body-focused repetitive behavior

The cause of BFRBs is unknown.{{cn|date=July 2021}}

Emotional variables may have a differential impact on the expression of BFRBs.{{cite journal | vauthors = Teng EJ, Woods DW, Marcks BA, Twohig MP |title=Body-Focused Repetitive Behaviors: The Proximal and Distal Effects of Affective Variables on Behavioral Expression |journal=Journal of Psychopathology and Behavioral Assessment |date=March 2004 |volume=26 |issue=1 |pages=55–64 |doi=10.1023/B:JOBA.0000007456.24198.e4 |s2cid=144926749 }}

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.{{cn|date=July 2021}}

Researchers are investigating a possible genetic component.ABC News 20/20 Hair Pulling, 2006

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

The main BFRB disorders are:{{cite web|url=http://www.thecenterforemotionalhealth.com/Trichotillomania_(TTM).html|title=Trichotillomania (TTM) & Related Body-Focused Repetitive Behaviors (BFRBs)|archive-url=https://web.archive.org/web/20111229195155/http://www.thecenterforemotionalhealth.com/Trichotillomania_(TTM).html|archive-date=2011-12-29|work=The Center for Emotional Health of Greater Philadelphia}}

• Skin
• Dermatillomania (excoriation disorder), skin picking
• Dermatophagia, skin nibbling
• Mouth
• Morsicatio buccarum, cheek biting
• Morsicatio labiorum, inner lip biting
• Morsicatio linguarum, tongue biting
• Nails
• Onychotillomania, nail picking
• Onychophagia, nail biting
• Nose
• Rhinotillexomania, nose picking
• Hair
• Trichotillomania, hair pulling
• Trichophagia, hair nibbling followed by consumption
• Trichodaganomania, hair biting{{Cite journal |last1=Jafferany |first1=Mohammad |last2=Feng |first2=Jing |last3=Hornung |first3=Robin L. |date=2009-04-01 |title=Trichodaganomania: The compulsive habit of biting one's own hair |url=https://www.jaad.org/article/S0190-9622(08)01011-6/abstract |journal=Journal of the American Academy of Dermatology |language=English |volume=60 |issue=4 |pages=689–691 |doi=10.1016/j.jaad.2008.07.055 |pmid=19293016 |issn=0190-9622}}
• Trichotemnomania, hair cutting{{Cite journal |last=Happle |first=Rudolf |date=January 2005 |title=Trichotemnomania: Obsessive-compulsive habit of cutting or shaving the hair |url=https://linkinghub.elsevier.com/retrieve/pii/S0190962204022388 |journal=Journal of the American Academy of Dermatology |language=en |volume=52 |issue=1 |pages=157–159 |doi=10.1016/j.jaad.2004.07.060|pmid=15627101 }}
• Trichoteiromania, hair rubbing{{Cite journal |last1=Reich |first1=Stefanie |last2=Trüeb |first2=Ralph M. |date=January 2003 |title=Trichoteiromanie: Trichoteiromania |url=https://onlinelibrary.wiley.com/doi/10.1046/j.1610-0387.2003.02012.x |journal=JDDG: Journal der Deutschen Dermatologischen Gesellschaft |language=en |volume=1 |issue=1 |pages=22–28 |doi=10.1046/j.1610-0387.2003.02012.x |issn=1610-0379}}

• Eyes
• Mucus fishing syndrome, removing or "fishing" strands of mucus from the eye

Treatment can include behavior modification therapy, medication, and family therapy. The evidence base criteria for BFRBs is strict and methodical.{{cite journal | vauthors = Woods DW, Houghton DC | title = Evidence-Based Psychosocial Treatments for Pediatric Body-Focused Repetitive Behavior Disorders | journal = Journal of Clinical Child and Adolescent Psychology | volume = 45 | issue = 3 | pages = 227–40 | date = 13 July 2015 | pmid = 26167847 | doi = 10.1080/15374416.2015.1055860 | doi-access = free }} Individual behavioral therapy has been shown as a "probably effective" evidence-based therapy to help with thumb sucking, and possibly nail biting. Cognitive behavioral therapy was cited as experimental evidence based therapy to treat trichotillomania and nail biting; a systematic review found best evidence for habit reversal training and decoupling.{{cite journal | vauthors = Lee MT, Mpavaenda DN, Fineberg NA | title = Habit Reversal Therapy in Obsessive Compulsive Related Disorders: A Systematic Review of the Evidence and CONSORT Evaluation of Randomized Controlled Trials | journal = Frontiers in Behavioral Neuroscience | volume = 13 | pages = 79 | date = 2019 | pmid = 31105537 | pmc = 6491945 | doi = 10.3389/fnbeh.2019.00079 | doi-access = free }} 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.

Excoriation disorder and trichotillomania have been treated with inositol and N-acetylcysteine.{{cite journal | vauthors = Torales J, Barrios I, Villalba J | title = Alternative Therapies for Excoriation (Skin Picking) Disorder: A Brief Update | journal = Advances in Mind-Body Medicine | volume = 31 | issue = 1 | pages = 10–13 | year = 2017 | pmid = 28183072 }}

Decoupling{{Cite journal |last1=Moritz |first1=Steffen |last2=Rufer |first2=Michael |date=2011 |title=Movement decoupling: A self-help intervention for the treatment of trichotillomania |journal=Journal of Behavior Therapy and Experimental Psychiatry |language=en |volume=42 |issue=1 |pages=74–80 |doi=10.1016/j.jbtep.2010.07.001 |pmid=20674888}} is a behavioral self-help intervention for body-focused repetitive behavior (BFRB). The user is instructed to modify the original dysfunctional behavioral path by performing a counter-movement shortly before completing the self-injurious behavior (e.g., biting nails, picking skin, pulling hair). This is intended to trigger an irritation, which enables the person to detect and stop the compulsive behavior at an early stage. A systematic review from 2012 suggested some efficacy of decoupling,{{Cite journal |last1=Sarris |first1=Jerome |last2=Camfield |first2=David |last3=Berk |first3=Michael |date=2012 |title=Complementary medicine, self-help, and lifestyle interventions for Obsessive Compulsive Disorder (OCD) and the OCD spectrum: A systematic review |journal=Journal of Affective Disorders |language=en |volume=138 |issue=3 |pages=213–221 |doi=10.1016/j.jad.2011.04.051 |pmid=21620478}} which was corroborated by another study in 2019.{{Cite journal |last1=Lee |first1=Melissa T. |last2=Mpavaenda |first2=Davis N. |last3=Fineberg |first3=Naomi A. |date=2019-04-24 |title=Habit Reversal Therapy in Obsessive Compulsive Related Disorders: A Systematic Review of the Evidence and CONSORT Evaluation of Randomized Controlled Trials |journal=Frontiers in Behavioral Neuroscience |volume=13 |pages=79 |doi=10.3389/fnbeh.2019.00079 |issn=1662-5153 |pmc=6491945 |pmid=31105537 |doi-access=free}} Decoupling was shown to be superior to habit reversal training in treating BFRB in one direct comparison study in 2021.{{Cite journal |last1=Moritz |first1=Steffen |last2=Penny |first2=Danielle N. |last3=Ahmed |first3=Kaser |last4=Schmotz |first4=Stella |date=2021-04-21 |title=A Head-to-Head Comparison of Three Self-Help Techniques to Reduce Body-Focused Repetitive Behaviors |journal=Behavior Modification |volume=46(4) |pages=894-912 |doi=10.1177/01454455211010707 |pmc=9158250 |pmid=33880943}}

BFRBs are among the most poorly understood, misdiagnosed, and undertreated groups of disorders.[http://www.aamft.org/families/index_nm.asp#Body-focused%20Repetitive%20Disorders Families & Health] {{webarchive |url=https://web.archive.org/web/20090328191832/http://www.aamft.org/families/index_nm.asp#Body-focused%20Repetitive%20Disorders |date=March 28, 2009 }}, American Association for Marriage and Family Therapy BFRBs may affect at least 1 out of 20 people. 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.{{cite journal | vauthors = Diefenbach GJ, Reitman D, Williamson DA | title = Trichotillomania: a challenge to research and practice | journal = Clinical Psychology Review | volume = 20 | issue = 3 | pages = 289–309 | date = April 2000 | pmid = 10779896 | doi = 10.1016/S0272-7358(98)00083-X }}

• Stereotypic movement disorder
• Rhythmic movement disorder
• Body dysmorphic disorder
• Habit reversal training
• Decoupling for body-focused repetitive behaviors

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Category:Conditions of the skin appendages

Category:Neurocutaneous conditions

Category:Self-harm