A Multi-Method Assessment in Adolescent and Adult Females with Giant Congenital Melanocytic Naevus and their Families: Body Image and Psychological Adjustment

Abstract

Background: Giant Congenital Melanocytic Naevus (GCMN) is a morphological skin alteration present from birth, involving up to 80% of the body surface. GCMN could have a detrimental effect on body perception due to several factors including its aspect, extension and the potential exposure to significant number of surgical interventions. Objective: This pilot study assessed quality of Body Image (BI) and psychological adjustment in subjects with GCMN and their parents. Methods: Subjects and parents underwent a multi-method assessment including a semi-structured interview, a self-administered rating scale to assess BI (Body Uneasiness Test, BUT) and two personality tests: A self-report (MMPI-2RF/A) and a performance test (Rorschach, R-PAS method). Results: Ten families were enrolled in the study. GCMN subjects were all females with high average surgical interventions (median=13). In GCMNs a substantial impairment of BI was detected by the BUT (global severity index=2.34 ± 0.81; Body Image Concern=3.25 ± 0.95), MMPI-2RF/A presented normal ranges and R-PAS showed elevations for the quality of human representations (PHR/GPHR: 119.1 ± 8.1). Mothers showed a trend for health concerns at MMPI-2RF (Malaise: 64.2 ± 9.5), fathers showed under-reporting in almost all tests. Conclusion: This set of GCMN females with relevant surgical history shows significant BI impairment with several aspects of non-integrated body identity at unconscious level, that may result in inability to envision the self and relations with others in adaptive way. Parents show different profiles, including conscious health concerns in mothers and denial in fathers. Families with a GCMN subject could benefit from integrated approaches including medical advice, psychological support and social integration projects.