Can itch-related visual stimuli alone provoke a scratch response in healthy individuals?

Lloyd, David T.; Hall, Elizabeth A.; Hall, Sarah; McGlone, Francis

doi:10.1111/bjd.12132

Cited by 49 publications

(65 citation statements)

References 24 publications

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“…The current study replicated previous findings showing that feelings of itch and the scratch response can be induced visually (ie, without delivery of a pruritogen) in response to itch-related images [5] . The highest self and other itch ratings were again given for skin contact pictures; however, a new category containing images of skin conditions also produced high levels of self and other itch ratings.…”

Section: Discussionsupporting

confidence: 90%

“…Results from the present and previous studies [5,17] suggest that itch perception and the scratch response are not as closely correlated as first assumed and must be explained by other factors. Behavioral interventions for skin conditions (such as habit reversal, which aims to modify/prevent unhelpful scratching behaviors by encouraging people to focus on an alternative action to scratching in response to itch such as clenching the fists or pinching the itchy spot [18] ) may be an important focus for therapeutic interventions, as this is the part of the itch-scratch cycle that seems to have the most damaging effect.…”

Section: Discussioncontrasting

confidence: 69%

“…], 8 taken from a previous study [5] and 1 photograph taken by the experimenters (images available on request). These were divided into 16 itch and 16 non-itch-related images, which were further subdivided into 4 picture types (4 in each category): (i) "skin contact," including images of itch-related versus non-itch-related objects in contact with the skin (eg, insects crawling on the hand vs. marbles touching the skin); (ii) "skin response," which included images of human responses to itch (ie, scratching) or non-itch-related touching of the skin (ie, washing the hands or rubbing cream onto the face); (iii) "context," which included pictures where itchy or nonitchy stimuli were seen in the environment but not on the body (eg, ants crawling on the ground or butterflies flying); and (iv) "skin condition" (eg, hives or freckles).…”

Section: Apparatus and Materialsmentioning

confidence: 99%

“…This cycle can be triggered by "contagious itch," that is an induced feeling of itch typically followed by a scratch response, resulting from viewing another person scratching [1] . While several studies have explored this effect using different methods for triggering the phenomenon [1][2][3][4] , only 1 study has thus far compared the effectiveness of different visual stimuli to evoke itch and scratch [5] . However, it did not assess the impact of individual differences such as sex or history of pruritic dermatological conditions on visually evoked itch (VEI).…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies have demonstrated that a combination of watching videos of people scratching while participants received either histamine or saline administration caused self-reported itch intensity to increase in all participants, but resulted in a doubling of spontaneous scratching episodes in those with AD who also appeared to scratch a more widespread area for longer [1] . Lloyd et al [5] have shown that images containing itch-related stimuli in contact with the body (such as ants crawling on the skin) produce the highest ratings of itch intensity. However, it has yet to be established whether participants with a history of PSCs, and/or images of skin conditions (such as psoriasis), produce higher ratings, thereby confirming the importance of VEI in the itch-scratch cycle.…”

Section: Introductionmentioning

confidence: 99%

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Are sex and history of pruritic skin conditions factors which affect the phenomenon of visually evoked itch? An exploratory study

Lloyd¹,

Dodd²,

Higgins³

et al. 2017

Itch

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Introduction:We have previously shown that sensations of itch and the scratch response can be evoked using itch-related images. However, we did not determine whether individual differences in a person's experience of itch could moderate this effect. This exploratory study aimed to determine whether sex or a history of pruritic skin conditions (PSCs) could influence the effects of visually evoked itch and scratch. Methods: Forty-one participants (19 males; 16 with a history of PSCs) viewed static images that could either be itch or nonitch related. These were further separated by picture type: "skin contact" (ants crawling on the hand vs. a butterfly on the finger); "skin response" (scratching an insect bite vs. washing the hands); "skin condition" (psoriasis vs. freckles) or "context only" (insects vs. birds). Images were rated using a 10-point scale by answering: "How itchy do you feel?" (Self-rating) and "How itchy do you think the person in the picture feels?" (Other-rating). Frequency and location of scratching was also recorded. Results: The highest itch scores were to itch-related skin contact pictures. Females gave higher itch ratings than males, and people with a history of PSCs gave higher itch ratings when viewing images of people scratching. There was no correlation between itch ratings and scratch response, and no relationship between body site viewed and location of scratching. Discussion: There is a heightened response to itch-related cues in females and those with PSCs, indicating a more centrally mediated pathway bringing subconscious itch sensations into conscious awareness in these populations. These findings could influence personalized treatment interventions aimed at reducing awareness of itch sensations in susceptible individuals.

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Section: Discussionsupporting

confidence: 90%

Section: Discussioncontrasting

confidence: 69%

Section: Apparatus and Materialsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Are sex and history of pruritic skin conditions factors which affect the phenomenon of visually evoked itch? An exploratory study

Lloyd¹,

Dodd²,

Higgins³

et al. 2017

Itch

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Placebo and nocebo effects on itch: effects, mechanisms, and predictors

Bartels

Laarhoven

Kerkhof

et al. 2015

European Journal of Pain

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Placebo and nocebo effects have been extensively studied in the field of pain and more recently also on itch. In accordance with placebo research on pain, expectancy learning via verbal suggestion or conditioning has shown to induce placebo and nocebo effects on itch, in which the combination of both procedures seems most promising. Moreover, itch can also be transferred 'contagiously' in which suggestion and social behavioural learning seem to play a role. With regard to predictors of placebo and nocebo responding on itch and contagious itch, preliminary evidence suggests a role for individual psychological characteristics and personality traits regarding negative outcome expectancies. Although findings on placebo and nocebo effects on itch seem comparable to pain, we have only just begun to understand the underlying mechanisms and predictors of placebo and nocebo effects on itch.

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Role of personality and expectations for itch and scratching induced by audiovisual itch stimuli

Schut

Rädel

Frey

et al. 2015

European Journal of Pain

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Itch is an unpleasant, bodily sensation, which--similar to pain--evokes behavioral reactions. As a response to itch, people start scratching. There are different ways to provoke itch and subsequent scratching in experimental settings. A non-invasive method to induce itch and scratching is the presentation of itch-related (audio-) visual stimulus material, like slide-supported lectures on skin diseases or crawling insects. Also, watching videos showing other people scratching provokes itch and the desire to scratch. In this review, we focus on psychological factors, which were shown to be associated with itch and scratching provoked by (audio-) visual itch stimuli. First, we summarize the findings on the relationship between personality characteristics and (audio-) visually induced itch. Agreeableness and self-consciousness were shown to be associated with induced itch and scratching in patients with chronic skin diseases, while neuroticism was linked to induced itch in healthy subjects. Second, we present results of a recent study, in which we altered the expectations towards audio-visually induced itch and scratching by changing the information given on upcoming itch stimuli. It was shown that subjects being informed about itch stimuli in a neutral way displayed a shorter scratch duration in itch inducing situations than subjects having catastrophizing expectations. Also, the increase in scratch duration and in the number of scratch movements induced by audiovisual itch stimuli was higher when the patients were not informed about itch induction. Thus, in itch patients neither catastrophizing nor trivializing symptoms seems to be helpful.

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Can itch-related visual stimuli alone provoke a scratch response in healthy individuals?

Abstract: This study demonstrates the impact of visual cues in eliciting sensations of itch and provoking a scratch response, and may provide behavioural evidence linking contagious itch to the mirror neuron system.

Cited by 49 publications

References 24 publications

Are sex and history of pruritic skin conditions factors which affect the phenomenon of visually evoked itch? An exploratory study

Are sex and history of pruritic skin conditions factors which affect the phenomenon of visually evoked itch? An exploratory study

Placebo and nocebo effects on itch: effects, mechanisms, and predictors

Role of personality and expectations for itch and scratching induced by audiovisual itch stimuli

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