Measuring Adjustment to Chronic Skin Disorders: Validation of a Self-Report Measure.

Abstract

This article describes the development of a questionnaire that assesses problems in adapting to chronic skin disorders, the Adjustment to Chronic Skin Diseases Questionnaire. Patients (N = 442) with different skin disorders completed the original item pool. Principal-components analysis suggested a 6-factor solution that was largely replicated with 2 additional samples of 192 patients with psoriasis or atopic dermatitis and 165 patients with atopic dermatitis. Four of the subscales showed very good internal consistencies, retest reliabilities, and sufficient correlations with expert ratings: Social Anxiety/Avoidance, Itch-Scratch Cycle, Helplessness, and Anxious-Depressive Mood. Two short additional subscales, Impact on Quality of Life and Deficit in Active Coping, showed moderate internal consistencies, but good retest reliabilities. Correlations of the subscales with measures of depression, anxiety, and coping, and meaningful differences between dermatological subgroups support their construct validity. A treatment study showed that changes in some of the subscales correlated with changes in the severity of the skin condition.

Health-Related Quality of Life in Chronic Pruritus: An Analysis Related to Disease Etiology, Clinical Skin Conditions and Itch Intensity

“…Moreover, in various (not necessarily CP-related) skin diseases, women suffer from greater social anxiety, helplessness, depression and stigmatization than men [31]. Although female gender was associated with lower HRQoL, we could not identify a significant impact of the type of skin lesions or the examined disease category in relation to gender.…”

Predicting Long-Term Outcome in Group Treatment of Atopic Dermatitis

“…The set of dependent variables included: (1) patient characteristics: age, sex, educational status; (2) medical and biological predictors assessed before treatment: intensity of scratching (11-point scale), use of antihistaminics (number per month), serum IgE level (<100 IU/ml = low level, 100–1,000 IU/ml = medium level, >1,000 IU/ml = high level; radioimmunoassay test Enzygnost IgE, Pharmacia Behring, Marburg, Germany), age of onset, duration of disease, family incidence of atopic diseases, comorbidity with asthma, comorbidity with hay fever, occurrence of contact allergy, occurrence of food allergy; (3) psychological predictors assessed before treatment: coping with itching, catastrophizing related to itching: subscales of the questionnaire on itch-related cognitions [24]; social anxiety/avoidance, itch-scratch circle, helplessness, anxious-depressive mood: subscales of the questionnaire on the adjustment to chronic skin disorders [25]; trait-anxiety subscale of the Spielberger State-Trait-Anxiety Inventory [26, 27]; depressive mood: Center for Epidemiological Studies for Depression Scale [28, 29]; internal, personal external and fatalistic external Health Locus of Control (HLC) Scales [30, 31]; patients’ rating of the therapists’ behavior including the subscales sympathy, experience and directiveness [32]; genetic, somatic and psychological causal attributions of disease (ratings of agreement on 5-point scales), and general psychological distress using a total of 18 items referring to different life domains (5-point distress scale).…”

Invloed van huidaandoeningen op het dagelijks leven (IHDL)

“…Aspecten van jeukkrab-problematiek of ervaren stigmatisatie worden weer met afzonderlijke vragenlijsten in kaart gebracht (Ehlers, Stangier, Dohn & Gieler., 1993, Leary et al,. 1998Stangier, Ehlers & Gieler, 2003). Er is dan ook geen instrument voor handen dat verschillende ziektespecifieke en generieke aspecten in kaart brengt.…”