Abnormal Psychology: Dematillomania
Lotus Bell
PSYC 221: Abnormal Psychology
Spychalski
April 21st, 2013
Dermatillomania
Dermatillomania, also known as neurotic excoriation, compulsive skin picking, or psychogenic excoriation, is an impulse control disorder typified by a person’s continual urge to pick at their skin. This is usually to the point where external damage is caused. An estimated 1.4 to 5.4% of the global population has it, so it is a fairly uncommon disorder. It generally occurs in women (about 85%), and onset usually begins in adolescence with the onset of acne. While it is classified as a subcategory of impulse control disorder in the DSM, a few researchers debate whether the disorder is more akin to a type of substance abuse disorder or obsessive compulsive disorder (OCD). There has been a recent push to present dermatillomania —and trichotillomania— as separate and distinct disorders in the DSM-V.
Because dermatillomania is so different from most impulse control disorders, specialists have to make sure that there are no medical conditions (eczema, psoriasis, Hodgkin’s disease, etc.) that may be causing the skin picking. There is also a fairly new scale called the Skin-Picking Impact Scale (SPIS) used to measure the effect the disorder has on an individual physically, emotionally, socially, and behaviorally.
There are many indications of dermatillomania. The most obvious is of course excessive skin picking, particularly before or during moments of high stress or anxiety. There may also be an intense urge to bite, chafe, or scratch one’s flesh, generally in one localized area of the body. The most common places for compulsive skin pickers to pick are the face, stomach, scalp, chest, the limbs, cuticles, and surprisingly, the gums. The amount of time spent skin picking varies from person to person, some spending only a few minutes, others using hours on in. While most dermatillomania sufferers use their fingers, there is a noted minority that prefers tools like
PSYC 221: Abnormal Psychology
Spychalski
April 21st, 2013
Dermatillomania
Dermatillomania, also known as neurotic excoriation, compulsive skin picking, or psychogenic excoriation, is an impulse control disorder typified by a person’s continual urge to pick at their skin. This is usually to the point where external damage is caused. An estimated 1.4 to 5.4% of the global population has it, so it is a fairly uncommon disorder. It generally occurs in women (about 85%), and onset usually begins in adolescence with the onset of acne. While it is classified as a subcategory of impulse control disorder in the DSM, a few researchers debate whether the disorder is more akin to a type of substance abuse disorder or obsessive compulsive disorder (OCD). There has been a recent push to present dermatillomania —and trichotillomania— as separate and distinct disorders in the DSM-V.
Because dermatillomania is so different from most impulse control disorders, specialists have to make sure that there are no medical conditions (eczema, psoriasis, Hodgkin’s disease, etc.) that may be causing the skin picking. There is also a fairly new scale called the Skin-Picking Impact Scale (SPIS) used to measure the effect the disorder has on an individual physically, emotionally, socially, and behaviorally.
There are many indications of dermatillomania. The most obvious is of course excessive skin picking, particularly before or during moments of high stress or anxiety. There may also be an intense urge to bite, chafe, or scratch one’s flesh, generally in one localized area of the body. The most common places for compulsive skin pickers to pick are the face, stomach, scalp, chest, the limbs, cuticles, and surprisingly, the gums. The amount of time spent skin picking varies from person to person, some spending only a few minutes, others using hours on in. While most dermatillomania sufferers use their fingers, there is a noted minority that prefers tools like
Cited: Lang, R., Didden, R., Machalicek, W., Rispoli, M., Sigafoos, J., Lancioni, G., & Mulloy, A. (2009). Retrieved April 19, 2013, from Science Direct: http://www.sciencedirect.com/science/article/pii/S0891422209001905 Ph.D., Williams M. (n.d.). Compulsive Skin Picking. Retrieved from Brain Physics: http://www.brainphysics.com/skin-picking.php Brian L., O., Katherine, L., Liana R.N., S., Gary, C., Katherine, D., & Jon E., G. (n.d). Skin picking disorder in university students: health correlates and gender differences. General Hospital Psychiatry, doi:10.1016/j.genhosppsych.2012.08.006 Kathrin, S., Ger P.J., K., & Mike, R. (n.d). The effects of brief cognitive-behaviour therapy for pathological skin picking: A randomized comparison to wait-list control. Behaviour Research And Therapy, 4911-17. doi:10.1016/j.brat.2010.09.005 Courtney Brooks, C., Kathleen, S., & Sara, F. (n.d). Assessment and Identification of Deliberate Self-Harm in Adolescents and Young Adults. The Journal For Nurse Practitioners, 8299-305. doi:10.1016/j.nurpra.2012.02.004 Gieler, U., Consoli, S. G., Tomas-Aragones, L., Linder, D. M., Jemec, G. E., Poot, F., & ... Consoli, S. M. (2013). Self-Inflicted Lesions in Dermatology: Terminology and Classification -- A Position Paper from the European Society for Dermatology and Psychiatry (ESDaP). Acta Dermato-Venereologica, 93(1), 4-12. doi:10.2340/00015555-1506