**4. Controversy**

No consensus exists on the personality of dermatological patients. Buske-Kirschbaum suggests that these patients have a common psychological profile (Buske-Kirschbaum et al., 2004). Despite the existence of features found in such patients, other authors do not accept the existence of a profile that differentiates them from the healthy population (Verhoeven et al., 2008). Similarly, research on personality variables in a Spanish dermatological population (Antuña-Bernardo, 2000), who were assessed using the Eysenck Personality Questionnaire, found that there were no differences between the healthy population and patients with various skin diseases, including psoriasis. However, they were found to have lower quality of life and above-average neuroticism scores.

Personality in Patients with Psoriasis 219

differences between specific subgroups of dermatological patients, particularly in relation to

There are few personality studies on dermatological patients, and on psoriasis patients in particular, indicating a need for further research in personality psychology and psychodermatology. Such studies would lead to a better understanding of this group of patients and to help them better manage stress and the impact this has on their disease, quality of

Alexander, E. J. (1951). Psychosomatic Medicine-Its Principles and Applications. *American* 

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Arck, P.C., Slominski, A., Theoharides, T. C., Peters, E. M. J. & Paus, R. (2006).

Berg, M., Svensson, M., Brandberg, M., & Nordlind, K. (2008). Psoriasis and stress: a prospective study. *J Eur Acad Dermatol Venereol, 22*(6), 670-674. ISSN: 1468-3083. Braun-Falco, O., Plewig, G., Wolff, H., & Winkelmann, R. Dermatology, 1991: Springer-

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life, and their relationships with others.

**6. References** 

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There may be several reasons why no personality differences have been found between the healthy population and psoriasis patients. Firstly, by including all skin diseases, those less associated with psychological variables may have obscured the influence of distinctive personality patterns, thus hindering the detection of differences between the 2 populations. Second, few studies have analyzed the strategies used or differences in the way psoriasis patients manage their emotions compared to the healthy population (Fortune, Richards, Main, & Griffiths, 2002), whereas, in comparison, psychological research on dermatologic patients has mainly focussed on variables such as stress, anxiety and depression. By placing too much emphasis on variables such as depression and anxiety, or on psychopathological abnormalities based on diagnostic categories, there is an increased risk of losing specificity in the search for potential differences between the healthy population and psoriasis patients. An increase in psychiatric disorders can be observed in the latter group, but it would be more useful to know how these abnormalities arise, how are they qualitatively different, and what characterizes this group of patients. The relevance of personality may have become lost as a research aim, leading to a reduction in the number of empirical studies investigating personality in this group of patients. Finally, another possibility is that instruments used in the past to assess personality were not designed to measure specific personality variables in this group or were not sufficiently sensitive to detect subtle differences. This could explain why some studies have failed to find any differences; questionnaires were used that were not designed to assess profound personality structures. According to some authors, sensitive instruments are now available for assessing the association between personality and disease (Friedman, 1990).

### **5. Conclusions**

The most important conclusion is that personality differences were found between the healthy population and psoriasis patients. These differences suggest that there is a greater tendency among psoriasis patients to be acquiescent and to restrain the expression of negative emotions in order to bond with others. The literature and the results from the study presented here shows a decreased capacity to adjust to the environment, which could, due to poor stress management, increase the risk of suffering psoriasis in susceptible individuals.

The number of subjects in the study presented here was sufficient to establish differences between psoriasis patients and healthy participants and the results are consistent with those obtained by other authors; however, further studies are needed that include a greater number of psoriasis patients, thereby providing stronger support to the results obtained here, as well as a greater degree of generalizability.

If we wish to understand the psychological characteristics of psoriasis patients and their characteristic personality styles, future studies should compare the personality of psoriasis patients to that of patients with other skin diseases associated with psychological traits in order to identify the different adaptation styles, if any.

Finally, the relevance of these findings lies in their deepening our understanding of the psychological problems of psoriasis patients.

If psychopathological abnormalities, such as depression and anxiety, are observed in dermatological patients as a group, then this should lead to investigating potential differences between specific subgroups of dermatological patients, particularly in relation to what qualitatively characterizes psoriasis patients as one such subgroup.

There are few personality studies on dermatological patients, and on psoriasis patients in particular, indicating a need for further research in personality psychology and psychodermatology. Such studies would lead to a better understanding of this group of patients and to help them better manage stress and the impact this has on their disease, quality of life, and their relationships with others.

#### **6. References**

218 Psoriasis

There may be several reasons why no personality differences have been found between the healthy population and psoriasis patients. Firstly, by including all skin diseases, those less associated with psychological variables may have obscured the influence of distinctive personality patterns, thus hindering the detection of differences between the 2 populations. Second, few studies have analyzed the strategies used or differences in the way psoriasis patients manage their emotions compared to the healthy population (Fortune, Richards, Main, & Griffiths, 2002), whereas, in comparison, psychological research on dermatologic patients has mainly focussed on variables such as stress, anxiety and depression. By placing too much emphasis on variables such as depression and anxiety, or on psychopathological abnormalities based on diagnostic categories, there is an increased risk of losing specificity in the search for potential differences between the healthy population and psoriasis patients. An increase in psychiatric disorders can be observed in the latter group, but it would be more useful to know how these abnormalities arise, how are they qualitatively different, and what characterizes this group of patients. The relevance of personality may have become lost as a research aim, leading to a reduction in the number of empirical studies investigating personality in this group of patients. Finally, another possibility is that instruments used in the past to assess personality were not designed to measure specific personality variables in this group or were not sufficiently sensitive to detect subtle differences. This could explain why some studies have failed to find any differences; questionnaires were used that were not designed to assess profound personality structures. According to some authors, sensitive instruments are now available for assessing the

The most important conclusion is that personality differences were found between the healthy population and psoriasis patients. These differences suggest that there is a greater tendency among psoriasis patients to be acquiescent and to restrain the expression of negative emotions in order to bond with others. The literature and the results from the study presented here shows a decreased capacity to adjust to the environment, which could, due to poor stress management, increase the risk of suffering psoriasis in susceptible

The number of subjects in the study presented here was sufficient to establish differences between psoriasis patients and healthy participants and the results are consistent with those obtained by other authors; however, further studies are needed that include a greater number of psoriasis patients, thereby providing stronger support to the results obtained

If we wish to understand the psychological characteristics of psoriasis patients and their characteristic personality styles, future studies should compare the personality of psoriasis patients to that of patients with other skin diseases associated with psychological traits in

Finally, the relevance of these findings lies in their deepening our understanding of the

If psychopathological abnormalities, such as depression and anxiety, are observed in dermatological patients as a group, then this should lead to investigating potential

association between personality and disease (Friedman, 1990).

here, as well as a greater degree of generalizability.

order to identify the different adaptation styles, if any.

psychological problems of psoriasis patients.

**5. Conclusions** 

individuals.


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**Part 3** 

**Treatment** 

