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A randomized crossover trial with experience sampling to test placebo effects on pathological skin-picking
Anne Schienle1,2, Sara Kohlhofer3, Johannes Wilhelm3
1Department of Clinical Psychology, University of Graz, Universitätsplatz 2, Graz, Austria. anne.schienle@uni-graz.at.
Scientific Reports
|July 1, 2025
Summary
Individuals with pathological skin-picking (PSP) show responsiveness to placebo treatments, which can reduce emotional distress and skin-picking severity. However, ecological momentary assessments suggest the placebo effect
Area of Science:
- Psychiatry
- Psychology
- Dermatology
Background:
- Pathological skin-picking (PSP) is often triggered by emotional distress.
- Placebo treatments have demonstrated efficacy in reducing emotional distress.
Purpose of the Study:
- To investigate placebo responsiveness in individuals diagnosed with pathological skin-picking.
- To compare questionnaire data with ecological momentary assessments for evaluating placebo effects.
Main Methods:
- A randomized crossover trial involving 69 participants with self-reported PSP.
- Participants underwent two weeks of daily placebo treatment and two weeks without, using a smartphone app for daily symptom and stress ratings.
- Standardized questionnaires assessed skin-picking severity, stress, and emotion regulation difficulties before and after each interval.
Main Results:
- Questionnaire data indicated significant reductions in skin-picking severity, perceived stress, and emotion regulation difficulties with placebo treatment.
- App-based assessments revealed only a moderate, short-term reduction in the urge to pick skin, with no significant impact on daily stress levels.
- The placebo effect magnitude was overestimated using retrospective questionnaires compared to real-time app-based data.
Conclusions:
- Individuals with pathological skin-picking exhibit responsiveness to placebo interventions.
- Ecological momentary assessment provides a more accurate measure of placebo effects in PSP than retrospective questionnaires.
- Understanding placebo effects is crucial for developing effective treatments for PSP.
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