Depression in people with skin conditions: The effects of disgust and self‐compassion

Abstract

Objectives. Skin conditions can be accompanied by significant levels of depression; there is therefore a need to identify the associated psychological factors to assist with the development of appropriate interventions. This study sought to examine the effects of disgust propensity, disgust sensitivity, self-focused/ruminative disgust, and self-compassion on depression in people with skin conditions. Design. A cross-sectional survey with follow-up survey. Methods. Dermatology outpatients (N = 147) completed self-report measures of disgust traits, self-compassion, and depression. At three-month follow-up, participants (N = 80) completed the depression measure again. Results. Multiple regression analyses revealed that disgust propensity, disgust sensitivity, self-focused/ruminative disgust, and self-compassion each explained significant amounts of variance in baseline depression. Self-compassion also explained a significant amount of variance in depression at follow-up, after accounting for baseline depression. In addition, self-compassion moderated the effect of disgust propensity on depression at baseline, such that at high levels of self-compassion, disgust propensity no longer had a positive relationship with depression. Conclusions. Disgust traits contribute to depression in people with skin conditions, while being self-compassionate may be protective against depression. High selfcompassion also buffers the effects of disgust propensity on depression in people with skin conditions. The findings indicate the potential of compassion-focused interventions for depression in people with skin conditions. Statement of contribution What is already known on this subject? People with skin conditions can experience depression that is not well explained by condition severity. Skin conditions can elicit disgust reactions that, in turn, may contribute to the development of depression. Self-compassion is negatively associated with depression. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

How does self-compassion help people adjust to chronic skin conditions? A template analysis study

“…As self-compassion is expected to promote behaviors that enhance or maintain wellbeing ( 15 ), people with skin conditions who are high in self-compassion are expected to take appropriate steps to manage skin-related distress, thus lessening its impact. Consistent with this notion, there is evidence to suggest that self-compassion helps protect against depression in dermatological outpatients ( 9 ).…”

“…The study was advertised via the University of Sheffield's volunteer list and social media (Facebook and Twitter). Consenting participants from a previous study ( 9 ) were also invited to take part. A purposive sample was formed by asking volunteers to complete an online screening survey, which consisted of the Self-Compassion Scale–Short Form (SCS–SF; 22 ), the PHQ-2 (a depression screener; 23 ) and questions about the skin condition.…”

“…Adjustment to illness has been described as “the process to maintain a positive view of the self and the world in the face of a health problem” ( 7 , p. 1161) and emerging evidence suggests that positive psychological factors may contribute to adjustment to skin conditions. Psychological flexibility, the ability to consciously engage with the present moment in a way that is consistent with one's values, has been linked with lower appearance anxiety in people with burn injuries ( 8 ), and mindfulness and self-compassion have both been linked with lower psychological distress in dermatology patients ( 9 , 10 ). Furthermore, there is preliminary evidence that mindfulness and compassion-based interventions can reduce shame and depression in people with skin conditions ( 11 , 12 ).…”

It’s more than just lubrication of the skin: parents’ experiences of caring for a child with ichthyosis

“…Broken skin (skin that has fissures, cracks, bleeds etc. ), such as in ichthyosis, may elicit disgust (Clarke, Thompson, & Norman, 2020 ), a concept that is understudied in research in the dermatologic field (Mento, Rizzo, Muscatello, Zoccali, & Bruno, 2020 ). Within clinical care, healthcare professionals may not feel confident in exploring this topic with parents or individuals with skin disorders such as ichthyosis.…”

Psychodermatological research priorities identified by Priority Setting Partnerships

“…The PSP for acne contains little psychological focus despite several acne studies, including a recent UK study with over 2000 participants, 6 indicating the importance of psychological issues for patients with acne. The results of the survey, which ran from 2012 to 2019, showed that people with acne vulgaris often experience significant psychosocial burden, including suicidal ideation and self‐harm 7 . The lack of psychological focus in the acne PSP may be related to the idiosyncrasies of the PSP process, but it is important to point out that, for patients and many healthcare professionals, psychological and psychiatric factors are key research questions that need addressing.…”