Body-focused repetitive behavior disorder

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Understanding Body-Focused Repetitive Behavior Disorder

Body-focused repetitive behavior disorder (BFRB) refers to a range of compulsive actions that involve damaging one’s body, often resulting in physical harm or changes to appearance. These behaviors can range from skin picking to hair pulling, and they fall under impulse-control disorders.

BFRBs are classified within the obsessive-compulsive spectrum of disorders. They are often associated with other conditions such as anxiety and attention deficit hyperactivity disorder (ADHD).

What Causes BFRBs?

The exact reasons behind BFRBs remain unclear. However, emotional factors seem to play a significant role in their expression. Studies suggest that the desire to engage in these repetitive behaviors may be linked to stress or emotional distress. Some researchers even compare the urge to self-harm to substance abuse disorders, indicating a complex relationship between emotions and these behaviors.

Ongoing research is exploring whether genetics might contribute to the likelihood of developing BFRBs.

When Do BFRBs Typically Start?

BFRBs usually begin in late childhood or early adolescence, making these critical periods for early detection and intervention.

Identifying BFRBs

Diagnosing BFRBs involves recognizing specific types of behaviors, which include:

• Skin-related:
  • Dermatillomania: compulsive skin picking
  • Dermatophagia: biting or consuming skin
• Mouth-related:
  • Morsicatio buccarum: cheek biting
  • Morsicatio labiorum: inner lip biting
  • Morsicatio linguarum: tongue biting
• Nail-related:
  • Onychotillomania: nail picking
  • Onychophagia: nail biting
• Nose-related:
  • Rhinotillexomania: nose picking
• Hair-related:
  • Trichotillomania: hair pulling
  • Trichophagia: biting and eating hair
  • Trichodaganomania: hair biting
  • Trichotemnomania: cutting hair
  • Trichoteiromania: rubbing hair
• Eye-related:
  • Mucus fishing syndrome: removing mucus from the eye

Treatment Options for BFRBs

Psychotherapy Approaches

Treatment for BFRBs may include various therapeutic methods such as behavior modification therapy, medication, and family therapy. Evidence suggests that individual therapy can be effective for some behaviors like thumb sucking and possibly nail biting. Cognitive behavioral therapy (CBT) has been recognized as a promising option for conditions like trichotillomania and nail biting.

A specialized approach called habit reversal training has shown effectiveness in treatment. Another method focuses on mindfulness and rewards, which has been beneficial for certain individuals. However, no treatment has yet been universally established as the definitive solution for all forms of BFRBs.

Pharmacological Treatments

BFRB conditions like excoriation disorder and trichotillomania have been treated using medications such as inositol and N-acetylcysteine, although responses can vary among individuals.

The Decoupling Technique

Decoupling is a self-help strategy designed to help manage BFRBs. This technique encourages individuals to perform a counter-movement right before engaging in harmful behavior,like lifting their hand away from their nails when they feel the urge to bite. This method aims to help individuals recognize and halt compulsive actions before they escalate. Research suggests decoupling may be more effective than habit reversal training for some patients.

The Prevalence of BFRBs

BFRBs are often misunderstood, misdiagnosed, and inadequately treated. It is estimated that at least 1 in 20 people may experience symptoms of BFRBs. Trichotillomania alone affects approximately 10 million individuals in the United States.

Conclusion

BFRB disorders encompass a variety of compulsive behaviors focused on the body, leading to self-harm and emotional distress. Understanding these disorders is essential for better diagnosis and effective treatment, allowing individuals struggling with them a path toward recovery.

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Sources

• https://en.wikipedia.org/wiki/Body-focused_repetitive_behavior

Image credit: Wikipedia / Wikimedia Commons

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