Coping with disability and the surgical experience: body image of scoliotic female adolescents

Twenty-five adolescent girls undergoing surgery for correction of idiopathic scoliosis (curvature of the spine) were administered the Rorschach Ink Blot Test preoperatively, and the House-Tree-Person Test preoperatively, postoperatively, and at one year follow-up. In the figure drawing test younger girls scored significantly higher than older girls in both the preoperative and postoperative periods. The older adolescent's sensitivity of issues of physical attractiveness and bodily functioning increased her painful awareness of the deformity. With other measures, girls who denied their deformity significantly differed from nondenyers in their ability to cope with the stress of surgery; they had greater feelings of vulnerability and perception of the self as the object of an aggressive attack. Such denying, highly anxious patients need greater psychologic preparation prior to surgery. The limited motility of the postoperative scoliotic patient distorts body image perception and promotes feelings of passivity and helplessness.