measuringadjutochronicskindiso

measuringadjutochronicskindiso - Psychological Assessment...

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Measuring Adjustment to Chronic Skin Disorders: Validation of a Self-Report Measure Ulrich Stangier University of Frankfurt Anke Ehlers Institute of Psychiatry Uwe Gieler University of Gießen This article describes the development of a questionnaire that assesses problems in adapting to chronic skin disorders, the Adjustment to Chronic Skin Diseases Questionnaire. Patients ( N 5 442) with different skin disorders completed the original item pool. Principal-components analysis suggested a 6-factor solution that was largely replicated with 2 additional samples of 192 patients with psoriasis or atopic dermatitis and 165 patients with atopic dermatitis. Four of the subscales showed very good internal consistencies, retest reliabilities, and sufficient correlations with expert ratings: Social Anxiety/Avoid- ance, Itch–Scratch Cycle, Helplessness, and Anxious–Depressive Mood. Two short additional subscales, Impact on Quality of Life and Deficit in Active Coping, showed moderate internal consistencies, but good retest reliabilities. Correlations of the subscales with measures of depression, anxiety, and coping, and meaningful differences between dermatological subgroups support their construct validity. A treatment study showed that changes in some of the subscales correlated with changes in the severity of the skin condition. Although skin disorders are rarely life threatening, they are often associated with serious emotional distress (for a review, see Stangier & Ehlers, 2000). In a study by Hughes, Barraclough, Hamblin, and White (1983), 30% of 196 dermatological outpa- tients and 60% of 40 dermatological inpatients reported impaired mental health. About 20% of the total sample displayed psycho- logical symptoms severe enough to be categorized as an adjust- ment disorder. Similarly, Wessley and Lewis (1989) reported that 30% of 173 dermatological outpatients showed clinically relevant psychiatric symptoms, indicating a high impact of the skin disease. In two recent studies, similar rates of psychiatric comorbidity of 33.4% and 25.2%, respectively, were observed in dermatological outpatient samples (Aktan, Ozmen, & Sanli, 1998; Picardi, Abeni, Melchi, Puddu, & Pasquini, 2000). Rapp, Feldman, Exum, Flei- scher, and Reboussin (1999) found that the health-related quality of life of psoriasis patients was comparable to that of patients with other chronic health conditions, including cancer, arthritis, hyper- tension, heart disease, diabetes, and depression. There is a growing body of research on psychological treatment of skin disorders. However, assessment instruments that measure the specific problems in the patient’s adjustment to these disorders have been developed only recently. Short questionnaires have been developed for single skin disorders such as psoriasis (Gupta & Gupta, 1995) and facial acne (Martin et al., 2001). However, these questionnaires do not allow a comparison of different skin condi- tions. In addition, these instruments focus particularly on problems resulting from the disfigurement by the skin disorders and are thus
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This note was uploaded on 10/08/2010 for the course PSY 3001w taught by Professor Stellmack during the Fall '10 term at Minnesota.

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measuringadjutochronicskindiso - Psychological Assessment...

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