Prediction of automatic and focused skin picking based on trait disgust and emotion dysregulation

The predominant symptom of skin picking disorder (SPD) is the repeated picking of ones' own skin, so that the skin is noticeably damaged. Previous research on a community sample found that two subtypes of skin picking (SP), automatic and focused SP, are associated respectively with specific aspects of emotion dysregulation. This study attempted to replicate those findings, and additionally examined whether disgust-related personality traits were able to improve the prediction of the two SP types. The sample consisted of 144 women and 50 men (mean age: 35 years; 51 with a confirmed SPD diagnosis). A strong association was found between focused SP and emotion dysregulation. More specifically, this SP subtype could be predicted based on difficulties in controlling impulsive behaviors, self-disgust (the tendency to feel disgusted by one's own behavior) and disgust proneness (the tendency to experience disgust towards potential transmitters of disease). Lack of emotional clarity was the only predictor of automatic SP. Based on the present findings, the functions of focused SP are firstly, an impulsive behavior that provides temporary relief of intense emotions, and secondly, a form of excessive grooming, and finally, a form of self-harm. These functions differ from those found in non-clinical samples.