Body-focused repetitive behavior

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Body-focused repetitive behavior
distal and proximal joints of the middle and little
fingers

Body-focused repetitive behavior (BFRB) is an umbrella name for

impulse-control[1] behaviors involving compulsively damaging one's physical appearance or causing physical injury.[2]

BFRB disorders are currently estimated to be under the obsessive–compulsive spectrum.[3] They are also associated with attention deficit hyperactivity disorder (ADHD) and anxiety.[citation needed]

Causes

The cause of BFRBs is unknown.[citation needed]

Emotional variables may have a differential impact on the expression of BFRBs.[4]

Research has suggested that the urge to repetitive self-injury is similar to a body-focused repetitive behavior but others have argued that for some the condition is more akin to a substance abuse disorder.[citation needed]

Researchers are investigating a possible genetic component.[1][5]

Onset

BFRBs most often begin in late childhood or in the early teens.[2]

Diagnosis

Types

The main BFRB disorders are:[3]

  • Skin
    • Dermatillomania
      (excoriation disorder), skin picking
    • Dermatophagia, skin nibbling
  • Mouth
    • Morsicatio buccarum, cheek biting
    • Morsicatio labiorum, inner lip biting
    • Morsicatio linguarum, tongue biting
  • Nails
  • Nose
    • Rhinotillexomania, nose picking[2]
  • Hair

Treatment

Psychotherapy

Treatment can include

behavior modification therapy, medication, and family therapy.[1][2] The evidence base criteria for BFRBs is strict and methodical.[9] Individual behavioral therapy has been shown as a "probably effective" evidence-based therapy to help with thumb sucking, and possibly nail biting.[9] Cognitive behavioral therapy was cited as experimental evidence based therapy to treat trichotillomania and nail biting;[9] a systematic review found best evidence for habit reversal training and decoupling.[10] Another form of treatment that focuses on mindfulness, stimuli and rewards has proven effective in some people. However, no treatment was deemed well-established to treat any form of BFRBs.[9]

Pharmacotherapy

N-acetylcysteine.[11]

Prevalence

BFRBs are among the most poorly understood, misdiagnosed, and undertreated groups of disorders.[12] BFRBs may affect at least 1 out of 20 people.[2] These collections of symptoms have been known for a number of years, but only recently have appeared in widespread medical literature. Trichotillomania alone is believed to affect 10 million people in the United States.[13]

See also

References

  1. ^ a b c "Scientific Advances in Trichotillomania and Related Body-Focused Repetitive Behaviors". National Institute of Mental Health. November 4, 2004. Archived from the original on July 21, 2011.
  2. ^ a b c d e "AAMFT Consumer Update - Hair Pulling, Skin Picking and Biting: Body-Focused Repetitive Disorders". American Association for Marriage and Family Therapy. Archived from the original on 2009-04-25.
  3. ^ a b "Trichotillomania (TTM) & Related Body-Focused Repetitive Behaviors (BFRBs)". The Center for Emotional Health of Greater Philadelphia. Archived from the original on 2011-12-29.
  4. S2CID 144926749
    .
  5. ^ ABC News 20/20 Hair Pulling, 2006
  6. PMID 19293016
    .
  7. PMID 15627101
    .
  8. ISSN 1610-0379
    .
  9. ^
    PMID 26167847
    .
  10. PMID 31105537
    .
  11. PMID 28183072
    .
  12. ^ Families & Health Archived March 28, 2009, at the Wayback Machine, American Association for Marriage and Family Therapy
  13. PMID 10779896
    .
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