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[German version of the Skin Shame Scale (SSS-24) : Validation with dermatological patients and dermatologically
Michaela Hiebler-Ragger1,2,3, Human-Friedrich Unterrainer2,3, Andrew R Thompson4
1Universitätsklinik für Dermatologie und Venerologie, Medizinische Universität Graz, Auenbrugger Platz 8, 8036, Graz, Österreich.
Background:
Skin shame plays an important role in the psychological distress of dermatological patients. However, it is rarely examined in research or clinical practice due to the lack of availability of a robust measure of skin shame. This study sought to adapt and validate the Skin Shame Scale (SSS-24) for use in the German-speaking population.
Methods:
The SSS-24 questionnaire was completed by 488 dermatologically healthy (DH) individuals (66.6% women) and 339 dermatological patients (DP; 66.7% women). Participants also completed measures of general shame (SHAME) and of psychological distress (BSI[Brief Symptom Inventory]-18).
Results:
The SSS-24 showed adequate psychometric properties and a high internal consistency in both samples (DH: α = 0.91; DP: α = 0.95). DP reported more skin shame than DH (p < 0.001) but in both samples more skin shame was associated with more general shame and more psychological distress (p < 0.001).
Conclusions:
Overall, the psychometric properties of the English original version were replicated in the German version of the SSS-24. Due to the strong associations with general shame and psychological distress, skin shame should be considered an important parameter in psychodermatology. The SSS-24 enables further research into the role of shame in skin conditions and provides a useful tool for identifying patients who might benefit from psychosocial interventions.

