Examination of gender in pathologic grooming behaviors

Skin picking disorder: Does a person's sex matter?

BACKGROUND

Skin picking disorder (SPD) is characterized by recurrent picking with scarring or tissue damage. Although research suggests that less than one-half of people with SPD are male, there is little clinical information about men with SPD.

METHODS

We recruited 95 non-treatment-seeking adults as part of a cross-sectional study of SPD. Men (n = 17) and women (n = 78) with SPD were compared on clinical and cognitive measures. Sex differences in the demographic and clinical characteristics, skin picking sites, and presence of comorbidities were examined using analysis of variance for continuous variables and likelihood ratio Chi-square tests for categorical variables.

RESULTS

Men were significantly more likely than women to report a first-degree relative with skin picking or hair pulling disorders (P = .0174). Men were less likely to pick from their scalps and backs and picked from fewer sites. Men and women did not significantly differ on skin picking severity, disability, impulsivity, or quality of life.

CONCLUSIONS

These data indicate that SPD is similarly impairing for men and women, but men may have higher familial loading and a somewhat different distribution and frequency of picking sites. Sex differences in SPD merit more detailed consideration in larger samples, including addressing potentially higher genetic/familial loading in males.

Dermatillomania: Strategies for Developing Protective Biomaterials/Cloth

Dermatillomania or skin picking disorder (SPD) is a chronic, recurrent, and treatment resistant neuropsychiatric disorder with an underestimated prevalence that has a concerning negative impact on an individual’s health and quality of life. The current treatment strategies focus on behavioral and pharmacological therapies that are not very effective. Thus, the primary objective of this review is to provide an introduction to SPD and discuss its current treatment strategies as well as to propose biomaterial-based physical barrier strategies as a supporting or alternative treatment. To this end, searches were conducted within the PubMed database and Google Scholar, and the results obtained were organized and presented as per the following categories: prevalence, etiology, consequences, diagnostic criteria, and treatment strategies. Furthermore, special attention was provided to alternative treatment strategies and biomaterial-based physical treatment strategies. A total of six products with the potential to be applied as physical barrier strategies in supporting SPD treatment were shortlisted and discussed. The results indicated that SPD is a complex, underestimated, and underemphasized neuropsychiatric disorder that needs heightened attention, especially with regard to its treatment and care. Moreover, the high synergistic potential of biomaterials and nanosystems in this area remains to be explored. Certain strategies that are already being utilized for wound healing can also be further exploited, particularly as far as the prevention of infections is concerned.

Neuropsychiatric Aspects of Impulse Control Disorders

Impulse control disorders (ICDs) are neuropsychiatric conditions characterized by the repeated inability to resist an impulse, drive, or temptation to perform an act that is harmful to the person or others. Although classification approaches to ICDs vary both diachronically and synchronically, this group of conditions encompasses a wide range of syndromes, including pathologic gambling, kleptomania, trichotillomania, excoriation (skin picking) disorder, intermittent explosive disorder, pyromania, oppositional defiant, conduct, and antisocial personality disorders. ICDs can play a significant role as comorbidities in both neurodevelopmental (eg, attention-deficit/hyperactivity disorder, Tourette syndrome) and neurodegenerative (eg, Parkinson disease) disorders.

Comorbidity and quality of life in adults with hair pulling disorder

Hair pulling disorder (HPD; trichotillomania) is thought to be associated with significant psychiatric comorbidity and functional impairment. However, few methodologically rigorous studies of HPD have been conducted, rendering such conclusions tenuous. The following study examined comorbidity and psychosocial functioning in a well-characterized sample of adults with HPD (N=85) who met DSM-IV criteria, had at least moderate hair pulling severity, and participated in a clinical trial. Results revealed that 38.8% of individuals with HPD had another current psychiatric diagnosis and 78.8% had another lifetime (present and/or past) psychiatric diagnosis. Specifically, HPD showed substantial overlap with depressive, anxiety, addictive, and other body-focused repetitive behavior disorders. The relationships between certain comorbidity patterns, hair pulling severity, current mood and anxiety symptoms, and quality of life were also examined. Results showed that current depressive symptoms were the only predictor of quality of life deficits. Implications of these findings for the conceptualization and treatment of HPD are discussed.

Skin picking disorder in university students: health correlates and gender differences

OBJECTIVE

This study sought to examine the prevalence of skin picking disorder (SPD) in a university sample and assess associated physical and mental health correlates.

METHODS

A 54-item anonymous, voluntary survey was distributed via random email generation to a sample of 6000 university students. Current psychological and physical status was assessed, along with academic performance. Positive screens for SPD were determined based upon individuals meeting full proposed DSM-V criteria.

RESULTS

A total of 1916 participants (31.9%; mean age 22.7 ± 5.1; 58.1% female) responded and were included in the analysis. The overall prevalence of SPD was 4.2% (females=5.8%; males=2.0%). SPD was associated with significantly higher lifetime rates of affective, anxiety, eating, substance use and impulse control disorders. Men with SPD had significantly higher BMI ratings and perceived themselves as significantly less attractive to others while women had significantly higher depressive symptoms.

CONCLUSION

SPD is common in both genders and is associated with significant mental and physical health detriments, including higher levels of stress, more psychiatric comorbidity and poorer perceived health. Academic institutions, clinicians and public health officials should be aware of the multimodal presentation of SPD and screen for it in primary care and dermatologic settings.

Effect of chronic psychosocial stress-induced by subordinate colony (CSC) housing on brain neuronal activity patterns in mice

Chronic subordinate colony (CSC) housing has been recently validated as a murine model of chronic psychosocial stress which induces alterations of stress-related parameters including decreased body-weight gain and an increased level of anxiety in comparison with single housed control (SHC) mice. By using immunohistochemical immediate early gene (IEG) mapping we investigated whether CSC housing causes alterations in neuronal activation patterns in limbic areas including the amygdala, hippocampus, septum and the periaqueductal gray (PAG) and hypothalamic paraventricular nucleus (PVN). While CSC housing increased basal Zif-268 expression in the nucleus accumbens shell compared to SHC, IEG responses to subsequent open arm (OA) exposure were attenuated in the ventral and intermediate sub-regions of the lateral septum, parvocellular PVN and the dorsal CA3 region of the hippocampus of CSC compared with SHC mice. In contrast, a potentiated c-Fos response in CSC mice was observed in the dorsomedial PAG after OA exposure. Confirming previous findings obtained on the elevated plus-maze, an enhanced anxiety-related behavior in CSC compared with SHC mice was also observed during OA exposure. In order to investigate the appropriate control conditions for CSC housing, group housed control (GHC) mice were additionally included in the behavioral testing. Interestingly, GHC as well as CSC mice showed significantly less risk assessment/exploratory behavior during OA exposure compared with SHC mice indicating that group housing itself is stressful for mice and not an adequate control for the CSC paradigm. Overall, CSC housing is an ethologically relevant chronic psychosocial stressor which results in an elevated sensitivity to a subsequent novel, aversive challenge. However, the CSC-induced increase in anxiety-related behavior was accompanied by differences in neuronal activation, compared with SHC, in defined sub-regions of brain areas known to be involved in the processing of emotionality and stress responses.