# Evaluation of Attachment Styles in Patients with Chronic Pruritus

## TL;DR

This study shows that people with chronic itching have higher levels of insecure attachment styles and emotional issues compared to healthy individuals.

## Contribution

The study is the first to explore the role of attachment styles in chronic pruritus and links preoccupied attachment to greater itch severity.

## Key findings

- Patients with chronic pruritus had higher fearful, dismissive, and preoccupied attachment scores than controls.
- Secure attachment scores were significantly higher in the healthy control group.
- Higher anxiety and preoccupied attachment were associated with moderate to high itch severity.

## Abstract

Background and Objectives: While associations between attachment styles and certain dermatologic conditions have been documented, their role in chronic pruritus remains unexplored. Given the significant psychosomatic component in the etiology of chronic pruritus, this study aimed to assess attachment styles in patients with chronic pruritus in the absence of organic or psychiatric disorders and to examine their potential contribution to its development. Methods: Sixty patients with chronic pruritus were compared with a healthy control group (n = 60). Socio-demographic data, the duration of the disease, and the itch severity were noted. Additionally, assessments performed via the Questionnaire of Relation Scale, Questionnaire of Relation, Hospital Anxiety and Depression Scale, General Health Questionnaire, and Dermatology Life Quality Index (DLQI). Results: Statistically higher scores of fearful, dismissive, and preoccupied attachment styles were observed in the patient group compared to the control group. Among patients, those with moderate to high itch severity had higher mean scores of anxiety and preoccupied attachment than those with low itch severity. In contrast, secure attachment scores were significantly higher in the control group than in the patient group. Limitations: Attachment styles were examined with a self-report instrument without stimulated recall procedures. Conclusions: Our findings clearly demonstrate that patients with chronic pruritus exhibit significantly higher levels of insecure attachment styles alongside elevated anxiety, depression, and psychosocial burden. Notably, the association between preoccupied attachment and greater itch severity highlights how emotional dysregulation may intensify pruritus symptoms. Due to limited research directly examining attachment in chronic pruritus, our study provides novel insight and supports a biopsychosocial approach to care.