Skin Picking Behavior Questionnaire
Please complete this questionnaire to help assess your skin picking behaviors, triggers, and their impact on your daily life.
Full Name
*
First Name
Last Name
Age
*
Gender
*
Female
Male
Non-binary
Prefer not to say
Other
How often do you engage in skin picking behaviors?
*
Several times a day
Once a day
A few times a week
Once a week
Less than once a week
At what age did you first notice your skin picking behavior?
Which areas of your body do you pick most frequently? (Select all that apply)
*
Face
Arms
Hands
Legs
Scalp
Other
Please rate the following statements about your skin picking behavior:
*
Rows
Never
Rarely
Sometimes
Often
Always
I feel urge to pick my skin when stressed
1
2
3
4
5
I pick my skin unconsciously
6
7
8
9
10
I try to stop but find it difficult
11
12
13
14
15
Skin picking causes noticeable marks or wounds
16
17
18
19
20
I feel relief or satisfaction after picking
21
22
23
24
25
What triggers your skin picking behavior? (Select all that apply)
*
Stress or anxiety
Boredom
Feeling or seeing imperfections
Habit
Other
How much distress or impairment does your skin picking cause in your daily life?
*
None
0
1
2
3
4
5
6
7
8
9
Severe
10
0 is None, 10 is Severe
Have you ever sought help or treatment for your skin picking behavior?
Yes, from a mental health professional
Yes, from a medical doctor
No, never sought help
Please describe any coping strategies you use to manage your skin picking behavior.
Is there anything else you would like to share about your experience with skin picking?
Submit Questionnaire
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