Adversarial growth in patients undergoing treatment for psoriasis: A prospective study of the ability of patients to construe benefits from negative events

The purpose of this prospective study was to identify predictors of "adversarial growth" or the ability of patients to construe benefits from negative events, in adaptation to the chronic, disfiguring, skin condition, psoriasis. Patients with a dermatologist confirmed diagnosis of psoriasis were assessed at induction to the study and again at between 4 and 6 months follow-up subsequent to active medical treatment. Patients completed assessments of adversarial growth, illness perceptions, alexithymia, anxiety, and depression. Patients who were classified according to clinical significance standards as demonstrating significant increases in adversarial growth at follow-up (18% of the sample), were characterized by a younger age at onset of psoriasis, less alexithymia, and, paradoxically, stronger beliefs in chronicity of their condition. Distress, illness identity, beliefs about severity of consequences, cure or control, and beliefs about emotional or physical causes and clinical severity of psoriasis at induction or at follow-up did not account for significant increases in growth. Results suggest that adversarial growth is related to greater psychological mindedness, awareness of the reality of disease course, and being younger at onset of the condition. Further work is required to investigate predictors of benefit finding and adversarial growth in patients with conditions that hold the possibility of being recurrent forms of trauma.