Dissociative Experiences Mediate the Relationship Between Traumatic Life Events and Types of Skin Picking. Findings From Non-clinical Sample (original) (raw)
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The relationship of psychological trauma with trichotillomania and skin picking
Neuropsychiatric Disease and Treatment, 2015
Interactions between psychological, biological and environmental factors are important in development of trichotillomania and skin picking. The aim of this study is to determine the relationship of traumatic life events, symptoms of post-traumatic stress disorder and dissociation in patients with diagnoses of trichotillomania and skin picking disorder. Methods: The study included patients who was diagnosed with trichotillomania (n=23) or skin picking disorder (n=44), and healthy controls (n=37). Beck Depression Inventory, Traumatic Stress Symptoms Scale and Dissociative Experiences Scale were administered. All groups checked a list of traumatic life events to determine the exposed traumatic events. Results: There was no statistical significance between three groups in terms of Dissociative Experiences Scale scores (P=0.07). But Beck Depression Inventory and Traumatic Stress Symptoms Scale scores of trichotillomania and skin picking groups were significantly higher than the control group. Subjects with a diagnosis of trichotillomania and skin picking reported statistically significantly higher numbers of traumatic and negative events in childhood compared to healthy subjects. Conclusion: We can conclude that trauma may play a role in development of both trichotillomania and skin picking. Increased duration of trichotillomania or skin picking was correlated with decreased presence of post-traumatic stress symptoms. The reason for the negatively correlation of severity of post-traumatic stress symptoms and self-harming behavior may be speculated as developing trichotillomania or skin picking symptoms helps the patient to cope with intrusive thoughts related to trauma. Future longitudinal research must focus on whether trauma and post-traumatic stress or trichotillomania and skin picking precede the development of mental disorder.
A Case of the Skin Picking Disorder who Had History of Childhood Abuse
Noro Psikiyatri Arsivi, 2015
Compulsive self-injurious behavior (SIB), including hair pulling, nail biting, skin picking (SP), and scratching, is habitual, repetitively occurs, and is frequently observed as a comorbid condition in various psychiatric disorders, such as borderline personality disorder (BPD), post-traumatic stress, depressive, anxiety, and eating disorders (1). SP disorder (SPD), also known as neurotic/psychogenic excoriation, involves pathological SP and dermatotillomania, which is characterized by recurrent and excessive skin picking or scratching, and this disorder has been recently introduced to The Fifth Edition of The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as an obsessive-compulsive-related disorder (2). Women are more likely to be affected than men (3). The prevalence of SPD has been found to be 1.25%-5.4% of the adult population (3), 2.4% of Turkish students (4), and 11.8% of adolescent psychiatric inpatients (5). Childhood abuse is associated with various psychopathologies, including personality disorders, maladaptive and impulsive behaviors, and SIB in adolescents and adults (6,7). Individuals with compulsive skin picking often present with a history of childhood abuse (6,7,8). The pathophysiology of this association is not well understood (5,7). Regardless of the reason, the known rates of SPD are becoming more prevalent; however, no one treatment has been found to be the most effective. Early childhood trauma leads to a negative self-image, decreased self-esteem, and feelings of incompetence (6,7). Moreover, most patients have a poor impulse control (5,8). Pathological SP behavior often results in important functional deterioration and boredom (5,7,8). The afflicted subjects mostly report shame and embarrassment, along with the avoidance of social situations. Skin picking disorder can present as a diagnostic puzzle to psychiatric professionals. Nevertheless, the psychosocial consequences of this problem have increasingly received recognition (3,4). Here, we report a case of a 26-year-old female with SPD who had a history of childhood abuse and a diagnosis of BPD. CASE A 26-year-old, right-handed, Turkish single female, who lived with her family in a village located in the southeastern part of Turkey, was admitted to our outpatient department of psychiatry. She began SP sporadically and presented with complaints of excessive skin scratching and
Journal of Anxiety Disorders, 2011
The current study examined the characteristics of pathological skin picking (PSP) in a population-based sample. Participants were recruited through several online resources for PSP and related conditions to complete a web-based survey assessing the functional and topographical phenomenology, physical and psychosocial impact, treatment utilization, and associated psychopathology of PSP. A total of 1663 participants consented, of whom 760 were over 18 and met study criteria for PSP. Results showed considerable heterogeneity in picking methods, body sites, and function (e.g., regulation of emotional, sensory, and cognitive states). Participants generally reported moderate psychosocial and physical impact from picking and tended to perceive available treatment as poor in quality. Severity of associated symptoms of psychopathology (depression, anxiety, and stress) was comparable to severity levels found in previous samples of persons with trichotillomania and obsessive-compulsive disorder. Severity of PSP was a statistically significant predictor of overall impairment after controlling for depression and anxiety symptoms. Results suggest that PSP is a significant public health concern in need of further rigorous investigation.
Cognitive behavioral therapy for excoriation (skin picking) disorder
Innovative Publication, 2016
Abstract In spite of excoriation (skin picking) disorder being first described in 1875, it has not yet been fully studied and understood. Furthermore over the years it has received multiple names (neurotic excoriation, psychogenic excoriation, pathological skin picking, compulsive skin picking) and only since late 2012 it has been included in diagnostic guidelines. Excoriation (skin picking) disorder can be a challenging condition for the non-experienced physician. Cognitive behavioral therapy is the most common form of (and most effective in our experience) psychotherapy for the treatment of patients with excoriation (skin picking) disorder and other body-focused repetitive behaviors, such as trichotillomania. In this review article, we present the main elements of this type of psychotherapy in the treatment of these psychodermatology patients. Key words: Excoriation disorder, Skin picking, Treatment, Cognitive behavioral therapy
Hairpulling and Skin Picking in Relation to Affective Distress and Obsessive-Compulsive Symptoms
Journal of Psychopathology and Behavioral Assessment, 2006
The current study examined the frequency and associated distress of both hairpulling and skin picking behaviors in 1,324 college students using the Massachusetts General Hospital Hairpulling Scale (MGHHS) and Skin Picking Scale (SPS). In this sample, many participants reported significant distress secondary to both hairpulling and skin picking. Participants who endorsed relatively frequent hairpulling or skin picking (N = 72) were scheduled for a follow-up testing session to further assess the relationship between these behaviors and measures of affective distress. Compared to a control sample, the follow-up sample endorsed significantly more symptoms of anxiety and stress reactivity, and had higher scores on a measure of obsessive-compulsive symptoms.
Disgust, shame and the psychosocial impact of skin picking: Evidence from an online support forum
Journal of Health Psychology, 2019
This paper examines the accounts of individuals who problematically pick their skin and explores their subjective experiences. One hundred problem disclosure statements were taken from posts made to a publicly accessible online skin picking support forum. These posts were systematically analysed using thematic analysis. Themes of disgust, shame and psychosocial avoidance dominated the analysis and appeared central to the experience of skin picking. Skin picking was shown to be a heterogeneous experience with a complex emotional profile. We argue that disgust, shame and related avoidance behaviour should be considered when conceptualising skin picking and considering treatment interventions.
CNS spectrums, 2018
Evidence suggests that skin picking disorder (SPD) could be a prevalent condition associated with comorbidity and psychosocial dysfunction. However, just a few studies have assessed the prevalence and correlates of SPD in samples from low- and middle-income countries. In addition, the impact of SPD on quality of life (QoL) dimension after multivariable adjustment to potential confounders remains unclear. Data were obtained from a Brazilian anonymous Web-based research platform. Participants provided sociodemographic data and completed the modified Skin Picking-Stanford questionnaire, the Hypomania Checklist (HCL-32), the Patient Health Questionnaire-9 (PHQ-9), the Fagerström Test for Nicotine Dependence, Alcohol Use Disorder Identification Test (AUDIT), Symptom Checklist-90-Revised inventory (SCL-90R), early trauma inventory self report-short form, and the World Health Organization quality of life abbreviated scale (WHOQOL-Bref). Associations were adjusted to potential confounders t...
The Skin Picking Impact Scale (SPIS): Scale Development and Psychometric Analyses
Psychosomatics, 2001
The Skin Picking Impact Scale (SPIS) is a self-report instrument developed to assess the psychosocial consequences of repetitive skin picking. An initial 28-item scale was administered to 31 individuals with severe self-injurious skin picking and 78 individuals with non-self-injurious skin picking. Item difficulty levels and part-whole correlations resulted in a 10-item scale with good internal consistency. SPIS scores for those with self-injurious skin picking were significantly higher than for those with non-self-injurious skin picking. SPIS scores for those with self-injurious skin picking correlated with duration of daily picking, satisfaction during picking, and shame subsequent to picking, as well as Beck Depression Inventory and Beck Anxiety Inventory scores. Sensitivity and specificity analyses indicate that a scale cutoff score of 7 optimally discriminates individuals with self-injurious skin picking from those with non-self-injurious skin picking.
[The relationship between traumatic experiences and dissociative phenomena]
Tijdschrift voor psychiatrie, 2006
Intuitively we are convinced that there must be a causal relationship between traumatic experiences and dissociation. However, although the theory is both elegant and attractive, the existence of a direct causal link between trauma and dissociation is open to question. Available studies on this theme have methodological shortcomings. To obtain more insight into the frequency with which psychiatric patients have undergone traumatic experiences and to find out more about the relationship between theses experiences and dissociative phenomena. Over a period of two years new outpatients attending psychiatric clinics completed questionnaires about their past life and mental health; in these questionnaires they gave information about traumatic experiences, dissociative phenomena, psychological symptoms and psychological functioning. Only 38 of the 351 patients who completed the questionnaire stated that they had never had any traumatic experiences. A relatively large number of patients men...