The role of adult attachment orientation and coping in psychological adjustment to living with skin conditions

Abstract

Skin conditions can impact significantly on everyday life, particularly relationships. However, some patients are more distressed by these problems than others, regardless of disease severity. There is some evidence that the extent to which patients seek support from friends and family (“attachment orientation”) predicts how well they cope with chronic health conditions, but there has been little previous research with regard to skin disorders. These psychologists in Sheffield, UK, investigated this using online questionnaires in 206 adults recruited through universities and patient support groups. Participants had to have been diagnosed with a skin condition by a health care professional and experiencing symptoms over the last 6 months. Psychological adjustment to their skin disorder was assessed using scores for appearance‐related distress and skin‐related quality of life (QoL). Two dimensions of attachment orientation were measured: fear of intimacy (“attachment avoidance”) and fear of abandonment (“attachment anxiety”). The use of 2 coping strategies was also studied: defeatism (e.g. giving up, denial or turning to drugs or alcohol) and activity (humour, venting, seeking help or coming up with a plan). They found that people showing higher attachment avoidance and attachment anxiety reported more defeatist attitudes, resulting in higher levels of appearance‐related distress and lower QoL, both emotional and functioning aspects. Surprisingly, people using active coping strategies also experienced more appearance‐related distress, perhaps being less accepting of their condition. The authors conclude that people with insecure attachment orientation are more troubled by their skin condition and might benefit from psychological interventions targeting underlying attachment orientation.