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Social Avoidance and Work Withdrawal Behavior Among Psoriasis and Vitiligo
Patients in China: Associations with Body Image and Distress

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X. Zhou, C. Tang, and Y. Zong 1
Nursing Department, Hospital for Skin Diseases and Institute of Dermatology, Chinese Academy of
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Medical Sciences & Perking Union Medical College, China, and School of Nursing, Nanjing Medical
University, China

Background: Chronic skin conditions have been well reported to affect a patient’s quality of life on
multiple dimensions, including the psychosocial domain. As a result of the visible and disfiguring skin
lesions, psoriasis and vitiligo patients often develop feelings of poor body image, which can in turn
lead to psychological distress and may affect employment and social activities. Therefore, it is a
priority to identify the mechanism between body image, distress, social avoidance and work
withdrawal behavior among psoriasis and vitiligo patients.

Objective: The study aimed to explore the influencing factors of social avoidance and work
withdrawal behavior among psoriasis and vitiligo patients and examine the associations between
Oral Presentation Abstracts
body image, distress, social avoidance and work withdrawal behavior.

Methods: This cross-sectional study was conducted in a dermatology specialist hospital in southern
China. A total of 308 psoriasis patients and 224 vitiligo patients were recruited from January 2022 to
July 2023 and investigated by a demographic and disease-related questionnaire, the body image
scale, the social avoidance and distress scale, and work withdrawal behavior scale. Structural
equation modelling (SEM)-path analysis was used to analyze the cross-sectional data.

Results: The mean score of social avoidance and work withdrawal behavior were 7.67 (±0.71) and 1.72
(±0.71) respectively. The mediating effect of distress was identified between body image and social
avoidance (indirect effect = 0.13, bias-corrected 95% confidence interval [0.09 to 0.19]). The mediating
effect of distress was identified between body image and psychological withdrawal behavior (indirect
effect = 0.07, bias-corrected 95% confidence interval [0.02 to 0.14]).

Conclusion: Social avoidance and work withdrawal behavior were prevalent among psoriasis and
vitiligo patients. Body image and psychological distress were significantly associated with social
avoidance and work withdrawal behavior. Health professionals could help them adapt to society by
relieving their body image disturbance and psychological distress.

Keywords: social avoidance, work withdrawal behavior, body image, psoriasis, vitiligo

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Correspondence: Chulei Tang, School of Nursing, Nanjing Medical University, China
E-mail: 1642308519@qq.com

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