Cognitive dysfunction in childhood-onset pathologic skin picking

Grant, Jon E., Odlaug, Brian L. and Chamberlain, Samuel R. (2012) Cognitive dysfunction in childhood-onset pathologic skin picking. Journal of Obsessive-Compulsive and Related Disorders, 1 (2), 73-76. (doi:10.1016/j.jocrd.2012.01.002).

Abstract

Objective: There has been little research examining cognitive correlates of childhood-onset pathologic skin picking. Methods: Of 50 subjects with Pathological Skin Picking (PSP), 24 (48%) (mean age 32.3±12.2 years; PSP onset at 7.67±2.54 years; 87.5% female) reported onset of skin picking before age 11 years. These subjects were compared to 26 subjects with later onset of picking after age 11 years (mean age 34.2±14.5 years; PSP onset 18.04±9.51 years; 92.3% female) on measures of symptom severity, comorbidity, and social functioning. Both groups undertook cognitive assessments using the Stop-signal task (assessing response impulsivity) and the Intra-dimensional/Extra-dimensional (ID/ED) Set Shift task (assessing cognitive flexibility). Results: There were no significant clinical differences based on age of PSP onset. Early and later onset PSP showed significantly prolonged stop-signal reaction times (i.e., worse inhibition) versus healthy controls, but, contrary to our hypothesis, only the later onset patients manifested significantly elevated errors on the set-shifting task versus controls (i.e., cognitive inflexibility: total errors corrected and errors for the extradimensional shift stage). Conclusion: These results indicate overlapping clinical features and impulse dyscontrol between early and later onset PSP, but heterogeneity with respect to set-shifting dysfunction. Future work should explore possible subgroups in PSP and whether age of onset and cognitive functioning is predictive of treatment outcomes.

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Contributors

Author: Samuel R. Chamberlain

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