A Latent Profile Analysis of Age of Onset in Pathological Skin Picking

Authors

Emily J. Ricketts, New York State Psychiatric InstituteFollow
Ivar Snorrason, University of Wisconsin - MilwaukeeFollow
Katharina Kircanski, National Institute of Mental Health
Jennifer R. Alexander, Marquette UniversityFollow
Hardian Thamrin, University of California - Los Angeles
Christopher A. Flessner, Kent State University
Martin E. Franklin, University of PennsylvaniaFollow
John Piacentini, University of California - Los AngelesFollow
Douglas W. Woods, Marquette UniversityFollow

Document Type

Article

Language

eng

Publication Date

11-2018

Publisher

Elsevier

Source Publication

Comprehensive Psychiatry

Source ISSN

0010-440X

Abstract

Background

Pathological Skin Picking (PSP) may begin at any age, but the most common age of onset is during adolescence. Age of onset is a potentially useful clinical marker to delineate subtypes of psychiatric disorders. The present study sought to examine empirically defined age of onset groups in adults with PSP and assess whether groups differed on clinical characteristics.

Method

Participants were 701 adult respondents to an internet survey, who endorsed recurrent skin picking with tissue damage and impairment. Latent profile analysis (LPA) was conducted to identify subtypes of PSP based on age of onset. Then subgroups were compared on demographic and clinical characteristics.

Results

The best fitting LPA model was a two-class solution comprised of a large group with average age of onset in adolescence (n = 650; 92.9% of the sample; Mean age of onset = 13.6 years) and a small group with average onset in middle adulthood (n = 50; 7.1% of the sample; Mean age of onset = 42.8 years). Relative to the early onset group, the late onset group reported significantly less focused picking, less skin picking-related impairment, lower rates of co-occurring body-focused repetitive behaviors, and trends towards reduced family history of PSP. Individuals in the late onset group also reported increased rates of comorbid depression, anxiety and posttraumatic stress disorder, and were more likely to report that initial picking onset seemed related to or followed depression/anxiety and physical illness.

Conclusion

Findings suggest the presence of two distinct PSP age of onset groups: (1) an early onset group with average onset in adolescence, clinical characteristics suggestive of greater picking-related burden and familiality, and a profile more representative of the general PSP population; and (2) a late onset group with average onset in middle adulthood, increased co-occurring affective and trauma conditions, and initial onset associated with or following other mental health and physical problems. Future replication is needed to assess the validity and clinical utility of these subgroups.

Comments

Accepted version. Comprehensive Psychiatry, Vol. 87 (November 2018): 46-52. DOI. © 2018 Elsevier. Used with permission.

Recommended Citation

Ricketts, Emily J.; Snorrason, Ivar; Kircanski, Katharina; Alexander, Jennifer R.; Thamrin, Hardian; Flessner, Christopher A.; Franklin, Martin E.; Piacentini, John; and Woods, Douglas W., "A Latent Profile Analysis of Age of Onset in Pathological Skin Picking" (2018). Psychology Faculty Research and Publications. 435.
https://epublications.marquette.edu/psych_fac/435