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Appearance Self-Esteem in Systemic Sclerosis

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Abstract

Although disease- and/or treatment-relatedchanges in physical appearance accompany many illnesses,the relationship of these physical changes to appearanceselfesteem and overall psychological adjustment has received little attention in the literature. Inthis study, subjects were 93 persons with diagnoses ofsystemic sclerosis, a chronic and progressive rheumaticdisease characterized by physical changes, especially skin thickening. Subjects receivedclinical examinations of skin thickening and providedself-reports via questionnaires of theirappearance-related self-esteem and overall psychologicaldistress. Results showed that disease-related physicalchanges were related to appearance self-esteem. Stepwisemultiple regression analysis found skin thickening ofthe righthand and fingers to be the strongest predictors of appearance self-esteem. Appearanceself-esteem was examined as a possible moderator ormediator of the relationship between skin thickening andpsychological distress. Results did not support amoderator role for appearance self-esteem; however,appearance self-esteem met statistical criteria as amediator of the relationship between skin thickening anddistress. Interestingly, results differed for thediffuse and limited subtypes ofsystemicsclerosis,suggesting that physical changes associatedwith disease may have stronger relationships withself-esteem and overall adjustment in the context ofless serious illnesses.

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REFERENCES

  • Baron, R.M., & Kenny, D. A. (1986). The moderator-mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51, 1173–1182.

    Google Scholar 

  • Ben-Tovin, D. I., & Walker, M. K. (1994). Influence of age and weight on women' s body attitudes as measured by the Body Attitudes Questionnaire (BAQ). Journal of Psychosomatic Research, 38, 477–481.

    Google Scholar 

  • Ben-Tovin, D. I., & Walker, M. K. (1995). Body image, disfigurement and disability. Journal of Psychosomatic Research, 39, 283–291.

    Google Scholar 

  • Burr, S., & Gradwell, C. (1966). The psychosocial effects of skin diseases: Need for support groups. British Journal of Nursing, 5, 1177–1182.

    Google Scholar 

  • Clements, P. J., Lachenbruch, P. A., Seibold, J. R., Zee, B., Steen, V. D., Brennan, P., Silman, A. J., Allegar, N., Varga, J., Massa, M., Wigley, F. M., Ingenito, F., Weisman, M., White, B., Martin, R. W., McCloskey, D., Moreland, L. W., Mayes, M., Lally, E. V., Unanue, M., Collier, D. H., Weiner, S., Weinstein, A., Medsger, T. A., Andrews, B., Dixon, M., & Furst D. E. (1993). Skin thickness score in systemic sclerosis: An assessment of interobserver variability in 3 independent studies. Journal of Rheumatology, 20, 1892–1896.

    Google Scholar 

  • Clements, P. J., Lachenbruch, P. A., Seibold, J. R., White, B., Weiner, S., Martin, R., Weinstein, A., Weisman, M., Mayes, M., Collier, D., Wigley, F., Medsger, T. A., Steen, V., Moreland, L., Dixon, M., Massa, M., Lally, E., McCloskey, D., Varga, J., Ingenito, F., & Furst, D. (1995). Inter-and intraobserver variability of total skin thickness score (modified Rodnan TSS) in systemic sclerosis. Journal of Rheumatology, 22, 1281–1285.

    Google Scholar 

  • Clements, P. J., & Medsger, T. A. Jr. (1996). Organ involvement: Skin. In P. J. Clements & D. E. Furst (Eds.), Systemic sclerosis (pp. 389–407). Baltimore: Williams & Wilkins.

    Google Scholar 

  • Coopersmith, S. (1968). Studies in self-esteem. Scientific American, 218 (2), 96–106.

    Google Scholar 

  • Cornwell, C. J., & Schmitt, M. H. (1990). Perceived health status, se lf-esteem and body image in women with rheumatoid arthritis or systemic lupus erythematosus. Research in Nursing & Health, 13, 99–107.

    Google Scholar 

  • Derogatis, L. R. (1986). The Psychosocial Adjustment to Illness Scale (PAIS). Journal of Psychosomatic Research, 30, 77–91.

    Google Scholar 

  • Derogatis, L. R., & Derogatis, M. F. (1990). Psychosocial Adjustment to Illness Scale administration, scoring and procedures manual—II. Baltimore: Clinical Psychometric Research.

    Google Scholar 

  • Druley, J. A., & Townsend, A. L. (1998). Self-esteem as a mediator between spousal support and depressive symptoms: A comparison of healthy individuals and individuals coping with arthritis. Health Psychology, 17, 255–261.

    Google Scholar 

  • Erdos, D. (1992). Redefining identity when appearance is altered. Dermatology Nursing, 4, 41–46.

    Google Scholar 

  • Gamba, A., Romano, M., Grosso, I., Tamburini, M., Cantu, G., Molinari, R., & Ventafridda, V. (1992). Psychosocial adjustment of patients surgically treated for head and neck cancer. Head & Neck, 14, 218–223.

    Google Scholar 

  • Heatherton, T. F., & Polivy, J. (1991). Development and validation of a scale for measuring state self-esteem. Journal of Personality and Social Psychology, 60, 895–910.

    Google Scholar 

  • Hill, C. (1985). Psychosocial adjustment of adult burns patients: Is it more difficult for people with visible scars? British Journal of Occupational Therapy, 48, 281–283.

    Google Scholar 

  • Ireys, H. T., Gross, S. S., Werthamer-Larsson, L. A., & Kolodner, K. B. (1994). Self-esteem of young adults with chronic health conditions: Appraising the effects of perceived impact. Journal of Developmental & Behavioral Pediatrics, 15, 409–415.

    Google Scholar 

  • Jone s, N. F. (1966). Surgical treatment of the hand in systemic sclerosis. In P. J. Clements & D. E. Furst (Eds.), Systemic sclerosis (pp. 569–579). Baltimore: Williams & Wilkins.

    Google Scholar 

  • Katz, M. R., Rodin, G., & Devins, G. M. (1995). Self-esteem and cancer: Theory and research. Canadian Journal of Psychiatry, 40, 608–615.

    Google Scholar 

  • Li, L., & Moore, D. (1998). Acceptance of disability and its correlates. Journal of Social Psychology, 138, 13–25.

    Google Scholar 

  • Malcarne, V. L., & Greenbergs, H. L. (1996). Psychological adjustment to systemic sclerosis. Arthritis Care and Research, 9, 51–59.

    Google Scholar 

  • Medsger, T. A. Jr., & Steen, V. D. (1996). Classification, prognosis. In P. J. Clements & D. E. Furst (Eds.), Systemic sclerosis (pp. 51–64). Baltimore: Williams & Wilkins.

    Google Scholar 

  • Poole, J. L. (1966). Occupational and physical therapy. In P. J. Clements & D. E. Furst (Eds.), Systemic sclerosis (pp. 581–590). Baltimore: Williams & Wilkins.

    Google Scholar 

  • Roca, R. P., & Wigley, F. M. (1996). Psychosocial aspects. In P. J. Clements & D. E. Furst, Systemic sclerosis (pp. 501–511). Baltimore: Williams & Wilkins.

    Google Scholar 

  • Silman, A. J., Black, C. M., & Welsh, K. I. (1996). Epidemiology, demographics, genetics. In P. J. Clements & D. E. Furst (Eds.), Systemic sclerosis (pp. 23–49). Baltimore: Williams & Wilkins.

    Google Scholar 

  • Skevington, S. M. (1993). Depression and causal attributions in the early stage s of a chronic painful disease: A longitudinal study of early synovitis. Psychology & Health, 8, 51–64.

    Google Scholar 

  • Skevington, S. M., Blackwell, F., & Britton, N. F. (1987). Self-esteem and perception of attractiveness: An investigation of early rheumatoid arthritis. British Journal of Medical Psychology, 60, 45–52.

    Google Scholar 

  • Stone, J. B., Bluhm, H. P., & White, M. I. (1984). Correlates of depression among long-term insulin-dependent diabetics. Rehabilitation Psychology, 29, 85–93.

    Google Scholar 

  • Vamos, M. (1990). Body image in rheumatoid arthritis: The relevance of hand appearance to desire for surgery. British Journal of Medical Psychology, 63, 267–277.

    Google Scholar 

  • Vamos, M. (1993). Body image in chronic illness-A re conceptualization. International Journal of Psychiatry in Medicine, 23(2), 163–178.

    Google Scholar 

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Malcarne, V.L., Hansdottir, I., Greenbergs, H.L. et al. Appearance Self-Esteem in Systemic Sclerosis. Cognitive Therapy and Research 23, 197–208 (1999). https://doi.org/10.1023/A:1018783329341

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  • DOI: https://doi.org/10.1023/A:1018783329341

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