Abstract
In this study we examined whether aspects of positive functioning [reappraisal, sense of coherence (SOC), and positivity] were associated with spiritual well-being and psychological distress after controlling for negative functioning (skin-related symptoms, type of disease, and expressive suppression) in individuals with skin diseases. We also examined whether negative functioning aspects were linked to spiritual well-being and distress when controlling for aspects of positive functioning. The study used a cross-sectional design with a sample of 192 individuals with psoriasis and systemic sclerosis (SSc) (Mage = 51.6 years, SD = 16.5). Two hierarchical multiple regressions were conducted to determine whether spiritual well-being and psychological distress were accounted for by skin-related symptoms, type of disease, emotion regulation strategies, SOC, and positivity. Positivity was the most important contributor to better spiritual well-being, followed by both the comprehensibility/manageability and meaningfulness SOC subscales, after controlling for the other variables. High skin-related symptoms and expressive suppression were associated with lower psychological distress, whereas high SOC and reappraisal correlated with higher psychological distress. The findings of this study pave the way for further research on how SOC and positivity may reduce the effects of both skin-related symptoms and emotion dysregulation and facilitate spiritual well-being of individuals with skin diseases. Interventions aimed to enhance inner resources of these individuals and help them to find a meaning in their experience of skin disease might reduce psychological distress and improve spiritual well-being. Our findings suggest that healthcare professionals should consider positive functioning aspects in future interventions for individuals with skin diseases.
Highlights
Psoriasis is a chronic, inflammatory, immune-mediated, skin disease that greatly affects healthrelated quality of life (HRQOL; Augustin and Radtke, 2014)
The optimal clinical management of individuals with chronic medical diseases should include the attempt to reduce the burden of disease and to promote positive functioning (Joseph and Patterson, 2016)
In the present study we investigated how aspects of positive and negative functioning are associated with psychological distress and spiritual well-being in individuals with chronic skin diseases
Summary
Inflammatory, immune-mediated, skin disease that greatly affects healthrelated quality of life (HRQOL; Augustin and Radtke, 2014). A consistent body of evidence showed that SSc is associated with quality of life impairment (Park et al, 2019), fatigue (Sandusky et al, 2008), and depression and anxiety (Baubet et al, 2011). Physical symptoms severity is an important clinical aspect of disability that may cause psychological distress in dermatological patients. Some of the most important somatic conditions that affect quality of life in patients with skin diseases are itch and fatigue, which were reported by more than 50% of all patients (Verhoeven et al, 2007). Different physical symptoms including itching, irritation, and burning, were prevalent in patients with psoriasis and with concurrent psychological distress (Sampogna et al, 2004a). Higher levels of fatigue best predicted psychological distress in patients with psoriasis and atopic dermatitis (Evers et al, 2005)
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