The importance of mindfulness in psychosocial distress and quality of life in dermatology patients
Open accessAbstract
BACKGROUND: Mindfulness, defined as purposively and nonjudgementally paying attention in the present moment, could be used within psychosocial interventions to reduce the distress associated with social anxiety and avoidance found in many skin conditions. However, little is known about the relationship between naturally occurring levels of mindfulness and distress in dermatology patients. OBJECTIVES: To examine the relationship between mindfulness and psychosocial distress in a dermatological population. It was hypothesized that higher levels of mindfulness would be associated with lower levels of social anxiety, anxiety, depression and skin shame, and with better quality of life. METHODS: Adult dermatology outpatients (n = 120) from one hospital completed items assessing subjective severity, skin shame, fear of negative evaluation, anxiety and depression, quality of life, and levels of mindfulness. RESULTS: Considering depression, 14% reported mild, 5% moderate and 2·5% severe symptoms. For anxiety, 22% reported mild, 23% moderate and 6% severe symptoms. In addition, 33·4% reported clinically significant social anxiety. After controlling for subjective severity, mindfulness explained an additional 19% of the variance in depression, 39% in anxiety, 41% in social anxiety, 13% in skin shame and 6% in dermatological quality of life. One specific facet of mindfulness (acting with awareness) was found to be the most consistent predictor of distress. CONCLUSIONS: The findings indicate that higher levels of mindfulness are associated with lower distress. This suggests that facilitating mindfulness may be helpful in reducing distress in dermatology patients, and the use of mindfulness techniques warrants further investigation.
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The findings provide preliminary evidence about the importance of psychological flexibility in the maintenance of appearance anxiety in those with a visible difference.
“This provides exciting preliminary evidence about the importance of psychological flexibility in the maintenance of appearance anxiety in those with a visible difference”
From The role of psychological flexibility in appearance anxiety in people who have experienced a visible burn injury. (2019) · cites this paper as [35]
The Discussion (page unavailable) reports that greater mindfulness was associated with lower social anxiety and distress in people with visible skin conditions. It does not establish a role for psychological flexibility specifically, measure appearance anxiety as such, or show that either maintains anxiety; the study was cross-sectional. (LLM, conf=0.86)
Experimental — accuracy not yet measuredMontgomery et al. found that mindful observing was associated with appearance-related distress in the opposite direction to what was expected.
“the same results were reported by Montgomery et al. [35] who explored the role of mindfulness in a dermatology sample. In their study, the authors also found that mindful observing was associated with appearance-related distress in the opposite direction to what was expected.”
From The role of psychological flexibility in appearance anxiety in people who have experienced a visible burn injury. (2019) · cites this paper as [35]
The Results (Mindfulness and psychosocial distress; page unavailable) show that observing was positively correlated with social anxiety and anxiety, an unexpected direction for distress. But the paper’s explicit statement that observing was related in the opposite direction to expected concerns impaired dermatological quality of life, not a measure identified as appearance-related distress; its correlation with skin shame was not significant. (LLM, conf=0.83)
Experimental — accuracy not yet measuredIn a dermatology sample, mindfulness explained a significant proportion of the variance in social anxiety, anxiety, depression, and health-related quality of life after controlling for subjective severity of the skin condition.
“In a dermatology sample mindfulness explained a significant proportion of the variance in social anxiety, anxiety, depression, and health-related quality of life after controlling for subjective severity of the skin condition (12).”
From Mindfulness as Predictor of Itch Catastrophizing in Patients With Atopic Dermatitis: Results of a Cross-Sectional Questionnaire Study (2021) · cites this paper as [12]
One study reported that increased mindfulness significantly predicted social anxiety and skin shame in people with visible skin conditions.
“One study explored the role of mindfulness in distress associated with visible skin conditions. It reported increased mindfulness significantly predicted social anxiety and skin shame.”
From The role of psychological flexibility in appearance anxiety in people who have experienced a visible burn injury. (2019) · cites this paper as [35]
In that study, acting with awareness was the most consistent predictor of distress.
“One particular facet of mindfulness, acting with awareness, was reported to be the most consistent predictor of distress [35].”
From The role of psychological flexibility in appearance anxiety in people who have experienced a visible burn injury. (2019) · cites this paper as [35]
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References 45 · Cited by 75
Research works printed but not linked: 3
- [12]Thompson A. Psychosocial impact of skin conditions. Dermatol Nurs 2009; 8: 43– 8.
- [30]Kellett S. Shame focused acne: a biopsycho‐social conceptualisation and treatment rationale In: Body Shame: Conceptualisation, Research and Treatment. (Gilbert P, Miles J, eds), Hove: Routledge, 2002; 135– 54.
- [31]Kent G, Thompson AR. The development and maintenance of shame in disfigurement: implications for treatment In: Body Shame: Conceptualisation, Research and Treatment. (Gilbert P, Miles J, eds), Hove: Routledge, 2002; 106– 16.
- Authors
- Montgomery, K., Norman, P., Messenger, A. G., & Thompson, A. R.
- Affiliations
- University of Sheffield (GB)
- Royal Hallamshire Hospital (GB)
- Corresponding author
- Montgomery, K.
- Venue
- British Journal of Dermatology
- Publisher
- Oxford University Press (OUP)
- Published
- 2016-09-18
- Volume
- 175
- Issue
- 5
- Pages
- 930-936
- ISSN
- 0007-0963 (ISSN-L)
- PMC
- PMC5091630
- OpenAlex
- W2381595339
- Cited by
- 75
- References
- 45
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 6 · 2023: 10 · 2022: 10 · 2021: 6 · 2020: 10 · 2019: 14 · 2018: 6 · 2017: 5 · 2016: 3
- FWCI
- 12.48
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- British Journal of Dermatology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- White Rose Research Online (University of Leeds, The University of Sheffield, University of York) (acceptedVersion)
- Funders
- Economic and Social Research Council (ES/J00215/1)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Psychiatry and Mental health › Psychosomatic Disorders and Their Treatments
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- mindfulness, psychosocial distress, quality of life, dermatology patients, social anxiety, depression, anxiety, acting with awareness, skin diseases, fear of negative evaluation
- MeSH terms
- Phobia, Social, Depressive Disorder, Female, Humans, Male, Middle Aged, Quality of Life, Shame, Skin Diseases, Stress, Psychological, Mindfulness
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