A cognitive comparison of pathological skin picking and trichotillomania
Abstract
Objective Pathological Skin Picking (PSP) and Trichotillomania (TTM) share overlapping comorbidity and phenomenology. The extent to which these disorders share a common cognitive phenotype, however, has yet to be examined. This study sought to compare inhibitory control processes in individuals with PSP or TTM. Methods Thirty-one subjects with PSP (mean age 31.2 ± 12.5 years; 93.5% female), 39 subjects with TTM (mean age 35.9 ± 10.7 years; 87.2% female), and 33 matched controls (mean age 31.9 ± 9.9 years; 72.7% female) 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). Groups were matched for age, gender, race/ethnicity, and education. Results PSP was associated with significantly impaired stop-signal reaction times but intact ID/ED cognitive flexibility compared to controls. TTM occupied an intermediate position in terms of stop-signal reaction times between controls and PSP but did not differ significantly from either group on the ID/ED Set Shift Task. Conclusion These results replicate the finding of impaired inhibitory control in PSP but suggest TTM may be heterogeneous with respect to such impairment. Future work should explore possible subgroups in TTM and whether cognitive variables are predictive of treatment outcomes.
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Research compared skin-picking disorder and trichotillomania and found that skin-picking was linked with deficits in response inhibition but not cognitive flexibility relative to healthy volunteers; trichotillomania took an intermediary position for response inhibition and did not display impairments in cognitive flexibility.
“Research has also directly compared the two OC‐related disorders, skin‐picking disorder and trichotillomania, and found that the former was linked with deficits in response inhibition but not cognitive flexibility relative to healthy volunteers; trichotillomania by contrast took an intermediary position vis‐à‐vis response inhibition relative to healthy controls and skin‐picking disorder patients:”
From Obsessive-compulsive disorder: Etiology, neuropathology, and cognitive dysfunction (2023) · cites this paper as Grant et al., 2011
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Aydin, P. Ç., & Gülseren, L. (2014)
Dermatillomanie (Skin-Picking-Störung): Diagnostik, Erklärung und Behandlung
Mehrmann, L. M., Gerlach, A. L., & Hunger, A. (2017) · PSYCH up2date · doi:10.1055/s-0043-108277
Os aspectos psicopatológicos e fenomenológicos do transtorno de escoriação
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Trastorno de excoriación en una mujer con panarteritis nudosa. Reporte de caso
Aranda, M., Suárez, G. M., Henao, A. M., & Lugo, G. F. O. (2018) · Revista Colombiana de Psiquiatría · doi:10.1016/j.rcp.2018.03.001
Information Processing in Obsessive-Compulsive and Related Disorders
Alcolado, G. M., Giraldo-O’Meara, M., Krause, S. C., Leonhart, M. W., & Radomsky, A. S. (2023) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780190068752.013.8
Obsessive-Compulsive Related Disorders (OCRD) Across the Lifespan
Prochwicz, K., Löchner, C., & Grünblatt, E. (2023) · Frontiers research topics · doi:10.3389/978-2-8325-3751-0
What Does Neuroimaging Indicate in Excoriation (Skin-Picking) Disorder?
Atmaca, M., & Tabara, M. F. (2025) · Harvard Review of Psychiatry · doi:10.1097/hrp.0000000000000435
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- Authors
- Grant, J. E., Odlaug, B. L., & Chamberlain, S. R.
- Affiliations
- University of Minnesota (US)
- University of Cambridge (GB)
- Venue
- Journal of Psychiatric Research
- Publisher
- Elsevier BV
- Published
- 2011-12
- Volume
- 45
- Issue
- 12
- Pages
- 1634-1638
- ISSN
- 0022-3956 (ISSN-L)
- OpenAlex
- W2143787531
- Cited by
- 80
- References
- 27
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 5 · 2023: 7 · 2022: 6 · 2021: 5 · 2020: 3 · 2019: 5 · 2018: 3 · 2017: 11 · 2016: 4 · 2015: 14 · 2014: 6 · 2013: 2 · 2012: 4
- FWCI
- 4.14
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Psychiatric Research (publishedVersion)
- PubMed (publishedVersion)
- ePrints Soton (University of Southampton) (submittedVersion)
- Funders
- National Institute on Drug Abuse
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Life Sciences › Neuroscience › Cognitive Neuroscience › Neural and Behavioral Psychology Studies
- Keywords
- trichotillomania, inhibitory control, impulsivity, cognitive flexibility, stop-signal task, set-shifting, cognitive phenotypes, comorbidities
- MeSH terms
- Adult, Analysis of Variance, Cognition Disorders, Female, Humans, Disruptive, Impulse Control, and Conduct Disorders, Male, Middle Aged, Neuropsychological Tests, Psychiatric Status Rating Scales, Quality of Life, Skin, Trichotillomania, Young Adult
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