Skin picking disorder and trichotillomania, also characterized as body-focused repetitive behaviors (BFRBs), often lead to functional impairment. Some people with BFRBs, however, report little if any psychosocial dysfunction. There has been limited research as to which clinical aspects of BFRBs are associated with varying degrees of functional impairment.

Adults (n = 98), ages 18 to 65 with a current diagnosis of trichotillomania (n = 37), skin picking disorder (n = 32), trichotillomania plus skin picking disorder (n = 10), and controls (n = 19) were enrolled. Partial least squares regression (PLS) was used to identify variables associated with impairment on the Sheehan Disability Scale.

PLS identified an optimal model accounting for 45.8% of variation in disability. Disability was significantly related to (in order of descending coefficient size): severity of picking, perceived stress, comorbid disorders (specifically, anxiety disorders / obsessive–compulsive disorder), trait impulsivity, family history of alcohol use disorder, atypical pulling/picking sites, and older age.

At present mental disorders are viewed as unitary entities; however, the extent of impairment varies markedly across patients with BFRBs. These data suggest that whereas symptom nature/severity is important in determining impairment, so too are other variables commonly unmeasured in clinical practice. Outcomes for patients may thus be maximized by rigorously addressing comorbid disorders; as well as integrating components designed to enhance top-down control and stress management. Interestingly, focused picking and emotional pulling were linked to worse disability, hinting at some differences between the two types of BFRBs, in terms of determinants of impairment.

皮肤采摘障碍和拔毛癖，也被称为以身体为中心的重复行为 (BFRB)，通常会导致功能障碍。然而，一些患有 BFRB 的人几乎没有心理社会功能障碍。关于 BFRB 的哪些临床方面与不同程度的功能障碍相关的研究有限。

成年人 (n = 98)、年龄在 18 至 65 岁之间且目前诊断为拔毛癖 (n = 37)、拔毛症 (n = 32)、拔毛症加拔毛症 (n = 10) 和对照组 (n = 19)被录取了。偏最小二乘回归 (PLS) 用于识别与 Sheehan 残疾量表上的损伤相关的变量。

PLS 确定了一个最优模型，该模型占残疾变异的 45.8%。残疾与以下因素显着相关（按系数大小降序排列）：采摘的严重程度、感知到的压力、合并症（特别是焦虑症/强迫症）、特质冲动、酒精使用障碍的家族史、不典型的拉扯/采摘部位, 年龄较大。

目前，精神障碍被视为单一的实体；然而，BFRBs 患者的损伤程度明显不同。这些数据表明，虽然症状性质/严重程度对于确定损伤很重要，但在临床实践中通常未测量的其他变量也很重要。因此，可以通过严格解决合并症来最大限度地提高患者的预后；以及集成旨在增强自上而下控制和压力管理的组件。有趣的是，集中采摘和情绪拉动与更严重的残疾有关，暗示两种类型的 BFRB 在损伤决定因素方面存在一些差异。