Disgust, shame and the psychosocial impact of skin picking: Evidence from an online support forum

Anxiety on the internet: Describing person, provider, and organization online posts

Anxiety is a pervasive phenomenon in contemporary society. With increased internet use in recent years, more people in the general population are seeking and providing help and participating in community online. The goal of our study was to evaluate the content of internet narratives among those who post about anxiety and determine what stakeholder groups are saying online. We used the bifurcated method; it is a multi-method (qualitative) approach with inductive, thematic analyses, and with quantification of content-related words via a computer program that crawls websites and counts the occurrences of specified terms (for cross-checking purposes). Themes of posts and webpages about anxiety were: using/reporting treatment strategies (83.3% saturation), providing help (77.8% saturation), telling personal stories (72.2% saturation), seeking help (61.1% saturation), and illustrating interpersonal impact (50% saturation). We argue that anxiety stakeholders may take part in health co-inquiry online (i.e., cooperating with others) in many of the same ways that they might collaborate in person. We recommend that clinicians query their clients about use of the internet in ways related to their anxiety (e.g., seeking information/treatment strategies, offering help to others, telling their personal stories, etc.) so that they might help them process what they experience online.

Is thematic analysis used well in health psychology? A critical review of published research, with recommendations for quality practice and reporting

Despite the persistent dominance of a 'scientific psychology' paradigm in health psychology, the use of qualitative research continues to grow. Qualitative approaches are often based on fundamentally different values from (post)positivistempiricism, raising important considerations for quality, and whether qualitative work adheres to, and is judged by, appropriate publication standards. Thematic analysis (TA) has become a particularly popular method in qualitative health psychology, but poor practice is widespread. To support high quality, methodologically coherent TA practice and reporting, we critically reviewed 100 systematically selected papers reporting TA, published in five prominent health psychology journals. Our review assessed reported practice, and considered this in relation to methodological and quality recommendations. We identified 10 common areas of problematic practice in the reviewed papers, the majority citing reflexive TA. Considering the role of three 'arbiters of quality' in a peer review publication system - authors, reviewers, and editors - we developed 20 recommendations for authors, to support them in conducting and reporting high quality TA research, with associated questions for reviewers and editors to consider when evaluating TA manuscripts for publication. We end with considerations for facilitating better qualitative research, and enriching the understandings and knowledge base from which health psychology is practiced.

The problem with picking: Permittance, escape and shame in problematic skin picking

OBJECTIVES

Problematic skin picking (SP) is a poorly understood experience characterised by a drive to pick the skin and related psychosocial impact. In the DSM-5, problematic SP is classified as 'excoriation (skin picking) disorder'. The aim of this article is to present a rare qualitative perspective on the lived experience of problematic SP, prioritising participants' voices and sense-making.

DESIGN

An in-depth qualitative study of individuals who self-identified as picking their skin problematically and experienced related distress.

METHODS

Seventeen UK-based participants were recruited online and interviewed about their SP. Participants were given choice of interview modality, including instant messenger platforms, telephone, email and Skype, to maximise comfort and improve the accessibility of the study. Transcripts were analysed using thematic analysis.

RESULTS

Three themes offering novel insight into the phenomenology of participants' SP are highlighted and explored: (1) how cognitions and circumstances drove and permitted SP, (2) how participants 'zoned out' while SP and the escape or relief that this attentional experience offered and (3) participants' feelings of shame and distress in how they felt their SP may appear to others.

CONCLUSIONS

This study contributes in-depth and novel ideas to the understanding of SP phenomenology and identifies how environmental factors, cognitions, contextual distress and shame may be considerations in therapeutic intervention. It presents the complexity of SP sense-making and demonstrates the need for individual formulation.

Appearance-related concerns in individuals with pathological skin picking-a comparison with individuals with dermatological conditions and skin-healthy controls

Introduction

Pathological skin picking (PSP) is an excessive behavior which characterizes Skin Picking Disorder. Individuals repeatedly pick their skin and cause skin lesions, but are unable to control the behavior, which can cause severe distress. Visible self-inflicted skin lesions can additionally affect individuals with PSP due to emerging appearance-related concerns. However, these concerns and their role in PSP have hardly been studied, especially not in comparison with individuals with dermatological conditions and skin-healthy controls.

Methods

The present cross-sectional study (n = 453, 83.9% female, 15.9% male, 0.2% diverse) aimed at analyzing appearance-related concerns and mental health outcomes between four groups: Individuals with PSP and dermatological conditions (SP/DC; n = 83), PSP without dermatological conditions (SP; n = 56), dermatological conditions without PSP (DC; n = 176) and skin-healthy controls (SH, n = 138). We compared questionnaire data on dysmorphic concerns, appearance-based rejection sensitivity, and body dysmorphic symptoms, as well as PSP-symptoms and mental health outcomes (depression, anxiety, and self-esteem) between groups.

Results

The analyses showed a significant multivariate group effect in the appearance-related variables, F(6, 896) = 19.92, Wilks' Λ = 0.78, p < 0.001, and mental health outcomes, F(6, 896) = 16.24, Wilks' Λ = 0.81, p < 0.001. The SP/DC group had the strongest appearance-related concerns and mental health impairments, followed by the SP group, the DC group and the SH group. The SP/DC group and SP group only differed significantly with regard to dysmorphic concerns, but not in other variables. The DC group was less affected but still showed higher dysmorphic concerns and mental health impairments than skin-healthy controls. In contrast to the PSP groups, the other two groups did not exceed clinically relevant cut-off scores.

Discussion

The present study shows that individuals with PSP exhibit strong appearance-related concerns, regardless of the presence or absence of underlying or comorbid dermatological conditions. These findings shed new light on the importance of appearance-related concerns in Skin Picking Disorder and the role of PSP as a potentially overlooked risk factor in dermatological patients. Therefore, appearance-related concerns should be explicitly addressed in dermatological and psychotherapeutic settings. Future studies should also include longitudinal and experimental analyses to more clearly classify the role of appearance-related concerns in the etiology of PSP and Skin Picking Disorder.

A Pragmatic Guide to Qualitative Analysis for Pediatric Researchers

OBJECTIVE

To describe four approaches to qualitative analysis in order to provide a pragmatic, application-oriented guide to their use in research focused on children and their families.

METHODS

Four commonly used approaches to qualitative analysis-framework analysis, rapid qualitative analysis, content analysis, and reflexive thematic analysis-are described and compared, including their analytic strategies, tips for use, terminology, and application to a hypothetical example.

RESULTS

A pragmatic guide to each method is provided as well as examples of how each analytic approach could be utilized to analyze the same dataset.

CONCLUSIONS

A variety of approaches to qualitative analysis are available to both novice and experienced qualitative researchers. The approach selected from the options presented in this article will depend on numerous factors, such as the clinical problem being explored, research context, aims, objectives, research questions, and resources available such as time and funds, and the qualitative expertise of the team.

Gambling treatment service providers' views about contingency management: a thematic analysis

Background

There is a need to improve retention and outcomes for treatment of problem gambling and gambling disorder. Contingency management (CM) is a behavioural intervention involving identification of target behaviours (such as attendance, abstinence, or steps towards recovery) and the provision of incentives (such as vouchers or credits towards the purchase of preferred items) contingent on objective evidence of these behaviours. Contingency management for abstinence and attendance in substance misuse treatment has a substantial evidence base but has not been widely adopted or extended to other addictive behaviours such as gambling. Potential barriers to the widespread adoption of CM may relate to practitioners’ perceptions about this form of incentive-based treatment. The present study sought to explore United Kingdom (UK) gambling treatment providers’ views of CM for treatment of problem gambling and gambling disorder.

Methods

We conducted semi-structured interviews with 30 treatment providers from across the UK working with people with gambling problems. Participants were provided with an explanation of CM, several hypothetical scenarios, and a structured questionnaire to facilitate discussion. Thematic analysis was used to interpret findings.

Results

Participants felt there could be a conflict between CM and their treatment philosophies, that CM was similar in some ways to gambling, and that the CM approach could be manipulated and reduce trust between client and therapist. Some participants were more supportive of implementing CM for specific treatment goals than others, such as for incentivising attendance over abstinence due to perceived difficulties in objectively verifying abstinence. Participants favoured providing credits accruing to services relevant to personal recovery rather than voucher-based incentives.

Conclusions

UK gambling treatment providers are somewhat receptive to CM approaches for treatment of problem gambling and gambling disorder. Potential barriers and obstacles are readily addressable, and more research is needed on the efficacy and effectiveness of CM for gambling.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12954-022-00600-0.

Global policymakers and catastrophic risk

There is a rapidly developing literature on risks that threaten the whole of humanity, or a large part of it. Discussion is increasingly turning to how such risks can be governed. This paper arises from a study of those involved the governance of risks from emerging technologies, examining the perceptions of global catastrophic risk within the relevant global policymaking community. Those who took part were either civil servants working for the UK government, U.S. Congress, the United Nations, and the European Commission, or cognate members of civil society groups and the private sector. Analysis of interviews identified four major themes: Scepticism; Realism; Influence; and Governance outside of Government. These themes provide evidence for the value of conceptualising the governance of global catastrophic risk as a unified challenge. Furthermore, they highlight the range of agents involved in governance of emerging technology and give reason to value reforms carried out sub-nationally.

Exploring Social Support in an Online Support Community for Tourette Syndrome and Tic Disorders: An Analysis of Postings (Preprint)

Background

Online support communities have become an accessible way of gaining social, emotional, and informational support from peers and may be particularly useful for individuals with chronic conditions. To date, there have been few studies exploring the online support available for tic disorders, such as Tourette syndrome. An exploratory study looking at users’ experiences with using online support communities for tic disorders suggested that members used such communities to share experiences, information, and strategies for tic management.

Objective

To build on these preliminary findings, this study examined the provision of social support in an online community for Tourette syndrome.

Methods

Data were collected from one publicly available online support community for Tourette syndrome and tics, from its inception to December 2019, by randomly selecting 10% of posts and their corresponding comments from each year for analysis. This resulted in 510 unique posts and 3802 comments posted from 1270 unique usernames. The data were analyzed using inductive thematic analysis.

Results

The findings of this study suggest that users utilized the online community as a multifaceted virtual place where they could share and ask for information about tics, unload and share their feelings arising from living with Tourette syndrome, find people facing similar situations and experiences, and freely share the realities of living with Tourette syndrome.

Conclusions

The results complement the findings from a preliminary study and suggest that online support communities have a potentially valuable role as a mechanism for sharing and gaining information on illness experiences from similar peers experiencing tics and can promote self-management of tics. Limitations and recommendations for future research are discussed.

The Impact of Term Fake News on the Scientific Community. Scientific Performance and Mapping in Web of Science

Nowadays, multiple phenomena have promoted an impact on society, constituting in some cases, not only a contribution of benefits but also of risks. Among them, the fake news phenomenon is considered one of the most burning phenomena today due to the risk it poses to society. In view of this situation, the research community has carried out numerous studies that seek to address this issue from a multidisciplinary perspective. Based on this, the objective of this work was to analyze the productivity and, therefore, the impact of this topic in the research community. To this end, this work advocated a scientometric-type methodology, through scientometric laws, impact indicators, and scientific evolution of 640 publications of the web of science (WOS). The results showed the impact of the fake news discipline today, which is considered an emerging issue that is of interest to many knowledge disciplines around the world. Likewise, the results showed that the publications not only have a focus on analyzing the veracity or not of the news, but that it begins to vertebrate a new line of an investigation directed to the informational education and towards the prevention of the consumption of this type of news through the internet.