Improving skin picking diagnosis among Brazilians: validation of the Skin Picking Impact Scale and development of a photographic instrument

Alice Castro Menezes Xavier, Camila Maria Barbieri de Souza, Luís Henrique Fernandes Flores, Clarissa Prati, Cecilia Cassal, Carolina Blaya Dreher, Alice Castro Menezes Xavier, Camila Maria Barbieri de Souza, Luís Henrique Fernandes Flores, Clarissa Prati, Cecilia Cassal, Carolina Blaya Dreher

Abstract

Background: Skin picking disorder is a prevalent disorder frequently comorbid with depression and anxiety, which is underdiagnosed mainly by dermatologists. Assessment of skin picking disorder is based on instruments influenced by the awareness about skin picking disorder and comorbid symptoms. To date, there is no validated instrument for Brazilian individuals nor an instrument to evaluate the severity of skin lesions in an objective way.

Objectives: Validate the Skin Picking Impact Scale for Brazilian Portuguese and create a photographic measurement to assess skin lesions.

Methods: The sample was assessed through the Skin Picking Impact Scale translated into Brazilian Portuguese, the Hamilton Anxiety Scale, the Beck Depression Inventory, and the Clinical Global Impression Scale. The patients' skin lesions were photographed. Photos were evaluated regarding active excoriation, crust/bleeding, exulceration, and linear lesions.

Results: There were 63 patients included. The Skin Picking Impact Scale translated into Brazilian Portuguese had good internal consistency (Cronbach's alpha=0.88), which tests of goodness-of-fit, showing a suitable model. The reliability of photographic measurement was 0.66, with a high internal consistency (Cronbach's alpha=0.87). Photographic measurement was not correlated with the Skin Picking Impact Scale, the Clinical Global Impression Scale, or comorbid symptoms.

Study limitations: Lack of a previously validated instrument to evaluate dermatillomania in the Brazilian population for comparison.

Conclusion: The Skin Picking Impact Scale validated in Brazilian Portuguese is a good instrument to evaluate skin picking disorder. Photographic measurement is a consistent way of assessing skin lesions, but it does not reflect the impact of skin picking disorder on the individual's life.

Keywords: Photography; Psychometrics; Symptom assessment; Validation studies.

Copyright © 2019. Published by Elsevier España, S.L.U.

Figures

Figure 1
Figure 1
Skin Picking Impact Scale validated for Brazilian Portuguese.
Figure 2
Figure 2
Photographic instrument to assess skin lesions caused by skin picking disorder.

References

    1. Tucker B.T., Woods D.W., Flessner C.A., Franklin S.A., Franklin M.E. The skin picking impact project: phenomenology, interference, and treatment utilization of pathological skin picking in a population-based sample. J Anxiety Disord. 2011;25:88–95.
    1. American Psychiatric Association . 5th ed. American Psychiatric Association; Arlington: 2013. Diagnostic and statistical manual of mental disorders.
    1. Grant J.E., Chamberlain S.R. Clinical correlates of symptom severity in skin picking disorder. Compr Psychiatry. 2017;78:25–30.
    1. Anzengruber F., Ruhwinkel K., Ghosh A., Klaghofer R., Lang U.E., Navarini A.A. Wide range of age of onset and low referral rates to psychiatry in a large cohort of acne excoriée at a Swiss tertiary hospital. J Dermatol Treat. 2018;29:277–280.
    1. Walther M.R., Flessner C.A., Conelea C.A., Woods D.W. The Milwaukee inventory for the dimensions of adult skin picking (MIDAS): initial development and psychometric properties. J Behav Ther Exp Psychiatry. 2009;40:127–135.
    1. Grant J.E., Odlaug B.L., Chamberlain S.R., Kim S.W. A double-blind, placebo-controlled trial of lamotrigine for pathologic skin picking: treatment efficacy and neurocognitive predictors of response. J Clin Psychopharmacol. 2010;30:396–403.
    1. Keuthen N.J., Wilhelm S., Deckersbach T., Engelhard I.M., Forker A.E., Baer L. The skin picking scale: scale construction and psychometric analyses. J Psychosom Res. 2001;50:337–341.
    1. Snorrason I., Ólafsson R.P., Flessner C.A., Keuthen N.J., Franklin M.E., Woods D.W. The skin picking scale-revised: factor structure and psychometric properties. J Obsessive Compuls Relat Disord. 2012;1:133–137.
    1. Keuthen N.J., Deckersbach T., Wilhelm S., Engelhard I., Forker A., O'Sullivan R.L. The skin picking impact scale (SPIS): scale development and psychometric analyses. Psychosomatics. 2001;42:397–403.
    1. Snorrason I., Olafsson R.P., Flessner C.A., Keuthen N.J., Franklin M.E., Woods D.W. The skin picking impact scale: factor structure, validity and development of a short version. Scand J Psychol. 2013;54:344–348.
    1. Teng E.J., Woods D.W., Twohig M.P. Habit reversal as a treatment for chronic skin picking a pilot investigation. Behav Modif. 2006;30:411–422.
    1. Schuck K., Keijsers G.P., Rinck M. The effects of brief cognitive-behaviour therapy for pathological skin picking: a randomized comparison to wait-list control. Behav Res Ther. 2011;49(1):11–17.
    1. Beck A.T., Ward C.H., Mendelson M., Mock J., Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatry. 1961;4:561–571.
    1. Gorenstein C., Andrade L. Validation of a Portuguese version of the beck depression inventory and the state-trait anxiety inventory in Brazilian subjects. Braz J Med Biol Res. 1996;29:453–457.
    1. Kummer A., Cardoso F., Teixeira A.L. Generalized anxiety disorder and the Hamilton anxiety rating scale in Parkinson's disease. Arq Neuropsiquiatr. 2010;68:495–501.
    1. Busner J., Targum S.D. The clinical global impression scale – applying a research tool in clinical practice. Psychiatry (Edgmont) 2007;4:28–37.
    1. Lima M.S., Soares B.G., Paoliello G., Machado Vieira R., Martins C.M., Mota Neto J.I. The Portuguese version of the clinical global impression – schizophrenia scale: validation study. Rev Bras Psiquiatr. 2007;29:246–249.
    1. Sheehan D.V., Lecrubier Y., Sheehan K.H., Amorim P., Janavs J., Weiller E. The mini-international neuropsychiatric interview (MINI): the development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. J Clin Psychiatry. 1998;59(Suppl. 20):22–33.
    1. Amorim P. Mini International Neuropsychiatric Interview (MINI): validation of a short structured diagnostic psychiatric interview. Rev Bras Psiquiatr. 2000;22:106–115.
    1. Hamilton M. The assessment of anxiety states by rating. Br J Med Psychol. 1959;32:50–55.
    1. Kline R.B. 2nd ed. Guilford Press; New York: 2005. Principles and practice of structural equation modeling.
    1. Streiner D.L., Norman G.R., Cairney J. 5th ed. Oxford University Press; Oxford: 2015. Health measurement scales – a practical guide to their development and use; p. 399.
    1. Landis J.R., Koch G.G. The measurement of observer agreement for categorical data. Biometrics. 1977;33:159–174.
    1. Conselho Nacional de Saude. Resolução n° 466, de 12 de dezembro de 2012. Diário Oficial da União. 12/12/2012.
    1. Grant J.E., Odlaug B.L., Chamberlain S.R., Keuthen N.J., Lochner C., Stein D.J. Skin picking disorder. Am J Psychiatry. 2012;169:1143–1149.
    1. Bloch M.H., Landeros-Weisenberger A., Dombrowski P., Kelmendi B., Wegner R., Nudel J. Systematic review: pharmacological and behavioral treatment for trichotillomania. Biol Psychiatry. 2007;62:839–846.
    1. Hu L., Bentler P.M. Cutoff criteria for fit indexes in covariance structure analysis: conventional criteria versus new alternatives. Struc Equ Model. 1999;6:1–55.

Source: PubMed

Sponsorer og samarbejdspartnere

Medicinske tilstande

Narkotikainterventioner

3
Abonner