# Associations with Methylphenidate Treatment in Emotion Regulation and Skin-Picking Severity in Adolescents with Attention-Deficit/Hyperactivity Disorder: A Clinical Follow-Up Study

## TL;DR

Methylphenidate treatment improved emotion regulation and reduced skin-picking severity in teens with ADHD and skin-picking disorder.

## Contribution

Shows methylphenidate's potential to reduce skin-picking severity through improved emotion regulation in adolescents with ADHD.

## Key findings

- Methylphenidate significantly reduced emotion regulation difficulties and skin-picking severity.
- Improvements in emotion regulation were moderately correlated with reductions in skin-picking severity.
- Changes in emotion regulation explained about 31% of the variance in skin-picking severity.

## Abstract

Objective: To evaluate changes in emotion regulation, skin-picking disorder (SPD) severity, and repetitive thoughts and behaviors in adolescents with attention-deficit/hyperactivity disorder (ADHD) and comorbid SPD during methylphenidate treatment, and to examine the association between emotion regulation and SPD severity. Materials and Methods: This naturalistic follow-up study included 26 adolescents aged 11–17 years with ADHD and comorbid SPD. Participants received methylphenidate and were reassessed after three months. Emotion regulation, SPD severity, and repetitive thoughts and behaviors were assessed at baseline and follow-up using the Difficulties in Emotion Regulation Scale (DERS), Skin Picking Scale–Revised (SPS-R), and Repetitive Thoughts and Behaviors Scale–Child Form (RTBS-CF). Pre–post differences were analyzed using paired-sample tests, and associations were examined using correlation and linear regression analyses. Results: Significant reductions were observed in total DERS scores (p < 0.001, Cohen’s d = 1.35) and all subscales except non-acceptance (p = 0.686, Cohen’s d = 0.08). SPS-R and RTBS-CF scores decreased significantly (both p < 0.001, Cohen’s d = 1.79 and 0.91, respectively). Changes in DERS scores were moderately correlated with changes in SPS-R scores (r = 0.554, p = 0.003). Changes in emotion regulation were significantly associated with changes in SPD severity, accounting for approximately 31% of the variance in this sample. Conclusions: Methylphenidate treatment was associated with significant improvements in emotion regulation and concurrent reductions in skin-picking severity in adolescents with ADHD and comorbid SPD. Given the single-arm, pre–post naturalistic design, these findings should be interpreted as associative and exploratory rather than causal.