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. 2017 Sep 13;12(9):e0183806.
doi: 10.1371/journal.pone.0183806. eCollection 2017.

Pathological grooming: Evidence for a single factor behind trichotillomania, skin picking and nail biting

Aniko Maraz  1 , Borbála Hende  1   2 , Róbert Urbán  1 , Zsolt Demetrovics  1
Affiliations

Pathological grooming: Evidence for a single factor behind trichotillomania, skin picking and nail biting

Aniko Maraz et al. PLoS One. .

Abstract

Although trichotillomania (TTM), skin picking (SP), and nail biting (NB) have been receiving growing scientific attention, the question as to whether these disorders can be regarded as separate entities or they are different manifestations of the same underlying tendency is unclear. Data were collected online in a community survey, yielding a sample of 2705 participants (66% women, mean age: 29.1, SD: 8.6). Hierarchical factor analysis was used to identify a common latent factor and the multiple indicators and multiple causes (MIMIC) modelling was applied to test the predictive effect of borderline personality disorder symptoms, impulsivity, distress and self-esteem on pathological grooming. Pearson correlation coefficients between TTM, SP and NB were between 0.13 and 0.29 (p < 0.01). The model yielded an excellent fit to the data (CFI = 0.992, TLI = 0.991, χ2 = 696.65, p < 0.001, df = 222, RMSEA = 0.030, Cfit of RMSEA = 1.000), supporting the existence of a latent factor. The MIMIC model indicated an adequate fit (CFI = 0.993, TLI = 0.992, χ2 = 655.8, p < 0.001, df = 307, RMSEA = 0.25, CI: 0.022-0.028, pclose = 1.000). TTM, SP and NB each were loaded significantly on the latent factor, indicating the presence of a general grooming factor. Impulsivity, psychiatric distress and contingent self-esteem had significant predictive effects, whereas borderline personality disorder had a nonsignificant predictive effect on the latent factor. We found evidence that the category of pathological grooming is meaningful and encompasses three symptom manifestations: trichotillomania, skin picking and nail biting. This latent underlying factor is not better explained by indicators of psychopathology, which supports the notion that the urge to self-groom, rather than general psychiatric distress, impulsivity, self-esteem or borderline symptomatology, is what drives individual grooming behaviours.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Correlating first-order factors model of grooming.
Note: all correlations and loadings are significant on the p < 0.001 level.
Fig 2
Fig 2. Hierarchical factor model of grooming.
Note: all correlations and loadings are significant on the p < 0.001 level.
Fig 3
Fig 3. The MIMIC model of pathological grooming and indicators of psychopathology.
Note: *p < 0.05, ***p < 0.01, n.s. = nonsignificant. Only significant (p < 0.05) path coefficients are included in the model for reasons of clarity.
See this image and copyright information in PMC

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References

    1. Bohne A, Keuthen N, Wilhelm S. Pathologic hairpulling, skin picking, and nail biting. Ann Clin Psychiatr 2005;17(4):227–32. - PubMed
    1. Bienvenu O, Wang Y, Shugart Y, Welch J, Grados M, Fyer A, et al. Sapap3 and pathological grooming in humans: Results from the OCD collaborative genetics study. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics. 2009;150(5):710–20. - PMC - PubMed
    1. Bijl RV, Ravelli A, Van Zessen G. Prevalence of psychiatric disorder in the general population: results of The Netherlands Mental Health Survey and Incidence Study (NEMESIS). Soc Psychiatry Psychiatric Epidem 1998;33(12):587–95. - PubMed
    1. Offord DR, Boyle MH, Campbell D, Goering P. One-year prevalence of psychiatric disorder in Ontarians 15 to 64 years of age. Can J Psychiatry, 1996;49(9):559–63. - PubMed
    1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders 5th edition (DSM-5). Fifth ed. Arlington, VA: American Psychiatric Association; 2013.

MeSH terms

Grants and funding

This work was supported by Hungarian National Research, Development and Innovation Office (Grant number: K111938). The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.