Heightened Sense of Incompleteness in Excoriation (Skin-Picking) Disorder

Abstract

Background

Excoriation (Skin-Picking) Disorder (SPD) is characterized by repetitive skin picking resulting in tissue damage. This study examined associations between the tendency to experience a sense of incompleteness (henceforth trait incompleteness) and pathological skin picking across two studies.

Methods

In study 1, undergraduate students (n = 481) completed self-report measures of skin picking severity, trait incompleteness, perfectionism, obsessive-compulsive symptoms, and negative affect (i.e., depression, anxiety). In study 2, undergraduate students with a diagnosis of SPD (n = 61) and a control group without SPD (n = 63) rated skin picking severity, trait incompleteness, obsessive-compulsive symptoms, and negative affect (i.e., depression, anxiety, and stress).

Results

In study 1, linear regression showed that trait incompleteness significantly predicted skin picking severity, after controlling for other variables. In study 2, logistic regression showed trait incompleteness significantly predicted SPD diagnosis, after controlling for other variables. There was no significant correlation between incompleteness and symptom severity within the SPD group.

Conclusions

The results indicate a robust association between SPD and trait incompleteness. More research is needed to establish whether trait incompleteness may represent a vulnerability factor underlying SPD, or if skin picking leads to susceptibility to trait incompleteness.

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Correspondence to Emily J. Ricketts.

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Conflict of interest

Dr. Ricketts has received research support from the BFRB Precision Medicine Initiative granted by the TLC Foundation for Body-Focused Repetitive Behaviors, and National Institute of Mental Health (NIMH). Dr. Snorrason, Dr. Ólafsson, Ms. Sigurvinsdottir and Mr. Mathew declare that they have no conflict of interest. Dr. Woods has received royalties from Oxford University Press and Springer Press. Dr. Lee has received research support from the TLC Foundation for Body-Focused Repetitive Behaviors, and the Tourette Association of America.

Research Involving Human Participants

Study 1 approval was granted by the National Bioethics Committee of Iceland and study 2 approval by the University of Wisconsin-Milwaukee Institutional Review Board. These studies were performed in line with the principles of the Declaration of Helsinki.

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Informed consent was obtained from all participants included in these studies.

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No animal studies were carried out by the authors for this article.

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Ricketts, E.J., Snorrason, Í., Mathew, A.S. et al. Heightened Sense of Incompleteness in Excoriation (Skin-Picking) Disorder. Cogn Ther Res (2021). https://doi.org/10.1007/s10608-020-10201-5

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Keywords

  • Picking
  • Incompleteness
  • Just right
  • Sensory