Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany.
Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany.
Gen Hosp Psychiatry. 2022 Sep-Oct;78:9-13. doi: 10.1016/j.genhosppsych.2022.06.002. Epub 2022 Jun 16.
Although traumatic stress including childhood maltreatment (CM) has a profound impact on mental health, its relation to pathological skin picking (PSP) has been understudied and results remain inconclusive. Likewise, posttraumatic stress disorder (PTSD) as the most typical sequelae of traumatic stress has hardly been investigated in those with PSP. The objective of our online case-control study was to shed further light on this issue.
Using an anonymous online survey, 325 adult participants with PSP defined by Skin Picking Scale-Revised (SPS-R) scores ≥ 7 as well as Skin Picking Impact Scale (SPIS) scores ≥ 7 were administered the Childhood Trauma Questionnaire (CTQ), the Short Screening Scale for DSM-IV PTSD (PTSD-7) including a list of traumatic events, and a brief measure of psychopathological distress. They were compared to an age-, sex-, and education-matched control group recruited online by means of analyses of variance (ANOVA).
The PSP sample scored significantly higher on the CTQ dimensions of sexual and emotional abuse as well as emotional neglect with small to moderate effect sizes (d between 0.27 and 0.49). Accounting for psychological distress, the only significant difference related to emotional abuse with a small effect (d = 0.23). Participants with PSP reported significantly more traumatic experiences in adulthood than the control group (59.1% vs. 38.2%; χ = 28.02, p < .001). Among those with PSP, a probable diagnosis of PTSD was found in 44 (13.5%) compared to zero cases in the control group.
Our findings indicate that emotional abuse in childhood may be of relevance in skin picking. Since exposure to traumatic events in adulthood as well as PTSD seem to be more frequent in those with PSP compared to a control group, it might be worthwhile to consider these factors in the assessment of patients with skin picking.
尽管创伤后应激包括儿童期虐待（CM）对心理健康有深远影响，但它与病理性皮肤搔抓（PSP）的关系研究不足，结果仍不确定。同样，创伤后应激障碍（PTSD）作为创伤后应激最典型的后遗症，在 PSP 患者中也几乎没有被研究过。我们的在线病例对照研究旨在进一步阐明这一问题。
使用匿名在线调查，对 325 名成人 PSP 患者（定义为皮肤搔抓量表修订版（SPS-R）评分≥7 分和皮肤搔抓影响量表（SPIS）评分≥7 分）进行儿童期创伤问卷（CTQ）、DSM-IV PTSD 短筛查量表（PTSD-7）包括创伤事件列表，以及简短的心理病理困扰测量。他们与通过方差分析（ANOVA）在线招募的年龄、性别和教育匹配的对照组进行比较。
PSP 样本在 CTQ 的性虐待和情感虐待以及情感忽视维度上的得分显著较高，具有小到中等的效应量（d 值在 0.27 到 0.49 之间）。考虑到心理困扰，唯一与情感虐待相关的显著差异，效应量较小（d=0.23）。与对照组相比，PSP 组报告的成年期创伤经历明显更多（59.1%比 38.2%；χ²=28.02，p<.001）。在 PSP 组中，44 例（13.5%）可能被诊断为 PTSD，而对照组中没有一例。
我们的研究结果表明，儿童期的情感虐待可能与皮肤搔抓有关。由于与对照组相比，成年期创伤暴露和 PTSD 在 PSP 患者中似乎更为常见，因此在评估皮肤搔抓患者时，考虑这些因素可能是值得的。
