Skip to main content

Research Repository

Advanced Search

Exploring and measuring the perceived impact of visible difference upon romantic relationships

Sharratt, Nicholas D

Exploring and measuring the perceived impact of visible difference upon romantic relationships Thumbnail



Appearance altering or disfiguring conditions can lead to a variety of ‘visible differences.’ The presence of a visible difference may impact negatively upon an individual’s well-being and be associated with psychosocial difficulties, including social anxiety, anxiety, depression, reduced quality of life, unfavourable self-perceptions, and challenging interpersonal interactions. One domain that may be impacted is that of visible difference, appearance concern, and intimate, romantic relationships. This topic has, however, received relatively little attention in the literature.

This thesis aimed to address this gap in the literature. This was done via the adoption of a pragmatic, mixed-methods approach, and the execution of three empirical research studies. First, a qualitative exploration was undertaken, involving semi-structured interviews with 22 participants with a variety of visible differences. Three intimacy-specific themes were generated through thematic analysis. These revealed a multitude of impacts, understandings, and experiences connected to this topic. As no measure of these existed, the themes were utilised in the development of draft items in order to create a research scale (named ‘CARRIS’) measuring appearance distress within a romantic context. Data were collected from participants with visible difference and a final sample of n=253 contributed to the second study, an exploratory factor analysis. This helped refine the scale into a parsimonious, three-factor, form, begin the validation process, and indicated some between-group differences. The final study involved the administration of the refined scale and the collection of fresh data from a final sample of n=144 participants in order to confirm the structure of the scale via confirmatory factor analysis. CARRIS’ four-week test-retest reliability (n=49) was also assessed.

This thesis explored visible difference and intimate and romantic life. It indicated this as an important component of participants’ experiences of and adjustment to visible difference. It generated, evaluated, and began the validation of a new measure of appearance distress within a romantic context, and introduced the theoretical and clinical implications of such work.


Sharratt, N. D. Exploring and measuring the perceived impact of visible difference upon romantic relationships. (Thesis). University of the West of England. Retrieved from

Thesis Type Thesis
Publicly Available Date Jan 20, 2021
Keywords visible difference, romantic relationships, intimacy, psychology, thematic analysis, factor analysis, appearance, disfigurement,
Public URL
Additional Information Additional Information : not yet examined, please hold in restricted access


You might also like

Downloadable Citations