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Effectiveness of stress inoculation training in the treatment of atopic dermatitis Coles, Nona Diane

Abstract

Research indicates that psychological stress plays a role in aggravating Atopic Dermatitis (AD), a genetically-based, chronic, inflammatory skin disorder. Most psychological interventions used to treat AD have employed behavioural techniques such as relaxation training and biofeedback. Some treatments have focused on reducing individuals' stress level, whereas others have focused on eliminating the scratching behaviour associated with exacerbation of the disorder. Very few studies have used a cognitive behavioural approach to treat AD. Stress Inoculation Training (SIT), a cognitive behavioural stress management program has been successful in treating a wide range of psychosomatic disorders. The purpose of this study, therefore, was to determine the effectiveness of SIT in treating seven women suffering from AD of the hands. A multiple baseline design was employed that included a baseline period of 4 weeks for two of the women and 5 weeks for the other 5 women, followed by 8 weeks of treatment, a 2-week post-intervention period, and a 3-month follow-up. Subjective measures of stress, coping, and extent of AD were repeatedly monitored using a diary technique. In addition, a self-report measure of anxiety and quality of life was administered weekly and objective ratings of skin condition were made on three occasions. The data were analyzed visually and statistically on an individual and group level to determine both they effectiveness of the intervention and the nature of the relationship between AD and aspects of the stress process. Overall, a positive treatment effect was revealed (p<.10), however on an individual basis it was apparent that SIT was effective for 4 of the women and not for 3. Positive relationships were also found between the women's skin condition and aspects of the stress and coping process. Implications for further research are discussed.

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