My interest in psoriasis shifted several years ago from the purely personal to the professional. I work as a university based researcher and clinical psychologist, so the idea of how other people experienced their psoriasis intrigued me. I collaborated with Dr. Sandy Murray, Ms. Janet Lowe (both dermatology associates in Halifax), Dr. Cynthia Mathieson (Mount Saint Vincent University), and Dr. Karen Ruggiero (formerly of Harvard University) to answer this question with the help of about 100 people receiving light treatments for their psoriasis. As two of the resulting published studies are some of the most recent in the scientific literature, I thought that sharing some of the results here might be useful.
What Is Physical and What Is Psychological?
Our findings showed that people think in more than one way about the negative effects of psoriasis. Most people make a clear distinction between what bothers them psychologically (what we call psychosocial impact) and what bothers them physically (how much people can do on a daily basis).
Although this may seem obvious, it seems important to note that two very different thought processes come into play when considering this disease. On the physical side, people reported different degrees of distress about how much pain, stinging, and itching they experienced. Psychosocial distress involved other people noticing their psoriasis, disruptions to social life, and disruptions to daily routines. It was interesting that the amount of scaling on the skin was associated with psychological distress and not physical impact.
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| Forms Of Psoriasis |
Gender Differences
It is generally accepted that physical appearance counts for more in the lives of women than in the lives of men. It is often assumed that this general truth extends to those with psoriasis, even though previous studies have failed to provide clear evidence of a more negative experience for women. Our survey provided some mixed findings on this point. Women did report that they faced more discrimination because of their psoriasis than did men, a conclusion with which the men in our study agreed. However, when asked more directly about how stigmatizing their experience with psoriasis has been (including feelings of self-worth), there was little to distinguish between men and women about how negatively the disease had affected their lives.
One of the many potential implications of our findings is the need to exercise caution when applying stereotypes to the experiences of others. It may be that all of the participants recognized that women should be more affected than men, but the reality may be that men and women cope (or fail to cope) equally with the disease. The findings also suggested that for most people, psoriasis is hardly a "show stopper" in their lives. Human beings are quite resourceful, resilient, and able to cope with whatever life serves up.
Age Differences
Older people surveyed reported that their psoriasis had a greater general psychosocial impact on their lives than did younger participants. We found this somewhat surprising as we expected the opposite. On the other hand, younger participants had greater feelings of guilt about their psoriasis than did older respondents.
We thought the degree to which psoriasis bothers people might not vary just on the basis of age when surveyed, but also on the basis of age when first diagnosed. Children and especially teenagers face the challenge of developing a sense of identity. We can all remember how important appearance and "fitting in" was during our junior and senior high school years.
We found those participants who were diagnosed at relatively earlier ages reported they were more sensitive and afraid of rejection than were those diagnosed later in life. It is important to remember that this finding did not relate to the current age of participants. It seems that those diagnosed earlier in life had greater trouble shaking off negative feelings about themselves as they grew older. This finding supports the fact that when facing psoriasis when you are young, the effects are lasting. Doctors and parents should be aware of the vulnerability of those coping with psoriasis when it strikes during the critical periods of identity formation and peer comparisons that occur during the teenage years.
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| Forms Of Psoriasis |
Severity
We were somewhat surprised to find that the severity of psoriasis, measured by the standard instrument dermatologists use, was not strongly linked to how negatively psoriasis had impacted participants' lives. The exception was for a number of participants with very severe conditions who were more likely to reach out to support groups. This finding doesn't mean that severity is irrelevant. One must consider that the people surveyed were all living with a significant degree of severity as indicated by their receiving light treatments. The situation of these participants might be quite different from those who experience milder forms of the disease. Still, this finding suggests that how one feels about his or her psoriasis is a very subjective and individual experience, so there is no right or wrong way to feel about your condition. It is important that the negative effects of psoriasis be dealt with on an individual, not a "one size fits all," basis. To find out more, you can check out Forms Of Psoriasis.