What is new in the psychology of chronic itch?

Abstract

Itch is often regarded as unpleasant or bothersome and is accompanied by symptoms of distress and impairments in daily life. The biopsychosocial model of chronic itch describes how psychological factors can contribute to the improvement or exacerbation of chronic itch and related scratching behaviour. Recent research underlines the important role of cognitive‐affective information processing, such as attention, affect and expectancies. This may not only play a role for acute itch states, but may particularly apply to the process of itch chronification, for example, due to the vicious cycle in which these factors shape the experience of itch. The present paper focuses on new insights into the relation between itch and the cognitive‐affective factors of attention, affect and expectancies. These factors are thought to play a possible aggravating role in itch in the long term and have received increasing attention in the recent empirical literature on maintaining and exacerbating factors for chronic physical symptoms. Possible psychophysiological and neurobiological pathways regarding these factors are discussed, as well as possible intervention methods.

Catastrophizing thinking towards itch and pain in chronic itch patients

“…In addition, there is a close interaction between itch and pain attributable to peripheral and central pain modulation processes, 4,5 and perceived severity of both has been linked with negative expectations. 6 The effects of catastrophizing thinking on the perception of chronic itch symptom perception however have rarely been investigated. Hence, we explored, in chronic itch patients, whether itch symptoms and pain perception are affected by psycho-cognitive parameters of catastrophizing thinking for both itch and pain.…”

Optimizing audiovisual itch induction: the role of attention and expectancy

“…Negative expectancies are known powerful itch amplifiers . In the present study, it is not unlikely that placebo iontophoresis induced nocebo effects on itch, amplifying the itch‐inducing effects of the audiovisual itch induction.…”

“…From this perspective, it is not surprising that audiovisual stimuli are more effective in patients with chronic itch . The persistent clinical itch of these patients may induce a tendency to be attentive to itch stimuli, to expect itch and to interpret stimuli in the context of itch …”

Development and psychometrics of the English version of the Itch Cognitions Questionnaire

“…Also, cognitive reactions to external demands such as stress are thought to play a role in the worsening or improvement of chronic itch [5]. Indeed, the role of cognitive factors like attention or expectancies for perceived itch have been studied in recent years [6][7][8][9]. Catastrophic cognitions about itch (e.g., "The itching will never stop") have been experimentally shown to increase severity of itch [10].…”