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Stress and Skin Disease Quality of Life: The Moderating Role of Anxiety Sensitivity Social Concerns
Laura J. Dixon1,2, Sara M. Witcraft1, Nancye K. McCowan2, & Robert T. Brodell2 1University of Mississippi, University, MS, United States; 2 Department of Dermatology, University of Mississippi Medical Center, Jackson, MS, United States British Journal of Dermatology. DOI: /bjd.16082
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Introduction What’s already known?
Psychological stress plays an important role in many skin diseases. Quality of life (QOL) is an important indicator of skin disease severity and patient well-being, and poor quality of life is associated with numerous adverse outcomes. Little is known about psychological risk factors that impact the association between stress and skin disease quality of life.
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Skin Disease & Anxiety Sensitivity
AS social concerns = fear of the social consequences that may result from observable anxiety symptoms1 Associated with psycho-dermatological disorders2 May amplify stress and skin disease symptoms 1Taylor et al., 2007; 2Dixon et al., 2016
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Aims of the Current Study
Examine associations between stress, AS social concerns, and QOL Test AS social concerns as a moderator of stress and each QOL domain Physical Symptoms Psychological/Emotional Overall impairment and interference AS SOCIAL STRESS SKIN QOL
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Methods Sample screened and recruited online from Amazon’s Mechanical Turk N = 237 U.S. adults with active skin disease Mage = years (SD = 9.57) 68% Female Self-Report Questionnaires Demographic and dermatology characteristics Anxiety Sensitivity Index-3 Social Concerns subscale Skindex-16
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Sample Characteristics: Skin Disease
Active dermatology condition M = 3.04 (SD = 1.81) Range = 1-12 Mode = 1.00 Most common conditions: acne, eczema, hives/rash, dermatitis, psoriasis, skin growth, rosacea, other 53.1% of participants saw a medical provider in the past year 62.9% of participants received treatment within past year Prescription topical treatment Over the counter oral/topical treatment Prescription oral medication Procedure, such as cortisone shots, removal of growth
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Results: Correlations
1. 2. 3. 4. 5. 1. Symptom Severity 2. Stress .11 3. AS Social .12 .52** 4. Physical QOL .46** .24** .31** 5. Psychological QOL .45** .23** .19* 6. Functioning QOL .41** .34** .70** .38** * p < .01, ** p < .001
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Results: Physical QOL Interaction was not significant (p = .966)
R2 = .00; F (1, 232) = .002
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Results: Psychological QOL
Full model accounted for 29% of the variance F (4, 232) = 23.83, p < .001 Interaction significant (p = .043) R2 = .013, F (1, 232) = 4.15 Johnson-Neyman Analysis ASI-3 Social Concerns > 16.36 24.05% of the moderator values fell within the region of significance
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Results: Functioning QOL
Full model accounted for 29% of the variance F (4, 232) = 24.10, p < .001 Interaction significant (p = .010) R2 = .021, F (1, 232) = 6.79 Johnson-Neyman Analysis ASI-3 Social Concerns > 11.78 48.10% of the moderator values fell within the significance region M = SD = 6.14
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Discussion What does this study add?
This study examines how stress and AS social concerns influence quality of life among individuals with skin disease. Stress was associated with psychological and functioning quality of life domains among individuals with high levels of AS social concerns. These results contribute to understanding the relationship of psychological risk factors and skin disease. In addition, potential targets for psychological interventions for dermatology patients are identified.
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