The effect of cognitive behavioral group therapy on experienc, expression, and control of anger quality of life, and severity of psoriasis

Document Type : Research Paper

Authors

1 Ph.D. student of health psychology, Department of psychology, Torbat-e Jam Branch, Islamic Azad University, Torbat-e Jam, Iran

2 Assistant professor of health psychology department, Department of psychology, Torbat-e Jam Branch, Islamic Azad University, Torbat-e Jam, Iran

3 Associate professor of Dermatology, Department of psychology, Torbat-e Jam Branch, Islamic Azad University, Torbat-e Jam, Iran

4 Assistant professor, Department of Persian medicine, school of Persian and complementary medicine, Mashhad University of Medical Sciences, Mashhad, Iran

5 Associate professor, Biostatistics and Epidemiology Department, School of health, Mashhad University of Medical Sciences, Mashhad, Iran

Abstract

Introduction:
Numerous studies have emphasized on the psychosomatic origin of psoriasis and shown that the inhibition of negative emotions can be considered as important primary causes or accelerator factors in its course. Our study conducted with a psychodermatologic approach to investigate the effects of Cognitive Behavioral Group therapy (CBGT) on anger aspects, clinical manifestations, and quality of life in patients suffering from psoriasis, and to find the relation of the changes of inner anger control and anger suppression with the changes of clinical manifestations.
 
Materials and methods:
This quasi-experimental research was performed during October 2019 to February 2020 on 30 patients involved in cutaneous psoriasis in Mashhad. After obtaining informed consent, the patients divided into control and trial groups by randomized allocation. The State–Trait Anger Expression Inventory II (STAXI-II), dermatology life quality index (DLQI), and Psoriasis Area Severity Index (PASI) were assessed for both groups at the beginning of study. The patients in both groups received classic medication by dermatologist prescription for 8 weeks, and 10 sessions of 90 minutes CBGT were performed just for 15 patients in the trial group. At the end of the study, STAXI-II, DLQI, and PASI were assessed again and the data were analysed.
 
Results:
According to the results of this study, CBGT could significantly decrease the Feeling Angry, Anger Expression–In, and Anger Control–Out, and could meaningfully increase the Anger Control–In, improve the quality of life, and decrees the PASI Score in patients with psoriasis in comparison to the control group. Also a positive correlation was found between the changes of Anger Expression–In with changes in PASI Score, and a negative correlation was found between the changes of Anger Control–In with changes in PASI Score in all the participants.
Conclusion:
These findings points out to the major effects of mind-body concerns in treatment of psoriatic patients and shows that the CBGT is an effective method to improve their psychological, physical and social health.

Keywords

References

Gupta MA, Gupta AK. Evaluation of cutaneous body image dissatisfaction in the dermatology
patient. Clinics in dermatology. 2013 Jan 1;31(1):72-9.
2. Jafferany M. Psychodermatology: a guide to understanding common psychocutaneous disorders.
Primary care companion to the Journal of clinical psychiatry. 2007;9(3):203.
3. Menter A, Gottlieb A, Feldman SR, Van Voorhees AS, Leonardi CL, Gordon KB, Lebwohl M, Koo
JY, Elmets CA, Korman NJ, Beutner KR. Guidelines of care for the management of psoriasis and
psoriatic arthritis: Section 1. Overview of psoriasis and guidelines of care for the treatment of
psoriasis with biologics. Journal of the American Academy of Dermatology. 2008 May 1;58(5):826-
50.
4. Dreyer LN, Brown GC. Oral manifestations of psoriasis. The New York state dental journal.
2012:p14-18.
5. Langley RG, Paller AS, Hebert AA, Creamer K, Weng HH, Jahreis A, Globe D, Patel V, Orlow SJ.
Patient-reported outcomes in pediatric patients with psoriasis undergoing etanercept treatment: 12-
week results from a phase III randomized controlled trial. Journal of the American Academy of
Dermatology. 2011 Jan 1;64(1):64-70.
6. Fry L. An Atlas of Psoriasis. New jersey: USA the Parthenon publishing group Inc; 1997, 1-32.
7. Mease PJ, Menter MA. Quality-of-life issues in psoriasis and psoriatic arthritis: outcome measures
and therapies from a dermatological perspective. Journal of the American Academy of Dermatology.
2006 Apr 1;54(4):685-704.
8. Barrea L, Nappi F, Di Somma C, Savanelli MC, Falco A, Balato A, Balato N, Savastano S.
Environmental risk factors in psoriasis: the point of view of the nutritionist. International journal of
environmental research and public health. 2016 Jul;13(7):743.
9. Kotrulja L, Tadinac M, JokIć-BegIć N, Gregurek R. A multivariate analysis of clinical severity,
psychological distress and psychopathological traits in psoriatic patients. Acta dermatovenereologica. 2010 May 1;90(3):251-6.
10. Fortune DG, Richards HL, Griffiths CE, Main CJ. Psychological stress, distress and disability in
patients with psoriasis: consensus and variation in the contribution of illness perceptions, coping and
alexithymia. British Journal of Clinical Psychology. 2002 Jun;41(2):157-74.
11. Farber EM, Nall L. The natural history of psoriasis in 5,600 patients. Dermatology. 1974;148(1):1-8.
12. Picardi A, Abeni D. Stressful life events and skin diseases: disentangling evidence from myth.
Psychotherapy and psychosomatics. 2001;70(3):118-36.
13. Koo JY, Lee CS. General approach to evaluating psychodermatological disorders. Koo JYM, Lee
CS eds Psychocutaneous Medicine.
14. Wahl A, Loge JH, Wiklund I, Hanestad BR. The burden of psoriasis: a study concerning healthrelated quality of life among Norwegian adult patients with psoriasis compared with general
population norms. Journal of the American Academy of Dermatology. 2000 Nov 1;43(5):803-8.
15. Weiss SC, Kimball AB, Liewehr DJ, Blauvelt A, Turner ML, Emanuel EJ. Quantifying the harmful
effect of psoriasis on health-related quality of life. Journal of the American Academy of
Dermatology. 2002 Oct 1;47(4):512-8.
16. Dinulos J, Psoriasis and other papulosquamous diseases. In: Habif T, Chapman M. Sh, Zug K. Skin
Disease: Diagnosis and Treatment. 4th ed. Elsevier, USA: 2017; 120-9.
17. Jankowiak B, Kowalewska B, Krajewska-Kułak E, Khvorik DF. Stigmatization and quality of life in
patients with psoriasis. Dermatology and therapy. 2020 Apr;10(2):285-96.
18. Basińska MA, Woźniewicz A. The relation between type D personality and the clinical condition of
patients suffering from psoriasis. Advances in Dermatology and Allergology/Postȩpy Dermatologii i
Alergologii. 2013 Dec;30(6):381.
19. Van de Kerkhof PC, editor. Textbook of psoriasis. John Wiley & Sons; 2nd ed. 2003.
20. Mommersteeg PM, Herr R, Bosch J, Fischer JE, Loerbroks A. Type D personality and metabolic
syndrome in a 7-year prospective occupational cohort. Journal of psychosomatic research. 2011 Nov
1;71(5):357-63.
21. Gupta MA, Gupta AK, Watteel GN. Perceived deprivation of social touch in psoriasis is associated
with greater psychologic morbidity: an index of the stigma experience in dermatologic disorders.
Cutis. 1998 Jun 1;61(6):339-42.
22. Langley RG, Krueger GG, Griffiths CE. Psoriasis: epidemiology, clinical features, and quality of
life. Annals of the rheumatic diseases. 2005 Mar 1;64(suppl 2):ii18-23.
23. Xiao Y, Zhang X, Luo D, Kuang Y, Zhu W, Chen X, Shen M. The efficacy of psychological
interventions on psoriasis treatment: a systematic review and meta-analysis of randomized controlled
trials. Psychology research and behavior management. 2019;12:97.
24. Alipour A, Zare H, Naser Emadi S, Abdollahzade H. The impact of group cognitive behavioral
therapy on the disease severity and mental health of psoriasis patients. Dermatology & Cosmetic.
2013 Dec 1;4(4).
25. Spielberger CD. Staxi-2: state-trait anger expression inventory-2; professional manual. PAR,
Psychological Assessment Resources; 1999.
26. Khodayarifard M. GHolamali lavasani M, Akbari Zardkhaneh S, Liaghat S. Psychometric properties
of spielbergers state–trait anger expression inventtory–2 among of Iranian students. Ournal of
rehabilitation. 2010;11(41):47-56.
27. Asghari MA, Hakimirad E, Rezazadeh T. A preliminary validation of the psychometric
characteristics of state and trait anger expression inventory-2 (STAXI-2) in a sample of university
students. 2008 April; 15 (28): 21-34.
28. Aghaei S, Sodaifi M, Jafari P, Mazharinia N, Finlay AY. DLQI scores in vitiligo: reliability and
validity of the Persian version. BMC dermatology. 2004 Dec;4(1):1-5.
29. Louden BA, Pearce DJ, Lang W, Feldman SR. A Simplified Psoriasis Area Severity Index (SPASI)
for rating psoriasis severity in clinic patients. Dermatology online journal. 2004;10(2).
30. Faria JR, Aarão AR, Jimenez LM, Silva OH, Avelleira JC. Inter-rater concordance study of the PASI
(Psoriasis Area and Severity Index). Anais brasileiros de dermatologia. 2010;85:625-9.
31. Faridhosseini F. Effectiveness of cognitive-behavioral stress management on anxiety, depression and
quality of life in patients with psoriasis. medical journal of mashhad university of medical sciences.
2016;59(5):337-44.
32. Fathi K, Mehrabizade Honarmand M, Zargar Y, Davoodi I, Shahba N. The Effect of CognitiveBehavioral Stress Management on Illness Perceptions, Quality of Life, General Health and Clinical
Symptoms of Women with Psoriasis. Journal of Psychological Achievements. 2013 Dec
22;20(2):193-216.
33. Bundy C, Pinder B, Bucci S, Reeves D, Griffiths CE, Tarrier N. A novel, web‐based, psychological
intervention for people with psoriasis: the electronic T argeted I ntervention for P soriasis (e TIP s)
study. British Journal of Dermatology. 2013 Aug;169(2):329-36.
34. Fortune DG, Richards HL, Kirby B, Bowcock S, Main CJ, Griffiths CE. A cognitive‐behavioural
symptom management programme as an adjunct in psoriasis therapy. British Journal of
Dermatology. 2002 Mar;146(3):458-65.
35. Seng TK, Nee TS. Group therapy: a useful and supportive treatment for psoriasis patients.
International journal of dermatology. 1997 Feb;36(2):110-2.
36. Price ML, Mottahedin I, Mayo PR. Can psychotherapy help patients with psoriasis?. Clinical and
Experimental Dermatology. 1991 Mar;16(2):114-7.
medical journal of mashhad university of medical sciences
Volume 64, Issue 4
November and December 2021
Pages 3744-3759

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