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Quizzes > Health & Medicine > Psychology & Mental Health

How Well Do You Know Scalp Picking Disorder? Take the Quiz!

Ready for the Scalp Picking Disorder Quiz? Identify key symptoms and test your knowledge.

Difficulty: Moderate
2-5mins
Learning OutcomesCheat Sheet
Paper art style head with hands picking scalp next to bold quiz text on golden yellow background

Use this scalp picking disorder quiz to see how well you can spot key symptoms and causes, then notice any gaps in what you know. You'll get quick questions, clear answers, and a score you can learn from; for a broader view of skin issues, try our skin diseases quiz.

In the DSM-5, scalp picking disorder is classified under which category?
Obsessive-Compulsive and Related Disorders
Mood Disorders
Neurodevelopmental Disorders
Anxiety Disorders
Excoriation (skin-picking) disorder, including scalp picking, is listed under Obsessive-Compulsive and Related Disorders in the DSM-5 because it shares features of repetitive behaviors and difficulty controlling urges. The classification groups conditions characterized by compulsivity and ritualistic behaviors. This placement aids clinicians in selecting evidence-based treatments common to related disorders.
What is the clinical term for chronic skin picking, which includes scalp picking?
Dermatophagia
Onychophagia
Trichotillomania
Excoriation Disorder
Chronic skin picking is clinically referred to as Excoriation (Skin-Picking) Disorder, characterized by recurrent picking leading to lesions and distress. Trichotillomania involves hair pulling rather than picking skin. Dermatophagia is nail biting down to the nail bed.
Which of the following is a primary symptom of scalp picking disorder?
Involuntary hair plucking
Compulsive bruxism
Excessive hair washing
Recurrent skin picking causing visible lesions
The hallmark of excoriation disorder is recurrent skin picking resulting in lesions, such as on the scalp. Involuntary hair plucking describes trichotillomania. Excessive hair washing is not a diagnostic criterion for skin-picking. Bruxism refers to teeth grinding.
At what age does scalp picking disorder most commonly onset?
After age 60
Late adulthood
Adolescence
Early childhood
Excoriation disorder typically begins during adolescence, coinciding with stress and hormonal changes. Early childhood onset is rare, and first presentation in late adulthood is uncommon. Recognizing early signs in teens can lead to prompt intervention.
Which of the following is NOT a common physical consequence of scalp picking?
Increased bone density
Secondary skin infections
Scarring and pigmentation changes
Permanent hair loss in the picked area
Increased bone density is unrelated to skin-picking behaviors. Secondary infections, scarring, pigmentation changes, and hair loss can all result from repetitive scalp picking. Treatment aims to minimize these physical outcomes.
Which gender is scalp picking disorder more commonly diagnosed in?
Male
Predominantly non-binary
Equal in both genders
Female
Research shows that excoriation disorder is diagnosed more frequently in females than males. The gender difference may relate to help-seeking behaviors or biological factors. Nonetheless, males are also affected.
Which of these is a common emotional trigger for scalp picking episodes?
Excessive happiness
Stress and anxiety
Neutral mood states
Boredom with no emotional distress
Stress and anxiety are widely recognized triggers for scalp picking, as individuals may use the behavior to cope with negative emotions. Some may pick during boredom, but emotional distress is the primary precipitant. Positive moods are less commonly linked to onset.
Which professional specialty is most likely to diagnose scalp picking disorder?
Psychiatrist
Cardiologist
Gastroenterologist
Orthopedic Surgeon
Psychiatrists and other mental health professionals diagnose excoriation disorder by assessing behavioral patterns and DSM-5 criteria. Medical specialists like cardiologists or orthopedic surgeons are not trained to diagnose psychiatric conditions.
According to DSM-5 criteria, which feature must be present for an excoriation disorder diagnosis?
Significant distress or impairment in functioning
Exclusive hair pulling
Onset after age 50
Presence of delusions
One DSM-5 criterion is that the skin-picking causes clinically significant distress or impairment in social, occupational, or other areas of functioning. Age or delusions are not required criteria. Hair pulling alone describes trichotillomania.
Which assessment tool is specifically designed to measure the severity of skin-picking behaviors?
Skin Picking Scale-Revised (SPS-R)
Yale-Brown Obsessive Compulsive Scale
Hamilton Anxiety Rating Scale
Beck Depression Inventory
The Skin Picking Scale-Revised (SPS-R) is a validated self-report measure assessing frequency, intensity, and control over skin-picking behaviors. Other scales measure depression, OCD, or anxiety rather than picking.
Which comorbid condition is most frequently reported alongside scalp picking disorder?
Bipolar I Disorder
Schizophrenia
Autism Spectrum Disorder
Obsessive-Compulsive Disorder
Obsessive-Compulsive Disorder is a common comorbidity in individuals with excoriation disorder, reflecting shared features of compulsivity. While other psychiatric disorders can co-occur, OCD has the strongest association.
Neurologically, scalp picking behavior has been linked to dysfunction in which brain area?
Medulla oblongata
Prefrontal cortex
Cerebellum
Occipital lobe
Dysfunction in the prefrontal cortex, which is key for impulse control and decision making, has been implicated in body-focused repetitive behaviors such as scalp picking. The cerebellum and medulla are less involved in compulsive urges.
Which behavioral intervention is considered first-line therapy for scalp picking disorder?
Deep Brain Stimulation
Habit Reversal Training
Exposure and Response Prevention
Electroconvulsive Therapy
Habit Reversal Training, part of Cognitive Behavioral Therapy, is the first-line behavioral treatment for excoriation disorder due to robust evidence supporting its efficacy. ERP is used primarily in OCD, and the other interventions are not standard.
Which pharmacological agent has evidence supporting its use in scalp picking disorder?
Antipsychotics alone
Benzodiazepines as monotherapy
Beta blockers
Selective Serotonin Reuptake Inhibitors (SSRIs)
SSRIs like fluoxetine have shown modest efficacy in reducing skin-picking behaviors, likely by modulating serotonin pathways. Beta blockers and benzodiazepines address anxiety but are not primary treatments. Antipsychotics may augment but are not first-line alone.
What is a key differential diagnosis to rule out when assessing scalp picking disorder?
Psoriasis
Tinea capitis
Trichotillomania
Eczema
Trichotillomania involves hair pulling rather than skin picking and must be distinguished from excoriation disorder. Eczema, psoriasis, and tinea capitis are dermatological conditions that may cause scratching but are not psychiatric disorders.
Which neural circuit abnormality has been implicated in scalp picking disorder?
Spinothalamic tract lesion
Dorsal visual stream disruption
Cortico-striato-thalamo-cortical (CSTC) loop dysfunction
Auditory pathway hyperactivity
Dysfunction in the CSTC circuitry, which modulates habit formation and inhibition, has been linked to body-focused repetitive behaviors like scalp picking. The other pathways are unrelated to compulsive rituals. CSTC Dysfunction Study
N-Acetylcysteine (NAC) may reduce scalp picking by modulating which neurotransmitter system?
Cholinergic
Glutamatergic
Dopaminergic
GABAergic
NAC is thought to restore extracellular glutamate homeostasis in the nucleus accumbens, reducing compulsive behaviors. While dopamine and GABA play roles in reward and inhibition, NAC's primary action is on glutamate.
Body-Focused Repetitive Behaviors (BFRBs) include scalp picking and are categorized under which term?
Body-Focused Repetitive Behaviors
Factitious Disorders
Somatic Symptom and Related Disorders
Habit and Impulse Control Disorders
BFRBs are recognized as a group including skin picking, nail biting, and hair pulling. They are distinct from somatic symptom or factitious disorders because they are driven by compulsive urges rather than concerns about physical illness.
Which subtype of skin-picking is characterized by low awareness during the behavior?
Intentional picking
Automatic picking
Focused picking
Reactive picking
Automatic picking occurs without full awareness, often while distracted or performing another task. Focused picking is deliberate and in response to an urge. The other terms are not standard DSM-5 subtypes.
A first-degree relative with which disorder increases genetic risk for scalp picking?
Schizophrenia
Major Depressive Disorder
Obsessive-Compulsive Disorder
Attention-Deficit/Hyperactivity Disorder
Family studies show a higher prevalence of OCD among first-degree relatives of individuals with excoriation disorder, indicating shared genetic vulnerabilities. While depression can co-occur, the familial link is strongest with OCD.
Elevated levels of which hormone have been correlated with increased scalp picking episodes?
Insulin
Testosterone
Cortisol
Thyroxine
Higher cortisol, the stress hormone, has been associated with more frequent and severe picking episodes, reflecting the role of stress response systems. The other hormones have not shown consistent links.
Meta-analytic evidence suggests the effect size of SSRIs in treating excoriation disorder is:
Very large
Small to moderate
Uniformly high across all patients
Negligible
Meta-analyses indicate SSRIs yield small to moderate reductions in skin-picking behaviors, with variable response rates. They are not uniformly effective, nor is their impact negligible.
Which neuromodulation technique has shown preliminary promise in refractory scalp picking disorder?
Deep Brain Stimulation (DBS)
Repetitive Transcranial Magnetic Stimulation (rTMS)
Vagus Nerve Stimulation
Electroconvulsive Therapy (ECT)
rTMS targeting prefrontal regions has shown early positive results in reducing compulsive skin-picking urges in small trials. DBS and ECT are more invasive and have less evidence. VNS is not used for this condition.
Which genetic polymorphism has been associated with increased risk of excoriation disorder?
DRD4 7-repeat allele
BDNF Val66Met variant
5-HTTLPR short allele
COMT Val158Met variant
Research suggests the short allele of the serotonin transporter gene promoter (5-HTTLPR) is linked to higher risk of body-focused repetitive behaviors, including skin picking. Other polymorphisms have weaker or inconsistent associations.
Acceptance and Commitment Therapy (ACT) differs from Habit Reversal Training by:
Focusing on accepting urges rather than directly altering behaviors
Emphasizing pharmacological management
Primarily using exposure exercises
Removing all environmental triggers
ACT encourages patients to observe and accept urges without acting on them, rather than teaching competing responses like HRT. Exposure exercises and medication are not central to ACT's core process.
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Study Outcomes

  1. Understand Key Symptoms -

    Recognize the most common scalp picking disorder symptoms to distinguish them from typical grooming behaviors.

  2. Identify Triggers and Causes -

    Learn about the psychological and environmental factors that contribute to compulsive scalp picking and how they manifest.

  3. Differentiate Related Behaviors -

    Compare scalp picking disorder to other skin-picking conditions to improve diagnostic accuracy and awareness.

  4. Evaluate Severity Through Quiz -

    Use your quiz results to gauge the extent of your scalp picking habits and pinpoint areas needing attention.

  5. Apply Management Strategies -

    Discover practical tips and coping techniques for reducing compulsive scalp picking and promoting healthier habits.

Cheat Sheet

  1. DSM-5 Diagnosis Criteria -

    According to the American Psychiatric Association, scalp picking disorder falls under Excoriation (Skin-Picking) Disorder (APA, 2013). Key criteria include recurrent picking causing skin lesions, failed attempts to stop, and significant distress or impairment. Use the "3 R's" mnemonic - Recurrent picking, Resistance attempts, and Resulting impairment - to recall core criteria quickly.

  2. Identifying Core Symptoms -

    Common scalp picking disorder symptoms include persistent urges to pick at scabs or healthy skin, feelings of tension before picking, and relief afterward (Mayo Clinic, 2021). Triggers often involve stress, boredom, or textured surfaces like hair tangles. Track episodes in a journal - date, mood, and trigger - to spot patterns and reduce symptom spikes.

  3. Understanding Underlying Causes -

    Research from the National Institute of Mental Health suggests genetic factors, neurotransmitter imbalances, and anxiety contribute to compulsive scalp picking. Cognitive-behavioral models highlight how negative thoughts like "I must clear every bump" fuel the behavior (Exner, 2017). A handy memory phrase is G.A.N.: Genetics, Anxiety, Neurochemistry, to recall the main biological and psychological drivers.

  4. Utilizing Self-Assessment Tools -

    Validated scalp picking disorder quizzes like the Massachusetts General Hospital Hair Pulling Scale (MGH-HPS) can double as a quick scalp picking disorder test. Items rate urge intensity, control attempts, and time spent picking on a 0 - 4 scale, offering a baseline score for progress tracking. Taking a brief quiz every week makes it easy to monitor improvements and tailor your coping plan.

  5. Effective Behavioral Interventions -

    Habit Reversal Training (HRT) and Cognitive Behavioral Therapy (CBT) are first-line treatments proven to reduce compulsive scalp picking (Stein et al., 2019). A simple ABC mnemonic - Awareness of urge, Behavior substitution (e.g., scalp massage), and Change reinforcement (self-praise) - guides practice. Pair these skills with mindfulness exercises to boost self-control and confidence.

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