Antje Bohne

Prevalence of body dysmorphic disorder in a German college student sample

The prevalence of body dysmorphic disorder (BDD) was investigated in a non-clinical sample. German college students (n=133; 73.7% female) completed self-report questionnaires assessing BDD, self-esteem, symptoms of depression, obsessive-compulsive disorder and skin picking. Based on our data, seven participants (5.3%) satisfied DSM-IV BDD criteria. Significant differences were found between students with and without BDD in the number of endorsed obsessive-compulsive disorder symptoms. Poor body image was associated with poor self-esteem, symptoms of depression and obsessive-compulsive disorder. One student with BDD also reported severe skin picking. In conclusion, BDD is a common psychiatric disorder in college students.

Skin Picking in German Students Prevalence, Phenomenology, and Associated Characteristics

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.

Visuospatial Abilities, Memory, and Executive Functioning in Trichotillomania and Obsessive-Compulsive Disorder

Few studies have compared neuropsychological functioning in trichotillomania (TTM) and obsessive-compulsive disorder (OCD). In OCD, most studies suggest abnormal visuospatial abilities, memory, and executive functioning. We compared 23 TTM, 21 OCD and 26 healthy control individuals on neuropsychological tasks assessing these abilities. Neither the TTM nor the OCD groups suffered from generalized neuropsychological deficits compared to the healthy control group. TTM participants showed increased perseveration on the Object Alternation Task suggesting difficulties with response flexibility. OCD participants showed impaired ability to learn from feedback on the Wisconsin Card Sorting Test. Other executive functions, as well as memory and visuospatial abilities were unimpaired in TTM and OCD. Our data suggest that TTM and OCD are characterized by different patterns of neuropsychological dysfunction. This research was partly supported by a doctoral stipend from the German Academic Exchange Service (DAAD) and a doctoral stipend from the University of Marburg, Germany, both awarded to Antje Bohne, by a grant from the Judah fund awarded to Michael A. Jenike and by a grant from the Obsessive Compulsive Foundation awarded to Cary R. Savage

Pathologic Hairpulling, Skin Picking, and Nail Biting

BACKGROUND Pathologic hairpulling (HP), skin picking (SP), and nail biting (NB) are repetitive, intentionally performed behaviors that cause noticeable hair loss or substantial physical damage, and result in clinically significant distress or functional impairment. To date, HP, SP, and NB have received little attention in the psychiatric literature despite being widespread behaviors. METHODS The present article reviews the up-to-date research findings on these three forms of pathologic behavior, highlighting their similarities and differences. RESULTS Despite HP, pathologic grooming behaviors have not yet been explicitly included in the diagnostic nomenclature. Phenomenology, triggers, consequences and functionality of HP, SP, and NB are similar, which suggest their joint diagnostic categorization. Sufferers often fail to admit the self-inflicted nature of their physical damage out of shame and embarrassment, which complicates the recognition and differential diagnosis of sufferers. Thus, practitioners need to be particularly attentive to physical signs possibly related to these behavior disorders. CONCLUSIONS Research suggests that HP, SP, and NB are underrecognized problems that occur on a continuum ranging from mild to severe. Further research is needed, especially regarding the etiology of pathologic HP, SP, and NB, to foster the development of both effective and long-lasting treatments and prevention strategies.

Impulse-control disorders in college students

We investigated impulse-control disorders (ICDs), alcohol use and outcome expectancies in students (n=571, 63.9% female, age: M=21.7) using questionnaires. Twenty (3.5%) were positively screened for lifetime ICDs, mostly males (n=16, 80%). Disorder-specific rates ranged between 0 and 1.2%. Differences in alcohol use and expectancies between ICDs and controls did not reach significance.

Modellvorschlag für die kognitive Verhaltenstherapie der Kleptomanie

Die Kleptomanie ist als Impulskontrollstörung klassifiziert. Empirische Untersuchungen zu Epidemiologie, Ätiologie und effektiven Behandlungsverfahren existieren kaum. Für die klinische Praxis fehlt außerdem ein systematisches Bedingungsmodell. Nach einem Kurzüberblick über den bisherigen Forschungsstand wird ein lerntheoretisches Teufelskreismodell für die Kleptomanie vorgeschlagen. Der Konzeption als Impulskontrollstörung folgend stehen dabei ein auslösender Spannungszustand, mit Kontextreizen verknüpfte Stehlimpulse und die kurzfristig spannungsreduzierende Wirkung der Stehlhandlung im Mittelpunkt. Konkrete kognitiv-verhaltenstherapeutische Interventionen werden aus dem Modell logisch abgeleitet. Am Beispiel einer ambulanten Kleptomanie-Behandlung wird die konkrete Anwendung des Modells veranschaulicht. Das vorgeschlagene Kleptomanie-Modell bietet eine systematische Arbeitsgrundlage für die verhaltenstherapeutische Praxis. Aufgrund der wenigen empirischen Studien ist weitere Forschung zur Entstehung und Aufrechterhaltung der Kleptomanie notwendig.