Latent Profiles of Perceived Stress and Their Predictors in Alopecia Areata: A Cross‐Sectional Study

BACKGROUND: Alopecia areata (AA) causes significant psychological distress. Standard assessments often classify patient stress as merely high or low, overlooking key differences in stress experiences, such as anxiety versus helplessness. This study employed a person-centered method to identify distinct subgroups of AA patients based on their unique patterns of anxiety-related stress. METHODS: A cross-sectional survey of adults with AA was conducted using the validated Chinese version of the 14-item Perceived Stress Scale (PSS-14). Latent profile analysis (LPA) was applied to the PSS-14 responses to identify distinct subgroups of stress experience. Multinomial logistic regression was then used to examine demographic and clinical predictors of subgroup membership. RESULTS: A total of 561 adult patients with AA were analyzed. LPA of the PSS-14 responses revealed three distinct stress profiles: a low-tension/low-loss-of-control group (42.4%), a high-tension/low-loss-of-control group (15.7%), and a low-tension/high-loss-of-control group (41.9%). Membership in the more distressed profiles was significantly associated with lower odds of having more severe disease (alopecia totalis/universalis), and sex was associated with membership in the high-tension/low-loss-of-control profile. No other clinical variables were significant. CONCLUSIONS: This study identified three distinct, clinically meaningful profiles of perceived stress in adults with AA. These findings demonstrate that psychological distress in AA is multifaceted and cannot be inferred from clinical severity alone. A more nuanced, profile-aware approach is advocated to tailor psychosocial support in clinical management.