Psychodermatology covers all aspects of how the mind and body interact in relation to the onset and progression of various skin disorders. This book is the first text written by a multidisciplinary team of psychiatrists, psychologists, child specialists and dermatologists for all the health professionals who treat patients with skin problems. They cover a broad range of issues affecting these patients, including: stigma, coping, relationships, psychological treatments, the impact on children, comorbidities, psychoneuroimmunology, quality of life and psychological treatments.

Preface

xi

Acknowledgments

xiii

Introduction

1

(14)

Carl Walker

Skin disease and psychology: a multitude of links

2

(2)

Skin disease and body image

4

(1)

Self-schema(s) and body image

5

(1)

The psychological impact of skin disease

6

(1)

Management

7

(1)

Theoretical models and psychodermatology

8

(1)

The diatheses-stress paradigm

8

(1)

Stress and dermatology

9

(1)

About the book

9

(6)

Psychoneuroimmunology

15

(14)

Leslie Millard

Introduction

15

(1)

History

16

(1)

Afferent pathway

17

(1)

Efferent pathway

18

(1)

Responses

18

(1)

The neuroendocrine pathway

19

(1)

Changes in disease

20

(1)

Cytokines in depression and anxiety

21

(1)

Inflammatory skin disease

21

(1)

Atopic eczema

21

(2)

Psoriasis

23

(1)

Cutaneous viral infections

24

(1)

Conclusion

24

(5)

Psychiatric comorbidity in dermatologic disorders

29

(15)

Madhulika A. Gupta

Introduction

29

(1)

Major depressive disorder

30

(4)

Obsessive-compulsive disorder

34

(1)

Social phobia (social anxiety disorder)

35

(1)

Post-traumatic stress disorder

35

(1)

BDD and other body image pathologies

36

(1)

Delusional disorder and other psychotic symptoms

37

(1)

Personality disorders

38

(1)

Conclusion

39

(5)

Stigmatisation and skin conditions

44

(13)

Gerry Kent

What types of stigmatisation do people encounter?

45

(2)

What is the nature of these experiences?

47

(1)

Why does stigmatisation occur?

48

(1)

What effects does stigmatisation have?

49

(1)

Why does stigmatisation matter?

50

(1)

How might stigmatisation be reduced?

51

(1)

Future research

52

(5)

Coping with chronic skin conditions: factors important in explaining individual variation in adjustment

57

(15)

Andrew Thompson

Introduction

57

(1)

Defining `skin conditions'

57

(1)

What do people living with chronic skin conditions have to cope with?

58

(3)

The symptoms and their treatments

58

(1)

The social and psychological impact of skin conditions

58

(2)

Individual variation in the psychosocial impact

60

(1)

Explanatory factors in coping and adjustment

60

(1)

Disease and treatment factors

61

(2)

Predisposing developmental factors

63

(1)

Ongoing sociocultural factors

63

(1)

Cognitive factors: personality characteristics and core beliefs

64

(1)

Coping

65

(1)

Conclusion

66

(6)

Skin disease and relationships

72

(17)

Litsa Anthis

In sickness and in health

72

(1)

Coping and adjustment

73

(2)

Attachment styles

75

(1)

Appearance, attraction and shame

76

(1)

Difficulties in communication

77

(2)

Changes in social networks

79

(1)

Body image and sexual intimacy

80

(1)

Relationship-focused coping

81

(2)

Conclusion

83

(6)

The impact of skin disease on children and their families

89

(12)

Penny Titman

The impact of skin disease on psychological well-being of the child and family

90

(1)

Theoretical models of the psychological impact of skin disease during childhood

91

(1)

The impact of skin disease on the mother-child relationship

92

(3)

The impact of skin conditions on self-esteem

95

(2)

Accessing psychological services for children with skin conditions

97

(1)

Summary

98

(3)

Psychological therapies for dermatological problems

101

(15)

Linda Papadopoulos

Introduction

101

(1)

Psychosocial impact of skin diseases

102

(3)

Psychological approaches to treatment for dermatological conditions

105

(5)

Behaviour therapy

106

(1)

Cognitive--behavioural therapy

107

(1)

Psychoanalytic psychotherapy and hypnosis

108

(1)

Group therapy

109

(1)

Recommendations for treatment

110

(1)

How can therapy help in the treatment and management of dermatology patients?

111

(1)

Levels of counselling

111

(1)

Information giving (education)

111

(1)

Implications counselling

111

(1)

Supportive counselling

111

(1)

Psychotherapeutic counselling: therapy

112

(1)

Conclusion

112

(4)

Research methodology in quality of life assessment

116

(15)

Andrew Finlay

Introduction

116

(1)

What is quality of life?

116

(1)

Why QoL measurement is important?

116

(1)

Development of QoL research in dermatology

117

(1)

Methods of creation of measures

118

(1)

Validation techniques

119

(2)

Methodology available

121

(1)

Dermatology-specific measures: adults

121

(1)

Dermatology-specific measures: children

121

(1)

Disease-specific measures

121

(1)

Other disease-specific measures

122

(1)

Critical reviews of methodology

122

(1)

Use of methods

122

(2)

Therapeutics

122

(1)

Health service research

122

(1)

Epidemiology: national surveys

122

(1)

Patient disease interaction

123

(1)

Recent further DLQI validation studies

123

(1)

Psychological symptoms and compliance

123

(1)

Influences affecting QoL

124

(1)

Further research challenges

124

(2)

Declaration of interest

126

(5)

Psychodermatology in context

131

(14)

Carl Walker

Introduction

131

(1)

A theoretical framework for skin disease: what do patients know about their own skin disorder?

132

(1)

Identity

133

(1)

Consequences

133

(1)

Causes

134

(1)

Timeline

134

(1)

The importance of personal illness beliefs and stigma regarding skin disease

134

(3)

Skin disease and psychotherapy: an example of how psychology can help

137

(1)

The case of Jake

138

(1)

The body as aesthetic object

139

(1)

Psychology and treatment

139

(1)

The professional perspective

140

(1)

Psychodermatology: the multidiscipline

141

(1)

A framework for the future

142

(3)

Index

145

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