
Journal of Personality and Social Psychology, 56 (1), 70-80.

Williams, Lisa A. and David Desteno (2008), "Pride and Perseverance: The Motivational
Role of Pride," Journal of Personality and Social Psychology, 94 (6), 1007-17.

---- (2009), "Pride: Adaptive Social Emotion or Seventh Sin?," Psychological Science, 20
(3), 284-88.

Winterich, Karen Page and Kelly L. Haws (2011), "Helpful Hopefulness: The Effect of
Future Positive Emotions on Consumption," Journal of Consumer Research, 38 (3), 505-
24.

142