A Model for Incorporating Psychological Factors into Acne Severity Assessment

Thesis Abstract

Acne vulgaris is a prevalent dermatological condition that significantly impacts affected individuals' psychological well-being, yet current severity assessment models predominantly focus on physical dermatological features, often neglecting the psychological dimensions influencing disease perception and management. This study aims to develop a comprehensive model that integrates psychological factors—such as self-esteem, social anxiety, and depression—into existing acne severity assessment frameworks, thereby enhancing diagnostic accuracy and personalized treatment strategies. The specific objectives are to identify key psychological variables associated with perceived acne severity, establish the relationship between these variables and clinical severity measures, and formulate an integrative model that reliably predicts overall disease impact. Employing a mixed-methods research design, the study combines quantitative and qualitative approaches to provide a holistic understanding of the interplay between dermatological and psychological factors. The quantitative phase targets a cross-sectional sample of 300 patients diagnosed with acne vulgaris, recruited from dermatology clinics in urban healthcare centers. Participants are selected through stratified random sampling to ensure representation across age, gender, and socioeconomic status. Data collection involves standardized instruments the Global Acne Severity Scale (GASS) for clinical assessment, the Rosenberg Self-Esteem Scale, the Social Phobia Inventory, and the Beck Depression Inventory to evaluate psychological correlates. Qualitative data are obtained through semi-structured interviews with a subset of 30 participants to explore in-depth perceptions of their condition and psychological experiences. Data analysis employs multiple regression analysis to determine the extent to which psychological variables predict perceived acne severity, alongside structural equation modeling (SEM) to develop and validate the proposed integrative model. The model's construct validity is assessed through confirmatory factor analysis, ensuring robust measurement of psychological constructs within the severity framework. Moreover, thematic analysis of qualitative transcripts elucidates contextual factors and subjective experiences underpinning quantitative findings, enhancing model comprehensiveness. Anticipated findings suggest significant correlations between psychological distress indicators—particularly social anxiety and low self-esteem—and perceived severity scores, even after controlling for clinical severity. It is expected that the integrated model will demonstrate improved predictive accuracy over traditional dermatological assessments alone (with an expected increase in R-squared values). These results are projected to underscore the necessity for a biopsychosocial approach in acne management, emphasizing psychological evaluation as a routine part of clinical practice. This study contributes to dermatological and psychological literature by proposing a validated, empirically supported theoretical model that explicates the multidimensional impact of acne vulgaris. It addresses the critical gap by operationalizing psychological factors within severity assessment, facilitating more holistic patient care. The findings advocate for the integration of psychological screening tools in dermatology clinics and suggest that tailored interventions targeting psychological well-being may improve treatment outcomes. In conclusion, the research highlights that incorporating psychological constructs into acne severity assessment enhances diagnostic sensitivity and supports patient-centered management. Recommendations include adopting the proposed model for clinical use, training dermatologists in psychological assessment, and further longitudinal studies to evaluate the model's utility over time. This interdisciplinary approach advances personalized medicine in dermatology and underscores the importance of addressing psychological health as an intrinsic component of acne treatment strategies.