Measuring and managing appearance anxiety in patients with systemic sclerosis

ABSTRACT

Introduction: Systemic sclerosis (SSc, scleroderma) is a progressive, autoimmune, connective tissue disease of unknown etiology that can cause changes in appearance in socially important areas of the body (e.g. face and hands). Social concerns related to changes in appearance can contribute to anxiety specific to situations where one’s appearance will be evaluated, or appearance anxiety. Appearance anxiety is a relevant but underexplored construct in SSc.

Areas covered: We review the current knowledge on appearance anxiety in SSc, including assessment of the construct and interventions. Relevant references in the field were obtained through a literature search in MEDLINE/PubMed and PsycINFO for articles published through September 2018.

Expert commentary: There is a dearth of research in the SSc literature examining the construct of appearance anxiety. A growing interest in appearance anxiety in SSc has led to several relevant measures being validated in this population, including the Social Appearance Anxiety Scale. Important areas for future research are the development of interventions to address appearance anxiety and the use of randomized controlled trials to evaluate these interventions.

KEYWORDS:

• Anxiety
• appearance
• appearance anxiety
• systemic sclerosis
• SSc

Article Highlights

• Changes in appearance are common and distressing for many people with SSc.

• Changes in appearance tend to occur in socially relevant areas of the body (i.e. face and hands), rendering appearance anxiety and related constructs of particular interest in SSc.

• The SAAS was partially validated for patients with SSc using the SPIN Cohort in 2018. The BFNE and SIAS-6were partially validated in 2018 and 2017, respectively, also using the SPIN cohort. The BCSS was partially validated in 2016 using the CSRG Cohort and externally validated in 2017 using the SPIN Cohort.

• With the relative influx of new measures for patients with SSc, future research should examine such areas as clinical and psychosocial correlates of appearance anxiety.

• There are currently no evidence-based interventions for the treatment of appearance anxiety in SSc.

Declaration of interest

The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Reviewer disclosures

Peer reviewers on this manuscript have no relevant financial or other relationships to disclose.

Additional information

Funding

This paper was not funded.