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Behavior Modification
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Skin Picking in German Students

Prevalence, Phenomenology, and Associated Characteristics

Antje Bohne

Massachusetts General Hospital and Harvard Medical School University of Marburg, Germany

Sabine Wilhelm

Nancy J. Keuthen

Lee Baer

Michael A. Jenike

Massachusetts General Hospital and Harvard Medical School

Severe skin picking (SP) is a repetitive, intentionally performed behavior that causes noticeable tissue damage and results in clinically significant distress or impairment. To date, SP has received little attentioninthe psychiatric literature. This study was conducted to further investigate SP and its characteristics in a German student population. The participants (N = 133) completed various self-report questionnaires. More than 90% (n = 122) reported occasional SP, with six students (4.6%) endorsing significant impairment from recurrent, self-injurious SP. SP was triggered by specific cutaneous stimuli, situations, and emotions. The students primarily squeezed (85%) and scratched (77.4%) the skin, with a primary focus on the face (94.7%) and cuticles (52.6%). About 20% (n = 26) ate the picked tissue afterward. Results suggest SP is an underrecognized problem that occurs on a continuum ranging from mild to severe with generally stable clinical characteristics across cultures.

Behavior Modification, Vol. 26, No. 3, 320-339 (2002)
DOI: 10.1177/0145445502026003002


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