Appearance Self-Esteem in Systemic Sclerosis

Although disease- and/or treatment-relatedchanges in physical appearance accompany many illnesses,the relationship of these physical changes to appearanceselfesteem and overall psychological adjustment has received little attention in the literature. Inthis study, subjects were 93 persons with diagnoses ofsystemic sclerosis, a chronic and progressive rheumaticdisease characterized by physical changes, especially skin thickening. Subjects receivedclinical examinations of skin thickening and providedself-reports via questionnaires of theirappearance-related self-esteem and overall psychologicaldistress. Results showed that disease-related physicalchanges were related to appearance self-esteem. Stepwisemultiple regression analysis found skin thickening ofthe righthand and fingers to be the strongest predictors of appearance self-esteem. Appearanceself-esteem was examined as a possible moderator ormediator of the relationship between skin thickening andpsychological distress. Results did not support amoderator role for appearance self-esteem; however,appearance self-esteem met statistical criteria as amediator of the relationship between skin thickening anddistress. Interestingly, results differed for thediffuse and limited subtypes ofsystemicsclerosis,suggesting that physical changes associatedwith disease may have stronger relationships withself-esteem and overall adjustment in the context ofless serious illnesses.