The Relationship Among Social Anxiety, Stigma And Resilience In Patients With Psoriasis

Objective The survey aimed to investigate the status of social anxiety among patients with psoriasis, and to explore the relationship between resilience, stigma and social anxiety. The study was performed to examine the contribution of resilience and stigma to social anxiety so as to provide a theoretical foundation for exploring the strategies of improving psychological problems among patients with psoriasis.Methods 110 patients with psoriasis were recruited from specialized hospital for psoriasis of Shandong Province by adopting convenience sampling methods in this survey. A series of self-reported questionnaires that dispose of the following constructs:general information, social anxiety, stigma, and resilience were estimated. Pearson correlation and multiple liner regression were conducted to explore the relationship among resilience, stigma and social anxiety.Results1. Socio-demographic and clinical informationThe average age was 36.63 years (SD=10.83), ranging from 16 to 63 years. 54.5% of patients were males, and 36.4% of patients had a college degree or above. 79.1% of patients had lesions in the body (including the head and face), and there were 73 patients with itching. The mean score of PASI was 21.57 (SD=11.02).2. The status of social anxiety and its differences in socio-demographic and clinical informationThe average scores of social anxiety, resilience were 38.95 (SD=8.95) and 27.16 (SD=7.05) respectively. The scores of two dimensions of stigma including discrimination and shame were 1.91 (SD=2.22) and 2.90 (SD=2.62), respectively. 64 patients experienced discrimination and 70% participants experienced a sense of shame. t test and ANOVA analysis showed that there was significant difference between score of social anxiety and education level. The score of social anxiety in patients with itching was significant higher than patients without. Results of Pearson correlation showed that there were no significant correlation between social anxiety with age and PASI (r=0.048, P>0.05; r=0.104, P>0.05). There were no differences in the social anxiety score among other variables.3. Correlation analysis among social anxiety, stigma and resilienceSocial anxiety was positively related to shame and discrimination scores, while resilience was negatively related to social anxiety. There were significant negative correlations between discrimination and a sense of shame and resilience.4. Hierarchical regression analysis of social anxietyHierarchical regression analysis was used to explore the association among resilience, stigma and social anxiety. The study selected social anxiety as the dependent variables, resilience and stigma as independent variables, general demographic variables as first-level control variables, the two dimensions of stigma as the second-level variable into the equation, and the level of resilience as third-level variables into the equation.The results indicated that demographic and clinical variables could explain the 11.7% variance of social anxiety as control variables entered into the regression equation. When the two dimensions of stigma was added into the regression equation, only shame could positively predict the social anxiety, with accounting for 20.6% variance of social anxiety. Resilience could negatively predict the social anxiety, and resilience, stigma, and demographic and clinical information could explain the 34.8% variance of social anxiety.Conclusions1. Patients with psoriasis were prone to experience social anxiety, had a severe stigma and medium resilience.2. The two dimensions of stigma were positively related to social anxiety, while resilience was negatively related to social anxiety. The relationship between the dimensions of stigma and resilience was significantly negative.3. Sense of shame and resilience could predict the social anxiety of patients with psoriasis. Taking measures to enhance the level of resilience and decrease the level of stigma might alleviate social anxiety.