How Does Anxiety Affect Adults with Skin Disease? Examining the Indirect Effect of Anxiety Symptoms on Impairment Through Anxiety Sensitivity
- 28 Downloads
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.
KeywordsSocial anxiety disorder Generalized anxiety disorder Health anxiety Anxiety sensitivity Dermatology Impairment
Laura J. Dixon was supported by the University of Mississippi College of Liberal Arts Research Grant for Faculty Research and Creative Achievement.
Compliance with Ethical Standards
Conflict of Interest
Laura J. Dixon, Sara M. Witcraft, and Megan M. Perry declare that they have no conflict of interest.
Human and Animal Rights
Study procedures were in accordance with the ethical standards of the institutional review board of the University of Mississippi and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individuals included in this study.
- 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.CrossRefPubMedPubMedCentralGoogle Scholar
- 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.CrossRefGoogle Scholar
- 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.CrossRefPubMedGoogle Scholar
- 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.CrossRefPubMedGoogle Scholar
- 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.CrossRefPubMedGoogle Scholar
- 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.CrossRefPubMedGoogle Scholar
- 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.CrossRefPubMedGoogle Scholar
- Hayes, A. F. (2013). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: Guilford Press.Google Scholar
- 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.CrossRefPubMedGoogle Scholar
- 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.Google Scholar
- 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.CrossRefPubMedPubMedCentralGoogle Scholar
- 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.CrossRefPubMedGoogle Scholar
- 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.Google Scholar
- 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.CrossRefPubMedGoogle Scholar
- 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.CrossRefPubMedGoogle Scholar
- 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.Google Scholar
- 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/10.1037/1040-35184.108.40.206.CrossRefPubMedGoogle Scholar
- 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.CrossRefPubMedGoogle Scholar
- World Health Organization (WHO). (2016). International statistical classification of diseases and related health problems (10th ed.). Geneva: WHO.Google Scholar