Is ACT-Informed Exposure a Viable Treatment for Excoriation Disorder? A Multiple Baseline Study

Area of Science:

• Psychiatry
• Behavioral Science
• Clinical Psychology

Background:

• Excoriation disorder (ExD) is a chronic condition characterized by repetitive skin picking.
• Current treatments like habit reversal training (HRT) show efficacy, but adjunctive therapies are needed.
• Acceptance and Commitment Therapy (ACT)-informed exposure is a potential novel approach.

Purpose of the Study:

• To pilot ACT-informed exposure as an adjunct to HRT for ExD.
• To assess the impact of exposure on skin picking severity and psychological flexibility.
• To compare the effectiveness of HRT and exposure in a single-case design.

Main Methods:

• A nonconcurrent multiple baseline single-case design was employed with four participants.
• Participants received HRT and ACT-informed exposure in varied sequences.
• Data collected included repeated measures and self-report on skin picking and psychological flexibility.

Main Results:

• HRT demonstrated significant effectiveness in reducing skin picking behaviors.
• Exposure therapy showed a weaker, less consistent impact on reducing picking compared to HRT.
• Psychological flexibility did not consistently improve during exposure phases as predicted.

Conclusions:

• HRT is an effective treatment for excoriation disorder.
• ACT-informed exposure may serve as a potential second-line treatment for ExD, warranting further investigation.
• All participants maintained treatment gains at follow-up, indicating lasting benefits.