(PS2-75) Family Functioning and Parenting Responses in Relation to Adolescents with Skin Picking Disorder

Skin picking (SP) is a common Body Focused Repetitive Behavior (BFRB) in which individuals pick at their skin resulting in injury to healthy skin areas. Skin-picking in children and teens is understood to be associated with certain affective states (i.e., bored, anxious, tired, etc.), and often serves a self-soothing function, but also can contribute to impairment at the individual and family-level. However, little is known about family functioning in adolescents who skin-pick, particularly what contributes to positive and negative outcomes. A qualitative design is best suited to understand the unique perspectives of both children and their parents currently experiencing skin picking disorder. This qualitative study is guided by the following aims to: 1) explore family functioning in families with an adolescent who engages in SP, 2) identify parent responses to the SP behavior, and 3) explore the child’s feelings about parent responses to their SP. Responses will also increase understanding of how SP develops in children and how the symptoms fluctuate over time.  Using a consensual qualitative research (CQR) design, 5 dyads of adolescent girls (ages 14-17) and their mothers were interviewed separately about their experiences with skin picking disorder. Analysis is ongoing, but preliminary findings by the coding team have identified domains related to: 1) parent intervention and involvement with child’s SP, 2) knowledge or perception of SP, 3) acceptance and understanding of SP, 4) child resilience factors and coping mechanisms related to SP, 5) negative feelings towards SP, 6) triggers for SP, 7) comorbidities related to SP, 8) characteristics of child not related to SP, 9) description of child’s life not related to SP, 10) relationship dynamics and SP, 11) concern over SP consequences, 12) role of SP in child’s life, 13) current SP presentation, and 14) SP progression and treatment. Illustrative of the following domains are quotes from parents and children such as: “I think my biggest impact today is to not pass judgment, to have empathy, and to love her.” “She’s trying to learn the tools, but her continual thing is like ‘Mom it’s not working.’” “My mom used to make me cover up…made me feel really insecure, and I was like oh god, this situation’s bad, I need to stop, but I can’t." As analysis continues, domains may shift until consensus is reached across all interviews. Further analyses will reveal themes that are central to all participants and apply across parent-child relationships versus which are unique to the child or parent experience. Insight into how SP impacts children and their families could have great clinical utility for the development of improved treatment options. Final results will be presented.