Body-focused repetitive behavior
Editor-In-Chief: Prab R Tumpati, MD
Obesity, Sleep & Internal medicine
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| Body-focused repetitive behavior | |
|---|---|
| Synonyms | N/A | 
| Pronounce | N/A | 
| Specialty | N/A | 
| Symptoms | Compulsive hair pulling, skin picking, nail biting | 
| Complications | Skin infections, alopecia, scarring | 
| Onset | Typically in childhood or adolescence | 
| Duration | Chronic | 
| Types | N/A | 
| Causes | Genetic predisposition, stress, anxiety | 
| Risks | Family history, stressful life events | 
| Diagnosis | Clinical diagnosis | 
| Differential diagnosis | Obsessive-compulsive disorder, trichotillomania, dermatitis | 
| Prevention | N/A | 
| Treatment | Cognitive behavioral therapy, habit reversal training, medication | 
| Medication | Selective serotonin reuptake inhibitors | 
| Prognosis | N/A | 
| Frequency | Common | 
| Deaths | N/A | 
Body-focused repetitive behavior (BFRB) is a term that encompasses a group of impulse control disorders in which individuals compulsively damage their physical appearance or cause physical injury through repetitive behaviors. The most common forms of BFRBs include trichotillomania (hair pulling), excoriation disorder (skin picking), and onychophagia (nail biting). These behaviors are not typically performed with the intention of self-harm but are instead a maladaptive response to relieve stress or anxiety.
Causes and Risk Factors
The exact causes of BFRBs are not fully understood, but a combination of genetic, neurological, and environmental factors is believed to contribute. Individuals with a family history of BFRBs or other obsessive-compulsive spectrum disorders are at a higher risk. Stressful life events, anxiety, and depression can also trigger or exacerbate these behaviors.
Symptoms and Diagnosis
Symptoms of BFRBs include repetitive touching, rubbing, scratching, picking, or pulling at the hair, skin, or nails, often resulting in visible damage or distress. The behavior is usually performed unconsciously and can be difficult to stop. Diagnosis is typically based on clinical assessment and the exclusion of other conditions. The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes criteria for diagnosing some BFRBs, such as trichotillomania and excoriation disorder.
Treatment
Treatment for BFRBs may involve a combination of psychotherapy, medication, and self-help strategies. Cognitive-behavioral therapy (CBT), particularly habit reversal training (HRT), has been shown to be effective in reducing the frequency of BFRBs. Medications, such as selective serotonin reuptake inhibitors (SSRIs), may also be prescribed to help manage underlying anxiety or depression. Support groups and online resources can provide additional help and information.
Impact
BFRBs can significantly impact an individual's quality of life, leading to physical damage, emotional distress, and social withdrawal. The shame and embarrassment associated with the visible signs of BFRBs can exacerbate the condition, creating a cycle of anxiety and repetitive behavior.
See Also
External Links
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Contributors: Prab R. Tumpati, MD