Coping as mediator of the relationship between stress and itch in patients with atopic dermatitis: a regression and mediation analysis

Even though it has been shown that stress and itch are associated in patients with atopic dermatitis (AD), it remains unclear whether this relationship occurs due to certain coping strategies being activated under stress. Therefore, this study investigates the role of coping as possible mediating factor between stress and itch in 31 patients with AD. Coping and itch were assessed by self-reported measures, while stress was measured both by a validated questionnaire and by a physiological stress marker, the postawakening cortisol. Using a regression and a mediation analysis, this study showed a relationship between perceived stress and itch (corrected R-2=0.21), which was fully mediated by negative itch-related cognitions. 62.3% of the variance of itch intensity could be explained by negative itch-related cognitions. This finding helps to explain the positive effects of cognitive restructuring in the treatment of chronic itch.