PS29 Breaking the cycle of self-stigma: randomized controlled trial results of a web-based self-compassion intervention for individuals with chronic skin disease
Juliane Traxler, Caroline Stuhlmann, Neuza da Silva Burger, Christian Stierle, Vahid Djamei, Anna Darzina, Marie Rudnik, Matthias Augustin, Marius Grosser, Georg Pliszewski, Markus Böhm, Claudia Ste, Petra Staubach, Daniela Kasche, Ralph von Kiedrowski, Athanasios Tsianakas, Rachel SommerAbstract
Self-stigmatization and concerns about body appearance are prevalent among people living with chronic skin disease, which can severely impact on their mental health and quality of life. As few online approaches targeting psychosocial needs of patients with skin disease are available, we developed a web-based programme based on cognitive behavioural therapy and self-compassion approaches. This parallel group-randomized controlled trial (registration: NCT06324695) examined the effectiveness of the programme in reducing self-stigma, and enhancing acceptance coping and self-compassion. We expected larger reductions in self-stigma, depression, anxiety and avoidance, as well as greater increases in acceptance coping, self-compassion and positive body image from pre- to postintervention and at the 6-month follow-up in the intervention group compared with the control group. German-speaking adults (n = 284) with alopecia areata, atopic dermatitis, hidradenitis suppurativa, psoriasis or and vitiligo were randomized 1 : 1 into an intervention group (n = 151), which worked through the eight self-guided modules, or a waitlist control group (n = 133). Self-stigma, self-compassion, acceptance and other psychosocial variables were assessed by self-report questionnaires before and after the programme, and at the 6-month follow-up. Data were analysed using generalized linear mixed models. There were significant differences between groups in self-stigma [F(1,169) = 13.4; P < 0.001], anxiety [F(1,168) = 5.17; P = 0.02] and acceptance [F(1,179) = 7.27; P = 0.008] from before to after the programme to the 6-month follow-up, with patients in the intervention group showing greater reductions in self-stigma and anxiety, and greater improvements in acceptance compared with those in the control group. Change scores in self-compassion did not differ between the two groups [F(1,180) = 2.77, P = 0.10]. The web-based programme demonstrated effectiveness in reducing self-stigma and enhancing acceptance among people living with chronic skin diseases. As the first intervention of its kind available in German, it marks a significant step forward in psychosocial care in dermatology.