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Quality and temporal properties of premonitory urges in patients with skin picking disorder.
Cortex 2019; 121:125-134C

Abstract

Skin picking is a newly recognized obsessive-compulsive spectrum disorder in DSM-5. Similar to some repetitive behaviors in Gilles de la Tourette syndrome (GTS) and obsessive-compulsive disorder (OCD), premonitory urges are assumed to play a critical role in maintaining skin picking behavior, by creating a vicious cycle. The present study is the first to investigate the quality of premonitory urges, as well as the temporal relationship between urges and skin picking behavior in individuals with skin picking disorder. Quality and intensity of premonitory urges was assessed in 15 individuals with skin picking. Urge quality was assessed with the translated University of São Paulo Sensory Phenomena Scale (USP-SPS). Urge intensity was assessed continuously over 20 min using a computer-based tool. Participants were instructed either a) to pick freely or b) to suppress their skin picking behavior. Skin picking events during the free and suppression condition were recorded on video and coded manually. Regarding the types of urges, individuals with skin picking reported mainly physical urge sensations (80%), visual "just-right" feelings (80%), and urge-only sensations (80%) similar to urges reported by GTS and OCD patients. Moreover, the data showed a strong temporal relationship between the intensity of premonitory urges and the emergence of skin picking behavior (R2 = .23) that was weakened when skin picking was suppressed (R2 = .06). The results suggest that skin picking behavior is maintained by premonitory urges and that this vicious cycle of negative reinforcement can be, at least partially, broken by suppressing skin picking behavior.

Authors+Show Affiliations

Department of Paediatric and Adult Movement Disorders and Neuropsychiatry, Center for Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany.Department of Neurology, University of Lübeck, Lübeck, Schleswig-Holstein, Germany.Department of Paediatric and Adult Movement Disorders and Neuropsychiatry, Center for Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany.Department of Paediatric and Adult Movement Disorders and Neuropsychiatry, Center for Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany.Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Schleswig-Holstein, Germany.Department of Paediatric and Adult Movement Disorders and Neuropsychiatry, Center for Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany; Department of Psychology, Centre for Innovation in Mental Health, University of Southampton, UK. Electronic address: V.C.Brandt@soton.ac.uk.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31605885

Citation

Dieringer, Meike, et al. "Quality and Temporal Properties of Premonitory Urges in Patients With Skin Picking Disorder." Cortex; a Journal Devoted to the Study of the Nervous System and Behavior, vol. 121, 2019, pp. 125-134.
Dieringer M, Beck C, Verrel J, et al. Quality and temporal properties of premonitory urges in patients with skin picking disorder. Cortex. 2019;121:125-134.
Dieringer, M., Beck, C., Verrel, J., Münchau, A., Zurowski, B., & Brandt, V. (2019). Quality and temporal properties of premonitory urges in patients with skin picking disorder. Cortex; a Journal Devoted to the Study of the Nervous System and Behavior, 121, pp. 125-134. doi:10.1016/j.cortex.2019.08.015.
Dieringer M, et al. Quality and Temporal Properties of Premonitory Urges in Patients With Skin Picking Disorder. Cortex. 2019 Sep 19;121:125-134. PubMed PMID: 31605885.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Quality and temporal properties of premonitory urges in patients with skin picking disorder. AU - Dieringer,Meike, AU - Beck,Christian, AU - Verrel,Julius, AU - Münchau,Alexander, AU - Zurowski,Bartosz, AU - Brandt,Valerie, Y1 - 2019/09/19/ PY - 2019/05/31/received PY - 2019/08/20/revised PY - 2019/08/29/accepted PY - 2019/10/13/pubmed PY - 2019/10/13/medline PY - 2019/10/13/entrez KW - Body focused repetitive behavior KW - Excoriation disorder KW - Exposure with response prevention KW - Premonitory urge KW - Skin picking SP - 125 EP - 134 JF - Cortex; a journal devoted to the study of the nervous system and behavior JO - Cortex VL - 121 N2 - Skin picking is a newly recognized obsessive-compulsive spectrum disorder in DSM-5. Similar to some repetitive behaviors in Gilles de la Tourette syndrome (GTS) and obsessive-compulsive disorder (OCD), premonitory urges are assumed to play a critical role in maintaining skin picking behavior, by creating a vicious cycle. The present study is the first to investigate the quality of premonitory urges, as well as the temporal relationship between urges and skin picking behavior in individuals with skin picking disorder. Quality and intensity of premonitory urges was assessed in 15 individuals with skin picking. Urge quality was assessed with the translated University of São Paulo Sensory Phenomena Scale (USP-SPS). Urge intensity was assessed continuously over 20 min using a computer-based tool. Participants were instructed either a) to pick freely or b) to suppress their skin picking behavior. Skin picking events during the free and suppression condition were recorded on video and coded manually. Regarding the types of urges, individuals with skin picking reported mainly physical urge sensations (80%), visual "just-right" feelings (80%), and urge-only sensations (80%) similar to urges reported by GTS and OCD patients. Moreover, the data showed a strong temporal relationship between the intensity of premonitory urges and the emergence of skin picking behavior (R2 = .23) that was weakened when skin picking was suppressed (R2 = .06). The results suggest that skin picking behavior is maintained by premonitory urges and that this vicious cycle of negative reinforcement can be, at least partially, broken by suppressing skin picking behavior. SN - 1973-8102 UR - https://www.unboundmedicine.com/medline/citation/31605885/Quality_and_temporal_properties_of_premonitory_urges_in_patients_with_skin_picking_disorder L2 - https://linkinghub.elsevier.com/retrieve/pii/S0010-9452(19)30304-1 DB - PRIME DP - Unbound Medicine ER -