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Psychosocial Adjustment to Stigma Am...

Stuhlmann, Caroline Faye Zimmermann,

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Psychosocial Adjustment to Stigma Among Young Adults With Chronic Visible Skin Disease /

Record Type:	Electronic resources : Monograph/item
Title/Author:	Psychosocial Adjustment to Stigma Among Young Adults With Chronic Visible Skin Disease // Caroline Faye Zimmermann Stuhlmann.
Author:	Stuhlmann, Caroline Faye Zimmermann,
Description:	1 electronic resource (261 pages)
Notes:	Source: Dissertations Abstracts International, Volume: 86-07, Section: B.
Contained By:	Dissertations Abstracts International86-07B.
Subject:	Psychology. -
Online resource:	https://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=31768249
ISBN:	9798302159823

Psychosocial Adjustment to Stigma Among Young Adults With Chronic Visible Skin Disease /
Stuhlmann, Caroline Faye Zimmermann,

Psychosocial Adjustment to Stigma Among Young Adults With Chronic Visible Skin Disease /Caroline Faye Zimmermann Stuhlmann. - 1 electronic resource (261 pages)

Source: Dissertations Abstracts International, Volume: 86-07, Section: B.

Skin diseases are the fourth leading cause of non-fatal disease burden worldwide (Karimkhani et al., 2017) and have high comorbidity with mental illness (Balieva et al., 2023). Moreover, people with chronic visible skin disease are often stigmatized because of their skin. Visible stigma may be especially problematic in the developmental context of emerging adulthood, when individuals are focused on identity, intimate relationships, and the transition from adolescence to adulthood. Bridging theories of stigma (Barreto, 2015; Major & O'Brien, 2005; Miller & Kaiser, 2001) and stress and coping (Lazarus & Folkman, 1984), the dissertation examined the mediational role of internalized stigma and coping (approach, avoidance, stigma resistance coping) in the relationship of social stigma and psychosocial adjustment among young adults with visible chronic skin diseases. Indicators of psychosocial adjustment spanned several domains: mental health (depression, anxiety, quality of life), physical health (somatic symptoms), dermatologic intimacy, and a health behavior (physical activity). It was hypothesized that greater social stigma would relate to poorer adjustment across all outcomes, and that this relationship would be serially mediated first, by internalized stigma and then, coping. This cross-sectional study obtained data about patients' sociodemographic information, experiences with social stigma, internalized stigma, coping strategies, and psychosocial adjustment from a self-report questionnaire using validated or adapted measures. Clinical and medical information including disease severity were obtained from electronic medical records or a physical exam. The sample consisted of 195 young adult patients between the ages of 18 - 35 (Mage = 28.06 years; 49% female) with psoriasis (55%), atopic dermatitis (23%), or hidradenitis suppurativa (22%) seeking care at an outpatient dermatology clinic at the University Medical Center Hamburg-Eppendorf in Hamburg, Germany. Serial mediation, using the PROCESS macro in SPSS, tested indirect effects of social stigma to psychosocial adjustment through internalized stigma and coping strategies. The major findings were that the relationship of social stigma with each outcome was significantly mediated by internalized stigma, and the effects were strong. None of the coping strategies were significant mediators; nor was the serial mediation path significant. Nevertheless, the model accounted for variance that reached 66% in dermatologic intimacy, signaling a way that stigma may hinder normative development for young adults. This dissertation highlighted that for young adults with chronic visible skin disease, social stigma has implications for a myriad of psychological, social, and health outcomes, and that internalized stigma, not coping, is a major driving force in these relationships. As such, this dissertation points to stigma, especially internalized stigma, as a potential target for clinical interventions and policy change to improve well-being for young adults with chronic visible skin disease.

English

ISBN: 9798302159823Subjects--Topical Terms:

519075
Psychology.
Subjects--Index Terms:

Coping

Psychosocial Adjustment to Stigma Among Young Adults With Chronic Visible Skin Disease /
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520 $a Skin diseases are the fourth leading cause of non-fatal disease burden worldwide (Karimkhani et al., 2017) and have high comorbidity with mental illness (Balieva et al., 2023). Moreover, people with chronic visible skin disease are often stigmatized because of their skin. Visible stigma may be especially problematic in the developmental context of emerging adulthood, when individuals are focused on identity, intimate relationships, and the transition from adolescence to adulthood. Bridging theories of stigma (Barreto, 2015; Major & O'Brien, 2005; Miller & Kaiser, 2001) and stress and coping (Lazarus & Folkman, 1984), the dissertation examined the mediational role of internalized stigma and coping (approach, avoidance, stigma resistance coping) in the relationship of social stigma and psychosocial adjustment among young adults with visible chronic skin diseases. Indicators of psychosocial adjustment spanned several domains: mental health (depression, anxiety, quality of life), physical health (somatic symptoms), dermatologic intimacy, and a health behavior (physical activity). It was hypothesized that greater social stigma would relate to poorer adjustment across all outcomes, and that this relationship would be serially mediated first, by internalized stigma and then, coping. This cross-sectional study obtained data about patients' sociodemographic information, experiences with social stigma, internalized stigma, coping strategies, and psychosocial adjustment from a self-report questionnaire using validated or adapted measures. Clinical and medical information including disease severity were obtained from electronic medical records or a physical exam. The sample consisted of 195 young adult patients between the ages of 18 - 35 (Mage = 28.06 years; 49% female) with psoriasis (55%), atopic dermatitis (23%), or hidradenitis suppurativa (22%) seeking care at an outpatient dermatology clinic at the University Medical Center Hamburg-Eppendorf in Hamburg, Germany. Serial mediation, using the PROCESS macro in SPSS, tested indirect effects of social stigma to psychosocial adjustment through internalized stigma and coping strategies. The major findings were that the relationship of social stigma with each outcome was significantly mediated by internalized stigma, and the effects were strong. None of the coping strategies were significant mediators; nor was the serial mediation path significant. Nevertheless, the model accounted for variance that reached 66% in dermatologic intimacy, signaling a way that stigma may hinder normative development for young adults. This dissertation highlighted that for young adults with chronic visible skin disease, social stigma has implications for a myriad of psychological, social, and health outcomes, and that internalized stigma, not coping, is a major driving force in these relationships. As such, this dissertation points to stigma, especially internalized stigma, as a potential target for clinical interventions and policy change to improve well-being for young adults with chronic visible skin disease.
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