Effects of parenting experiences and early maladaptive schemas on adjustment to atopic dermatitis
Atopic dermatitis (eczema) is a psychosomatic chronic skin condition. Onset of the condition usually occurs in early life. Some people however, do develop it much later. Even though studies have demonstrated high levels of psychological disturbance and maladjustment among most people with AD, some others still do not, suggesting that a certain level of variability exists in the way people adjust to their skin condition. The goal of the present study was to identify the factors that determine adjustment to AD and account for this variability. Existing studies on this topic have considered factors such as: age of onset of the condition, demographic characteristics, disease severity and visibility, cognitive representations of illness and condition appraisals. Most of these studies however are limited in the explanations that they offer. Drawing upon the schema theory model of personality development and psychopathology, the present study proposes that adjustment to AD is mediated by personality-level structures (self-schemas) that have their origins in early experiences. Design: A cross-sectional design was employed with three groups: a) patients with an early onset of atopic dermatitis (n = 130), b) patients with a late onset (n = 76) and c) people with no chronic medical condition (n = 74). Method: All groups completed the Young Parenting Inventory- Revised, and the Young Schema Questionnaire-Short Form 3. The two atopic dermatitis groups also completed the Adjustment to Chronic Skin Disease Questionnaire. Results suggest that: a) people with an early and a late onset of atopic dermatitis were presented with a certain schematic profile that differentiated them from participants in the control groups; b) a certain pattern of early parenting experiences was linked to the development of this schematic profile and c) this schematic profile predicted high levels of dysfunctional coping and difficulties in adjustment. Findings have a clear relevance to the practice of Counselling Psychology. Limitations of the study and clinical implications are discussed.
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