جراحی زیبایی و رابطه بین رضایت ظاهر و برونگرایی: تست یک مدل معاملاتی شخصیتی

Few studies have tested potential explanatory mechanisms for the high stability of extraversion. In this study, the relationship between extraversion, appearance evaluation, and cosmetic surgery was investigated to examine such mechanisms. The “Big Five” personality traits were assessed in 155 female cosmetic surgery patients prior to and 6 months after surgery, as well as from a representative sample of 907 women. Patients showed higher extraversion scores prior to surgery than were found in the representative sample; further, extraversion scores increased after surgery, while the increase diminished when controlled for appearance evaluation. The results are in accordance with a transactional model, whereby extraverts engage in actions that reinforce extravert tendencies, which may account for the high stability of extraversion.

After decades of research on personality traits, a general taxonomy of broad personality dimensions called the “Big Five” has become increasingly popular. One important finding concerning these five personality traits is their high stability over time (Roberts & DelVecchio, 2000), with extraversion being the most stable of the five (Vaidya, Gray, Haig, & Watson, 2002). Even though several studies have been conducted investigating the stability of extraversion and the other four broad personality traits, little research has been undertaken to examine just how this high stability can be explained. In this paper, mechanisms that might account for the stability of extraversion are therefore investigated by studying the mutually reinforcing relationship between extraversion and evaluation of own appearance, as well as subsequent behaviors engaged to enhance appearance. More specifically, we examine whether extraversion influences the decision to undergo cosmetic surgery at the same time as cosmetic surgery’s impact on extraversion is in turn explored. In order to contrast the extraversion findings with results from the other personality traits, analyses on the remaining Big Five personality traits were also conducted. Core features of extraversion are the tendency to frequently experience positive moods, sensitivity to potential positive rewards, and the tendency to evoke and enjoy social attention (Ashton et al., 2002, Caspi et al., 2005 and Lucas et al., 2000). A review has shown that the rank-order stability of extraversion and other personality traits in adulthood is considerable, reaching a peak test–retest consistency at about the age of 50, whereas consistency is somewhat lower in early adulthood (Roberts and Caspi, 2003 and Roberts and DelVecchio, 2000). Further, the rank-order stability has been shown to be especially high for extraversion as compared to the other personality traits (Conley, 1984 and Vaidya et al., 2002). The relative high stability of extraversion that has been observed raises the question of how this stability can be explained. According to Costa and McCrae (1994), the most prominent proponents of a trait model of personality, personality is “set like plaster”. The relative stability of personality traits is explained by their genetic pre-determination, thereby leaving limited room for the influence of environmental factors in adulthood (McCrae and Costa, 1999 and McCrae et al., 2000). Thus, from the trait model perspective, the high stability of extraversion in adulthood can be understood by a considerable biological component determining basic personality traits. Contextual perspectives on personality, on the other hand, propose that personality traits are mainly shaped by environmental contingencies often connected to social roles (for a discussion of this perspective, see Roberts & Caspi, 2003). In this case, stability in extraversion would be due to consistency of social environment. There is however little research that can confirm the explanatory power of this perspective in accounting for personality stability (Roberts and Caspi, 2003 and Srivastava et al., 2003). The relatively narrow perspective of both these models, with their one determining focus on personality, may render them insufficient for understanding development and change in personality. Instead, approaches have been suggested whereby both environmental influences and the relatively stable characteristics of personality are recognized. One such perspective involves focusing on transactions between individuals’ personalities and their experiences; from this view, individuals can be seen as active agents who play an important role in selecting and shaping their environment, an environment that in turn affects their personality. These transactions often serve to amplify or strengthen earlier dispositions and thereby contribute to the remarkable stability of personality traits. More specifically, predispositions – manifested as personality traits – lead to engagement in specific behavior that in turn strengthens the same trait (Caspi and Moffitt, 1993 and Srivastava et al., 2003). One personality study showing just such an example of transactional mechanisms is the longitudinal research conducted on women who were followed-up through the 1960s to the 1980s with respect to their involvement in the women’s movement. Personality traits such as openness and ambition were shown to predict involvement in the women’s movement, which in turn led to subsequent increases in these same traits (Agronick & Duncan, 1998). The study demonstrates that personality stability may be explained by the fact that individuals scoring high on a specific personality trait perform specific actions that in turn maintain or increase their high score on this trait. If, given the implications of the above research, transactional mechanisms can be considered potent in explaining stability in extraversion, it should be expected that extraverts seek situations that serve to reinforce this disposition. However, rather sparse research has been conducted to shed light on transactional mechanisms to account for the stability of extraversion; data in this respect have been primarily provided by research showing that extraverts are more prone to be involved in contexts where social skills are required. Compared to introverts, extraverts are for example more likely to seek social recreational situations (Diener, Larsen, & Emmons, 1984). Furthermore, they prefer jobs that are described as social or enterprising, such as teaching or business management (Ackerman & Heggestad, 1997), have an increased likelihood to assume leadership roles in various settings (Anderson, John, Keltner, & Kring, 2001), and they enjoy higher social status (Anderson et al., 2001). However, though the relationship between extraversion and social involvement seems to be well established in the literature, the relationship may only be moderate in strength (Lucas, Le, & Dyrenforth, 2008). The positive feedback extraverts generally receive when acting in such social situations may in turn motivate them to seek out similar social situations in the future, which may again serve to reinforce their extravert trait. Stability in extraversion might thus be partly explained by the mutually reinforcing relationship between extraversion and encounters with social settings. Few studies thus far, however, have directly tested such transactional mechanisms. In this paper, just such transactional mechanisms are investigated by examining how appearance satisfaction and behavior to improve appearance are related to extraversion. Satisfaction with own appearance can impact social interactions, as shown by studies indicating that appearance satisfaction is related to greater intimacy, and less discomfort and concerns about approval and acceptance in social interactions (Cash et al., 2004 and Nezlek, 1999). Feeling unattractive may as such have a negative impact on social interactions. Since extraverted persons more often encounter and enjoy social interaction, it stands to reason that it be more important for them to perceive their own appearance as attractive, such that they do not feel restrained by it in social settings. It would therefore be expected that extraverts be more prone to engage in actions that increase satisfaction with own appearance. Were such behavior exercised, the transactional perspective would further predict increased extraversion as a result, since increased appearance satisfaction would lead to greater possibilities to encounter and enjoy social situations. Such a selection of extraverts into behavior that increases their mean level of extraversion is a possible explanation for the high rank-order stability of extraversion in the population at large. In other words, persons high on extraversion would maintain a high level compared to more introverted persons who would not engage actions leading to increased extraversion. In this way, individuals would maintain their relative level of extraversion over time, thereby leading to high rank-order stability. The following hypotheses concerning the relationship between appearance satisfaction and extraversion are thus proposed in accordance with the transactional perspective: (i) there is a cross-sectional relationship between appearance satisfaction and extraversion; (ii) extraverted persons are more prone to undertake actions to increase appearance satisfaction; and (iii) increased appearance satisfaction will in turn lead to an increase in extraversion. To examine these hypotheses, data from a sample of cosmetic surgery patients is analyzed. As cosmetic surgery is typically conducted to enhance the patient’s appearance, it is well-suited to investigating the relationship between changes in appearance and extraversion. Research has also shown that cosmetic surgery indeed improves satisfaction with own appearance, at least shortly after the operation, such that it can be seen as an effective means to manipulate self-evaluated attractiveness (Honigman et al., 2004 and von Soest et al., in press). It has also been shown that patients are less satisfied with own appearance before surgery compared to a normative sample (von Soest, Kvalem, Skolleborg, & Roald, 2006). Thus, cosmetic surgery patients seem indeed to be motivated to enhance own appearance and surgery has been seen to have the desired effect. In the following we will review evidence concerning the three hypotheses with a special emphasis on cosmetic surgery research. First, concerning a possible cross-sectional relationship between appearance satisfaction and extraversion (i), self-evaluated attractiveness has been shown to be most strongly correlated to extraversion in both adolescents and adults compared with the other Big Five dimensions; only neuroticism is about as strongly related to appearance evaluation as extraversion (see for instance, Kvalem et al., 2006 and Simis et al., 2001). A meta-analysis also gives indication that people who are social and dominant – traits related to extraversion – are more satisfied with own appearance than less social and dominant people are (Feingold, 1992). We therefore expect to find a cross-sectional relationship between appearance satisfaction and extraversion in the present study as well. Second, few studies to date have examined whether extraversion leads to behavior to increase satisfaction with own appearance (ii). However, initial evidence for such a mechanism has been provided in a study by Kyl-Heku and Buss (1996), where extraverts reported engaging in more appearance-enhancing activities, such as attempts to change hairstyle or style of dress, as a deliberate tactic to improve their status than introverts. Such strategies may result in greater satisfaction with one’s own appearance in extraverts compared to introverts; in relation to cosmetic surgery, it would be expected that extraverted people be more prone to undergo cosmetic operations than introverts as one such strategy to better harmonize appearance with behavior in social settings. Two studies have examined differences in extraversion scores or related concepts as dominance and sociability between cosmetic surgery patients and control groups (Shipley et al., 1977 and Thomas and Goldberg, 1995), with no differences found between groups in either study. However, both studies had small surgery samples (N < 30), thereby reducing the statistical power of the analyses. The control groups further consisted of a convenience sample, compromising as such the representativeness of the group. Third, a potential temporal relationship between increasing appearance satisfaction and extraversion has to be investigated (iii). For instance, people with high satisfaction with one’s own appearance may be more comfortable in social settings, again leading to more outgoing and extraverted behavior. Moreover, attractive people may be more encouraged in social settings to engage in such behavior compared to less attractive people, as underscored by Feingold’s (1992) finding that attractive people are perceived as more sociable, more dominant and more socially skilled than less attractive people. With respect to cosmetic surgery, it would be expected that extraversion scores increase after cosmetic surgery; it would further be expected that this increase disappear when taking into account the rise in appearance satisfaction after surgery. Studies so far have obtained mixed findings concerning changes in extraversion after such operations: one study found short-term increases in extraversion after cosmetic nose surgery (Ercolani et al., 1999a and Ercolani et al., 1999b), whereas another did not find differences in dominance and sociability after cosmetic breast surgery (Shipley, O’Donnel, & Bader, 1978). Here, too, the studies showed methodological flaws, including small sample size and surgery samples where both patients undergoing cosmetic surgery and medically indicated operations were included. Moreover, measures of appearance satisfaction were not included in any of these studies, thereby further limiting their validity regarding the relationship between appearance satisfaction and personality. Thus, there remains little reliable information on the relationship between extraversion and cosmetic surgery as regards the three hypotheses posited. The transactional perspective on personality would predict all three hypotheses be confirmed, thereby indicating that extraversion and appearance evaluation mutually influence each other. When investigating the relationship between cosmetic surgery and extraversion, it has to be examined whether the relationship found is specific to extraversion or if it can also be applied to other personality traits. Neuroticism is the most obvious other candidate to be influenced by cosmetic surgery. On the one hand, neuroticism may increase the likelihood to undergo cosmetic surgery since neuroticism is positively related to appearance dissatisfaction (Kvalem et al., 2006 and Simis et al., 2001), which in turn predicts the decision to undergo cosmetic surgery (von Soest et al., 2006). On the other hand, neuroticism has been shown to be positively related to passive coping styles as seen in disengagement strategies, whereas active coping styles such as problem-solving were shown to be less common in neurotics compared to emotionally stable persons (Connor-Smith & Flachsbart, 2007). Those with high scores on neuroticism may therefore be less inclined to undergo cosmetic surgery compared to more emotionally stable persons, as the decision may imply an active coping strategy. Different potential mechanisms may, then, result in opposing predictions concerning how neuroticism and cosmetic surgery are related to each other. To our knowledge, only one study has investigated whether neuroticism predicted the decision to undergo cosmetic surgery, and showed that cosmetic nose surgery patients reported higher pre-operative neuroticism scores than nose surgery patients who underwent the operation for medical reasons (Ercolani et al., 1999b). It was further shown that neuroticism scores decreased after surgery (Ercolani et al., 1999a). This research is however limited, since only cosmetic nose surgery patients were included when investigating changes after cosmetic surgery. How such surgery will influence neuroticism remains an open question, though we do not expect that neuroticism will be seen to influence cosmetic surgery in the same transactional manner as extraversion does. No study to date, meanwhile, has investigated the relationship between cosmetic surgery and the remaining three personality traits – openness, conscientiousness, and agreeableness. Research has furthermore shown small or non-significant correlations between these personality traits and appearance satisfaction (Kvalem et al., 2006 and Simis et al., 2001). We therefore do not expect that these traits will influence the decision to undergo cosmetic surgery or that they will be changed after a cosmetic operation. In sum, studying cosmetic surgery offers as such a possibility to disentangle the temporal order of the relationship between appearance evaluation and personality in general, and extraversion in specific. The three hypotheses for the relationship between attractiveness and extraversion presented above are investigated in this paper. In addition to extraversion, we conduct analyses on the other Big Five personality traits to acquire a comprehensive overview of how cosmetic surgery and all of the Big Five personality traits are related. We hypothesize that the other personality traits are not related to cosmetic surgery, which would confirm a potential specific relationship between extraversion and cosmetic surgery.