The Mediator Role of Body Image-Related Cognitive Fusion in the Relationship between Disease Severity Perception, Acceptance and Psoriasis Disability

Abstract

Psoriasis is a long-term skin disorder without a cure, whose patients are particularly susceptible to mental health diseases. Using a sample of patients diagnosed with psoriasis, this study aimed to: (1) identify the clinical and positive psychological variables that contribute the most to psoriasis disability and (2) assess the mediator role of body image-related cognitive fusion in the relation between disease severity perception and acceptance and self-compassion, on one hand, and psoriasis disability on the other. This is an initial cross-sectional exploratory study, with 75 patients diagnosed with psoriasis (males 52%; mean age 54.99 ± 13.72) answering a sociodemographic and a clinical questionnaire, the Psoriasis Disability Index (PDI), the Cognitive Fusion Questionnaire—Body Image (CFQ-BI), the Acceptance and Action Questionnaire—II (AAQ-II), and the Self-Compassion Scale (SCS). Descriptive and inferential statistics were used to characterize and assess the measures and the final model used. Through path analysis and a hierarchical multiple linear regression, it was found that the variables that significantly contributed to psoriasis disability were years of education, impact on social life and body image, explaining 70% of the variance. Body image-related cognitive fusion was a significant mediator in the relationship between disease severity and acceptance, and psoriasis disability. The implications of this study are considered to be extremely relevant, since it will allow additional information to be provided to psoriasis patients, appropriated to their educational level, aiming to reduce distorted perceptions of disease severity and intervene in the ability to accept this specific and important chronic health condition.

Does the Vehicle Matter? Real-World Evidence on Adherence to Topical Treatment in Psoriasis

“…Adherence W (%) = Wu/Wex × 100 (1) where: Wu = medication weight used per application = (weight dispensed-weight returned)/number of applications registered in the medication log; Wex = expected medication weight per application = 0.25 g × % BSA; BSA = body surface area. A value of 0.25 g corresponds roughly to the amount needed for each application on an area corresponding to that of the palm of the hand (1% of BSA) [30][31][32].…”

“…Psoriasis is a chronic skin disease with high psychosocial impact [1,2] that is estimated to affect 2% of the world's population but varies according to regions [3]. Most patients with mild or moderate plaque psoriasis can be managed with topical therapy [4,5].…”

Influence of Clinical and Psychosocial Factors on the Adherence to Topical Treatment in Psoriasis

“…Given the correlation between treatment satisfaction and adherence, factors such as convenience, safety, treatment type, perceived quality of life improvements, and response time, which are positive predictors of treatment satisfaction [30], could indirectly predict treatment adherence. Patients with psoriasis have a high prevalence of several mental disorders [31,32]. Some studies have examined the reasons for psoriasis treatment adherence in patients.…”

The Effect of Acceptance and Commitment Therapy on Youth with Body Dysmorphic Disorders Symptoms: A Randomized Clinical Trial

“…It was reported that BDD individuals have a distorted body image and experience a high depression and suicide ideation (10). Several studies showed that individuals with BDD symptoms signi cantly have problem to cognitive fusion (11,12), body image in exibility (13), and emotional symptoms (14,15). Multiple pharmacological as well as psychological therapies are used for the treatment of BDD.…”