Evaluating the Effect of Approach-avoidance Training on Action Tendencies for Individuals with Skin Picking Disorder

Abstract

Pathological skin picking (PSP) or excoriation disorder is a destructive behavior that affects 1-2% of the general population. The purpose of this pilot study was to evaluate the effect of a computerized behavior modification task on action tendencies (i.e., approach or avoidance) in adults with PSP. We aimed to reduce these action tendencies by having participants with PSP complete the Approach-Avoidance Training (AAT) task. Thirty-two participants with PSP were placed in one of three training conditions: (1) Avoidance Training (AvT) (2) Approach Training (ApT) (3) Placebo Training (PT). Using a joystick to simulate an approach (=pull) or avoidance (=push) response, we hypothesized that after training those in the AvT would have the greatest reduction in behavioral approach (i.e., their overall reaction time (RT) to approach pictures of irregular skin stimuli). Results of the pre-assessment task revealed a positive correlation between behavioral approach to irregular skin stimuli and skin picking severity reported on the Skin Picking Scale-Revised (SPS-R). After training, a decrease in behavioral approach and urges to pick were found in the AvT and PT groups, while those in the ApT reported an increase in behavioral approach and urges. After two-week follow up, no significant changes on the SPS-R were reported between groups. Our preliminary data suggest that the AAT is a promising avenue of research to develop as a cognitive intervention to address an excessive behavioral approach tendency that characterizes skin picking problems.