title: Examination of the association of sex and race/ethnicity with appearance concerns: a Scleroderma Patient-centered Intervention Network (SPIN) Cohort study.
abstract: Appearance concerns are common in systemic sclerosis (SSc) and have been linked to younger age and more severe disease. No study has examined their association with sex or race/ethnicity.
  
  
  
  SSc patients were sampled from the Scleroderma Patient-centered Intervention Network Cohort. Presence of appearance concerns was assessed with a single item, and medical and sociodemographic information were collected.
  
  
  
  Of 644 patients, appearance concerns were present in 72%, including 421 of 565 women (75%), 42 of 79 men (53%), 392 of 550 patients who identified as White (71%), 35 of 41 who identified as Black (85%), and 36 of 53 who identified as another race/ethnicity (68%). In multivariate analysis, women had significantly greater odds of reporting appearance concerns than men (odds ratio (OR)=2.97, 95% confidence interval (CI)=1.78-4.95, p<.001). Black patients had significantly greater odds of appearance concerns than White patients in unadjusted (OR=2.64, 95% CI=1.01-6.34, p=.030), but not multivariate analysis (OR=1.76, 95% CI=0.67-4.60, p=.250). Compared to a general population sample, appearance concerns were substantially more common in SSc, particularly for men across all age groups and for younger women. The most commonly reported features of concern were related to the face and head, followed by the hands and fingers; this did not differ by sex or race/ethnicity.
  
  
  
  Appearance concerns were common in SSc. Women were substantially more likely than men to have appearance concerns. Although non-significant in multivariate analysis, Black patients were more likely to have concerns than White patients, likely due to more severe changes in appearance.
authors: Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal; and Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada.
authors: Lisa R
authors: LR
authors: Jewett
authors: Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal; Department of Psychiatry, McGill University, Montreal, Quebec, Canada; and Behavioural Science Institute, Clinical Psychology, Radboud University, Nijmegen, the Netherlands.
authors: Linda
authors: L
authors: Kwakkenbos
authors: Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal, Quebec, Canada.
authors: Marie-Eve
authors: ME
authors: Carrier
authors: Department of Psychology, San Diego State University, San Diego, CA, USA; and San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
authors: Vanessa L
authors: VL
authors: Malcarne
authors: McGill University, Health Center, Montreal; and Department of Medicine, McGill University, Montreal, Quebec, Canada.
authors: Susan J
authors: SJ
authors: Bartlett
authors: Division of Rheumatology, Geffen School of Medicine at the University of California, Los Angeles, USA.
authors: Daniel E
authors: DE
authors: Furst
authors: Scleroderma Foundation, USA.
authors: Karen
authors: K
authors: Gottesman
authors: Department of Internal Medicine, Division of Rheumatology, University of Texas McGovern Medical School, Houston, TX, USA.
authors: Maureen D
authors: MD
authors: Mayes
authors: Department of Internal Medicine, Division of Rheumatology, University of Texas McGovern Medical School, Houston, TX, USA.
authors: Shervin
authors: S
authors: Assassi
authors: Centre for Appearance Research, University of the West of England, Bristol, UK.
authors: Diana
authors: D
authors: Harcourt
authors: Centre for Appearance Research, University of the West of England, Bristol, UK.
authors: Heidi
authors: H
authors: Williamson
authors: Toronto Scleroderma Program, Division of Rheumatology, Department of Medicine, Toronto Western and Mount Sinai Hospitals, Toronto, Ontario, Canada.
authors: Sindhu R
authors: SR
authors: Johnson
authors: Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal; and Department of Educational and Counselling Psychology, McGill University, Montreal, Quebec, Canada.
authors: Annett
authors: A
authors: Körner
authors: Department of Medicine, Georgetown University, Washington, DC, USA.
authors: Virginia
authors: V
authors: Steen
authors: San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
authors: Rina S
authors: RS
authors: Fox
authors: San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
authors: Shadi
authors: S
authors: Gholizadeh
authors: San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
authors: Sarah D
authors: SD
authors: Mills
authors: Department of Psychology, McGill University, Montreal, Quebec, Canada.
authors: Jacqueline C
authors: JC
authors: Molnar
authors: Lady Davis Institute for Medical Research, Jewish General Hospital, Montreal; and Department of Psychology, McGill University, Montreal, Quebec, Canada.
authors: Danielle B
authors: DB
authors: Rice
authors: Lady Davis Inst.Med.Res, Jewish Gen.Hosp; Depts. Educational & Counselling Psychology, Psychiatry, McGill Univ; Dept.of Medicine, McGill Univ; Depts. Psychology, Epidemiology, Biostats & Occupational Health, School Nursing, McGill Univ, Montreal, Canada.
authors: Brett D
authors: BD
authors: Thombs
mesh_terms: D000293:Adolescent; D000328:Adult; D001741:Black or African American / Q000523:psychology; D000368:Aged; D044383:Black People / Q000523:psychology*; D001828:Body Image / Q000523:psychology*; D002170:Canada / Q000453:epidemiology; D016009:Chi-Square Distribution; D015331:Cohort Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice / Q000208:ethnology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D016017:Odds Ratio; D012307:Risk Factors; D012595:Scleroderma, Systemic / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology*; D012737:Sex Factors; D013315:Stress, Psychological / Q000208:ethnology / Q000523:psychology; D011795:Surveys and Questionnaires; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology; D044465:White People / Q000523:psychology*; D055815:Young Adult