Improving skin picking diagnosis among Brazilians: validation of the Skin Picking Impact Scale and development of a photographic instrument

Xavier, Alice Castro Menezes; Souza, Camila Maria Barbieri de; Flores, Luís Henrique Fernandes; Prati, Clarissa; Cassal, Cecilia; Dreher, Carolina Blaya

doi:10.1016/j.abd.2018.10.001

Cited by 5 publications

(9 citation statements)

References 22 publications

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“…These results reflect the severity of SPD skin lesions and are a reliable way of determining skin picking habit reduction. Since previous studies have found that change in photographic instrument results is not correlated with change in depression or anxiety symptoms, 30 it can be hypothesized that the treatment applied in this study directly reduced the skin picking habit, independently of other variables.…”

Section: Discussionmentioning

confidence: 69%

“…For Study 2, we also included a photographic instrument developed by two dermatologists to directly evaluate SPD lesions. 30 All photos were analyzed by two blinded dermatologists with the photographic instrument, which has high internal consistency and moderate reliability. This measure is important since it specifically assesses lesion severity apart from the influence of patient habit awareness or associated depressive/anxious symptoms.…”

Section: Procedures and Measuresmentioning

confidence: 99%

“…This measure is important since it specifically assesses lesion severity apart from the influence of patient habit awareness or associated depressive/anxious symptoms. 30 The patients were randomized in blocks of 6 to receive individual or group treatment. The 8-week Rothbaum CBT protocol adapted for SPD, as described in Study 1, was applied in weekly sessions of 45 minutes for individual treatment and 90 minutes for group treatment, with the same therapists applying both formats.…”

Section: Procedures and Measuresmentioning

confidence: 99%

“… 23 , 28 The CGI scale is a questionnaire for assessing the impact that a disease/disorder has on a patient’s life; in the Brazilian Portuguese version, scores range from 1 (asymptomatic) to 7 (very severe impact). 24 , 29 The SPIS is a self-applied questionnaire 30 for assessing the severity and life impact of skin picking; the validated Brazilian Portuguese version consists of 10 items on skin-picking habits and their influence on the patient’s daily life during the last week. Each item is rated from 0 to 5 on a Likert scale, and total scores range between 0 and 50, with higher scores indicating more severe impact.…”

Section: Studymentioning

confidence: 99%

“…This measure is important since it specifically assesses lesion severity apart from the influence of patient habit awareness or associated depressive/anxious symptoms. 30 …”

Section: Studymentioning

confidence: 99%

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Skin picking treatment with the Rothbaum cognitive behavioral therapy protocol: a randomized clinical trial

Xavier

Souza

Flores

et al. 2020

Braz. J. Psychiatry

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Introduction: Although behavioral therapies can effectively treat skin picking disorder (SPD), there is no standardized treatment for improving SPD and its comorbidities and there is no group intervention option. This trial aimed to adapt the Rothbaum trichotillomania protocol to SPD (Study 1) and test its efficacy for treating SPD and comorbidities in individual and group formats (Study 2). Methods: The adapted protocol was applied to 16 SPD patients, who were allocated to group or individual treatment (Study 1). Afterwards, 54 patients were randomly allocated to treatment in an individual (n=27) or group format (n=27) (Study 2). In both studies, assessments of SPD severity, anxiety, depression, clinical status and skin lesion severity were performed at baseline and the endpoint. Results: The adapted protocol was feasible in both treatment modalities (Study 1) and led to high SPD remission rates (individual 63%; group 52%), with no significant difference between intervention types (p = 0.4) (Study 2). SPD, anxiety, and depression symptoms and objective patient lesion measures improved after treatment. There was large effect size for SPD symptom improvement in both treatment types (Cohen's d: group = 0.88; individual = 1.15) (Study 2). Conclusion: The adapted Rothbaum protocol was effective for SPD remission, comorbidities, and skin lesions, both in individual and group formats. Clinical trial registration: NCT03182478

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Section: Discussionmentioning

confidence: 69%

Section: Procedures and Measuresmentioning

confidence: 99%

Section: Procedures and Measuresmentioning

confidence: 99%

Section: Studymentioning

confidence: 99%

“…This measure is important since it specifically assesses lesion severity apart from the influence of patient habit awareness or associated depressive/anxious symptoms. 30 …”

Section: Studymentioning

confidence: 99%

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Skin picking treatment with the Rothbaum cognitive behavioral therapy protocol: a randomized clinical trial

Xavier

Souza

Flores

et al. 2020

Braz. J. Psychiatry

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Assessment tools for clinical excoriation (skin picking) disorder: a mini review for diagnosing and monitoring symptoms severity

Sapuppo,

Sbrizzi,

Boltri

et al. 2024

Curr Psychol

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Excoriation (Skin Picking) Disorder (SPD) is a psychiatric condition characterized by repetitive skin picking, often affecting areas like the face, arms, and hands. It has its own diagnostic classification in ICD-10, DSM-5-TR and PDM-2. Individuals with SPD may use various tools to pick at their skin and often struggle to stop the behavior. The disorder typically arises during adolescence and is more common in females, with a lifetime prevalence of 1.4% in adults. SPD is associated with decreased quality of life and increased rates of anxiety disorders, depression, and substance abuse. Validated assessment tools are essential for diagnosing and monitoring SPD symptoms. The Skin Picking Scale (SPS), Skin Picking Scale-Revised (SPS-R), Skin Picking Impact Scale (SPIS), and Skin Picking Symptom Assessment Scale (SP-SAS) are commonly used instruments for evaluating the severity of SPD symptoms. While these tools have shown reliability and validity, there are limitations, including potential biases in self-reporting and the need for further validation in different populations and languages. Future research is needed to enhance the effectiveness of screening and assessment tools for SPD in clinical settings.

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Anticipatory Detection of Compulsive Body-focused Repetitive Behaviors with Wearables

Searle

Spathis

Constantinides

et al. 2021

Proceedings of the 23rd International Conference on Mobile Human-Computer Interaction

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Body-focused repetitive behaviors (BFRBs), like face-touching or skin-picking, are hand-driven behaviors which can damage one's appearance, if not identified early and treated. Technology for automatic detection is still under-explored, with few previous works being limited to wearables with single modalities (e.g., motion). Here, we propose a multi-sensory approach combining motion, orientation, and heart rate sensors to detect BFRBs. We conducted a feasibility study in which participants (N=10) were exposed to BFRBs-inducing tasks, and analyzed 380 mins of signals 1 under an extensive evaluation of sensing modalities, cross-validation methods, and observation windows. Our models achieved an AUC > 0.90 in distinguishing BFRBs, which were more evident in observation windows 5 mins prior to the behavior as opposed to 1-min ones. In a follow-up qualitative survey, we found that not only the timing of detection matters but also models need to be context-aware, when designing just-in-time interventions to prevent BFRBs. CCS CONCEPTS• Human-centered computing → Ubiquitous and mobile computing; Ubiquitous and mobile computing design and evaluation methods.

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Improving skin picking diagnosis among Brazilians: validation of the Skin Picking Impact Scale and development of a photographic instrument

Cited by 5 publications

References 22 publications

Skin picking treatment with the Rothbaum cognitive behavioral therapy protocol: a randomized clinical trial

Skin picking treatment with the Rothbaum cognitive behavioral therapy protocol: a randomized clinical trial

Assessment tools for clinical excoriation (skin picking) disorder: a mini review for diagnosing and monitoring symptoms severity

Anticipatory Detection of Compulsive Body-focused Repetitive Behaviors with Wearables

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