Examining Individual Differences in Wellbeing, Anxiety and Depression in Psoriasis Using a Clinically Modified Buddhist
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Examining Individual Differences in Wellbeing, Anxiety and Depression in Psoriasis Using a Clinically Modified Buddhist Psychological Model Alan Maddock1 · David Hevey1 · Paul D’Alton2 · Brian Kirby2
© Springer Science+Business Media, LLC, part of Springer Nature 2019
Abstract Psoriasis patients can experience a range of psychosocial difficulties, which can lead to issues with wellbeing, anxiety and depression. Mindfulness-based interventions have positive impacts on these outcomes; however, there is a need to identify the mechanisms of action of such interventions. This study attempts to do so by examining individual differences in psoriasis patients’ wellbeing, anxiety and depression using a clinically modified Buddhist psychological model (CBPM). Psoriasis patients (N = 285) and (N = 209) completed measures of each CBPM component at time 1 and 2. SEM analyses found that a direct and mediated effect of CBPM model was a good fit to the participant’s data. This study suggests that non-attachment, aversion, acceptance and self-compassion could have a direct effect on the wellbeing, anxiety and depression of psoriasis patients and an indirect effect through reduced worry and rumination. This study provided preliminary evidence for the CBPM as being a useful explanatory framework of psoriasis patients’ anxiety, depression and wellbeing. Keywords Psoriasis · Mindfulness · Depression · Anxiety · Wellbeing
Introduction Psoriasis is a chronic, common, non-communicable skin disease, with no clear cause or cure (World Health Organization [WHO], 2016). It has been estimated that psoriasis affects 125 million people across the world (Kelly-Sell & Gudjonsson, 2017). It has been estimated that 1.6% of the Irish population, around 73,205 people, suffer from psoriasis (Irish Skin Foundation [ISF], 2015). Beyond its physical dimensions, psoriasis can impact all aspects of a person’s life, with the psychosocial burden of coping with psoriasis being rated by patients as one of the worst aspects of the disease (Armstrong, Schupp, Wu, & Bebo, 2012). Due to the impact of psoriasis, patients can experience a number of psychosocial issues, which can impact their psychological wellbeing and also lead to higher levels of anxiety and depression. These can include poor psychological * Alan Maddock [email protected] 1
School of Psychology, Trinity College, 49 Tamarisk Way, Kilnamanagh, Dublin 2, Ireland
St.Vincent’s University Hospital, Elm Park, Dublin 4, Ireland
2
adjustment; maladaptive avoidant coping responses; and problems in body image, self-image, embarrassment, stigmatization, shame, isolation, social discomfort, helplessness and frustration (Armstrong et al., 2012; Augustin & Radtke, 2014; Bhosle, Kulkarni, Feldman, & Balkrishman, 2006; Hayes & Koo, 2010; Kimball, Jacobson, Weiss, Vreeland, & Wu, 2005; Rieder & Tausk, 2012; Wahl, Moum, Hanestad, & Wiklund, 1999). In a US population-based cohort study of psoriasis patients (N = 149,998), 80% of patients reported their condition to be a moderate-or-large problem in their
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