A Preliminary Analysis of the Phenomenology of Skin-picking in Prader-Willi Syndrome

Abstract

To examine the nature and psychosocial correlates of skin-picking behavior in youth with Prader-Willi Syndrome (PWS). Parents of 67 youth (aged 5-19 years) with PWS were recruited to complete an internet-based survey that included measures of: skin-picking behaviors, the automatic and/or focused nature of skin-picking, severity of skin-picking symptoms, anxiety symptoms, developmental functioning, symptoms of inattention, impulsivity, and oppositionality, and quality of life. Results indicated that skin-picking was endorsed in 95.5% of youth. Direct associations of moderate strength were found between skin-picking severity and symptoms of anxiety, inattention, oppositionality, developmental functioning, and quality of life. Other descriptive data, such as areas picked, cutaneous factors, antecedents, and consequences related to skin-picking are reported. The prevalence and consequences associated with skin-picking in PWS indicate a greater need for clinician awareness of the behavior and interventions tailored to meet the needs of this population.

Is there a genomically imprinted social brain?

“…[26,55,56]). (iii) Crespi has viewed these findings as potentially supportive of the ''imprinted brain theory'' (Box 3, see comment on Garfield et al at http://www.nature.com/nature/journal/ v469/n7331/full/nature09651.html) in that the loss of paternal expression of Grb10 corresponds to higher rates of OCD-like behavior (increased barbering), similar to the higher rates of OCD and skin-picking behavior found among PWS patients [57,58]. It should also be noted here that the brain paternal expression of Grb10 is also found in humans potentially indicating an evolutionarily conserved role [59].…”

Anomalous basal ganglia connectivity and obsessive–compulsive behaviour in patients with Prader Willi syndrome

“…The observed correlations with self picking behaviours may be of particular relevance to this proposal. Skin picking is very common among patients with Prader Willi syndrome 3,[42][43][44] and is often considered a compulsion (included in the Compulsive Behaviour Checklist) that shows moderate correlation with obsessive-compulsive behaviour. 42 However, self picking has also been clearly differentiated from the other compulsive behaviour by factor analyses 5,27 and may in fact also covary with impulsivity traits.…”

Functional Assessment and Behavioral Treatment of Skin Picking in a Teenage Girl With Prader-Willi Syndrome

“…This case conceptualization is supported by functional assessments of skin picking conducted in previous research, which suggest that both forms of automatic reinforcement may be common for skin picking (Didden et al, 2007;Lang, Didden, et al, 2010;Lang et al, 2009). Further strength for the self-stimulation hypothesis was found by Morgan et al (2010) who studied 67 youth with PWS. A majority of these individuals engaged in skin picking while waiting, sitting in the car or in front of the television, or while they were in bed.…”