Stressful Life Events, Social Support, Attachment Security and Alexithymia in Vitiligo

Abstract

Background: It has often been suggested that stress might trigger vitiligo. However, only one study supported this hypothesis, and no study explored the role of other personality or social factors. Methods: Out-patients experiencing a recent onset or exacerbation of vitiligo (n = 31) were compared with out-patients with skin conditions in which psychosomatic factors are commonly were regarded as negligible (n = 116). Stressful events during the last 12 months were assessed with Paykel’s Interview for Recent Life Events. Attachment style, alexithymia and social support were assessed with the ‘Experiences in Close Relationships’ questionnaire, the Toronto Alexithymia Scale (TAS-20), and the Multidimensional Scale of Perceived Social Support, respectively. Results: Cases and controls did not differ regarding the total number of events and the number of undesirable, uncontrollable or major events. Three or more uncontrollable events had occurred more frequently among cases than controls. Perceived social support was lower in cases than in controls. Cases scored higher than controls on anxious attachment, tended towards higher scores on avoidant attachment and were classified more often as insecure. Cases scored higher than controls on the TAS-20 and were classified more often as alexithymic or borderline alexithymic. The occurrence of many uncontrollable events, alexithymia and anxious attachment were associated with vitiligo also in multiple logistic regression analysis. Conclusions: These findings suggest that vulnerability to vitiligo is not increased by stressful events, except for many uncontrollable events. Alexithymia, insecure attachment and poor social support appear to increase susceptibility to vitiligo, possibly through deficits in emotion regulation or reduced ability to cope effectively with stress.

The Psychosocial Aspects of Vitiligo: A Focus on Stress Involvement in Children with Vitiligo

“…There was no difference with men or the vitiligo cohort as a whole. These results were concordant with respect to those of Picardi et al (Picardi et al, 2003). They also found no differences between vitiligo patients and controls regarding the total number of stressful events or the number of undesirable, uncontrollable, or major events.…”

“…In Agarwal's study (Agarwal, 1998), half of the patients with vitiligo reported stressful events before disease onset. Meanwhile, other reports (Picardi et al, 2003) found no differences between vitiligo patients and controls when comparing numbers of stressful events. In our previous study, we found significant differences in the mean number of stressful events only between women with vitiligo and controls.…”

“…Furthermore, depressive illnesses, generalized anxiety, mixed anxiety and depression, social phobia, agoraphobia, and sexual dysfunction are also common in vitiligo patients (Mechri et al, 2006). Patients with vitiligo also have high rates of alexthymia and avoidant behaviors (Picardi et al, 2003).…”

Personality traits and common psychiatric conditions in patients with seborrheic dermatitis

“…It is widely believed that psychological stress, some personality traits, and psychiatric disorder complications are related to, and manifest as skin disease 13 . Thus, in the current study, the SCL-90-R was used to investigate common psychiatric symptoms in SD patients.…”

A Critical Appraisal of Vitiligo Etiologic Theories. Is Melanocyte Loss a Melanocytorrhagy?

“…NSV is commonly precipitated by stress. This view has been recently challenged in a case-control study; however, a reduced ability to cope with stress may contribute to the clinical findings (38). There is a marked increase of calcitonin gene related peptide (CGRP) positive nerve fibers in involved skin (39).…”