Understanding psychodermatological distress : constructing a skin shame scale.

Literature Review
This section offers a review of the literature concerning psychodermatological
assessment, that is, the assessment of the interface between the skin and its
psychological correlates, and evaluates selected psychodermatological scales. Using
defined criteria, fifty articles were identified, including twenty-three scales, which are
reviewed in detail. Findings demonstrated that quantitative self-report scales dominated
assessment. When evaluated against psychometric and theoretical criteria, the scales
were found to have limited robustness and validity. These findings are discussed in
relation to the relationship between disease severity and skin-related distress and
subsequent theoretical and clinical implications explored.
Research Report
Living with a skin condition can lead to considerable psychological distress.
Understanding the mechanisms of skin-related distress is crucial in developing a
psychodermatological theory and devising meaningful psychological interventions. The
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present study employed Kellett's (2002) theory of "dermatological shame" to construct
a psychodermatological assessment scale for use in dermatological outpatient
populations, in this case, at Barnsley District General Hospital dermatology department.
The scale was subjected to exploratory factor analysis and reduced from thirty to
twenty-four items. Reliability and validity analyses were then carried out and the results
discussed in relation to dermatological shame and cognitive models of disfigurement
(Kent & Thompson, 2002; Thompson & Kent, 2001).
Critical Appraisal
A reflexive account is offered of the research process, through four sections: project
conception, study implementation, learning and development, including methodological
limitations, and process issues. This section concludes with recommendations for
further research.