Atopic dermatitis anxiety and conditioned scratch responses

Jordan, Jacob; Whitlock, F. A.

doi:10.1016/0022-3999(74)90047-6

Cited by 53 publications

(26 citation statements)

References 4 publications

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“…This personality profile is in line with other reports suggesting that, for example, high levels of anxiety are commonly displayed in AD patients [White and Horne, 1990;Rogerson, 1947;Ginsburg et al, 1993;Garrie, 1978;Ahmar and Kurban, 1976]. Jordan and Whitlock [1974] even discuss high anxiety levels in AD patients as a potential key personality characteristic. They reported that differences between AD and control subjects in other psychological test data (i.e., suppression of hostility, aggression) are associated with the differences in anxiety levels and disappear when controlling the anxiety factor by matching the AD and the control group on anxiety scores.…”

Section: Discussionsupporting

confidence: 75%

Personality Characteristics and Their Association with Biological Stress Responses in Patients with Atopic Dermatitis

Buske‐Kirschbaum¹,

Ebrecht²,

Kern³

et al. 2004

Dermatol Psychosom

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Background: The potential relevance of personality factors on atopic dermatitis (AD) has long been a focus of psychodermatological research. A central premise underlying this line of research is that AD sufferers show a distinct personality profile that may increase the vulnerability to develop or to exacerbate AD especially under stress. Objective: The specific goal of the present study was to assess specific personality traits in AD sufferers and their possible relationship to biological stress responses. Material and Methods: 36 AD patients, 23 patients suffering from psoriasis (PSO) and 37 non-atopic controls were investigated. To determine different personality domains, Spielberger’s State-Trait Anxiety Inventory (STAI), the Questionnaire for Competence and Control (FKK) and the Questionnaire for Stress Vulnerability (MESA) were administered. In order to investigate whether these personality dimensions are related to biological stress responses, AD subjects and healthy controls were confronted with a standardized laboratory stressor (Trier Social Stress Test; TSST). Blood and saliva samples were obtained before and after the stress test to measure endocrine (cortisol, ACTH, catecholamines) and immunological (immunoglobulin-E, cytokines, leukocyte subsets) stress responses. Furthermore, heart rate responses to the stressor and morning cortisol after awakening were recorded. Results: When compared to healthy controls, AD and PSO patients showed significantly higher scores in trait anxiety (STAI) and stress vulnerability (MESA) in situations characterized by failure, job overload, social conflicts and uncertainness. In addition, they scored significantly lower in positive self-concept (FKK). No difference in these personality traits could be detected between AD and PSO subjects. When confronted with the laboratory stressor (TSST), significantly altered endocrine and immune responses in AD patients could be determined which are described elsewhere [J Clin Endocrinol Metab 2002;87:4245–4251; J Neuroimmunol 2002;129:161–167]. However, Pearson correlational analysis indicated no significant correlation between the different personality domains and any of the endocrine, immunological or physiological stress responses. The cortisol response to awakening in the morning, however, was significantly correlated with the stress vulnerability in situations characterized by job overload and criticism. Conclusions: AD patients show a distinct personality pattern, which does not differ from that found in PSO patients suggesting that there may be no specific ‘atopic’ personality type but rather a personality pattern linked to chronic inflammatory skin disorders.

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Section: Discussionsupporting

confidence: 75%

Personality Characteristics and Their Association with Biological Stress Responses in Patients with Atopic Dermatitis

Buske‐Kirschbaum¹,

Ebrecht²,

Kern³

et al. 2004

Dermatol Psychosom

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“…The severity of atopic dermatitis correlated with increased anxiety levels in children 45 and an increased ease of conditioning patients with atopic dermatitis to scratch have been attributed to their higher levels of anxiety. 46,47 Depression has also been found to correlate with itch intensity in atopic dermatitis, psoriasis, and chronic idiopathic urticaria. 48,49 …”

Section: Pruritic Conditions Aggravated By Psychosocial Factorsmentioning

confidence: 96%

Psychosomatic factors in pruritus

Tey

Wallengren

Yosipovitch

2013

Clinics in Dermatology

100

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Pruritus and psyche are intricately and reciprocally related, with psychophysiological evidence and psychopathological explanations helping us to understand their complex association. Their interaction may be conceptualized and classified into 3 groups: pruritic diseases with psychiatric sequelae, pruritic diseases aggravated by psychosocial factors, and psychiatric disorders causing pruritus. Management of chronic pruritus is directed at treating the underlying causes and adopting a multidisciplinary approach to address the dermatologic, somatosensory, cognitive, and emotional aspects. Pharmcotherapeutic agents that are useful for chronic pruritus with comorbid depression and/or anxiety comprise selective serotonin reuptake inhibitors, mirtazapine, tricyclic antidepressants (amitriptyline and doxepin), and anticonvulsants (gabapentin, pregabalin); the role of neurokinin receptor-1 antagonists awaits verification. Antipsychotics are required for treating itch and formication associated with schizophrenia and delusion of parasitosis (including Morgellons disease).

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“…Unfortunately, this hypothesis has not been really tested by the authors, and a potential relationship between CRF and itch threshold in AD patients has not been evaluated. Others were able to show that AD patients score higher on anxiety and that elevated anxiety in these patients is associated with increased conditioning of a scratch response to an itching stimulus [30]. The idea that anxiety levels in AD sufferers might be related to the ease of showing a learned scratch response may be of clinical relevance since scratching is considered as a core symptom of AD.…”

Section: Psychological Factors and Admentioning

confidence: 99%

Psychobiological Aspects of Atopic Dermatitis: An Overview

Buske‐Kirschbaum

Geiben

Hellhammer³

2001

Psychother Psychosom

198

119

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Atopic dermatitis (AD) is a chronic, pruritic inflammatory skin disease with increasing incidence characterized by eczematous inflammation of the skin, a chronically relapsing course and severe pruritus. In the last decade, there has been growing evidence indicating that psychological factors such as personality and stress may play an important role in the pathogenesis of AD. While there is only little consensus on an AD-specific personality profile and its etiological significance, a growing number of reports support the role of psychosocial stress in the onset and the course of AD symptomatology. However, although a close association between psychosocial stress and skin condition in AD patients has been demonstrated by several investigators, pathological models that integrate stress and its effect on atopy-relevant biological processes, e.g. immune processes, are still missing. This overview summarizes the role of immunological and psychological factors in AD pathogenesis and discusses potential psychobiological pathways of stress-related modulation of AD symptoms.

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Atopic dermatitis anxiety and conditioned scratch responses

Cited by 53 publications

References 4 publications

Personality Characteristics and Their Association with Biological Stress Responses in Patients with Atopic Dermatitis

Personality Characteristics and Their Association with Biological Stress Responses in Patients with Atopic Dermatitis

Psychosomatic factors in pruritus

Psychobiological Aspects of Atopic Dermatitis: An Overview

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