尽管包括儿童虐待(CM)在内的创伤压力对心理健康产生了深远的影响,它与病理性皮肤采摘(PSP)的关系尚未得到充分研究,结果尚无定论。同样,创伤后应激障碍(PTSD)是最典型的创伤应激后遗症,在PSP患者中几乎没有研究过。我们的在线病例对照研究的目的是进一步阐明这一问题。
使用匿名在线调查,325名成人参与者的PSP定义为修订的皮肤采摘量表(SPS-R)评分≥7,以及皮肤采摘影响量表(SPIS)评分≥7,接受儿童创伤问卷(CTQ),DSM-IVPTSD(PTSD-7)的短期筛查量表,包括创伤事件列表,和精神病态痛苦的简短测量。他们被比作年龄-,sex-,和教育匹配的对照组通过方差分析(ANOVA)在线招募。
PSP样本在性虐待和情感虐待以及情感忽视的CTQ维度上得分明显更高,效应大小为小到中等(d介于0.27和0.49之间)。考虑到心理困扰,唯一的显着差异与情感虐待有关,影响很小(d=0.23)。PSP参与者报告的成年期创伤经历明显多于对照组(59.1%vs.38.2%;χ2(1;N=638)=28.02,p<.001)。在那些有PSP的人中,有44例(13.5%)可能诊断为PTSD,而对照组为0例.
我们的研究结果表明,儿童时期的情感虐待可能与皮肤采摘有关。由于与对照组相比,PSP患者在成年期以及PTSD中暴露于创伤事件的频率似乎更高,在评估皮肤采摘患者时,考虑这些因素可能是值得的。
Although traumatic stress including childhood maltreatment (CM) has a profound impact on mental health, its relation to pathological skin picking (PSP) has been understudied and results remain inconclusive. Likewise, posttraumatic stress disorder (PTSD) as the most typical sequelae of traumatic stress has hardly been investigated in those with PSP. The objective of our online
case-control study was to shed further light on this issue.
Using an anonymous online survey, 325 adult participants with PSP defined by Skin Picking Scale-Revised (SPS-R) scores ≥ 7 as well as Skin Picking Impact Scale (SPIS) scores ≥ 7 were administered the Childhood Trauma Questionnaire (CTQ), the Short Screening Scale for DSM-IV PTSD (PTSD-7) including a list of traumatic events, and a brief measure of psychopathological distress. They were compared to an age-, sex-, and education-matched control group recruited online by means of analyses of variance (ANOVA).
The PSP sample scored significantly higher on the CTQ dimensions of sexual and emotional abuse as well as emotional neglect with small to moderate effect sizes (d between 0.27 and 0.49). Accounting for psychological distress, the only significant difference related to emotional abuse with a small effect (d = 0.23). Participants with PSP reported significantly more traumatic experiences in adulthood than the control group (59.1% vs. 38.2%; χ2(1; N=638) = 28.02, p < .001). Among those with PSP, a probable diagnosis of PTSD was found in 44 (13.5%) compared to zero cases in the control group.
Our findings indicate that emotional abuse in childhood may be of relevance in skin picking. Since exposure to traumatic events in adulthood as well as PTSD seem to be more frequent in those with PSP compared to a control group, it might be worthwhile to consider these factors in the assessment of patients with skin picking.