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Statistical predictors of psychosocial impairment in body-focused repetitive behaviors

Statistical predictors of psychosocial impairment in body-focused repetitive behaviors
Statistical predictors of psychosocial impairment in body-focused repetitive behaviors
Objective: skin picking disorder and trichotillomania, also characterized as body-focused repetitive behaviors (BFRBs), often lead to functional impairment. Some people with BFRBs, however, report little if any psychosocial dysfunction. There has been limited research as to which clinical aspects of BFRBs are associated with varying degrees of functional impairment.

Methods: adults (n=98), ages 18-65 with a current diagnosis of trichotillomania (n=37), skin picking disorder (n=32), trichotillomania plus skin picking disorder (n=10), and controls (n=19) were enrolled. Partial least squares regression (PLS) was used to identify variables associated with impairment on the Sheehan Disability Scale.

Results: PLS identified an optimal model accounting for 45.8% of variation in disability. Disability was significantly related to (in order of descending coefficient size): severity of picking, perceived stress, comorbid disorders (specifically, anxiety disorders / obsessive-compulsive disorder), trait impulsivity, family history of alcohol use disorder, atypical pulling/picking sites, and older age.

Conclusions: at present mental disorders are viewed as unitary entities; however, the extent of impairment varies markedly across patients with BFRBs. These data suggest that whereas symptom nature/severity is important in determining impairment, so too are other variables commonly unmeasured in clinical practice. Outcomes for patients may thus be maximized by rigorously addressing comorbid disorders; as well as integrating components designed to enhance top-down control and stress management. Interestingly, focused picking and emotional pulling were linked to worse disability, hinting at some differences between the two types of BFRBs, in terms of determinants of impairment.
Disability, dysfunction, impairment, predictors, skin picking, trichotillomania
1092-8529
1-5
Chamberlain, Samuel
8a0e09e6-f51f-4039-9287-88debe8d8b6f
Aslan, Ibrahim
5ba26f3a-7df2-4b9d-8f65-e316a8b07864
Grant, Jon E.
15ed8f1b-3f52-4576-b842-1056cf9331b0
Chamberlain, Samuel
8a0e09e6-f51f-4039-9287-88debe8d8b6f
Aslan, Ibrahim
5ba26f3a-7df2-4b9d-8f65-e316a8b07864
Grant, Jon E.
15ed8f1b-3f52-4576-b842-1056cf9331b0

Chamberlain, Samuel, Aslan, Ibrahim and Grant, Jon E. (2021) Statistical predictors of psychosocial impairment in body-focused repetitive behaviors. CNS Spectrums, 1-5. (doi:10.1017/S1092852921000468).

Record type: Article

Abstract

Objective: skin picking disorder and trichotillomania, also characterized as body-focused repetitive behaviors (BFRBs), often lead to functional impairment. Some people with BFRBs, however, report little if any psychosocial dysfunction. There has been limited research as to which clinical aspects of BFRBs are associated with varying degrees of functional impairment.

Methods: adults (n=98), ages 18-65 with a current diagnosis of trichotillomania (n=37), skin picking disorder (n=32), trichotillomania plus skin picking disorder (n=10), and controls (n=19) were enrolled. Partial least squares regression (PLS) was used to identify variables associated with impairment on the Sheehan Disability Scale.

Results: PLS identified an optimal model accounting for 45.8% of variation in disability. Disability was significantly related to (in order of descending coefficient size): severity of picking, perceived stress, comorbid disorders (specifically, anxiety disorders / obsessive-compulsive disorder), trait impulsivity, family history of alcohol use disorder, atypical pulling/picking sites, and older age.

Conclusions: at present mental disorders are viewed as unitary entities; however, the extent of impairment varies markedly across patients with BFRBs. These data suggest that whereas symptom nature/severity is important in determining impairment, so too are other variables commonly unmeasured in clinical practice. Outcomes for patients may thus be maximized by rigorously addressing comorbid disorders; as well as integrating components designed to enhance top-down control and stress management. Interestingly, focused picking and emotional pulling were linked to worse disability, hinting at some differences between the two types of BFRBs, in terms of determinants of impairment.

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BFRB dysfunction-4-17-21_accepted - Accepted Manuscript
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More information

Accepted/In Press date: 22 April 2021
e-pub ahead of print date: 30 April 2021
Published date: 30 April 2021
Additional Information: Publisher Copyright: © 2021 Lippincott Williams and Wilkins. All rights reserved.
Keywords: Disability, dysfunction, impairment, predictors, skin picking, trichotillomania

Identifiers

Local EPrints ID: 448836
URI: http://eprints.soton.ac.uk/id/eprint/448836
ISSN: 1092-8529
PURE UUID: 432e65bc-a077-4e4c-88c0-016e1b6f8b32
ORCID for Samuel Chamberlain: ORCID iD orcid.org/0000-0001-7014-8121
ORCID for Ibrahim Aslan: ORCID iD orcid.org/0000-0001-7366-9037

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Date deposited: 06 May 2021 16:32
Last modified: 17 Nov 2022 05:03

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Contributors

Author: Samuel Chamberlain ORCID iD
Author: Ibrahim Aslan ORCID iD
Author: Jon E. Grant

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