Is dermatophagia a mental disorder

Draft Proposal for Dermatophagia Study

PSY625: Biological Bases of Behavior Dr. Roxanne Beharie September 11, 2017

Running Head: DRAFT PROPOSAL FOR DERMATOPHAGIA STUDY

They say the squeaky wheel gets the oil, but what about the other wheels are they not just as needed to function what if the squeaky wheel isn’t the only wheel that is broken. Many times when it comes to funding and research the attention goes to the trend or to the one affecting the purse strings interest the most. Dermatophagia is not a disorder that squeaks too loud but is nonetheless a disorder. Children and adults suffer from this disorder.

Specific Aims:
The first aim of this proposal is to conduct further research on the compulsive disorder Dermatophagia. Dermatophagia is not a wide known term when the public thinks of compulsive disorders. The more common known name as “wolf bitters” as stated on Skinpick.com (2014), although not known as a scholarly source websites like

this are easy targets to get information. By the name, it would be easy to imply the term is the coyote’s ugly cousin in reference to a limb being knawel off to escape. In this case, I proposed the gnawing is caused by stress. The neurological connection of how external stress triggers an individual to find comforting biting to the point of eating ones on flesh to the point of endangerment. Many of us bite our nails, we may even pick at hangnail caused by dry skin. Dermatophagia goes beyond these regularly observed behaviors.

The Specific study of this compulsive disorder is not limited in research. There are broader research works such as the exploration of dermatology practice and psychiatric disorders (Tareen, R. S., & Tareen, A. N. 2015). Because of the limits of specifically

Draft Proposal for Dermatophagia Study 10

PSY625: Biological Bases of Behavior Ashford University

historical and generalized research, we will look at who demographics as to what groups have a higher percentage rate to develop this disorder as well the median age rage. The research conclusion will show that the link between stress and biting can be mitigated or finding methods of treatment to help with the disorder.

The second Aim of this proposal is to find and substantiate if Dermatophagia a standalone disorder or is a comorbidity illness. Evidence and preliminary article research will support that Dermatophagia is a secondary result of other psychological disorders such as anxiety, depression, attention deficit disorder and many more. The study results will help to recognize the symptoms of the Dermatophagia and prevent doctors, psychologist, and hopefully the public from misdiagnosing or ignoring the symptoms because they are not intentional self-harm or suicidal triggers alone. This disorder can cause serious health issues with the skin because of the open or expose wounds brought on by the biting. There are extreme cases where the biting caused subjects to go the hospital for treatment.

The third and final Aim is to focus on whether Dermatophagia can fall into two categories. For example although the stress maybe a well know indicator of Dermatophagia and also is synonymous with Dermatillomania. Compare/Contrast study would validate the theory that skin biting can be both a compulsive disorder and classified as a body-focused disorder or BFRB. The study would also dispel urban myths or common in correct assertions.

The biggest barriers for all three of the Aims will be finding enough legitimate sources for Dermatophagia. There were more sources available for the BFRB term Dermatillomania. Maybe because of the association of disfiguring one’s own self instead

of with most compulsive disorders they are carried out due to outer interactions such as stress or a result of outer source interaction. The purpose of this proposal over all is to find out the and conclude the results of these three aims.

Background:
As the world gets smaller and we as humans better understand ourselves overall when it comes to psychology we are able to take broad categories of disorders and look at them more specifically. Breaking down these categories to in detail can help map out recognize when they are linked to a bigger problem or if they are an isolated situation.

Overall, in the medical industry many “new” diagnoses are made because a patient’s signs and symptoms did not fit into the proposed box that all other patients had in the past. Psychology has been around for centuries but compulsive disorders are somewhat new when it comes to the different categories. Dermatophagia is one such disorder. (Tomas-Aragones et al.; 2017) It is the eating ones on skin especially the hands and feet. It is not just your regular nail or hangnail biting.

Since 1952 there have only been seven updates to the diagnostic and statistical manual of mental disorders; which currently in its fifth edition. The last update was made in 2016. Categorizes Dermatophagia under Obsessive Compulsive Disorder and related Disorders. The diagnostic book helps to recognized symptoms in patients and diagnoses them with possible treatments to various disorders. Compulsive disorders are the 10th highest recognized disability in developed countries. There are seven categories falling under the “Other Specified Obsessive-Compulsive and Related disorder and Body Focused repetitive behaviors are third on the list. (Reichenberg, L. W.; 2013 pg. 44)

In fact, it falls under the umbrella of Impulsive Control Disorder. The signs and symptoms can start to reveal themselves early in a child’s life. For example those with the compulsive disorders cannot mentally control their processes. “Obsessive-compulsive behavior is highly distressing because it feels as if one’s behavior or thoughts are no longer voluntarily controlled.” (Baldridge & Piotrowski; 2017) Although, the average productive individual would be quick to own up to over thinking or having negative thoughts at times a person a person with an associated compulsive disorder would not be able to control thinking about the negative aspects. They would not be able to control one or more of their impulses. Depending the degree of the behavior this disorder could prove to be debilitating and cause other psychological issues to present themselves or it could be a result of other issues affecting the patient such as anxiety. The skin biting very well could be the unconscientiously coping mechanism the patient uses. There have been small studies here and there but each ones states the need for new studies and a well as a varied and wider pool of participants.

The significance of this proposal is to further understand and update the signs, causes, symptoms, and possible treatment. This proposal is just as important the world of psychology as the discovery of STD physical signs and symptoms by dermatologist.

There are two modes of science involved in the diagnosis and treatment of the Dermatophagia; of course dermatology and psychology. There are treatments established but they are not inclusive of all associated causes of the skin disorder. There is also the quest to help answer the debate of whether the skin biting can be categorized as a self-

mutilation or at least the possibility of distinguishing between the different disorders doctors and combine treatment options to help patients either live with or eliminate the disorder all together through behavior therapy, pharmaceutical, as well surgical.

Another reason for this study is to help the public recognize signs and symptoms of the behavior that causes the disorder. Mental health is becoming more of a health issue in need of a customized treatment for children adolescents and their families, in one review of children’s mental issues states the importance of providing standards of care for mental health issues. (Pyle, N., Jordan, J., & Saklofske, D. H. 2009) Educating young mothers of children who eat their hands and feet could help the overall family unit and prevent other psychological issues from developing. Not to mention the hope that as mental health becomes more widely recognized as a Health Issue insurance companies and medical industries will help cover some of the more expensive treatment options.

When a study has little to no research or historical significance, it is hard to justify treatment.

In conclusion, Dermatophagia is a disorder that has many what ifs and maybes associated with it. Is it an impulsive disorder, is self-mutilation, what some ways patients are dealing with it and how are dermatologist and psychologist collaborating on treatments. (Seyhan, M., Aki, T., Karincaoglu, Y., & Ozcan, H. 2006) Our study would continue to look at the emotional aspects of the disorder as well as the treatment. The previous methods of study involved patients that were hospitalized to in a Dermatology Clinic with morbidity to include suicide attempts. Our method would be a combined study of current patients and families members being counsel treated for the

dermatophagia disorder specifically and those who have overcome the disorder.

Proposed Study
Participants:

To optimize research data an even number 100 participants will be recruited. All participants’ diagnosis must meet the DSM-5 Changes: Obsessive Compulsive and Related Disorders criteria for dermatophagia. (Grohol, J.;2013) Forty participants will represent dermatologist initial diagnosed derma in current treatment. Forty participants will represent initial psychiatrist diagnosis of dermatophagia in current. Twenty participants will consist of diagnosed and completed treatment to the point of cured resulting in no signs or symptoms of disorder. The twenty participants will be broken into categories of treatment and support.

Assistants will inform participants research is not treat or cure their current condition but to record data of their condition as well provide them with assurance of how the data collected will only identify symptoms, treatments and any other non- personal identifying information. Adhering to ethics guidelines as addressed in the AERA Council Code of Ethics (2011). During the study, their information will be collected using a DD number or PD number and DC number. This will allow for group identification but not jeopardize participant’s privacy.

Methods:
The key to the study is to identify alternative symptoms (if any) the best treatments (clinical and psychological), social support and medical team based approach. The method used will resemble the same method used in Seyhan’s study of morbidity in dermatology patients (2006).

There will be in depth look at already recognized skin/dermatology disorders and the associated psychiatry associated with them to help identify any new or overlooked similarities. Much in the way that doctors R & A. Tareen conducted their research (2015). If new discovers are made they will documented as such but if the data supports previous research then it will be noted as such the third outlier may be that the research supports neither a need to further analyze dermatophagia as more of impulsive behavior instead of compulsive behavior.

Hypothesis/Conclusion:
As mental health starts to cross the lines of medical treatment, signs of social disorders and physically recognized behaviors, there must be a holistic approach to help patients find a cure and stay cured. The more methods of treatment, public education, and precise diagnosis the psychological and dermatological community has the easier it will be to identify give the public a much needed conversation this grants research results will open that dialogue.

Budget Justification:
In order to allow control in budgeting and provide oversight of all expenditures the research department is requesting for three lines of accounting. The First line of accounting at would be in the form of a credit card to be utilized for any expenditures over hundred dollars for any office supplies or equipment not including participant pay. The second line of accounting would be an account in which participants would receive direct deposits to their designated account of choice. Transportation Account with a debt

/ATM authorization of usage not to seventy-five dollar ATM withdrawals for gas and travel miscellaneous expenses. Anything transaction over seventy-five dollars will

require direct card to merchant transactions and copies of all receipts over twenty-five dollars.

Request funding for two half-time graduate research assistants oversee participant recruitment, interviews, and data collection. Additional funding of 10% is requested for the principal investigator who will direct the study and analyze collected data and publication of results.

Travel funding is requested for the principal investigator to attend two national meetings. The two meeting may be; one Annual dermatology Research Review and one Psychology Annual or specified national meeting or convention to present the preliminary results of the study on research. Additional travel expenses are requested to pay for costs of transportation of research assistants to participant’s home, families (if in 100 mile radius), and treatment facilities.

The proposed subject payment of $50 per participant (100 total) is requested to reimburse subjects for their participation time.

Research Supply funding is requested, 1 Touch screen Laptop computer; 2 Tablets w/video & audio Recoding capabilities; that will be used for data collection and analysis. Additional funding will be used to purchase the Quality of Life Scale and office supplies.

See Appendix A: Budget for detailed budget figures

Appendix A: Budget Worksheet

Principal Investigat

Grant Title:

Research for Distintion & treatment of Dermatophagia

Period of Performa

n February 2018 - July 2018

Funds Requested

Salaries

Full T ime Faculty Annual Salary

$ 70,000

10%

6

Percentage of effort

Number of months

Full T ime A/P (10% time 12 Mo)

$ 3,500

2 Full T ime Graduate Assistant Annual

$ 50,000

50%

6

Percentage of effort

Number of months

Graduate Assistant (50% time, 12 months)

$ 12,500

Total Salaries

$ 16,000

Equipmen

2 Tablets w/audio & video capability (see office

supplies)

$ -

Travel

T ravel for PI to one meeting to present results

$ 2,200

Research assistant travel to subjects homes &

treatment facilities

$ 2,000

Total Travel Costs

$ 4,200

Participants

number of subjects:

100

$50

payment per subject:

Total Participant Cost

$ 5,000

Supplies

Computer (1 Laptop/2 T ablets)

$ 3,500

$ 1,200

$ 900

Quality of Life Scale

Office supplies (postage, paper, etc)

Total Supplies

$ 5,600

Total Direct Costs

$ 30,800

37.5%

Indirect Costs*

11,550

Total Funds Requested

$ 42,350

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