PSORIASIS ASSOCIATION RESEARCH REPORT

Title of the research project
Cognitive vulnerability to stress through information processing biases in psoriasis patients

Grant Awarded £7500

Location of the research Hope Hospital, Manchester

Lead researcher Professor C E M Griffiths

Reasons for doing the research
To see whether patients with psoriasis tend to process some types of information more readily than other types particularly when compared with people who do not have psoriasis.

Type of research
Controlled clinical experiment. Sixty patients with psoriasis and 60 age- and sex-matched controls (without psoriasis) were asked to complete an attentional interference task (a modified Stroop test). This tested the extent to which different words distracted them from performing a simple task. Their disease severity, and anxiety, depression and levels of worry were also measured using validated tools.

Date grant awarded 1998

Date research published 2003

Outcomes of the research
Patients with psoriasis showed significant attentional interference with processing words related to the disease, self and others’ behaviour, than did the control group. The time they took to respond to the information (i.e. the period of latency) was significantly longer than those who did not have psoriasis in all the categories except when shown neutral words, where there was no difference between the psoriasis and the control groups. This performance difference was not influenced by levels of anxiety, depression or worry.

Conclusions
Patients with psoriasis tend to find some words (especially those relating to the condition and to negative emotions) more threatening than someone who does not have psoriasis i.e. their periods of latency were longer. This is accounted for by disease status rather than psychological distress and demonstrates that suffering from psoriasis leads to cognitive stress.

What does this project mean for people with psoriasis?
Whilst it is increasingly accepted that cognitive stress in the forms of anticipatory anxiety, avoidance coping, fear of negative evaluation, pathological worrying and fear of negative evaluation are commonly associated with psoriasis, this is the first study to show such effects using an objective method. Greater understanding of the cognitive processes should help to develop a more comprehensive model of the impact of living with psoriasis. A better model should assist the discovery of the most appropriate interventions to counter cognitive stress.

Have there been any publications as a result of the research?
Yes. An article was published in the Journal of Behavioural Medicine.

Glossary
The Modified Stroop test: This is carried out on a computer. Participants are shown words which fall into one of four categories (a) negative, emotional words about self; (b) negative, emotional words about reactions of others; (c) commonly reported words relating to the disease; (d) neutral words. The words are shown written in different coloured “ink” and the participants are asked to speak the colour of the ink rather than the word itself. The time between the word appearing on the screen and the person speaking the colour is noted and is known as latency.
Validated tools: These are questionnaires that have been shown to accurately measure what they say they measure.