Skin Picking Approach Avoidance Task

NCT ID: NCT04099537

Last Updated: 2022-02-28

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 45 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2018-07-02
• Study Completion Date: 2020-06-22

Brief Summary

Pathological skin picking (PSP) is conceptualized as a behavioral addiction. Research has shown that behavioral addictions (e.g., problematic alcoholism or smoking) can be reduced using a cognitive retraining tool called approach-avoidance training (AAT). Participants will be randomly assigned to a single-session of AAT: (a) approach training, (b) avoidance training, or (c) placebo training and will be assessed at baseline, post-training (i.e., 30 minutes after training), and 2-week follow up. The investigators hypothesize that those in the approach training will show greater reduction in approach tendencies at post-treatment and 2-week follow up, compared to those in the approach training or placebo conditions. This study may produce data that will guide the development of a training program that focuses on the maladaptive action tendencies in skin picking symptoms.

Detailed Description

Pathological Skin Picking (PSP) is one of many debilitating Body Focused Repetitive Behaviors (BFRBs) that involves repetitive picking to gain the gratification of relieving anxiety or tension. Thus, this behavior may cause infections, lesions, and scarring, resulting in psychosocial impairment or medical attention. Because of the habitual/compulsive nature of the disorder, researchers conceptualize this maladaptive coping mechanism as a behavioral addiction which may occur without conscious awareness. Therefore, it is important to identify the automatic motivational orientations behind BFRBs. There is compelling evidence to suggest that a novel technological behavior paradigm, called Approach Avoidance Training (AAT), can be used to assess and modify action tendencies (i.e., approach or avoidance) in behavioral addictions like PSP. This game-like task has the participant push (=avoid) or pull (=approach) a joystick based on a target and control stimulus presented on a computer screen. This push-pull paradigm is in response to the individual's inherent action tendencies.

The overarching goal is to determine effective principles of change in interventions for BFRBs. Therefore, assessing neurocognitive components using computer-based training programs can help identify the implicit processes underlying the disorder. The objective of the study is to examine the feasibility of using AAT to modify PSP action tendencies, and potentially improve PSP symptoms. The investigators predict that individuals with PSP will have a pathological approach tendency towards skin as measured by the Approach-Avoidance Assessment (AAA). Therefore, AAT will promote reduction of approach to skin stimuli. To retrain one's action tendencies the investigators will randomize participants to the following training conditions: Avoidance Training (AvT; avoidance of skin stimuli), Approach Training (ApT; approach skin stimuli), or Placebo Training (PT; equal approach/avoidance of skin stimuli). The investigators will also administer an eye-tracking task to assess visual gaze response to pictures of irregular skin and neutral stimuli to evaluate training-induced changes in action tendencies. Previous studies have shown the AAT's success in reducing action tendencies and symptoms in other addictions like problematic alcohol use and cigarette smoking Therefore, AAT may prove effective in modifying the behavioral addiction of PSP. Sixty adults with PSP will be randomly assigned to (a) approach training (b) avoidance training or (c) placebo training. All participants will then be sent a follow-up survey approximately two weeks after completion of the main study to determine changes in symptoms. This pilot study is expected to guide the development of an accessible, cost-efficient, and effective cognitive training programs for individuals with PSP.

Conditions

Skin-Picking

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: TREATMENT
• Blinding Strategy: SINGLE

Study Groups

Approach cognitive training

This training is a single session training. Each session lasts about 30 minutes where participants are to pull the joystick toward (approach) them when seeing skin stimuli on a computer screen.

Group Type: EXPERIMENTAL

Computerized cognitive training

Intervention Type: BEHAVIORAL

Participants are trained to approach or avoid stimuli of skin using a joystick. Participants are to pull or push the joystick toward or away when skin stimuli are present. Thus, behaviorally, there may be an increase, decrease, or no change in approach tendencies towards skin.

Avoidance cognitive training

This training is a single session training. Each session lasts about 30 minutes where participants are to push the joystick away (avoidance) from them when seeing skin stimuli on a computer screen.

Group Type: EXPERIMENTAL

Computerized cognitive training

Intervention Type: BEHAVIORAL

Participants are trained to approach or avoid stimuli of skin using a joystick. Participants are to pull or push the joystick toward or away when skin stimuli are present. Thus, behaviorally, there may be an increase, decrease, or no change in approach tendencies towards skin.

Placebo cognitive training

This training is a single session training. Each session lasts about 30 minutes where participants are to push and pull the joystick towards or away from them (no rule) when seeing skin stimuli on a computer screen.

Group Type: PLACEBO_COMPARATOR

Computerized cognitive training

Intervention Type: BEHAVIORAL

Participants are trained to approach or avoid stimuli of skin using a joystick. Participants are to pull or push the joystick toward or away when skin stimuli are present. Thus, behaviorally, there may be an increase, decrease, or no change in approach tendencies towards skin.

Interventions

Computerized cognitive training

Participants are trained to approach or avoid stimuli of skin using a joystick. Participants are to pull or push the joystick toward or away when skin stimuli are present. Thus, behaviorally, there may be an increase, decrease, or no change in approach tendencies towards skin.

Intervention Type: BEHAVIORAL

Eligibility Criteria

Inclusion Criteria

1. A current diagnosis of skin picking

2. Moderate symptoms of skin picking a Skin Picking Severity Scale (SPS) score of ≥ 7

3. Ages 18-60,

4. Fluent English speakers.

Exclusion Criteria

1. Self-reported visual impairment that cannot be adjusted and will prevent participants from clearly recognizing words and pictures on computer screen

2. A positive diagnosis of bipolar disorder or psychotic disorder

• Minimum Eligible Age: 18 Years
• Maximum Eligible Age: 60 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

University of Wisconsin, Milwaukee

OTHER

Sponsor Role: lead

Responsible Party

Han Joo Lee

Professor

Responsibility Role: PRINCIPAL_INVESTIGATOR

Principal Investigators

Han Joo Lee, Ph.D.

Role: PRINCIPAL_INVESTIGATOR

University of Wisconsin, Milwaukee

Locations

Psychology Clinic, University of Wisconsin-Milwaukee

Milwaukee, Wisconsin, United States

Countries

United States

Other Identifiers

SPAAT2018

Identifier Type: -

Identifier Source: org_study_id