Available online at www.sciencedirect.com Procedia - Social and Behavioral Scien ce s 84 ( 2013 ) 686 690 3rd World Conference on Psychology, Counselling and Guidance (WCPCG-2012) Symptoms of Cluster B Personality Disorders in Iranian Females Wearing Thick Makeup: A case-control Study Aisan Ghaemian Oskouei a*, Salman Abdi b a Department of Psychology,school of social sciences, Brunel University, London, United Kingdom b Research Development & Coordination Center, Tabriz University of Medical Sciences, Tabriz, Iran Abstract The present study was aimed to determine the relationship between symptoms of Cluster B Personality Disorders (CBPD) and the thickness of facial makeup applied by female students. 336 unmarried girls were identified through some English learning institutions in Tabriz, Iran. The subjects were divided into two groups; Thick Makeup Wearers (TMW) and Normal Makeup Wearers (NMW). Our results demonstrated that subjects in the TMW group tended to be preoccupied with being beautiful more frequently (P<0.05). According to discriminant analysis, antisocial, borderline and histrionic personality disorders were positively common predictors of the TMW. The findings were discussed in cultural context. 2013 The Authors. Published by Elsevier Ltd. Open access under CC BY-NC-ND license. Selection 2013 Published and peer-review by Elsevier under Ltd. responsibility Selection and of peer Prof. review Dr. Huseyin under the Uzunboylu responsibility & Dr. of Mukaddes Dr. Melehat Demirok, Halat Near East University, Cyprus Keywords: Cluster B personality disorders, Makeup, cultural psychology 1. Introduction Attempts to achieve social influence are the most important features of socialized humans. Individuals who have proper social reputation are able to follow their goals more effectively (Aronson, 2008). Regarding the trait of society, in value, specific patterns of behavior have emerged. One of them is modification of the appearance of the body, such as using makeup or cosmetic surgery (Paul, 2011). Reports show that Iranian girls and women, after Saudi Arabians, are ranked the second largest consumers of cosmetics in the Middle East and the seventh in the world (Movahed, Ghafari nasab, & Hoseini, 2011). Also, Movahed & et al (2011) argued that since the starting age of using makeup is decreasing, and there is extremely high tendency toward it, the issue is worth exploring scientifically. (American Psychiatric Association, 2000). It can be argued that moderate makeup wearing is probably accepted as natural social behavior. However, thick makeup wearing, which is not acceptable within the social norms framework, could be considered as a personal or social abnormality. Personality is considered as a fundamental individual behavioral pattern and to some extent is predictable (Pervin, Cervone, & John, 2005). Therefore, personality might be related to or social influence (Soest, Kvalem, Skolleborg, & et al, 2009; Aronson, 2008). Corresponding author name: * Aisan. Ghaemian Oskouei. Tel: +44-7429350377 Email address: Aisan.Ghaemianoskouei@brunel.ac.uk 1877-0428 2013 The Authors. Published by Elsevier Ltd. Open access under CC BY-NC-ND license. Selection and peer-review under responsibility of Prof. Dr. Huseyin Uzunboylu & Dr. Mukaddes Demirok, Near East University, Cyprus doi: 10.1016/j.sbspro.2013.06.627
Aisan Ghaemian Oskouei and Salman Abdi / Procedia - Social and Behavioral Sciences 84 ( 2013 ) 686 690 687 Although there is a difference between seeking thick makeup and applying for cosmetic surgery, both of them share the same targets. In other words, applicants consider big changes to their appearance as the final goal. This orientation might come from their personality problems. In this regard, according to a previous report, when considering Diagnostic and statistical Manual for Mental Disorders, fourth edition, Text Revision (DSM-IV-TR) criteria, 70% and 19.5 % of applicants for cosmetic surgery had a mental disorder and personality disorder, respectively (Napleon, & Lewis, 1993). Another study claimed that obsessive-compulsive personality disorder had the highest and antisocial personality disorder had the lowest frequency among individuals seeking rhinoplasty (Zojaji, javanbakht, Ghanadiyan, & et al., 2007). Moreover, it was reported that the following disorders were more common among people seeking rhinoplasty: impulsive traits, competitive reactions, symptoms of anxiety and tension, and feeling of inferiority ( & et al., 2003). Also, another study referred to a low quality relationship between TMW However, according to other research, no differences in mental health indicators (depression, anxiety, social dysfunction, somatic symptoms) and self concept were found in cosmetic surgery applicants (Zahiroddin, Shafiee- Kandjani, Khalighi-Sigaroodi, 2008). Positive long-term impact of cosmetic interventions was also reported (Soest, Kvalem, Skolleborg, & et al., 2011). To date, surveys among individuals applying for cosmetic interventions were limited to applicants seeking cosmetic surgery. To the best of our knowledge, there is no study that investigates the relationship between facial makeup features and personality traits. The aim of this study was to determine the relationship between cluster B personality disorders and the tendency of girls to thick makeup. We were interested in comparing the prevalence of CBPD symptoms between TMW and NMW. subjects were selected among girls who either habitually wore thick makeup, or wore normal makeup, without any seeking medical cosmetic intervention. So, the necessity of investigating these people will help us to be familiar with their characters more specifically. 2. Method We carried out a cross-sectional and case-control study. Based on the multistage sampling method, subjects were randomly selected from female students studying English at foreign language institutions in Tabriz (North West of Iran), in 2011. The sample size was estimated using P-S Power and Sample size Software (version 3.0). According to our pilot study of 30 subjects, these parameters were: Power= 0.80; Mean difference between two groups = 2.56; Standard deviation within group = 7.12; and ratio of case to control (M) = 2. So, 112 subjects were selected as members of the case group and 224 subjects as the control group. The latter was matched with the former considering three characteristics of age, educational status, and same level of English skills. 2.1. Subjects and inclusion criteria All 336 subjects were divided into two groups: 112 TMW, and 224 NMW age of subjects were years old years old in the control group. All subjects were high school graduates or undergraduate students. The inclusion criteria for subjects were: giving consent to participate in the study; being unmarried (having no previous marriage); and being aged 20 to 30.We defined the TMW subjects as follows: 1. Scoring Desire for Makeup Q Spending More than two hours on applying for makeup before leaving home; 3. B by two close classmates. The NMW subjects were identified with these attributes: 1. Scoring re for Makeup Q Spending less than half an hour on applying for makeup before leaving home; 3. With evaluating with other classmate, she wears normal makeup. 2.2. Measures 2.2.1. Millon Clinical Multiaxial Inventory-III (MCMI-III) The third version of the MCMI which consists of 175 yes/no questions was given to the subjects. According to the DSM-IV TR (2000), this questionnaire is one of the most objective tools for evaluating the clinical syndromes in axis one and personality disorders in axis two. The MCMI-III covers 24 clinical scales which are classified into four
688 Aisan Ghaemian Oskouei and Salman Abdi / Procedia - Social and Behavioral Sciences 84 ( 2013 ) 686 690 categories: A) The eleven personality clinical scales: Schizoid, Avoidant, Depressive, Dependent, Histrionic, Narcissistic, Antisocial, Sadistic, Compulsive, Negativistic, Masochistic; B) Three severe personality pathology scales: Schizotypal, Borderline, Paranoid; C) Seven Clinical Syndrome Scales: Anxiety, Somatoform, Bipolar, Dysthymia, Alcohol Dependence, Drug Dependence, Posttraumatic Stress Disorder; D) Three Severe Clinical (American Psychiatric Association, 2000). In the present study, those scales measuring the personality disorders of cluster B were chosen. The Persian version of the MCMI-III is as valid and reliable as the original version. The diagnostic validity of the Persian version of the MCMI-III scales have been reported between 0.58 and 0.83 (Sharifi, Malawi, & Namdar, 2008). In the present study, internal reliability was assessed using Cronbach alpha coefficient between 0.79 and 0.94. M Questionnaire (GDMQ) This researcher-made questionnaire was designed to wear thick makeup, considering cultural and social criteria, and it consisted of seven items (see table 1). The scoring of the questionnaire was followed by the ordinal scoring model based on a five-point Likert scale ranging from strongly disagrees to strongly agree. Low scores indicate a lower tendency to thick makeup and high scores show a higher tendency to thick makeup. Before using the questionnaire, all design principles (construct validity and reliability) were considered. According to our pilot study, the internal reliability of the GDMQ was 0.83. In this study, GDMQ was used for the quantitative evaluation and classification of subjects in the groups. Table1.The items within the researcher-made GDMQ 1 Some of my friends have commented on my thick makeup 2 I really like to try newly launched cosmetics 3 4 Sometimes I wear thick makeup to look completely different 5 One of my priorities before leaving home is to put on makeup 6 I would like to wear makeup to look different from other girls 7 2.3. Procedure The following ethical issues were applied: all the subjects singed an informed consent form; the information was treated confidentially; there was no interference in the both case and control groups. The questionnaires were completed individually by the participants, followed by self reports. Participants in the study did not receive any gifts or money for their participation. 2.3. Data analysis All collected data were analyzed using SPSS software (version 17). The independent T-test was used to compare the symptoms of cluster B personality disorders of the TMW and NMW groups. To determine who should belong to which group, we used discriminant analysis. In order to find the relationship between thick makeup and tendency to look much prettier, 3. Results In response to the question of "How much do you want to have perfect beauty? 87 subjects (77.6 %) of the TMW reported that they were preoccupied with their appearance and desperately want to achieve unique beauty. In contrast, 150 subjects (66.9%) of NMW reported this tendency. Based on the Fisher exact test, there is a significant 2 = 0.55, df=1, P<0.05). The sum of the scores of related items in the CBPD was compared by independent T test in both groups. As seen in table 2, the mean of symptoms of cluster B personality disorders (Borderline, Antisocial, Narcissistic, and Histrionic) in the case group was more than the control group (P<0.01). To differentiate the mean scores of CBPD in the case and control groups, discriminant analysis with stepwise method was used. The results showed that the discriminating factors were as follows: antisocial in the first step;
Aisan Ghaemian Oskouei and Salman Abdi / Procedia - Social and Behavioral Sciences 84 ( 2013 ) 686 690 689 antisocial and borderline in the second step; and antisocial, borderline and histrionic in the third step. Regarding these three types of personality disorders, we were able to distinguish 69 TMW individuals (61.6%) from 112 in the case group, and 149 NMW individuals (66.5%) from 224 in the control group. In total, with 64.9% of the estimated profile, we could predict the TMW from NMW. Table2. Independent T-test results of cluster B personality profile in comparison between TMW and NMW TMW NMW MCMI-III scales T-value P-Value Histrionic 15.59 14.17 3.13 <0.01 Narcissistic 16.87 15.22 3.33 <0.01 Antisocial 9.90 7.79 5.02 <0.01 Borderline 9.98 7.77 3.88 <0.01 df=125; TMW = Thick Makeup Wearers ; NMW= Normal Makeup Wearers 4. Discussion The present study was carried out to determine the relationship between cluster B personality disorders and thick makeup wearing. The research findings showed that thick makeup wearers had a tendency to strive for perfect beauty and were preoccupied with their appearance. This finding underscores the fact that thick makeup wearers want to be uniquely beautiful. Further studies are needed to investigate this issue to answer this question: can such attempts to become beautiful, understand the concept of aesthetic or attempt to change their appearance be considered as mental status changes, rather than a simple desire to become beautiful? Although cosmetic interventions in many cases lead to satisfaction (Honigman, Phillips, & Castle, 2004), some people will never achieve their inner contentment about their appearance (Gorney, 2007; Gorney, 2010; Ilango & Nambi, 2011). The findings of this research showed that antisocial, borderline and histrionic personality disorders were the most significant predictors of thick makeup behaviour among girls, respectively. This outcome is in line with several studies emphasizing the presence of psychiatric deficiencies and personality disorders among individuals attempting cosmetic interventions (Honigman, & et al., 2004). A previous report indicates that anxiety, depression, body dysmorphic disorder and narcissistic personality disorder were the most common characteristic of applicants seeking cosmetic intervention (Shridharani, Magarakis, Mansor, & et al., 2010). is restricted to unmarried females. It is possible that married and unmarried females may differ in their attitudes toward makeup. Secondly, the sample was intentionally restricted to the Iranian girls. Therefore, the results were affected by the socio-cultural conditions: as a matter of fact, Iranian females have to wear the Hijab as an accepted social norm. Consequently, their behaviour toward alternating their appearance has been shifted to their face. This simple fact highlights the importance of wearing makeup in the Iranian culture. It could be argued that in a different culture (e.g. the western culture) in which there is no obligations in dressing, makeup would not be considered as the only way of seeking attention through appearance. The results of this paper underscore the importance of further studying Cluster B symptoms in other societies in terms of different social-cu their tendency to appearance satisfaction and social attention. Our findings are consistent with another study demonstrating that the concept of beauty and the methods people choose to alternate their appearance (e.g. cosmetic intervention) are strongly affected by culture (Sarwer, Grossbart, & Didie, 2003). Finally, studying makeup features. 4.1. Conflict of interest There is no conflict of interest. 4.2. Acknowledgement We are indebted to all subjects in this study for their cooperation.
690 Aisan Ghaemian Oskouei and Salman Abdi / Procedia - Social and Behavioral Sciences 84 ( 2013 ) 686 690 References American Psychiatric Association. (2000). Diagnostic and statistical Manual for Mental Disorders (4rd ed), Text Revision. Washington, DC: American Psychiatric Press. Aronson, E., (2008). The social animal. (10rd ed). New York: Worth publisher, (Chapter 1). Babuccu, O.,., Atabay, K., Oral, N., &. Aesthetic Plast Surg, 27, 1, 44-49. Gorney, M. (2007). Recognition of the patient unsuitable for aesthetic surgery. Aesthet Surg J, 27, 6, 62-69. Gorney, M. (2010). Recognition and management of the patient unsuitable for aesthetic surgery. Plast Reconstr Surg, 126, 6, 2268-2271. Honigman, R. J., Phillips, K. A., & Castle, D. J. (2004). A review of psychosocial outcomes for patients seeking cosmetic surgery. Plast Reconstr Surgery, 113, 4, 1229-1237. ILango,.N., & Nambi, M. C. (2011). Unsuitable patient selection in plastic surgery. Plast Reconstr Surg, 128, 3, 831. Javo, I.M., & Sorlie, T. (2010). Psychosocial predictors of an interest in cosmetic surgery among young Norwegian women: a population-based study. Plastic Surg Nurs, 30, 3, 180-186. Napleon, A., & lewis, C. (1993). Psychological considerations in lipoplasty: the problematic or special care patient. J Annual of Plastic Surgery, 23, 430-432. Movahed, M., Ghafarinasab, E., & Hosseini, M. (2011). Makeup and social life of young girls. Women in development & politics, 6, 79-105. (In Persian) Paul, M.D. (2011). An overview of cosmetic medicine and surgery: past, present, and future. Clin Plas Surg, 38, 3, 329-34. Pervin, L. A., Cervone, D., & John, O. P. (2005). Personality: Theory and Research (9th ed.). Hoboken, NJ: John Wiley & Sons. Sarwer, D., Grossbart, T., Didie, E. (2003). Beauty and society. Semin Cutan Med Surg, 22, 2, 79-92. Sharifi, A. A., Moulavi, H., & Namdari, K. (2008). The validity of MCMI-III (MILLON, 1994) Scales. Danesh va Pezheuhesh in Psychology, 9, 34, 27-38. (In Persian) Shridharani, S. M., Magarakis, M., Mansoun, P. N., & Rodriguez, E. D. (2010). Psychology of plastic and reconstructive surgery: a systematic clinical review. Plast Reconstr Surg, 126, 6, 2243-51. Soest, V. T., Kvalem, I. L., Skolleborg, K. C., & Roald, H.E. (2009). Cosmetic surgery and the relationship between appearance satisfaction and extraversion :Testing a transactional model of personality. J Res Pers, 43, 1017-1025 Soest,V.T., Kvalem, I.L., Skolleborg, K.C., & Roald, H.E. (2011).Psychosocial changes after cosmetic surgery: a 5-year follow-up study. Plast Reconstr Surg, 128, 3, 765-72. Zahiroddin, A. R., Shafiee-Kandjani, A. R., & Khalighi-Sigaroodi, E. (2008). Do mental health and self-concept associate with rhinoplasty requests?. J Plast Reconstr Aesthet Surg, 61, 9, 1100-3. Zojaji, R., Javanbakht, M., Ghanadan, A., Hosien, H., & Sadeghi, H. (2007). High prevalence of personality abnormalities in patients seeking rhinoplasty. Otolaryngol Head Neck Surgy, 137, 1, 83-7