The Skin Picking Impact Project: Phenomenology, interference, and treatment utilization of pathological skin picking in a population-based sample

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.

Research highlights▶ Adults with self-reported problematic skin picking (PSP) showed considerable heterogeneity in picking methods, body sites, and function (e.g., regulation of emotional, sensory, and cognitive states). ▶ Adults with self-reported PSP generally reported moderate psychosocial and physical impact from picking, and tended to perceive available treatment as poor in quality. ▶ In adults with PSP, the severity of associated symptoms of psychopathology (depression, anxiety, and stress) were comparable to severity levels found in previous samples of persons with trichotillomania and obsessive–compulsive disorder. ▶ PSP severity was a statistically significant predictor of overall impairment after controlling for depression and anxiety symptoms.