Objective: Skin picking disorder (SPD) affects up to 5.4% of the population. Less than half of patients are correctly diagnosed and treated. Developing tools to recognize SPD can help professionals and patients alike. This trial aimed to validate the Skin Picking Scale-Revised (SPS-R) for the Brazilian population and assess the psychiatric and dermatological comorbidities of patients with SPD. Methods: Brazilians with a primary diagnosis of SPD, 18 years or older, were recruited from a community sample by media advertising and evaluated by a dermatologist and a psychiatrist. Self-report instruments were used: SPS-R, Dermatology Life Quality Index (DLQI), General Anxiety Disorder-7 (GAD-7), and Patient Health Questionnaire-9 (PHQ-9). Confirmatory factor analysis (CFA) was performed to evaluate the SPS-R, and Pearson correlation (r) was used to assess the relationship between instruments. Results: Overall, 124 patients were included. The SPS-R demonstrated good internal consistency (Cronbach’s coefficient = 0.84). CFA found a good fit to the model according to all indices (χ2 = 29.67; degrees of freedom [df] = 19; p = 0.056; root mean square error of approximation [RMSEA] = 0.067; comparative fit index [CFI] = 0.969; non-normed fit index [NNFI] = 0.954). SPS-R correlated with DLQI (r = 0.73), GAD-7 (r = 0.51), and PHQ-9 (r = 0.43). The sample had a high prevalence of psychiatric disorders, mainly generalized anxiety disorder (62.1%) and current (32.3%) and past (37.1%) depressive episodes. Conclusion: The Brazilian version of the SPS-R presents good psychometric properties. The severity of SPD is related to severity of depression, anxiety, and impairment in quality of life. Clinical trial registration: ClinicalTrials.gov, NCT04731389

Introduction: Although behavioral therapies can effectively treat skin picking disorder (SPD), there is no standardized treatment for improving SPD and its comorbidities and there is no group intervention option. This trial aimed to adapt the Rothbaum trichotillomania protocol to SPD (Study 1) and test its efficacy for treating SPD and comorbidities in individual and group formats (Study 2). Methods: The adapted protocol was applied to 16 SPD patients, who were allocated to group or individual treatment (Study 1). Afterwards, 54 patients were randomly allocated to treatment in an individual (n=27) or group format (n=27) (Study 2). In both studies, assessments of SPD severity, anxiety, depression, clinical status and skin lesion severity were performed at baseline and the endpoint. Results: The adapted protocol was feasible in both treatment modalities (Study 1) and led to high SPD remission rates (individual 63%; group 52%), with no significant difference between intervention types (p = 0.4) (Study 2). SPD, anxiety, and depression symptoms and objective patient lesion measures improved after treatment. There was large effect size for SPD symptom improvement in both treatment types (Cohen’s d: group = 0.88; individual = 1.15) (Study 2). Conclusion: The adapted Rothbaum protocol was effective for SPD remission, comorbidities, and skin lesions, both in individual and group formats. Clinical trial registration: NCT03182478

Objective: Anxiety and depression are prevalent among medical students. Brazilian medical students have higher levels of depression and lower quality of life than their U.S. counterparts, and no preventive intervention exists for this risk group in Brazil. The Unified Protocol for Transdiagnostic Treatment of Emotional Disorders (UP), a cognitive-behavioral treatment protocol for neuroticism, was recently adapted into a single-session, preventive intervention. This study tested the impact of this protocol on psychiatric symptoms and quality of life in Brazilian medical students. Methods: In this open trial, the intervention protocol was translated and adapted to Brazilian Portuguese. Medical students over 18 years of age without psychotic symptoms, severe depressive episodes, or acute psychiatric risk were included, undergoing a psychiatric clinical interview (Mini-International Neuropsychiatric Interview [MINI]) and evaluation at baseline and at 7 and 30 days after a single-session UP that included experimental avoidance, quality of life, self-esteem, empathy, and anxiety symptom scales. A new evaluation was performed 90 days after the intervention. Results: Sixty-two students participated. Ninety days after the intervention, there were significant reductions in the number of students who met the criteria for social anxiety disorder (p = 0.013) or panic disorder (p = 0.001). There were also significant improvements in depressive symptoms (Beck Depression Inventory, p < 0.001) and quality of life (Quality of Life Enjoyment and Satisfaction Questionnaire, p < 0.001). Conclusion: UP improved anxiety and depressive symptoms in medical students. The single-session group format could reduce costs and facilitate application. Future placebo-controlled studies are necessary to confirm these findings.

Abstract Background Skin picking disorder is a prevalent disorder frequently comorbid with depression and anxiety, which is underdiagnosed mainly by dermatologists. Assessment of skin picking disorder is based on instruments influenced by the awareness about skin picking disorder and comorbid symptoms. To date, there is no validated instrument for Brazilian individuals nor an instrument to evaluate the severity of skin lesions in an objective way. Objectives Validate the Skin Picking Impact Scale for Brazilian Portuguese and create a photographic measurement to assess skin lesions. Methods The sample was assessed through the Skin Picking Impact Scale translated into Brazilian Portuguese, the Hamilton Anxiety Scale, the Beck Depression Inventory, and the Clinical Global Impression Scale. The patients’ skin lesions were photographed. Photos were evaluated regarding active excoriation, crust/bleeding, exulceration, and linear lesions. Results There were 63 patients included. The Skin Picking Impact Scale translated into Brazilian Portuguese had good internal consistency (Cronbach's alpha = 0.88), which tests of goodness-of-fit, showing a suitable model. The reliability of photographic measurement was 0.66, with a high internal consistency (Cronbach's alpha = 0.87). Photographic measurement was not correlated with the Skin Picking Impact Scale, the Clinical Global Impression Scale, or comorbid symptoms. Study limitations Lack of a previously validated instrument to evaluate dermatillomania in the Brazilian population for comparison. Conclusion The Skin Picking Impact Scale validated in Brazilian Portuguese is a good instrument to evaluate skin picking disorder. Photographic measurement is a consistent way of assessing skin lesions, but it does not reflect the impact of skin picking disorder on the individual's life.

No presente estudo alguns conceitos antropológicos - ideia de vocabulário nativo, inteligibilidade e aproximação do outro - e sociológicos são acionados como estratégia para a ressignificação da aplicação de questionários, levando a considerá-la como instância de processos sociais complexos que produzem opinião. A análise das reações e atuações dos atores escolares no momento de aplicação dos questionários é considerada como uma possibilidade para a interpretação da diversidade de características materiais, das disposições e ações individuais, fundamentando a leitura dos dados quantitativos para além das explanações estatísticas. Durante a descrição deste tipo de atividade, pôde-se dimensionar a relação entre as exceções e a regularidade de comportamentos, ampliando o olhar para o futuro trabalho de observação do campo, para os mecanismos de identificação e interação com os pesquisadores e desta etapa como espaço para a reflexão de aspectos da experiência escolar. Recomenda-se, enquanto instrumento de ampliação para a abordagem quantitativa, que o conjunto de impressões sobre a aplicação de questionários na pesquisa educacional deva ser contabilizado na análise das frequências, compondo a interpretação dos resultados de pesquisa.

In this study, some anthropological concepts - the idea of native vocabulary, understanding and approach to the other - and sociological concepts are triggered as a strategy to reframe the application of questionnaires, considering it as an instance of complex social processes which generate opinion. The analysis of the reactions and actions of the school actors during the application of questionnaires is considered as a possibility for the interpretation of the diversity of characteristics of the materials, individual actions and dispositions, grounding the analysis of the quantitative data beyond the statistical explanations. During the description of this type of activity, it was possible to scale the relation between the exceptions and the behavior regularity, extending the look to the future work of field observation and the mechanisms for identification and interaction with the researchers, and to this step as a space for reflection on aspects of school experiences. As a tool in the expansion to the quantitative approach, it is recommended that the set of views on the use of questionnaires in educational research is accounted in the frequency analysis, being a part of the interpretation of the research results.

Nosso objetivo no presente trabalho foi ampliar a compreensão do processo de desenvolvimento e manutenção do habitus escolar que favorece o desempenho dos estudantes de ensino fundamental. Analisamos parte das respostas fornecidas por pais e alunos bem como as observações de campo obtidas durante a aplicação de um survey em um conjunto formado por dez escolas públicas municipais e privadas da cidade do Rio de Janeiro. As escolas incluídas na amostra pesquisada foram escolhidas com base nos resultados obtidos pelos alunos na Prova Brasil e no ENEM. Apresentamos os resultados da análise cruzada das rotinas e esforços familiares com as práticas institucionais que apontam para o reforço de disposições favoráveis ao sucesso escolar. Encontramos entre as famílias de camadas populares indícios de empenho relativamente maior no acompanhamento e apoio aos estudos, do que nas famílias dos alunos de nível sociocultural mais elevado. Este resultado levou-nos a procurar caracterizar as experiências estudantis e as diferentes formas de apoio familiar que respondem às demandas escolares. Encontramos ainda estilos de gestão institucional que, articulados a estilos de lidar com a escolaridade dos filhos por parte das famílias, indicam a presença de estratégias combinadas de produção de habitus escolares, oferecendo um panorama instigante para o debate sobre o efeito-escola em estabelecimentos de prestígio.

This paper aims to enlarge the knowledge about the development and maintenance of the students habitus that reinforce the good performance of elementary school students. We analysed some parents and students answers as well as some notes that we got during a survey developed in ten of the best public and private schools in Rio de Janeiro. The schools included in this research sample were choosen based on the students results in Prova Brasil and ENEM. This paper shows some results of a crossed analysis between the routines and family efforts and institutional practices that pointed to the reinforcement of the student habitus that supports their good performances in those schools. We find among popular families traces of a relatively stronger parent's engagement to accompany and support their children studies than among the families with higher social and cultural level. This result drove us to pursuit students experience and characteristics of family support that reinforce the student habitus as an answer of school requests. We also find different management styles articulated with family styles to deal with children scholarity indicating the presence of combined strategies to produce the student habitus, offering an instigate overview about family and school relationship in the production of schools quality.

Nuestro objetivo en el presente trabajo fue ampliar la comprensión del proceso de desarrollo y manutención del habitus escolar que favorece los ingresos de los estudiantes del enseño fundamental. Analizamos parte de las respuestas fornecidas por los padres y alumnos así como las observaciones de campo obtenidas en la aplicación de uno survey en un grupo de diez escuelas públicas munícipes y privadas del Rio de Janeiro/Brazil. El resultado de los alumnos en la Prueba Brasil y en el ENEM fueran la basis para sí incluir las escuelas en la muestra investigada. Presentamos los resultados del análisis cruzada de las rutinas y esfuerzos familiares con las prácticas institucionales que muestran el esfuerzo de disposiciones favorables para el éxito académico. Nosotros encontramos entre las familias de clase popular evidencias de un esfuerzo relativamente mayor en el acompañamiento y apoyo a los estudios, que en las familias de alumnos de nivel socio-cultural más elevado. Este resultado nos hice buscar caracterizar las experiencias estudiantiles y las diferentes formas de apoyo familiar que responden a las demandas académicas. También hemos encontrado estilos de gestión institucional que, articulados a estilos de tratar con la escolaridad de los hijos por parte de las familias, indican la presencia estratégica combinada de producción de habitus académicos, ofreciendo uno panorama excitante para el debate del efecto-escuela en estabelecimientos de prestigió.