[Attachment security and quality of life in atopic dermatitis]

Attachment style is an important variable of influence on general and disease specific quality of life. Insecure attachment may go along with increased autonomic vulnerability and with compromised social support and coping resources. Patients with atopic dermatitis often report interactions of the status and severity of their disease with psychic wellbeing. It was the purpose of the present study to clarify the influence of attachment style and social support on the quality of life in probands with atopic dermatitis. We hypothesized that securely attached test persons with severe skin affection feel less constrained in their quality of life, because they may "buffer" strains from the disease more successfully due to better social support deriving from more satisfying relationships.

We carried through a cross-sectional study on 124 probands with atopic dermatitis of varying severity, assessed with self report (Neurodermitis Severity Index, NSI) and in part by clinical dermatological ratings (NSI/SCORAD). Attachment style was captured with the Relationship Scales Questionnaire (RSQ), social support with the F-SOZU (K-22), and quality of life with the Skindex-29.

We found slightly more insecurely attached individuals in the study sample than it was to be expected from representational healthy samples. Securely attached participants have no lower severity of their disease, but show a higher amount of social support. Irrespective of severity, securely attached persons feel less limited in their quality of life compared to insecurely attached participants. In their symptom based quality of life both feel equally limited. Severity predicts quality of life: contrary to our expectation of a buffering effect of attachment security this association is closer in securely attached probands.

Suffering from atopic dermatitis may go along with more attachment insecurity. The unexpected stronger association between severity and quality of life in securely attached individuals can be interpreted as a more direct reaction to their skin condition in the absence of other encumbering factors (relationship problems etc.).