The Mediating Role of the Self- Regulatory Process in the Relationship between Perceived Stress on Depression, Shame and Guilt in Two Groups of Psoriasis Patients and patients’ Companions

Document Type : Research Paper

Authors

1 Department of Psychology, Faculty of Psychology and Educational Science, University of Tehran, Tehran, Iran

2 Department of Psychology, Faculty of Psychology and Educational Science, University of Tehran, Tehran, Iran.

Abstract

The purpose of the current study is to investigate the mediating role of self-regulation processes in the relationship between perceived stress, depression, shame, and remorse in patients with psoriasis and healthy individuals. This research has a practical orientation and employs a quantitative correlational methodology. It’s statistical demographic included all psoriasis patients and healthy patients referred to the follow-up skin clinic at Tehran’s Razi Hospital in 2016. Available sampling was used to select 168 patients (85 males and 83 females) and 121 healthy patients' companions (22 males and 99 females). The following questionnaires were completed: Integrative Self- Knowledge (ISK), Self-Control (SCS), Consciousness (MAAS), Perceived Stress (PSS), and Depression Scale (MMPI). The data were analyzed using SPSS-22. The data were analyzed using descriptive and inferential statistical techniques, such as Pearson’s correlation coefficient, adjusted hierarchical regression, and the T-test. Integrated self-knowledge and shame were found to be greater in patients’ companions than in psoriasis patients. In contrast, anxiety and depression were more prevalent in psoriasis patients than in their healthy counterparts.Integrated self-knowledge was also found to moderate the relationship between perceived stress, depression, and shame. Therefore, it is essential that mental health professionals, educational institutions, and parents cultivate the process of self-regulation in individuals.
Keywords: Depression, Perceived Stress, Psoriasis, Shame, Self-Regulation Process.
 

Keywords

References

امیدبیگی، م.، خلیلی، ش.، غلامعلی لواسانی، م.، و قربانی، ن. (1393). رابطۀ ذهن‌آگاهی و خودشناسی منسجم با رضایتمندی زناشویی. مجلۀ روان‌شناسی. 18(3)، 341-327.
تبیک، م. ت.، قربانی، ن.، و رضازاده، س. م. ر. (1392). نقش فرایندهای خودشناختی و عوامل بزرگ شخصیت در فضایل اخلاقی، فصلنامۀ روان‌شناسی و دین. 6(3)، 80-71.
شاه‌محمدی، خ.، قربانی، ن.، بشارت، م.، و نصرت‌آبادی، م. (1388). تأثیر پیش‌بین خودشناسی انسجامی، بهوشیاری و سبک‌های دفاعی بر سلامت. روان‌شناسی و علوم تربیتی. 39(3)، 119-99.
قاسمی‌پور، ی.، و قربانی ن. (1389). بهوشیاری و نیازهای بنیادی روان‌شناختی در بیماران قلبی-عروقی. مجلۀ روان‌پزشکی و روان‌شناسی بالینی ایران. 16(2)، 162-154.
موسوی، آ. س.، و قربانی، ن. (1385). خودشناسی، خودانتقادی و سلامت روان. مطالعات روان‌شناختی. 2(8 و 9)، 92-75.
 
References
Abbasi, M., Ghorbani, N., Imani, A. H., & Tahbaz Hoseinzadeh, S. (2021). Exploring the mediating role of integrative self-knowledge in the relationship between mindfulness and well-being in the context of a mindfulness-based stress reduction program. International Journal of Psychology, 56(2), 249-256. http://dx.doi.org/10.1002/ijop.12705
Abbass, A., Lovas, D., & Purdy, A. (2008). Direct diagnosis and management of emotional factors in chronic headache patients. Cephalalgia, 28(12), 1305-1314. https://doi.org/10.1111/j.1468-2982.2008.01680.x
Afshar, L., Hosseini, M., & Abbasi, M. (2011). Ethical considerations in educational research. The Journal of Medical History, 3(8), 65-91. https://doi.org/10.22037/mhj.v3i8.5783
Böhm, D., Stock Gissendanner, S., Bangemann, K., Snitjer, I., Werfel, T., Weyergraf, A., Schulz, W., Jager, G., & Schmid-Ott, G. (2013). Perceived relationships between severity of psoriasis symptoms, gender, stigmatization and quality of life. Journal of the European Academy of Dermatology and Venereology, 27(2), 220-226.  https://doi.org/10.1111/j.1468-3083.2012.04451.x 
Booth, R. J., & Ashbridge, K. R. (1992). Teleological coherence: Exploring the dimensions of the immune system. Scandinavian Journal of Immunology, 36(6), 751-759. https://doi.org/10.1111/j.1365-3083.1992.tb03136.x
Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822–848. https://doi.org/10.1037/0022-3514.84.4.822
Brown, K. W., Ryan, R. M., & Creswell, J. D. (2007). Mindfulness: Theoretical foundations and evidence for its salutary effects. Psychological Inquiry, 18(4), 211-237. . https://doi.org/10.1080/10478400701598298
Bruni, F., Alessandrini, A., Starace, M., Orlando, G., & Piraccini, B. M. (2021). Clinical and trichoscopic features in various forms of scalp psoriasis. Journal of the European Academy of Dermatology and Venereology, 35(9), 1830-1837. https://doi.org/10.1111/jdv.17354
Bundy, C., Pinder, B., Bucci, S., Reeves, D., Griffiths, C. E. M., & Tarrier, N. (2013). A novel, web-based, psychological intervention for people with psoriasis: the electronic Targeted Intervention for Psoriasis (e TIP s) study. British Journal of Dermatology, 169(2), 329-336. https://doi.org/10.1111/bjd.12350
Carlson, L. E., & Brown, K. W. (2005). Validation of the Mindful Attention Awareness Scale in a cancer population. Journal of Psychosomatic Research, 58(1), 29–33. https://doi.org/10.1016/j.jpsychores.2004.04.366
Chiu, H. Y., Cheng, Y. P., & Tsai, T. F. (2012). T helper type 17 in psoriasis: From basic immunology to clinical practice. Dermatologica Sinica, 30(4), 136-141.‌ https://doi.org/10.1016/j.dsi.2012.08.002
Chiu, H. Y., Wang, T. S., Chen, P. H., Hsu, S. H., Tsai, Y. C., & Tsai, T. F. (2018). Psoriasis in Taiwan: From epidemiology to new treatments. Dermatologica Sinica, 36(3), 115-123. https://doi.org/10.1016/j.dsi.2018.06.001
Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385-396.‌
https://doi.org/10.2307/2136404
Costello, C. G., & Comrey, A. L. (1967). Scales for measuring depression and anxiety. The Journal of Psychology, 66(2), 303-313. https://doi.org/10.1080/00223980.1967.10544910
Creswell, J. D., Way, B. M., Eisenberger, N. I., & Lieberman, M. D. (2007). Neural correlates of dispositional mindfulness during affect labeling. Psychosomatic Medicine, 69(6), 560-565.‌ https://doi.org/10.1097/PSY.0b013e3180f6171f
Danson, S. J., Johnson, P., Ward, T. H., Dawson, M., Denneny, O., Dickinson, G., Aarons, L., Watson, A., Jowle, D., Cummings, J., Robson, L., Ranson, M. (2011). Phase I pharmacokinetic and pharmacodynamics study of the bio reductive drug RH1. Annals of Oncology, 22(7), 1653-1660. https://doi.org/10.1093/annonc/mdq638
Davidson, R. J., Kabat-Zinn, J., Schumacher, J., Rosenkranz, M., Muller, D., Santorelli, S. F., Urbonowski, F., Harington, A., Bouns, K., & Sheridan, J. F. (2003). Alterations in brain and immune function produced by mindfulness meditation. Psychosomatic Medicine, 65(4), 564-570. https://doi.org/10.1097/01.psy.0000077505.67574.e3
Dobrică, E. C., Cozma, M. A., Găman, M. A., Voiculescu, V. M., & Găman, A. M. (2022). The Involvement of Oxidative Stress in Psoriasis: A Systematic Review. Antioxidants, 11(2), 282-288. https://doi.org/10.3390/antiox11020282
Dowlatshahi, E. A., Wakkee, M., Arends, L. R., & Nijsten, T. (2014). The prevalence and odds of depressive symptoms and clinical depression in psoriasis patients: a systematic review and meta-analysis. Journal of Investigative Dermatology, 134(6), 1542-1551.‌ https://doi.org/10.1038/jid.2013.508
Duckworth, A. L., & Kern, M. L. (2011). A meta-analysis of the convergent validity of self-control measures. Journal of Research in Personality, 45(3), 259-268. https://doi.org/10.1016/j.jrp.2011.02.004 
Ferreira, B. I. R. C., Abreu, J. L. P. D. C., Dos Reis, J. P. G., & Figueiredo, A. M. D. C. (2016). Psoriasis and associated psychiatric disorders: a systematic review on etiopathogenesis and clinical correlation. The Journal of Clinical and Aesthetic Dermatology, 9(6), 36-43. ‌
Frischknecht, L., Vecellio, M., & Selmi, C. (2019). The role of epigenetics and immunological imbalance in the etiopathogenesis of psoriasis and psoriatic arthritis. Therapeutic Advances in Musculoskeletal Disease, 11(3), 1-8. https://doi.org/10.1177/1759720X19886505
Fulton, S., Décarie-Spain, L., Fioramonti, X., Guiard, B., & Nakajima, S. (2022). The menace of obesity to depression and anxiety prevalence. Trends in Endocrinology & Metabolism, 33(1), 18-35. https://doi.org/ 10.1016/j.tem.2021.10.005
Ghorbani, N., & Watson, P. J. (2004). Two facets of self-knowledge, the five-factor model, and promotions among Iranian managers. Social Behavior and Personality: An International Journal, 32(8), 769-776. https://doi.org/10.2224/sbp.2004.32.8.769 
Ghorbani, N., & Watson, P. J. (2006). Religious orientation types in Iranian Muslims: Differences in alexithymia, emotional intelligence, self-consciousness, and psychological adjustment. Review of Religious Research, 47(3), 303-310.
Ghorbani, N., Bing, M. N., Watson, P. J., Davison, H. K., & LeBreton, D. L. (2003). Individualist and collectivist values: Evidence of compatibility in Iran and the United States. Personality and Individual Differences, 35(2), 431-447. https://doi.org/10.1016/S0191-8869(02)00205-2
Ghorbani, N., Bing, M. N., Watson, P. J., Davison, H. K., & Mack, D. A. (2002). Self-reported emotional intelligence: Construct similarity and functional dissimilarity of higher-order processing in Iran and the United States. International Journal of Psychology, 37(5), 297-308. https://doi.org/10.1080/00207590244000098
Ghorbani, N., Cunningham, C. J., & Watson, P. J. (2010). Comparative analysis of integrative self-knowledge, mindfulness, and private self-consciousness in predicting responses to stress in Iran. International Journal of Psychology, 45(2), 147-154. https://doi.org/10.1080/00207590903473768
Ghorbani, N., Mousavi, A., Watson, P. J., & Chen, Z. (2011). Integrative self-knowledge and the harmony of purpose model in Iranian autoimmune patients. Electronic Journal of Applied Psychology, 7(2), 1-8.‌
Ghorbani, N., Watson, P. J., & Hargis, M. B. (2008). Integrative Self-Knowledge Scale: Correlations and incremental validity of a cross-cultural measure developed in Iran and the United States. The Journal of Psychology, 142(4), 395-412. https://doi.org/10.3200/JRPL.142.4.395-412
Ghorbani, N., Watson, P. J., Hamzavy, F., & Weathington, B. L. (2010). Self-knowledge and narcissism in Iranians: Relationships with empathy and self-esteem. Current Psychology, 29(2), 135-143.‌ https://doi.org/10.1007/s12144-010-9079-5
Ghorbani, N., Watson, P. J., Rezazadeh, Z., & Cunningham, C. J. L. (2011). Dialogical Validity of Religious Measures in Iran: Relationships with Integrative Self- Knowledge and Self-Control of the Perfect Man (Ensan-e-Kamel). Archive for the Psychology of Religion, 33, 93-113. https://doi.org/10.1163/157361211X552209
Gino, F., Schweitzer, M. E., Mead, N. L., & Ariely, D. (2011). Unable to resist temptation: How self-control depletion promotes unethical behavior. Organizational Behavior and Human Decision Processes, 115(2), 191-203. https://doi.org/10.1016/j.obhdp.2011.03.001
Ginsburg, I. H., & Link, B. G. (1989). Feelings of stigmatization in patients with psoriasis. Journal of the American Academy of Dermatology, 20(1), 53-63.‌ https://doi.org/10.1016/s0190-9622 (89)70007-4
Griffiths, C. E., & Richards, H. L. (2001). Psychological influences in psoriasis. Clinical and Experimental Dermatology, 26(4), 338-342. https://doi.org/10.1046/j.1365-2230.2001.00834.x ‌
Jawad, M. A., & Kadhim, A. J. (2021). Psoriasis-cell Mediated Autoimmune Disease: A Review. Journal of Pharmaceutical Quality Assurance, 12(3), 306-310. https://doi.org/10.25258/ijpqa.12.3.27
Jonason, P. K., & Tost, J. (2010). I just cannot control myself: The Dark Triad and self-control. Personality and Individual differences, 49(6), 611-615. https://doi.org/10.1016/j.paid.2010.05.031
Kılıç, A., Güleç, M. Y., Gül, Ü. & Güleç, H. (2008). Temperament and character profile of patients with psoriasis. Journal of the European Academy of Dermatology and Venereology, 22(5), 537-542. https://doi.org/10.1111/j.1468-3083.2007.02460.x ‌
Kline, R. B. (2015). Principles and practice of structural equation modeling. Guilford publications: New York.
Konstam, V., Chernoff, M., & Deveney, S. (2001). Toward forgiveness: The role of shame, guilt anger, and empathy. Counseling and Values, 46(1), 26-39.  https://doi.org/10.1002/j.2161-007X.2001.tb00204.x
Lakshmy, S., Balasundaram, S., Sarkar, S., Audhya, M., & Subramaniam, E. (2015). A cross-sectional study of prevalence and implications of depression and anxiety in psoriasis. Indian Journal of Psychological Medicine, 37(4), 434-440.‌ https://doi.org/10.4103/0253-7176.168587
Ledić Drvar, D. L., Vlahinić, T., Maleš, Ž., Turčić, P., & Čeović, R. (2019). A modern approach to the treatment of plaque psoriasis. Acta Pharmaceutica, 69(4), 511-523. https://doi.org/10.2478/acph-2019-0047
Lee, G. S., & Yom, Y. H. (2013). Structural equation modeling on life-world integration in people with severe burns. Asian Nursing Research, 7(3), 112-119.‌ https://doi.org/10.1016/j.anr.2013.06.003
Lewis, H. B. (1971). Shame and guilt in neurosis. Psychoanalytic Review, 58(3), 419-438.‌
Martínez-Ortega, J. M., Nogueras, P., Muñoz-Negro, J. E., Gutiérrez-Rojas, L., González-Domenech, P., & Gurpegui, M. (2019). Quality of life, anxiety and depressive symptoms in patients with psoriasis: A case-control study. Journal of Psychosomatic Research, 124(8), 1-7. https://doi.org/10.1016/j.jpsychores.2019.109780
Masuda, A., & Tully, E. C. (2012). The role of mindfulness and psychological flexibility in somatization, depression, anxiety, and general psychological distress in a nonclinical college sample. Journal of Evidence-Based Complementary & Alternative Medicine, 17(1), 66-71. https://doi.org/10.1177/2156587211423400
McManus, F., Surawy, C., Muse, K., Vazquez-Montes, M., & Williams, J. M. G. (2012). A randomized clinical trial of mindfulness-based cognitive therapy versus unrestricted services for health anxiety (hypochondriasis). Journal of Consulting and Clinical Psychology, 80(5), 817-828. https://doi.org/10.1037/a0028782
Mills, R. S. (2005). Taking stock of the developmental literature on shame. Developmental Review, 25(1), 26-63. https://doi.org/10.1016/j.dr.2004.08.001
Morone, N. E., Lynch, C. P., Losasso, V. J., Liebe, K., & Greco, C. M. (2012). Mindfulness to reduce psychosocial stress. Mindfulness, 3(1), 22-29. https://doi.org/10.1007/s12671-011-0076-z
Murphy, C., & MacKillop, J. (2012). Living in the here and now: interrelationships between impulsivity, mindfulness, and alcohol misuse. Psychopharmacology, 219(2), 527-536.‌ https://doi.org/10.1007/s00213-011-2573-0
 
Narmandakh, A., Roest, A. M., de Jonge, P., & Oldehinkel, A. J. (2021). Psychosocial and biological risk factors of anxiety disorders in adolescents: a TRAILS report. European Child & Adolescent Psychiatry, 30(12), 1969-1982. https://doi.org/10.1007/s00787-020-01669-3
Neborsky, R. J. (2003). Shame and guilt from a developmental neuroscience perspective: Implications for technique in intensive short-term dynamic psychotherapy. Ad Hoc Bulletin of Short-Term Dynamic Psychotherapy, 7(1), 54-75.
O'Connor, L. E., Berry, J. W., Weiss, J., Bush, M., & Sampson, H. (1997). Interpersonal guilt: The development of a new measure. Journal of Clinical Psychology, 53(1), 73-89. https://doi.org/10.1002/(SICI)1097-4679(199701)53:1<73::AID-JCLP10>3.0.CO;2-I
Piet, J., Würtzen, H., & Zachariae, R. (2012). The effect of mindfulness-based therapy on symptoms of anxiety and depression in adult cancer patients and survivors: a systematic review and meta-analysis. Journal of Consulting and Clinical Psychology, 80(6), 1007-1020. https://doi.org/10.1037/a0028329
Rodríguez-Zúñiga, M. J. M., & García-Perdomo, H. A. (2017). Systematic review and meta-analysis of the association between psoriasis and metabolic syndrome. Journal of the American Academy of Dermatology, 77(4), 657-666. https://doi.org/10.1016/j.jaad.2017.04.1133
Roller, L., & Gowan, J. (2022). Disease state management: Psoriasis. AJP: The Australian Journal of Pharmacy, 103(1213), 76-85.
Russo, P. A., Ilchef, R., & Cooper, A. J. (2004). Psychiatric morbidity in psoriasis: a review. Australasian Journal of Dermatology, 45(3), 155-161.‌ https://doi.org/10.1111/j.1440-0960.2004.00078.x
Sahi, F. M., Masood, A., Danawar, N. A., Mekaiel, A., & Malik, B. H. (2020). Association between psoriasis and depression: a traditional review. Cureus, 12(8), e9708. https://doi.org/10.7759/cureus.9708
Salman, A., Kurt, E., Topcuoglu, V., & Demircay, Z. (2016). Social anxiety and quality of life in vitiligo and acne patients with facial involvement: a cross-sectional controlled study. American Journal of Clinical Dermatology, 17(3), 305-311. https://doi.org/10.1007/s40257-016-0172-x
Sampogna, F., Tabolli, S., & Abeni, D. (2012). Living with psoriasis: prevalence of shame, anger, worry, and problems in daily activities and social life. Acta Dermato-Venereologica, 92(3), 299-303.‌ https://doi.org/10.2340/00015555-1273
Sarafino, E. P., & Smith, T. W. (2014). Health psychology: Biopsychosocial interactions. John Wiley & Sons: New York.
Schmertz, S. K., Masuda, A., & Anderson, P. L. (2012). Cognitive processes mediate the relation between mindfulness and social anxiety within a clinical sample. Journal of Clinical Psychology, 68(3), 362-371. https://doi.org/10.1002/jclp.20861
Sloman, S. A. (1996). The empirical case for two systems of reasoning. Psychological Bulletin, 119(1), 3-22. https://doi.org/10.1037/0033-2909.119.1.3
Smith, B. W., Ortiz, J. A., Steffen, L. E., Tooley, E. M., Wiggins, K. T., Yeater, E. A., Montoya, J. D., & Bernard, M. L. (2011). Mindfulness is associated with fewer PTSD symptoms, depressive symptoms, physical symptoms, and alcohol problems in urban firefighters. Journal of Consulting and Clinical Psychology, 79(5), 613-617. https://doi.org/10.1037/a0025189
Song, Y. S. (2011). Depression, stress, anxiety and mindfulness in nursing students. Korean Journal of Adult Nursing, 23(4), 397-402.
Stuewig, J., & Tangney, J. P. (2007). Shame and guilt in antisocial and risky behaviors.
In J. L. Tracy, R. W. Robins, & J. P. Tangney (Eds.), The self-conscious emotions:
Theory and research (pp. 371–388). New York: Guilford Press.
Tangney, J. P., & Dearing, R. L. (2002). Shame and guilt. New York: Guilford Press.
Tangney, J. P., Baumeister, R. F., & Boone, A. L. (2004). High self-control predicts good adjustment, less pathology, better grades, and interpersonal success. Journal of Personality, 72(2), 271-324. https://doi.org/10.1111/j.0022-3506.2004.00263.x
Tangney, J. P., Miller, R. S., Flicker, L., & Barlow, D. H. (1996). Are shame, guilt, and embarrassment distinct emotions? Journal of Personality and Social Psychology, 70(6), 1256–1269. https://doi.org/10.1037//0022-3514.70.6.1256
Valikhani, A., & Goodarzi, M. A. (2017). Contingencies of self-worth and psychological distress in Iranian patients seeking cosmetic surgery: Integrative self-knowledge as mediator. Aesthetic plastic surgery, 41(4), 955-963. https://doi.org/10.1007/s00266-017-0853-8
Van Der Lee, M. L., & Garssen, B. (2012). Mindfulness-based cognitive therapy reduces chronic cancer-related fatigue: a treatment study. Psycho-Oncology, 21(3), 264-272.‌ https://doi.org/10.1002/pon.1890
Van Voorhees, A. S., & Fried, R. (2009). Depression and quality of life in psoriasis. Postgraduate medicine, 121(4), 154–161. https://doi.org/10.3810/pgm.2009.07.2040
Vladut, C. I., & Kállay, É. (2010). Psychosocial implications of psoriasis: theoretical review. Cognition, Brain, Behavior, 14(1), 23-35.
Wang, X., Lin, J., Liu, Q., Lv, X., Wang, G., Wei, J., Zhu, G., Chen, Q., Tian, H., Zhang, K., Wang, X., Zhang, N., Yu, X., Su, Y. A., & Si, T. (2022). Major depressive disorder comorbid with general anxiety disorder: Associations among neuroticism, adult stress, and the inflammatory index. Journal of psychiatric research, 148(Apr), 307–314. https://doi.org/10.1016/j.jpsychires.2022.02.013
Williams, J. E., & Pykett, J. (2022). Mental health monitoring apps for depression and anxiety in children and young people: A scoping review and critical ecological analysis. Social Science & Medicine, 29(Mar), 114802. https://doi.org/10.1016/j.socscimed.2022.114802
Zheng, Y., Zhou, Z., Liu, Q., Yang, X., & Fan, C. (2019). Perceived stress and life satisfaction: a multiple mediation model of self-control and rumination. Journal of Child and Family Studies, 28(Jun), 3091-3097. https://doi.org/10.1007/s10826-019-01486-6 
Zill, J. M., Dirmaier, J., Augustin, M., Dwinger, S., Christalle, E., Härter, M., & Mrowietz, U. (2018). Psychosocial distress of patients with psoriasis: protocol for an assessment of care needs and the development of a supportive intervention. JMIR Research Protocols, 7(2), e22. https://doi.org/10.2196/resprot.8490 
Journal of Applied Psychological Research
Volume 13, Issue 4
2022
Pages 71-89

Files

History

  • Receive Date: 22 July 2022
  • Revise Date: 24 September 2022
  • Accept Date: 08 October 2022
  • First Publish Date: 31 December 2022
  • Publish Date: 31 December 2022

Share

How to cite

Statistics