Acute Itch Induces Attentional Avoidance of Itch-related Information




attention, pruritus, histaminergic, agonist


Attention is known to modulate itch intensity. In contrast, the reverse relationship, i.e. the degree to which the presence of an acute itch affects attention, is currently not well understood. The aims of this study were to investigate whether acute itch induces an attentional bias towards or away from visual itch-related stimuli, and if so, whether it occurs in the early or later stages of processing. A volunteer sample of 60 healthy individuals were subjected to a skin prick (either histamine or placebo), followed by completion of a spatial cueing paradigm using itch-related and neutral words as cues, in order to obtain reaction time estimates of attentional bias. The results suggest that experience of acute itch induces attentional avoidance of visual itch threats. This attentional avoidance occurs at a later processing stage in the form of facilitated disengagement of attention from itch and/or delayed disengagement from neutral information.


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Ikoma A, Steinhoff M, Stander S, Yosipovitch G, Schmelz M. The neurobiology of itch. Nat Rev Neurosci 2006; 7: 535-547.

van Laarhoven AI, Kraaimaat FW, Wilder-Smith OH, Evers AW. Role of attentional focus on bodily sensations in sensitivity to itch and pain. Acta Derm Venereol 2010; 90: 46-51.

Crombez G, Van Ryckeghem DML, Eccleston C, Van Damme S. Attentional bias to pain-related information: a meta-analysis. Pain 2013; 154: 497-510.

van Laarhoven AIM, van Damme S, Lavrijsen APM, van Ryckeghem DM, Crombez G, Evers AWM. Attentional processing of itch. Psychol Res 2018; 82: 876-888.

van Laarhoven AIM, van Damme S, Lavrijsen ASPM, van Ryckeghem DM, Crombez G, Evers AWM. Do tonic itch and pain stimuli draw attention towards their location? Biomed Res Int 2017; 2017: 2031627-2031627.

Posner MI. Orienting of attention. Q J Exp Psychol 1980; 32: 3-25.

Grubert A, Righi LL, Eimer M. A unitary focus of spatial attention during attentional capture: Evidence from event-related brain potentials. J Vis 2013; 13: 1-11.

Zhou Y, Liang L, Pan Y, Qian N, Zhang M. Sites of overt and covert attention define simultaneous spatial reference centers for visuomotor response. Scientific Reports 2017; 7: 46556.

Posner MI, Petersen SE. The attention system of the human brain. Annu Rev Neurosci 1990; 13: 25-42.

Bar-Haim Y, Lamy D, Pergamin L, Bakermans-Kranenburg MJ, van IMH. Threat-related attentional bias in anxious and nonanxious individuals: a meta-analytic study. Psychol Bull 2007; 133: 1-24.

Cohen J. A power primer. Psychol Bull 1992; 112: 155-159.

Fox E, Russo R, Bowles R, Dutton K. Do threatening stimuli draw or hold visual attention in subclinical anxiety? J Exp Psychol Gen 2001; 130: 681-700.

Kosteletzky F, Namer B, Forster C, Handwerker HO. Impact of scratching on itch and sympathetic reflexes induced by cowhage (Mucuna pruriens) and histamine. Acta Derm Venereol 2009; 89: 271-277.

van Heuven WJ, Mandera P, Keuleers E, Brysbaert M. SUBTLEX-UK: a new and improved word frequency database for British English. Q J Exp Psychol (Hove) 2014; 67: 1176-1190.

Jones O, Schindler IC, Holle H. Assessing acute itch intensity: general labelled magnitude scale is more reliable than classic visual analogue scale. Acta Derm Venereol 2017; 97: 375-376.

LaMotte RH, Shimada SG, Green BG, Zelterman D. Pruritic and nociceptive sensations and dysesthesias from a spicule of cowhage. J Neurophysiol 2009; 101: 1430-1443.

Singmann H, Bolker B, Westfall J, Aust F, Ben-Shachar MS. afex: analysis of factorial experiments. R package version 1.0-1. 2021.

Lenth RV. emmeans: estimated marginal means, aka least-squares means. R package version 1.7.0. 2021.

Pronk T, Molenaar D, Wiers RW, Murre J. Methods to split cognitive task data for estimating split-half reliability: a comprehensive review and systematic assessment. Psychon Bull Rev 2021.

Becker JM, Vreijling SR, Dobbinga S, Giesbers JJJ, Evers AWM, Veldhuijzen DS, et al. Attentional bias towards visual itch and pain stimuli in itch- and pain-free individuals? Acta Derm Venereol 2020; 100: adv00199.

Holle H, Gunter TC. The role of iconic gestures in speech disambiguation: ERP evidence. J Cogn Neurosci 2007; 19: 1175-1192.

Twilley LC, Dixon P. Meaning resolution processes for words: a parallel independent model. Psychon Bull Rev 2000; 7: 49-82.

Todd J, Sharpe L, Johnson A, Nicholson Perry K, Colagiuri B, Dear BF. Towards a new model of attentional biases in the development, maintenance, and management of pain. Pain 2015; 156: 1589-1600.

Shiffrin RM, Schneider W. Controlled and automatic human information-processing. 2. perceptual learning, automatic attending, and a general theory. Psychol Rev 1977; 84: 127-190.

Schneider W, Chein JM. Controlled & automatic processing: behavior, theory, and biological mechanisms. Cogn Sci 2003; 27: 525-559.

Mogg K, Bradley BP. A cognitive-motivational analysis of anxiety. Behav Res Ther 1998; 36: 809-848.

Koster EH, Crombez G, Verschuere B, Van Damme S, Wiersema JR. Components of attentional bias to threat in high trait anxiety: facilitated engagement, impaired disengagement, and attentional avoidance. Behav Res Ther 2006; 44: 1757-1771.

Van Ryckeghem DML, Noel M, Sharpe L, Pincus T, Van Damme S. Cognitive biases in pain: an integrated functional-contextual framework. Pain 2019; 160: 1489-1493.

Fortune DG, Richards HL, Corrin A, Taylor RJ, Griffiths CE, Main CJ. Attentional bias for psoriasis-specific and psychosocial threat in patients with psoriasis. J Behav Med 2003; 26: 211-224.

Broadbent P, Schoth DE, Liossi C. Association between attentional bias to experimentally induced pain and to pain-related words in healthy individuals: the moderating role of interpretation bias. Pain 2022; 163: 319-333.


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Etty, S., George, D. N., van Laarhoven, A. I., & Holle, H. (2022). Acute Itch Induces Attentional Avoidance of Itch-related Information. Acta Dermato-Venereologica, 102, adv00691.