Expressive Suppression and Negative Affect, Pathways of Emotional Dysregulation in Psoriasis Patients

The main goal of this study was to assess the emotion regulation (ER) mechanisms, such as expressive suppression and cognitive reappraisal, in patients with psoriasis, as compared with healthy persons not afflicted by dermatological diseases. Moreover, the study intended to carry on a multidimensional assessment of emotional mechanisms in persons with psoriasis, highlighting the differences between psoriasis patients and healthy participants, in order to identify the specific patterns of emotion dysregulation (ED) in psoriasis. Another goal of the study was to investigate the predictors of ED among different emotional patterns. We presumed that the maladaptive ER mechanisms are higher in psoriasis patients than in the control group and there are specific dysregulation patterns in psoriasis patients as negative emotions tendency. This cross-sectional study was performed on 192 individuals aged between 35 and 75 years (mean age 59). The sample was divided in two groups: the clinical group including 91 patients with a diagnosis of psoriasis vulgaris and the control group including 101 healthy persons. The results of the present study suggest that psoriasis patients more frequently used emotional suppression – a maladaptive ER mechanism – as well as ED patterns – i.e., impulse control difficulties, and nonacceptance of emotional responses. They also displayed trait tendency to a negative emotional response. In fact, in people with psoriasis, the presence of suppression mechanism and negative affect of trait could predict that 35% of patients will show emotional dysregulated patterns, while living with higher levels of ED. The results of our study are important in the clinical practice, helping clinicians to better understand the emotional vulnerability of people that live with psoriatic disease, and to optimize the disease management and patient care in an interdisciplinary approach.

[1]  A. Mufti,et al.  Diagnosis and Management of Cutaneous Psoriasis: A Review , 2019, Advances in skin & wound care.

[2]  K. Reich,et al.  Definition of psoriasis severity in routine clinical care: current guidelines fail to capture the complexity of long‐term psoriasis management , 2018, The British journal of dermatology.

[3]  B. Given,et al.  Emotion Regulation in Chronic Disease Populations: An Integrative Review , 2017, Research and Theory for Nursing Practice.

[4]  I. Almeida,et al.  Emotion Regulation in Patients with Psoriasis: Correlates of Disability, Clinical Dimensions, and Psychopathology Symptoms , 2017, International Journal of Behavioral Medicine.

[5]  U. Wollina,et al.  Psychoneurocutaneous medicine: past, present and future , 2017, Wiener Medizinische Wochenschrift.

[6]  D. Lester,et al.  Health-related quality of life and its association with alexithymia and difficulties in emotion regulation in patients with psoriasis. , 2016, Comprehensive psychiatry.

[7]  Maya Tamir Why Do People Regulate Their Emotions? A Taxonomy of Motives in Emotion Regulation , 2016, Personality and social psychology review : an official journal of the Society for Personality and Social Psychology, Inc.

[8]  M. Jeong Development and Validation of the , 2016 .

[9]  S. Balasundaram,et al.  A Cross-sectional Study of Prevalence and Implications of Depression and Anxiety in Psoriasis , 2015, Indian journal of psychological medicine.

[10]  Steven W. Evans,et al.  ADHD and Emotion Dysregulation Among Children and Adolescents , 2015, Clinical child and family psychology review.

[11]  N. Balato,et al.  PSOCUBE, a multidimensional assessment of psoriasis patients as a both clinically/practically sustainable and evidence‐based algorithm , 2015, Journal of the European Academy of Dermatology and Venereology : JEADV.

[12]  P. Amerio,et al.  Emotion Regulation Strategies and Quality of Life in Dermatologic Patients , 2014 .

[13]  G. Jemec,et al.  Meta-analysis of psoriasis, cardiovascular disease, and associated risk factors. , 2013, Journal of the American Academy of Dermatology.

[14]  D. Mennin,et al.  Emotion Regulation Strategies , 2013 .

[15]  T. Narang,et al.  Psychodermatology: a comprehensive review. , 2013, Indian journal of dermatology, venereology and leprology.

[16]  C. Chew‐Graham,et al.  Recognition of need in health care consultations: a qualitative study of people with psoriasis , 2013, The British journal of dermatology.

[17]  L. Naldi,et al.  Metabolic abnormalities associated with initiation of systemic treatment for psoriasis: evidence from the Italian Psocare Registry , 2013, Journal of the European Academy of Dermatology and Venereology : JEADV.

[18]  L. Cordingley,et al.  Adherence to medication in patients with psoriasis: a systematic review , 2012 .

[19]  K. Reich The concept of psoriasis as a systemic inflammation: implications for disease management , 2012, Journal of the European Academy of Dermatology and Venereology : JEADV.

[20]  F. Tausk,et al.  Psoriasis, a model of dermatologic psychosomatic disease: psychiatric implications and treatments , 2012, International journal of dermatology.

[21]  R. Rashmi,et al.  Stress and quality of life in psoriasis: an update , 2011, International journal of dermatology.

[22]  S. Dickerson,et al.  Emotion regulation and cortisol reactivity to a social-evaluative speech task , 2009, Psychoneuroendocrinology.

[23]  A. Kring,et al.  Measuring Changes in Emotion During Psychotherapy: Conceptual and Methodological Issues , 2007 .

[24]  O. John,et al.  Healthy and unhealthy emotion regulation: personality processes, individual differences, and life span development. , 2004, Journal of personality.

[25]  K. L. Gratz,et al.  Multidimensional Assessment of Emotion Regulation and Dysregulation: Development, Factor Structure, and Initial Validation of the Difficulties in Emotion Regulation Scale , 2004 .

[26]  O. John,et al.  Individual differences in two emotion regulation processes: implications for affect, relationships, and well-being. , 2003, Journal of personality and social psychology.

[27]  H. Kumbasar,et al.  The depression, anxiety, life satisfaction and affective expression levels in psoriasis patients , 1998, Journal of the European Academy of Dermatology and Venereology : JEADV.

[28]  J. Gross,et al.  Hiding feelings: the acute effects of inhibiting negative and positive emotion. , 1997, Journal of abnormal psychology.

[29]  G. G. Kent,et al.  The relationship between stress and the onset and exacerbation of psoriasis and other skin conditions , 1994, The British journal of dermatology.

[30]  J. Gross,et al.  Emotional suppression: physiology, self-report, and expressive behavior. , 1993, Journal of personality and social psychology.

[31]  P. Ekman An argument for basic emotions , 1992 .

[32]  D. Watson,et al.  Development and validation of brief measures of positive and negative affect: the PANAS scales. , 1988, Journal of personality and social psychology.

[33]  J. Stainer,et al.  The Emotions , 1922, Nature.

[34]  A. Toga,et al.  Emotion Regulation , 2015 .

[35]  James J. Gross,et al.  Emotion regulation and psychopathology: A conceptual framework. , 2010 .

[36]  G. Baliva,et al.  Recognition of depressive and anxiety disorders in dermatological outpatients. , 2004, Acta dermato-venereologica.

[37]  J. Gross Antecedent- and response-focused emotion regulation: divergent consequences for experience, expression, and physiology. , 1998, Journal of personality and social psychology.

[38]  D. Parham,et al.  Diagnosis and Management , 2005 .