Document Type
Article
Journal/Book Title/Conference
Journal of Obsessive-Compulsive and Related Disorders
Author ORCID Identifier
Emily M. Bowers https://orcid.org/0000-0002-7210-8454
Volume
43
Publisher
Elsevier BV
Publication Date
9-6-2024
Journal Article Version
Accepted Manuscript
First Page
1
Last Page
32
Creative Commons License
This work is licensed under a Creative Commons Attribution-Noncommercial-No Derivative Works 4.0 License.
Abstract
Skin picking disorder is a chronic repetitive condition that impacts daily functioning and causes significant distress. Acceptance and commitment therapy (ACT) enhanced behavioral training (A-EBT) has shown promise in targeting skin picking symptoms but is not widely disseminated among providers. This study examines the efficacy and feasibility of an eight-week fully-automated online A-EBT program for skin picking disorder. Participants with skin picking disorder (N = 84) were randomized into either an online intervention (n = 43) or a waitlist control (n = 41). All participants completed self-report assessments at baseline, mid-, post-intervention, and 1-month follow-up. Analyses used multilevel linear modeling with the full intent-to-treat sample. Results demonstrated statistically stronger improvements from baseline to 1-month follow-up in the intervention condition compared to waitlist for skin picking symptoms (SMD=0.90), skin picking-related psychological flexibility (SMD=-0.82), and well-being (SMD=-0.31), with no significant effects on distress. Treatment effects were maintained at one-month follow-up, with 29.0% of intervention participants meeting responder status, compared to 0.1% of waitlist participants. High usability and acceptability scores provide preliminary evidence of its feasibility as a fully automated intervention. These findings suggest an automated online A-EBT program may be an effective and scalable treatment for individuals with skin picking disorder.
Recommended Citation
Emily M. Bowers, Leila K. Capel, Mercedes G. Woolley, Aubry Barnes, Michael P. Twohig, Michael E. Levin, Efficacy and Feasibility of Web-Based ACT-Enhanced Behavioral Treatment for Skin Picking in Adults: A Randomized Waitlist-Controlled Trial, Journal of Obsessive-Compulsive and Related Disorders, 2024, https://doi.org/10.1016/j.jocrd.2024.100909.
