Schienle Anne, Kohlhofer Sara, Wilhelm Johannes, Tanzmeister Sandra
Department of Clinical Psychology, University of Graz, Universitätsplatz 2, Graz, Austria.
BioTechMed, 8010, Graz, Austria.
Sci Rep. 2025 Jul 2;15(1):22782. doi: 10.1038/s41598-025-04360-2.
Emotional distress is a typical trigger for pathological skin-picking (PSP). Given that placebo treatments can reduce emotional distress, the present study sought to investigate placebo responsiveness in individuals with PSP. In this randomized crossover trial, 69 participants (90% female, M = 31 years) with self-reported PSP underwent two weeks with daily placebo treatment (pills introduced as 'N-acetylcysteine' to reduce skin-picking) and two weeks without placebo treatment. Participants used a smartphone application to provide daily ratings for their skin-picking symptoms, as well as their stress levels. Questionnaires assessing the severity of skin-picking, stress, and difficulties in emotion regulation were completed before and after the two-week intervals (with and without the placebo). Questionnaire data indicated that placebo treatment reduced skin-picking severity (large effect) as well as perceived stress and difficulties in emotion regulation (medium effects). App-based assessments revealed that the placebo effect was limited to a moderate reduction in the urge to engage in skin-picking behavior, observed only during the second week of treatment, with no significant impact on daily stress levels. Individuals with PSP are responsive to placebo treatment. However, the magnitude of the placebo effect appears to be overestimated when relying on retrospective questionnaire data compared to ecological momentary assessments.
情绪困扰是病理性皮肤搔抓（PSP）的典型触发因素。鉴于安慰剂治疗可以减轻情绪困扰，本研究旨在调查PSP患者的安慰剂反应性。在这项随机交叉试验中，69名自我报告有PSP的参与者（90%为女性，平均年龄31岁）接受了为期两周的每日安慰剂治疗（将药丸介绍为“N-乙酰半胱氨酸”以减少皮肤搔抓）和两周的无安慰剂治疗。参与者使用智能手机应用程序对其皮肤搔抓症状以及压力水平进行每日评分。在两周的间隔期前后（有和没有安慰剂）完成了评估皮肤搔抓严重程度、压力和情绪调节困难的问卷。问卷数据表明，安慰剂治疗降低了皮肤搔抓的严重程度（效果显著）以及感知到的压力和情绪调节困难（效果中等）。基于应用程序的评估显示，安慰剂效应仅限于在治疗的第二周观察到的参与皮肤搔抓行为冲动的适度降低，对每日压力水平没有显著影响。PSP患者对安慰剂治疗有反应。然而，与生态瞬时评估相比，依靠回顾性问卷数据时，安慰剂效应的大小似乎被高估了。
