Acceptance of psoriasis in the context of body image, body experience, and social support
More details
Hide details
Department of Psychology, Adam Mickiewicz University, Poznan, Poland
Department of Geriatric Medicine and Gerontology, Poznan University of Medical Sciences, Poznan, Poland
Department of Dermatology, Poznan University of Medical Sciences, Poznan, Poland
Submission date: 2016-07-03
Acceptance date: 2016-09-09
Online publication date: 2017-01-31
Publication date: 2017-01-30
Health Psychology Report 2017;5(3):251–257
Acceptance of disease is an important determinant of quality of life in psoriasis patients. Social support and positive body image are considered important contributors to coping with the disease, but no studies have yet examined the role of body image and body experience in relation to psychological adjustment to psoriasis. We aimed to identify the role of biopsychosocial aspects – medical characteristics, body image, body experience, and social support – in acceptance of psoriasis.

Participants and procedure
The Berlin Social Support Scale, the Acceptance of Illness Scale, and the Body-Self Questionnaire (BSQ) were administered to 109 patients. Disease severity was measured with the Psoriasis Area and Severity Index (PASI).

None of the investigated medical aspects were related to disease acceptance. Disease acceptance was associated with perceived social support (instrumental, informational, and emotional) and the following aspects of body experience and body image: lack of disturbances in perceiving, interpretation and regulation of emotions and physiological needs, appearance satisfaction, acceptance of biological sex, and fitness satisfaction. The acceptance of appearance and biological sex and social support were the best predictors, explaining 33% of the variance in disease acceptance (R2 = .33, F = 18.93).

Disease acceptance is independent of medical disease parameters, which demonstrates the limitations of the biomedical model in explaining the process of coping with psoriasis. Our findings demonstrate the buffering effect of social support, positive body image, and body experience against the negative consequences of psoriasis. Psychological intervention focused on body image and body experience enhancement can support psychological adjustment to disease.
Adamska, M., & Mniszewska, J. (2016). Determinants of acceptance of an illness in the case of patients suffering from psoriasis treated in the hospital and outpatient clinic settings. Health Psychology Report, 4, 54–64.
Basińska, M. A., & Kasprzak, A. (2012). Związek między strategiami radzenia sobie ze stresem a akceptacją choroby w grupie osób chorych na łuszczycę [The relationship between strategies of coping with stress and acceptance of illness among patients with psoriasis]. Przegląd Dermatologiczny, 99, 692–700.
Bewley, A., Burrage, D. M., Ersser, S. J., Hansen, M., & Ward, C. (2014). Identifying individual psychosocial and adherence support needs in patients with psoriasis: a multinational two-stage qualitative and quantitative study. Journal of the European Academy of Dermatology and Venereology, 28, 763–770.
Blashill, A. J., & Wilhelm, S. (2014). Body image distortions, weight, and depression in adolescent boys: longitudinal trajectories into adulthood. Psychology of Men & Masculinity, 15, 445–451.
Cash, T. F., & Deagle, E. A. (1997). The nature and extent of body‐image disturbances in anorexia nervosa and bulimia nervosa: A meta‐analysis. International Journal of Eating Disorders, 2, 107–126.
Felton, B. J., Revenson, T. A., & Hinrichsen, G. A. (1984). Stress and coping in the explanation of psychological adjustment among chronically ill adults. Western Journal of Nursing Research Western, 14, 211–224.
Fortune, D. G., Richards, H. L., Griffiths, C. E., & Main, C. J. (2002). Psychological stress, distress and disability in patients with psoriasis: consensus and variation in the contribution of illness perceptions, coping and alexithymia. British Journal of Clinical Psychology, 41, 157–174.
Fuere, S., Adjadj, L., & Pawin, H. (2005). How patients experience psoriasis: results from European survey. Journal of the European Academy of Dermatology and Venereology, 19, 2–6.
Gupta, M. A., & Gupta, A. K. (1995). The Psoriasis Life Stress Inventory: a preliminary index of psoriasis – related stress. Acta Dermato-Venereologica, 75, 240–243.
Gupta, M. A., Gupta, A. K., & Haberman, H. F. (1987). Psoriasis and psychiatry: an update. General Hospital Psychiatry, 9, 157–166.
Hayes, J., & Ko, J. (2010). Psoriasis: depression, anxiety, smoking and drinking habits. Dermatology and Therapy, 23, 174–188.
Janowski, K., Steuden, S., Pietrzak, A., Krasowska, D., Kaczmarek, Ł., Gradus, I., & Chodorowska, G. (2012). Social support and adaptation to disease in men and women with psoriasis. Archives of Dermatological Research, 304, 421–432.
Juczyński, Z. (2009). Narzędzia pomiaru w promocji i psychologii zdrowia [Measurment tools in promotion and psychology of health]. Warszawa: Pracownia Testów Psychologicznych Polskiego Towarzystwa Psychologicznego.
Khoury, L. R., Danielsen, P., & Skiveren, J. (2012). Body image altered by psoriasis. A study based on individual interviews and a model for body image. Journal of Dermatological Treatment, 25, 2–7.
Kubiak, A., & Sakson-Obada, O. (2016). Repetitive self-injury and the body self. Psychiatria Polska, 50, 43–54.
Kurd, S. K., & Gelfand, J. M. (2009). The prevalence of previously diagnosed and undiagnosed psoriasis in US adults: results from NHANES 2003-2004. Journal of the American Academy of Dermatology, 60, 218–224.
Leichtman, S. R., Burnett, J. W., & Robinson, H. M. (1981). Body image concerns of psoriasis patients as reflected in human figure drawings. Journal of Personality Assessment, 45, 478–484.
Leventhal, H., Benyamini, Y., Brownlee, S., Diefenbach, M., Leventhal, E. A., Patrick-Miller, L., & Robitaille, C. (1997). Illness representation: Theoretical foundation. In K. Petrie & J. A. Weinman (eds.), Perception of Health and Illness (pp. 19–46). London: Harwood Academic Publisher.
Łuszczyńska, A., Kowalska, M., Mazurkiewicz, M., & Schwarzer, R. (2006). Berlińskie Skale Wsparcia Społecznego (BSSS). Wyniki wstępnych badań nad adaptacją skal i ich własnościami psychometrycznymi [Berlin Social Support Scales (BSSS): Polish version of BSSS and preliminary results on its psychometric properties]. Studia Psychologiczne, 44, 17–27.
Molina-Leyva, A., Jiménez-Moleón, J. J., Naranjo-Sintes, R., & Ruiz-Carrascosa, J. C. (2015). Sexual dysfunction in psoriasis: a systematic review. Journal of the European Academy of Dermatology and Venereology, 29, 649–655.
Richards, H. L., Fortune, D. G., Griffith, E. M., & Main, C. J. (2001). The contribution of perception of stigmatization to disability in patients with psoriasis. Journal of Psychiatric Research, 50, 11–15.
Sakson-Obada, O. (2009). Pamięć ciała. Ja cielesne w przywiązaniu i traumie [Memory of the body. Body Self in trauma and attachment]. Warszawa: Difin.
Sakson-Obada, O., & Wycisk, J. (2015). The body self and the frequency, intensity and acceptance of menopausal symptoms. Przegląd Menopauzalny, 14, 82–89.
Schiøtz, M. L., Bøgelund, M., Almdal, T., Jansen, B. B., & Willaing, I. (2012). Social support and self-management behaviour among patients with Type 2 diabetes. Diabetic Medicine, 29, 654–661.
Schmitt, J., & Wozel, G. (2005). The Psoriasis Area and Severity Index is the adequate criterion to define severity in chronic plaque-type psoriasis. Dermatology, 210, 194–199.
Schulz, U., & Schwarzer, R. (2003). Soziale Unterstützung bei der Krankheitsbewältigung. Die Berliner Social Support Skalen (BSSS) [Social support in coping with illness: The Berlin Social Support Scales (BSSS)]. Diagnostica, 49, 73–82.
Teo, I., Novy, D. M., Chang, D. W., Cox, M. G., & Fingeret, M. C. (2015). Examining pain, body image, and depressive symptoms in patients with lymphedema secondary to breast cancer. Psychooncology, 24, 1377–1383.
Vardy, D., Besser, A., Amir, M., Biton, A., & Buskila D. (2002). Experiences of stigmatization play a role in mediating the impact of disease severity on quality of life in psoriasis patients. British Journal of Dermatology, 147, 736–742.
Wojtyna, E., Łakuta, P., Marcinkiewicz, K., Bergier-Czop, B., & Brzezińska-Wcisło, L. (2017). Gender, body image and social support: Biopsychosocial determinants of depression among patients with psoriasis. Acta Dermato-Venereologica, 96, 91–97.
Zalewska, A., Miniszewska, J., Chodkiewicz, J., & Narbutt, J. (2007). Acceptance of chronic illness in psoriasis vulgaris patients. Journal of the European Academy of Dermatology and Venereology, 21, 235–242.
Zade, T. T., Mahmoodi, M., & Hashemi, L. (2015). Study of the effectiveness of exercise on the self-esteem, happiness, and quality of life. Trends in Life Science, 4, 123–129.