Self- and social perception of physical appearance in chest wall deformity

► Self- vs. social perception of appearance in patients with chest wall deformity. ► No agreement in rating of appearance between patients and objective raters. ► Patients rate own physical appearance more negatively than adult raters. ► Patients rate own physical appearance slightly different than adolescent raters. ► CWD characteristics related to adolescent raters’ rating, not to self-rating. This study analyzes self- and social perception of physical appearance in patients with chest wall deformity (CWD), including both pectus carinatum and pectus excavatum. Self-perception of appearance in 76 patients with CWD and social perception of patients’ appearance by 20 adult and 20 adolescent raters was assessed using the Appearance Rating Scale (Stangier et al., 2000) and evaluated for agreement and multivariate correlates. Results indicate no agreement between self- and social rating. Based on mean scores patients rated their appearance significantly more negatively than adult raters but only slightly different than adolescent raters. Adolescent raters’ judgment of the patients’ appearance was related to CWD characteristics, while self-rating rather seems to be related to psychosocial factors. Because adolescents are a relevant peer group for adolescent patients with CWD their evaluation of the appearance might influence patients’ self-image and might affect their psychological functioning. Effective interventions focusing on social interactions are needed.