Skin Picking in German Students: Prevalence, Phenomenology, and Associated Characteristics

Bohne, Antje; Wilhelm, S.; Keuthen, N.J.; Baer, L.; Jenike, M.A.

doi:10.1177/01445502026003002

Cited by 59 publications

(127 citation statements)

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“…Consistent with studies finding that skin picking is relatively common and largely benign (Bohne et al, 2002;Hajcak, Franklin, Simons, & Keuthen, 2006;Keuthen et al, 2000), most participants endorsed the behavior in some form. Body sites most susceptible to skin picking closely matched those referenced in Keuthen et al (2000), and included the face, cuticles and nails, arms, scalp, and hands and feet.…”

Section: Discussionsupporting

confidence: 80%

“…A total of 5.4% of the sample reported clinically significant self-injurious skin picking and associated psychosocial impairment, which is also consistent with Keuthen et al (2000). That women represented the vast majority of those with clinically significant skin picking is consistent with others (Arnold et al, 1998;Bohne et al, 2002;Hajcak et al, 2006;Lochner et al, 2002;Wilhelm et al, 1999), and may suggest a gender preponderance to this condition and/or be secondary to societal demands that value appearance in females. Indeed, correlational analyses showed that skin picking severity was more robustly associated to skin picking impact for women relative to men.…”

Section: Discussionsupporting

confidence: 53%

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mentioning

confidence: 99%

“…Those who engage in skin picking use their fingers or instruments (e.g., pins, tweezers) to manipulate areas most commonly found on the face, back, neck, or scalp (Arnold et al, 1998;Bohne et al, 2002;Keuthen et al, 2000;Wilhelm et al, 1999). Approximately 2-4% of the population demonstrates pathological skin picking (Keuthen et al, 2000) with associated tissue damage, including infections, ulcerations, and disfiguring scars, being seen in many patients (Greisemer, 1978).…”

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confidence: 99%

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Skin picking behaviors: An examination of the prevalence and severity in a community sample

Hayes

Storch

Berlanga

2009

Journal of Anxiety Disorders

202

138

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Body-focused repetitive behaviors (BFRBs) have recently gained attention in the psychiatric literature given their prevalence, considerable associated impairment (Bohne, Wilhelm, Keuthen, Baer, & Jenike, 2002;Teng, Woods, Twohig, & Marcks, 2002), and possible link to other obsessive-compulsive spectrum disorders (Bienvenu et al., 2000;Hollander, 1993;Hollander & Wong, 1995;Jaisoorya, Reddy, & Srinath, 2003). ''Nervous habits'' such as nailbiting, hair pulling, and skin picking are often seen by healthcare practitioners as common and benign, but awareness of the impairment linked to these behaviors is limited (Arnold, Auchenbach, & McElroy, 2001;Bohne, Keuthen, & Wilhelm, 2005). Due to the variance in criteria defining the BFRBs and under-reporting of symptoms, prevalence rates have been difficult to determine. At least one BFRB was reported by 13.7% of 105 college students, nailbiting being the most common (Teng et al., 2002). While suspected to regulate negative affective states (Christenson, Ristvedt, & Mackenzie, 1993;Diefenbach, Mouton-Odum, & Stanley, 2002;Keuthen et al., 2000), BFRBs often directly result in significant distress and impaired social or occupational functioning as a result of their wounds or attempts to conceal them (Christenson, Mackenzie, & Mitchell, 1991;Flessner & Woods, 2006;O'Sullivan et al., 1997;Wilhelm et al., 1999). Further, many people report that their BFRB causes such shame and embarrassment that they withdraw from social activities (Keuthen et al., 2000;Stemberger, Thomas, Mansueto, & Carter, 2000;Wilhelm et al., 1999;Woods, Fuqua, & Outman, 1999). Together, BFRBs have been unofficially grouped under the obsessive-compulsive spectrum (Arnold et al., 1998;Hollander, 1993;Hollander & Wong, 1995;Stein et al., 1995), which includes conditions associated with OCD on one anchor point to behaviors characteristic of impulse-control disorders (ICDs), such as pathological gambling.Of the BFRBs discussed, trichotillomania is the only condition given distinct classification in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-R; American Psychiatric Association, 2000). Trichotillomania, affecting an estimated 1-3% of the general population, is listed as an ICD and characterized by repetitive hair pulling which results in noticeable hair loss most commonly from the scalp, eyebrows, and eyelashes (Christenson et al., 1991). The behavior can result in serious physical consequences. For example, irreversible damage to hair roots due to repetitive pulling can cause permanent baldness, and the chewing and eating of pulled hair can lead to dental complications and gastrointestinal blockage (O'Sullivan et al., 1997). Like other disorders marked by impulsivity, individuals with trichotillomania typically experience an increase in Body-focused repetitive behaviors such as skin picking have gained recent attention in the psychiatric literature. Prevalence of skin picking has not been well researched and is difficult to estimate; however, consequences of such behaviors can include seve...

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Section: Discussionsupporting

confidence: 80%

Section: Discussionsupporting

confidence: 53%

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confidence: 99%

mentioning

confidence: 99%

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Skin picking behaviors: An examination of the prevalence and severity in a community sample

Hayes

Storch

Berlanga

2009

Journal of Anxiety Disorders

202

138

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“…For example, research has found high rates of bodyfocused habits in college populations: 64% for nail biting, 38% for knuckle cracking, and 30% for finger tapping (Hansen, Tishelmian, Hawkins, & Doepke, 1990). Other studies have found rates of occasional skin picking in college students between 78% and 90% (Bohne et al, 2002;Keuthen et al, 2000). surveyed 426 college students and asked how often they engaged in many repetitive habits.…”

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confidence: 99%

Evidence-Based Psychosocial Treatments for Pediatric Body-Focused Repetitive Behavior Disorders

Woods

Houghton

2015

Journal of Clinical Child & Adolescent Psychology

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Habits, such as hair pulling and thumb sucking, have recently been grouped into a category of clinical conditions called body-focused repetitive behavior disorders (BFRBDs). These behaviors are common in children and, at extreme levels, can cause physical and psychological damage. This article reviews the evidence base for psychosocial treatment of pediatric BFRBDs. A review of academic databases and published reviews revealed 60 studies on psychosocial treatments for pediatric BFRBDs, 23 of which were deemed suitable for review. Based on stringent methodological and evidence base criteria, we provided recommendations for each specific BFRBD. Individual behavior therapy proved probably efficacious for thumb sucking, possibly efficacious for several conditions, and experimental for nail biting. Individual and multicomponent cognitive-behavioral therapy was named experimental for trichotillomania and nail biting, respectively. No treatment met criteria for well-established status in the treatment of any BFRBD. Recommendations for clinicians are discussed. Reasons for the limitations of existing research in children and adolescents are explored. Several recommendations are presented for future pediatric treatment research on BFRBDs.

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Trichotillomania (hair pulling disorder), skin picking disorder, and stereotypic movement disorder: toward DSM-V

et al. 2010

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In DSM-IV-TR, trichotillomania (TTM) is classified as an impulse control disorder (not classified elsewhere), skin picking lacks its own diagnostic category (but might be diagnosed as an impulse control disorder not otherwise specified), and stereotypic movement disorder is classified as a disorder usually first diagnosed in infancy, childhood, or adolescence. ICD-10 classifies TTM as a habit and impulse disorder, and includes stereotyped movement disorders in a section on other behavioral and emotional disorders with onset usually occurring in childhood and adolescence. This article provides a focused review of nosological issues relevant to DSM-V, given recent empirical findings. This review presents a number of options and preliminary recommendations to be considered for DSM-V: (1) Although TTM fits optimally into a category of body-focused repetitive behavioral disorders, in a nosology comprised of relatively few major categories it fits best within a category of motoric obsessive-compulsive spectrum disorders, (2) available evidence does not support continuing to include (current) diagnostic criteria B and C for TTM in DSM-V, (3) the text for TTM should be updated to describe subtypes and forms of hair pulling, (4) there are persuasive reasons for referring to TTM as "hair pulling disorder (trichotillomania)," (5) diagnostic criteria for skin picking disorder should be included in DSM-V or in DSM-Vs Appendix of Criteria Sets Provided for Further Study, and (6) the diagnostic criteria for stereotypic movement disorder should be clarified and simplified, bringing them in line with those for hair pulling and skin picking disorder.

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Skin Picking in German Students: Prevalence, Phenomenology, and Associated Characteristics

Cited by 59 publications

References 0 publications

Skin picking behaviors: An examination of the prevalence and severity in a community sample

Skin picking behaviors: An examination of the prevalence and severity in a community sample

Evidence-Based Psychosocial Treatments for Pediatric Body-Focused Repetitive Behavior Disorders

Trichotillomania (hair pulling disorder), skin picking disorder, and stereotypic movement disorder: toward DSM-V

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