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Cognitive Therapy and Research

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10.07.2018 | Original Article

How Does Anxiety Affect Adults with Skin Disease? Examining the Indirect Effect of Anxiety Symptoms on Impairment Through Anxiety Sensitivity

verfasst von: Laura J. Dixon, Sara M. Witcraft, Megan M. Perry

Erschienen in: Cognitive Therapy and Research | Ausgabe 1/2019

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Abstract

Emerging research suggests social anxiety, health anxiety, and generalized anxiety disorder symptoms are particularly relevant for dermatology patients. Unfortunately, very few studies have investigated how these anxieties affect quality of life among individuals with skin disease. The aims of the present study were to characterize the rates of these anxiety syndromes among adults with active skin disease symptoms, examine correlations between anxiety and skin disease symptoms, and test the mediating role of anxiety sensitivity in skin-related impairment. A considerable number of participants (N = 237) screened positive for social anxiety disorder (62.9%), health anxiety (18.1%), and generalized anxiety disorder (32.5%). Consistent with hypothesis, each anxiety syndrome was indirectly related to skin-related impairment through anxiety sensitivity. Overall, the findings emphasize the importance of anxiety symptoms in dermatological outcomes.

Abramowitz, J. S., Deacon, B. J., & Valentiner, D. P. (2007). The short health anxiety inventory: Psychometric properties and construct validity in a non-clinical sample. Cognitive Therapy and Research, 31(6), 871–883.CrossRef

Alberts, N. M., Hadjistavropoulos, H. D., Jones, S. L., & Sharpe, D. (2013). The Short Health Anxiety Inventory: A systematic review and meta-analysis. Journal of Anxiety Disorders, 27(1), 68–78. https://doi.org/10.1016/j.janxdis.2012.10.009.PubMedCrossRef

Allan, N. P., Korte, K. J., Capron, D. W., Raines, A. M., & Schmidt, N. B. (2014a). Factor mixture modeling of anxiety sensitivity: A three-class structure. Psychological Assessment, 26(4), 1184–1195. https://doi.org/10.1037/a0037436.PubMedCrossRef

Allan, N. P., Raines, A. M., Capron, D. W., Norr, A. M., Zvolensky, M. J., & Schmidt, N. B. (2014b). Identification of anxiety sensitivity classes and clinical cut-scores in a sample of adult smokers: Results from a factor mixture model. Journal of Anxiety Disorders, 28(7), 696–703. https://doi.org/10.1016/j.janxdis.2014.07.006.PubMedPubMedCentralCrossRef

Antony, M. M., Bieling, P. J., Cox, B. J., Enns, M. W., & Swinson, R. P. (1998). Psychometric properties of the 42-item and 21-item versions of the Depression Anxiety Stress Scales in clinical groups and a community sample. Psychological Assessment, 10(2), 176.CrossRef

Arditte, K. A., Cek, D., Shaw, A. M., & Timpano, K. R. (2016). The importance of assessing clinical phenomena in Mechanical Turk research. Psychological Assessment, 28(6), 684–691. https://doi.org/10.1037/pas0000217.PubMedCrossRef

Asmundson, G. J. G., Wright, K. D., & Hadjistavropoulos, H. D. (2000). Anxiety sensitivity and disabling chronic health conditions: State of the art and future directions. Scandanvian Journal of Behaviour Therapy, 29(3–4), 100–117. https://doi.org/10.1080/028457100300049719.CrossRef

Avallone, K. M., McLeish, A. C., Luberto, C. M., & Bernstein, J. A. (2012). Anxiety sensitivity, asthma control, and quality of life in adults with asthma. Journal of Asthma, 49(1), 57–62. https://doi.org/10.3109/02770903.2011.641048.PubMedCrossRef

Bakhshaie, J., Paulus, D. J., Medvedeva, A., Otal, T., Lemaire, C., Garza, M., … Viana, A. G. (2017). The differential role of anxiety sensitivity and its components in the relation between emotional nonacceptance and anxiety and depressive symptoms and disorders among latinos in primary care. Journal of Psychopathology and Behavioral Assessment, 39(3), 563–574.CrossRef

Baptista, C. A., Loureiro, S. R., de Lima Osório, F., Zuardi, A. W., Magalhães, P. V., Kapczinski, F., … Crippa, J. A. S. (2012). Social phobia in Brazilian university students: Prevalence, under-recognition and academic impairment in women. Journal of Affective Disorders, 136(3), 857–861.PubMedCrossRef

Basra, M. K., & Shahrukh, M. (2009). Burden of skin diseases. Expert Review of Pharmacoeconomics & Outcomes research, 9(3), 271–283.CrossRef

Bez, Y., Yesilova, Y., Kaya, M. C., & Sir, A. (2011). High social phobia frequency and related disability in patients with acne vulgaris. European Journal of Dermatology, 21(5), 756–760. https://doi.org/10.1684/ejd.2011.1418.PubMedCrossRef

Bhate, K., & Williams, H. (2013). Epidemiology of acne vulgaris. British Journal of Dermatology, 168(3), 474–485.PubMedCrossRef

Bohm, D., Schwanitz, P., Stock Gissendanner, S., Schmid-Ott, G., & Schulz, W. (2014). Symptom severity and psychological sequelae in rosacea: Results of a survey. Psychology, Health & Medicine, 19(5), 586–591. https://doi.org/10.1080/13548506.2013.841968.CrossRef

Böhm, D., Stock Gissendanner, S., Bangemann, K., Snitjer, I., Werfel, T., Weyergraf, A., … Schmid-Ott, G. (2013). Perceived relationships between severity of psoriasis symptoms, gender, stigmatization and quality of life. Journal of the European Academy of Dermatology and Venereology, 27(2), 220–226.PubMedCrossRef

Buhrmester, M., Kwang, T., & Gosling, S. D. (2011). Amazon’s Mechanical Turk a new source of inexpensive, yet high-quality, data? Perspectives on Psychological Science, 6(1), 3–5.PubMedCrossRef

Capron, D. W., & Schmidt, N. B. (2016). Development and randomized trial evaluation of a novel computer-delivered anxiety sensitivity intervention. Behaviour Research and Therapy, 81, 47–55.PubMedCrossRef

Chren, M.-M., Lasek, R. J., Sahay, A. P., & Sands, L. P. (2001). Measurement properties of Skindex-16: A brief quality-of-life measure for patients with skin diseases. Journal of Cutaneous Medicine and Surgery, 5(2), 105–110.PubMedCrossRef

Cohen, J. (1992). A power primer. Psychological Bulletin, 112(1), 155–159. https://doi.org/10.1037/0033-2909.112.1.155.PubMedCrossRef

Connor, K. M., Davidson, J. R., Churchill, L. E., Sherwood, A., Weisler, R. H., & Foa, E. (2000). Psychometric properties of the social phobia inventory (SPIN). The British Journal of Psychiatry, 176(4), 379–386.PubMedCrossRef

Dalgard, F. J., Gieler, U., Tomas-Aragones, L., Lien, L., Poot, F., Jemec, G. B., … Kupfer, J. (2015). The psychological burden of skin diseases: A cross-sectional multicenter study among dermatological out-patients in 13 European countries. Journal of Investigative Dermatology, 135(4), 984–991. https://doi.org/10.1038/jid.2014.530.PubMedCrossRef

Dixon, L., Witcraft, S., McCowan, N., & Brodell, R. (2018). Stress and skin disease quality of life: The moderating role of anxiety sensitivity social concerns. British Journal of Dermatology. https://doi.org/10.1111/bjd.16082.PubMedCrossRef

Dixon, L. J., Lee, A. A., Viana, A. G., McCowan, N. K., Brodell, R. T., & Tull, M. T. (2016). Anxiety sensitivity in dermatological patients. Psychosomatics, 57(5), 498–504. https://doi.org/10.1016/j.psym.2016.03.001.PubMedCrossRef

Fergus, T. A., & Bardeen, J. R. (2013). Anxiety sensitivity and intolerance of uncertainty: Evidence of incremental specificity in relation to health anxiety. Personality and Individual Differences, 55(6), 640–644.CrossRef

Fortune, D., Main, C., O’sullivan, T., & Griffiths, C. (1997). Quality of life in patients with psoriasis: The contribution of clinical variables and psoriasis-specific stress. British Journal of Dermatology, 137(5), 755–760.PubMedCrossRef

Fortune, D. G., Richards, H. L., & Griffiths, C. E. (2005). Psychologic factors in psoriasis: Consequences, mechanisms, and interventions. Dermatologic Clinics, 23(4), 681–694. https://doi.org/10.1016/j.det.2005.05.022.PubMedCrossRef

Fortune, D. G., Richards, H. L., Main, C. J., & Griffiths, C. E. (2000). Pathological worrying, illness perceptions and disease severity in patients with psoriasis. British Journal of Health Psychology, 5(1), 71–82.CrossRef

Gascón, M. R. P., Ribeiro, C. M., Bueno, L. M. d. A., Benute, G. R. G., Lucia, M. C. S. d., Rivitti, E. A., & Festa Neto, C. (2012). Prevalence of depression and anxiety disorders in hospitalized patients at the dermatology clinical ward of a university hospital. Anais Brasileiros de Dermatologia, 87(3), 403–407.PubMedCrossRef

Ghajarzadeh, M., Ghiasi, M., & Kheirkhah, S. (2012). Associations between skin diseases and quality of life: A comparison of psoriasis, vitiligo, and alopecia areata. Acta Medica Iranica, 50(7), 511–515.PubMed

Gupta, M. A., & Gupta, A. K. (2003). Psychiatric and psychological co-morbidity in patients with dermatologic disorders. American Journal of Clinical Dermatology, 4(12), 833–842.PubMedCrossRef

Hay, R. J., Johns, N. E., Williams, H. C., Bolliger, I. W., Dellavalle, R. P., Margolis, D. J., … Wulf, S. K. (2014). The global burden of skin disease in 2010: An analysis of the prevalence and impact of skin conditions. Journal of Investigative Dermatology, 134(6), 1527–1534.PubMedCrossRef

Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: Guilford Press.

Hayes, J., & Koo, J. (2010). Psoriasis: Depression, anxiety, smoking, and drinking habits. Dermatologic Therapy, 23(2), 174–180. https://doi.org/10.1111/j.1529-8019.2010.01312.x.PubMedCrossRef

Henry, J. D., & Crawford, J. R. (2005). The short-form version of the Depression Anxiety Stress Scales (DASS-21): Construct validity and normative data in a large non-clinical sample. British Journal of Clinical Psychology, 44(2), 227–239.PubMedCrossRef

Hesser, H., & Andersson, G. (2009). The role of anxiety sensitivity and behavioral avoidance in tinnitus disability. International Journal of Audiology, 48(5), 295–299.PubMedCrossRef

Hon, K. L., Pong, N. H., Poon, T. C., Chan, D. F., Leung, T. F., Lai, K. Y., … Luk, N. M. (2015). Quality of life and psychosocial issues are important outcome measures in eczema treatment. Journal of Dermatological Treatment, 26(1), 83–89. https://doi.org/10.3109/09546634.2013.873762.PubMedCrossRef

Hong, J., Koo, B., & Koo, J. (2008). The psychosocial and occupational impact of chronic skin disease. Dermatologic Therapy, 21(1), 54–59.PubMedCrossRef

Horton, J. J., & Chilton, L. B. (2010). The labor economics of paid crowdsourcing. Paper presented at the proceedings of the 11th ACM conference on electronic commerce.

Joinson, A. (1999). Social desirability, anonymity, and Internet-based questionnaires. Behavior Research Methods, Instruments, & Computers, 31(3), 433–438.CrossRef

Joshi, S. S., Ortiz, S., Witherspoon, J. N., Rademaker, A., West, D. P., Anderson, R., … Lacouture, M. E. (2010). Effects of epidermal growth factor receptor inhibitor-induced dermatologic toxicities on quality of life. Cancer, 116(16), 3916–3923.PubMedCrossRef

Kent, G., & Keohane, S. (2001). Social anxiety and disfigurement: The moderating effects of fear of negative evaluation and past experience. British Journal of Clinical Psychology, 40(1), 23.PubMedCrossRef

Keough, M. E., & Schmidt, N. B. (2012). Refinement of a brief anxiety sensitivity reduction intervention. Journal of Consulting and Clinical Psychology, 80(5), 766–772. https://doi.org/10.1037/a0027961.PubMedPubMedCentralCrossRef

Kessler, R. C., Petukhova, M., Sampson, N. A., Zaslavsky, A. M., & Wittchen, H. U. (2012). Twelve-month and lifetime prevalence and lifetime morbid risk of anxiety and mood disorders in the United States. International Journal of Methods in Psychiatric Research, 21(3), 169–184. https://doi.org/10.1002/mpr.1359.PubMedPubMedCentralCrossRef

Linnet, J., & Jemec, G. B. (1999). An assessment of anxiety and dermatology life quality in patients with atopic dermatitis. The British Journal of Dermatology, 140(2), 268–272.PubMedCrossRef

Litman, L., Robinson, J., & Abberbock, T. (2017). TurkPrime.com: A versatile crowdsourcing data acquisition platform for the behavioral sciences. Behavior Research Methods, 49(2), 433–442. https://doi.org/10.3758/s13428-016-0727-z.PubMedCrossRef

Livermore, N., Sharpe, L., & McKenzie, D. (2012). Catastrophic interpretations and anxiety sensitivity as predictors of panic-spectrum psychopathology in chronic obstructive pulmonary disease. Journal of Psychosomatic Research, 72(5), 388–392.PubMedCrossRef

Loney, T., Standage, M., & Lewis, S. (2008). Not just ‘skin deep’: Psychosocial effects of dermatological-related social anxiety in a sample of acne patients. Journal of Health Psychology, 13(1), 47–54. https://doi.org/10.1177/1359105307084311.PubMedCrossRef

Long, V., & Elpern, D. J. (2017). Health anxiety in dermatology. International Journal of Dermatology, 56(9), 968–971. https://doi.org/10.1111/ijd.13692.PubMedCrossRef

Lovibond, P. F., & Lovibond, S. H. (1995). The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behaviour Research and Therapy, 33(3), 335–343.PubMedCrossRef

Meade, A. W., & Craig, S. B. (2012). Identifying careless responses in survey data. Psychological Methods, 17(3), 437.PubMedCrossRef

Mizawa, M., Yamaguchi, M., Ueda, C., Makino, T., & Shimizu, T. (2013). Stress evaluation in adult patients with atopic dermatitis using salivary cortisol. Biomed Research International, 2013, 138027. https://doi.org/10.1155/2013/138027.PubMedPubMedCentralCrossRef

Montgomery, K., Norman, P., Messenger, A. G., & Thompson, A. R. (2016). The importance of mindfulness in psychosocial distress and quality of life in dermatology patients. British Journal of Dermatology, 175(5), 930–936. https://doi.org/10.1111/bjd.14719.PubMedCrossRef

Nguyen, C. M., Beroukhim, K., Danesh, M. J., Babikian, A., & Koo, J. (2016). The psychosocial impact of acne, vitiligo, and psoriasis: A review. Clinical, Cosmetic and Investigational Dermatology, 9, 383.PubMedPubMedCentralCrossRef

Norman, S. B., & Lang, A. J. (2005). The functional impact of anxiety sensitivity in the chronically physically ill. Depression and Anxiety, 21(4), 154–160.PubMedCrossRef

Ocañez, K. L., Kathryn McHugh, R., & Otto, M. W. (2010). A meta-analytic review of the association between anxiety sensitivity and pain. Depression and Anxiety, 27(8), 760–767.PubMedCrossRef

Olatunji, B. O., & Wolitzky-Taylor, K. B. (2009). Anxiety sensitivity and the anxiety disorders: A meta-analytic review and synthesis. Psychological Bulletin, 135(6), 974–999. https://doi.org/10.1037/a0017428.PubMedCrossRef

Olthuis, J. V., Watt, M. C., Mackinnon, S. P., & Stewart, S. H. (2014). Telephone-delivered cognitive behavioral therapy for high anxiety sensitivity: A randomized controlled trial. Journal of Consulting and Clinical Psychology, 82(6), 1005–1022. https://doi.org/10.1037/a0037027.PubMedCrossRef

Olthuis, J. V., Watt, M. C., & Stewart, S. H. (2014). Anxiety Sensitivity Index (ASI-3) subscales predict unique variance in anxiety and depressive symptoms. Journal of Anxiety Disorders, 28(2), 115–124. https://doi.org/10.1016/j.janxdis.2013.04.009.PubMedCrossRef

Osinubi, O., Grainge, M. J., Hong, L., Ahmed, A., Batchelor, J., Grindlay, D., … Ratib, S. (2017). The prevalence of psychological co-morbidity in people with vitiligo: A systematic review and meta-analysis. British Journal of Dermatology, 178, 863–878.CrossRef

Pärna, E., Aluoja, A., & Kingo, K. (2015). Quality of life and emotional state in chronic skin disease. Acta Dermato-Venereologica, 95(3), 312–316. https://doi.org/10.2340/00015555-1920.PubMedCrossRef

Picardi, A., Abeni, D., Mazzotti, E., Fassone, G., Lega, I., Ramieri, L., … Pasquini, P. (2004a). Screening for psychiatric disorders in patients with skin diseases. Journal of Psychosomatic Research, 57(3), 219–223. https://doi.org/10.1016/s0022-3999(03)00619-6.PubMedCrossRef

Picardi, A., Amerio, P., Baliva, G., Barbieri, C., Teofoli, P., Bolli, S., … Abeni, D. (2004b). Recognition of depressive and anxiety disorders in dermatological outpatients. Acta Dermato-Venereologica, 84(3), 213–217.PubMedCrossRef

Picardi, A., Porcelli, P., Pasquini, P., Fassone, G., Mazzotti, E., Lega, I., … Fava, G. A. (2006). Integration of multiple criteria for psychosomatic assessment of dermatological patients. Psychosomatics, 47(2), 122–128. https://doi.org/10.1176/appi.psy.47.2.122.PubMedCrossRef

Rapp, S. R., Feldman, S. R., Exum, M. L., Fleischer, A. B., & Reboussin, D. M. (1999). Psoriasis causes as much disability as other major medical diseases. Journal of the American Academy of Dermatology, 41(3), 401–407.PubMedCrossRef

Rasoulian, M., Ebrahimi, A. A., Zare, M., & Taherifar, Z. (2010). Psychiatric morbidity in dermatological conditions. International Journal of Psychiatry in Clinical Practice, 14(1), 18–22. https://doi.org/10.3109/13651500903262370.PubMedCrossRef

Reiss, S., & McNally, R. J. (1985). Expectancy model of fear. In S. Reiss & R. R. Bootzin (Eds.), Theoretical issues in behavior therapy (pp. 107–121). New York: Academic Press.

Salkovskis, P. M., Rimes, K. A., Warwick, H., & Clark, D. (2002). The Health Anxiety Inventory: Development and validation of scales for the measurement of health anxiety and hypochondriasis. Psychological Medicine, 32(5), 843–853.PubMedCrossRef

Salman, A., Kurt, E., Topcuoglu, V., & Demircay, Z. (2016). Social anxiety and quality of life in vitiligo and acne patients with facial involvement: A cross-sectional controlled study. American Journal of Clinical Dermatology, 17(3), 305–311. https://doi.org/10.1007/s40257-016-0172-x.PubMedCrossRef

Schmitt, J., & Ford, D. E. (2007). Understanding the relationship between objective disease severity, psoriatic symptoms, illness-related stress, health-related quality of life and depressive symptoms in patients with psoriasis—A structural equations modeling approach. General Hospital Psychiatry, 29(2), 134–140. https://doi.org/10.1016/j.genhosppsych.2006.12.004.PubMedCrossRef

Shapiro, D. N., Chandler, J., & Mueller, P. A. (2013). Using mechanical turk to study clinical populations. Clinical Psychological Science, 1(2), 213–220. https://doi.org/10.1177/2167702612469015.CrossRef

Spitzer, R. L., Kroenke, K., Williams, J. B., & Löwe, B. (2006). A brief measure for assessing generalized anxiety disorder: The GAD-7. Archives of Internal Medicine, 166(10), 1092–1097.PubMedCrossRef

Stern, R. S. (2004). Dermatologists and office-based care of dermatologic disease in the 21st century. Paper presented at the journal of investigative dermatology symposium proceedings.

Taylor, S., Zvolensky, M. J., Cox, B. J., Deacon, B., Heimberg, R. G., Ledley, D. R., … Cardenas, S. J. (2007). Robust dimensions of anxiety sensitivity: Development and initial validation of the Anxiety Sensitivity Index-3. Psychological Assessment, 19(2), 176–188. https://doi.org/10.1037/1040-3590.19.2.176.PubMedCrossRef

Wheaton, M. G., Berman, N. C., & Abramowitz, J. S. (2010). The contribution of experiential avoidance and anxiety sensitivity in the prediction of health anxiety. Journal of Cognitive Psychotherapy, 24(3), 229.CrossRef

Wheaton, M. G., Deacon, B. J., McGrath, P. B., Berman, N. C., & Abramowitz, J. S. (2012). Dimensions of anxiety sensitivity in the anxiety disorders: Evaluation of the ASI-3. Journal of Anxiety Disorders, 26(3), 401–408. https://doi.org/10.1016/j.janxdis.2012.01.002.PubMedCrossRef

Wittkowski, A., Richards, H. L., Griffiths, C. E. M., & Main, C. J. (2004). The impact of psychological and clinical factors on quality of life in individuals with atopic dermatitis. Journal of Psychosomatic Research, 57(2), 195–200. https://doi.org/10.1016/S0022-3999(03)00572-5.PubMedCrossRef

Woodruff, P., Higgins, E., Du Vivier, A., & Wessely, S. (1997). Psychiatric illness in patients referred to a dermatology-psychiatry clinic. General Hospital Psychiatry, 19(1), 29–35.PubMedCrossRef

World Health Organization (WHO). (2016). International statistical classification of diseases and related health problems (10th ed.). Geneva: WHO.

Yazici, K., Baz, K., Yazici, A., Köktürk, A., Tot, S., Demirseren, D., & Buturak, V. (2004). Disease-specific quality of life is associated with anxiety and depression in patients with acne. Journal of the European Academy of Dermatology and Venereology, 18(4), 435–439.PubMedCrossRef

Titel: How Does Anxiety Affect Adults with Skin Disease? Examining the Indirect Effect of Anxiety Symptoms on Impairment Through Anxiety Sensitivity
verfasst von: Laura J. Dixon
Sara M. Witcraft
Megan M. Perry
Publikationsdatum: 10.07.2018
Verlag: Springer US
Erschienen in: Cognitive Therapy and Research / Ausgabe 1/2019
Print ISSN: 0147-5916
Elektronische ISSN: 1573-2819
DOI: https://doi.org/10.1007/s10608-018-9942-5

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