Prevalence of pathological skin-picking in dermatological patients

Spitzer, Carsten; Lübke, Laura; Lindstädt, Tereza; Gallinat, Christina; Tietze, Julia K.; Emmert, Steffen; Thiem, Alexander

doi:10.1016/j.jpsychires.2022.01.035

Cited by 8 publications

(5 citation statements)

References 25 publications

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“…While this finding is in line with results from previous studies on body image and mental health impairment in dermatological patients (e.g., 30–38), the results of the present study also indicate that skin picking, as a common behavioral pattern in dermatological patients ( 12 , 14 ), should be given particular sensitive attention. Skin picking can lead to additional appearance-related impairments as well as negatively affect mental health of individuals with skin conditions and should therefore be assessed and addressed by dermatological professionals and, if present, be treated in cooperation with specialists for psychodermatological conditions with primary psychopathology [see, e.g., ( 57 )].…”

Section: Discussionsupporting

confidence: 93%

“…Thus, appearance concerns might arise from or be aggravated by existing skin conditions in individuals with PSP. Further, skin conditions can trigger the development and single episodes of PSP (12)(13)(14). However, PSP alone seems to account for a marked impairment regarding appearance concerns, such as dysmorphic concerns or appearance-based rejection sensitivity.…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Many affected individuals report having difficulties suppressing the behavior when confronted with these skin imperfections (11). Therefore, transient or persistent skin conditions may increase the risk for PSP (12)(13)(14). Subsequently, PSP may occur in individuals with transient (e.g., pubertal) skin conditions and persist as a behavior even after the skin conditions have vanished in adulthood.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the study did not include comparisons with skin-healthy controls or other control groups that might be affected by a similar skin appearance. Here, potential groups of interest include individuals with (visible) dermatological conditions (e.g., acne, atopic dermatitis or psoriasis) that might also promote skin picking behavior, PSP and/or body image concerns (12,14,(30)(31)(32). The present study is therefore addressing the research question to what extent individuals with PSP with (SP/DC) and without (SP) dermatological conditions differ from individuals with dermatological conditions only (DC) and skin-healthy controls (SH) regarding the degree of their dysmorphic concerns, ARS, and BDD-symptoms.…”

Section: Introductionmentioning

confidence: 99%

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Appearance-related concerns in individuals with pathological skin picking—a comparison with individuals with dermatological conditions and skin-healthy controls

2023

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IntroductionPathological skin picking (PSP) is an excessive behavior which characterizes Skin Picking Disorder. Individuals repeatedly pick their skin and cause skin lesions, but are unable to control the behavior, which can cause severe distress. Visible self-inflicted skin lesions can additionally affect individuals with PSP due to emerging appearance-related concerns. However, these concerns and their role in PSP have hardly been studied, especially not in comparison with individuals with dermatological conditions and skin-healthy controls.MethodsThe present cross-sectional study (n = 453, 83.9% female, 15.9% male, 0.2% diverse) aimed at analyzing appearance-related concerns and mental health outcomes between four groups: Individuals with PSP and dermatological conditions (SP/DC; n = 83), PSP without dermatological conditions (SP; n = 56), dermatological conditions without PSP (DC; n = 176) and skin-healthy controls (SH, n = 138). We compared questionnaire data on dysmorphic concerns, appearance-based rejection sensitivity, and body dysmorphic symptoms, as well as PSP-symptoms and mental health outcomes (depression, anxiety, and self-esteem) between groups.ResultsThe analyses showed a significant multivariate group effect in the appearance-related variables, F(6, 896) = 19.92, Wilks’ Λ = 0.78, p < 0.001, and mental health outcomes, F(6, 896) = 16.24, Wilks’ Λ = 0.81, p < 0.001. The SP/DC group had the strongest appearance-related concerns and mental health impairments, followed by the SP group, the DC group and the SH group. The SP/DC group and SP group only differed significantly with regard to dysmorphic concerns, but not in other variables. The DC group was less affected but still showed higher dysmorphic concerns and mental health impairments than skin-healthy controls. In contrast to the PSP groups, the other two groups did not exceed clinically relevant cut-off scores.DiscussionThe present study shows that individuals with PSP exhibit strong appearance-related concerns, regardless of the presence or absence of underlying or comorbid dermatological conditions. These findings shed new light on the importance of appearance-related concerns in Skin Picking Disorder and the role of PSP as a potentially overlooked risk factor in dermatological patients. Therefore, appearance-related concerns should be explicitly addressed in dermatological and psychotherapeutic settings. Future studies should also include longitudinal and experimental analyses to more clearly classify the role of appearance-related concerns in the etiology of PSP and Skin Picking Disorder.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 99%