Appearance self-esteem in systemic sclerosis

Although disease- and/or treatment,lent-related changes in physical appearance accompany many illnesses, the relationship of these physical changes to appearance self-esteem and overall psychological adjustment has received little attention in the literature. In this study, subjects were 93 persons with diagnoses of systemic sclerosis, a chronic and progressive rheumatic disease characterized by physical changes, especially skill thickening. Subjects received clinical examinations of skin tickening and provided self-reports via questionnaires of their appearance-related self-esteem and overall psychological distress. Results showed that disease-related physical changes were related to appearance self-esteem. Stepwise multiple regression analysis found skin thickening of the right hand and fingers to be the strongest predictors of appearance self-esteem. Appearance self-esteem was examined as a possible moderator or mediator of the relationship between skin thickening and psychological distress. Results did not support a moderator role for appearance self-esteem; however, appearance self-esteem met statistical criteria as a mediator of the relationship between skin thickening and distress. Interestingly, results differed for the diffuse and limited subtypes of systemic sclerosis, suggesting that physical changes associated with disease may have stronger relationships with, self-esteem and overall adjadjustment in the context of less serious illnesses.