Mekeres’ Psychosocial Internalization Scale: A Scale for the Evaluation of Aesthetic Prejudice in Victims of Accidents and Violence

Abstract

Background and objectives: One important forensic activity is the assessment of aesthetic injuries where expert criteria and analysis are insufficiently outlined due to the subjective elements related to the traumatized victim. Unaesthetic morphological changes may occur due to various circumstances committed under the Penal Code, resulting in permanent unaesthetic morphological scarring. Considering that most of the existing scales for the assessment of aesthetic prejudices refer only to morphometric changes, our aim was to create a modern method for the evaluation of aesthetic damage that also considers its social and psychological consequences. Materials and Methods: In this study, we developed the Mekereș Psychosocial Internalization Scale (MPIS), which proposes a clear boundary between the presence or absence of aesthetic damage. The traumatized person is evaluated after a minimum of six months (in the case of an average scar, necessary for defining the character of the scar) to assess changes in the physiognomy or even alterations in the victim’s aesthetic perception of their own body. Our study was conducted on 103 patients with scars, and the results were compared to 101 controls (subjects without scars). Results: Individuals with scars have a distorted perception (compared to controls) of the support provided by significant people [t (202) = 2.473; p = 0.01]. Hypothetically, they will most likely exhibit a nuanced socio-cognitive and psycho-emotional vulnerability that may be the source of future dysfunctions. The fidelity of the MPIS scale was estimated by employing Cronbach’s alpha coefficient, resulting in a value of 0.934 (15 items). The exploratory factorial analysis with Varimax rotation mode sustains a single dominant factor, indicating a good internal consistency. The results of this study provide evidence regarding the psychosocial or psychometric worthiness of MPIS. Conclusions: MPIS can be used for research and as an instrument to assess aesthetic damage or disfigurement by forensic physicians and lawyers.

The practical utility of psychometric scales for the assessment of the impact of posttraumatic scars on mental health

“…Mekeres’ Psychosocial Internalization Scale (MPIS) takes into account the awareness of the presence of the scar, the sex of the victim, the morphological characteristics of the scar, the negative influence of social interaction and the impact on the professional development of the patient, etc. ( 3 , 6 ).…”

“…Scars can constitute distinctive signs that can give useful information for identifying people because they remain strongly fixed in the memory of relatives or those close to them; the way of production (mechanical, physical, chemical, therapeutic agents, etc. ), the time elapsed since the occurrence of the event, and their severity can determine psycho-emotional consequences (anxiety, depression), medico-legal (aesthetic prejudice), legal (criminal) and socio-economic (divorce, job loss) ( 6 ).…”

Objective Criteria in Evaluating the Consequences of The Posttraumatic Scars

“…The rating of the MPIS scale represents the sum in a total score between 15 and 75 points. The main objective of the scale is to quantify and objectify the psychosocial impact of scars and interpret the results so that the forensic pathologist or lawyers can use it to determine whether or not the patient has cosmetic damage [44].…”

Epidemiological Study on Spinal Cord Injuries in a Hospital from North-West of Romania

“…Among the general population, the perceived impact of spinal cord injuries that people have is often limited to the visible effects of impaired mobility [1][2][3]. Less appreciated by the general population is the impact that spinal cord injuries have on pelvic function, resulting in bowel, bladder, and sexual dysfunction [4][5][6].…”