Assessing Excoriation (Skin-Picking) Disorder: Clinical Recommendations and Preliminary Examination of a Comprehensive Interview

Abstract

Excoriation (skin-picking) disorder (SPD) is a psychiatric condition with variable clinical presentation. We developed the Diagnostic Interview for Skin Picking Problems (DISP), a semi-structured interview designed to assess (1) DSM-5 criteria for SPD and (2) several clinical features of SPD, including the frequency and duration of picking episodes, and the proportion of time devoted to picking at different body areas. The DISP was administered along with other measures to 120 college students (88% women, average age = 22 years) with suspected skin picking problems (based on their responses to a screening survey). The results showed that the DISP had good inter-rater reliability, test– retest reliability over 1–5 months, and convergent/divergent validity. We also found that participants displayed divergent clinical characteristics depending on the pattern of frequency, duration, and body location of picking episodes (e.g., those who primarily picked at the fingers had a unique clinical presentation). Overall, the findings provide preliminary support for the psychometric properties and clinical utility of DISP. The results also underscore the importance of accurately assessing frequency, duration, and body location of picking episodes.