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Habit Reversal Training
Habit reversal training (HRT) is a "multicomponent behavioral treatment package originally developed to address a wide variety of repetitive behavior disorders". Behavioral disorders treated with HRT include tics, trichotillomania, nail biting, thumb sucking, skin picking, temporomandibular disorder (TMJ), lip-cheek biting and stuttering. As reported in It consists of five components: awareness training, competing response training, contingency management, relaxation training, and generalization training. Research on the efficacy of HRT for behavioral disorders have produced consistent, large effect sizes (approximately 0.80 across the disorders). It has met the standard of a well-established treatment for stuttering, thumb sucking, nail biting, and TMJ disorders. According to a meta-analysis from 2012, decoupling, a self-help variant of HRT, also shows efficacy. For tic disorders In the case of tics, these components are intended to increase tic awareness, develop a competi ...
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Trichotillomania
Trichotillomania (TTM), also known as hair-pulling disorder or compulsive hair pulling, is a mental disorder characterized by a long-term urge that results in the pulling out of one's own hair. A brief positive feeling may occur as hair is removed. Efforts to stop pulling hair typically fail. Hair removal may occur anywhere; however, the head and around the eyes are most common. The hair pulling is to such a degree that it results in distress and hair loss can be seen. The disorder may run in families. It occurs more commonly in those with obsessive compulsive disorder. Episodes of pulling may be triggered by anxiety. People usually acknowledge that they pull their hair, and broken hairs may be seen on examination. Other conditions that may present similarly include body dysmorphic disorder; however, in that condition people remove hair to try to improve what they see as a problem in how they look. Treatment is typically with cognitive behavioral therapy. The medication clom ...
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Nail Biting
Nail biting, also known as onychophagy or onychophagia (or even erroneously onyhophagia), is an oral compulsive habit of biting one's fingernails. It is sometimes described as a parafunctional activity, the common use of the mouth for an activity other than speaking, eating, or drinking. Nail biting is very common, especially amongst children. 25–30 percent of children bite nails. More pathological forms of nails biting are considered an impulse control disorder in the DSM-IV-R and are classified under obsessive-compulsive and related disorders in the DSM-5. The ICD-10 classifies the practice as "other specified behavioral and emotional disorders with onset usually occurring in childhood and adolescence". However, not all nail biting is pathological, and the difference between harmful obsession and normal behavior is not always clear. The earliest reference to nail biting as a symptom of anxiety was in late sixteenth century in France. Signs and symptoms Nail biting usually ...
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Thumb Sucking
Thumb sucking is a behavior found in humans, chimpanzees, captive ring-tailed lemurs, and other primates.Benjamin, Lorna S.: "The Beginning of Thumbsucking." ''Child Development'', Vol. 38, No. 4 (Dec., 1967), pp. 1065–1078. It usually involves placing the thumb into the mouth and rhythmically repeating sucking contact for a prolonged duration. It can also be accomplished with any organ within reach (such as other fingers and toes) and is considered to be soothing and therapeutic for the person. As a child develops the habit, it will usually develop a "favorite" finger to suck on. At birth, a baby will reflexively suck any object placed in its mouth; this is the sucking reflex responsible for breastfeeding. From the very first time they engage in nutritive feeding, infants learn that the habit can not only provide valuable nourishment, but also a great deal of pleasure, comfort, and warmth. Whether from a mother, bottle, or pacifier, this behavior, over time, begins to become a ...
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Temporomandibular Disorder
Temporomandibular joint dysfunction (TMD, TMJD) is an umbrella term covering pain and dysfunction of the muscles of mastication (the muscles that move the jaw) and the temporomandibular joints (the joints which connect the mandible to the skull). The most important feature is pain, followed by restricted mandibular movement, and noises from the temporomandibular joints (TMJ) during jaw movement. Although TMD is not life-threatening, it can be detrimental to quality of life; this is because the symptoms can become chronic and difficult to manage. In this article, the term ''temporomandibular disorder'' is taken to mean any disorder that affects the temporomandibular joint, and ''temporomandibular joint dysfunction'' (here also abbreviated to TMD) is taken to mean symptomatic (e.g. pain, limitation of movement, clicking) dysfunction of the temporomandibular joint. However, there is no single, globally accepted term or definition concerning this topic. TMDs have a range of cause ...
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Morsicatio Buccarum
Morsicatio buccarum is a condition characterized by chronic irritation or injury to the buccal mucosa (the lining of the inside of the cheek within the mouth), caused by repetitive chewing, biting or nibbling. Signs and symptoms The lesions are located on the mucosa, usually bilaterally in the central part of the anterior buccal mucosa and along the level of the occlusal plane (the level at which the upper and lower teeth meet). Sometimes the tongue or the labial mucosa (the inside lining of the lips) is affected by a similarly produced lesion, termed morsicatio linguarum and morsicatio labiorum respectively. There may be a coexistent linea alba, which corresponds to the occlusal plane, or crenated tongue. The lesions are white with thickening and shredding of mucosa commonly combined with intervening zones of erythema (redness) or ulceration. The surface is irregular, and people may occasionally have loose sections of mucosa that comes away. Causes The cause is chronic parafunc ...
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Stuttering
Stuttering, also known as stammering, is a speech disorder in which the flow of speech is disrupted by involuntary repetitions and prolongations of sounds, syllables, words, or phrases as well as involuntary silent pauses or blocks in which the person who stutters is unable to produce sounds. The term ''stuttering'' is most commonly associated with involuntary sound repetition, but it also encompasses the abnormal hesitation or pausing before speech, referred to by people who stutter as ''blocks'', and the prolongation of certain sounds, usually vowels or semivowels. According to Watkins et al., stuttering is a disorder of "selection, initiation, and execution of motor sequences necessary for fluent speech production". arlson, N. (2013). Human Communication. In Physiology of behavior (11th ed., pp. 497–500). Boston: Allyn and Bacon./ref> For many people who stutter, repetition is the main concern. The term "stuttering" covers a wide range of severity, from barely perceptible imp ...
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Efficacy
Efficacy is the ability to perform a task to a satisfactory or expected degree. The word comes from the same roots as ''effectiveness'', and it has often been used synonymously, although in pharmacology a pragmatic clinical trial#Efficacy versus effectiveness, distinction is now often made between efficacy and effectiveness. The word ''efficacy'' is used in pharmacology and medicine to refer both to the maximum response achievable from a pharmaceutical drug in research settings, and to the capacity for sufficient therapeutic effect or beneficial change in clinical settings. Pharmacology In pharmacology, efficacy () is the maximum response achievable from an applied or dosed agent, for instance, a small molecule drug. Intrinsic activity is a relative term for a drug's efficacy relative to a drug with the highest observed efficacy. It is a purely descriptive term that has little or no mechanistic interpretation. In order for a drug to have an effect, it needs to bind to its t ...
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Effect Size
In statistics, an effect size is a value measuring the strength of the relationship between two variables in a population, or a sample-based estimate of that quantity. It can refer to the value of a statistic calculated from a sample of data, the value of a parameter for a hypothetical population, or to the equation that operationalizes how statistics or parameters lead to the effect size value. Examples of effect sizes include the correlation between two variables, the regression coefficient in a regression, the mean difference, or the risk of a particular event (such as a heart attack) happening. Effect sizes complement statistical hypothesis testing, and play an important role in power analyses, sample size planning, and in meta-analyses. The cluster of data-analysis methods concerning effect sizes is referred to as estimation statistics. Effect size is an essential component when evaluating the strength of a statistical claim, and it is the first item (magnitude) in the MAGI ...
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Decoupling For Body-focused Repetitive Behaviors
Decoupling is a behavioral self-help intervention developed for body-focused and related behaviors (DSM-5) such as trichotillomania, onychophagia (nail biting), skin picking and lip-cheek biting. 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 showed the efficacy of decoupling, which was corroborated by Lee et al. {{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, page ...
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Tourette Syndrome
Tourette syndrome or Tourette's syndrome (abbreviated as TS or Tourette's) is a common neurodevelopmental disorder that begins in childhood or adolescence. It is characterized by multiple movement (motor) tics and at least one vocal (phonic) tic. Common tics are blinking, coughing, throat clearing, sniffing, and facial movements. These are typically preceded by an unwanted urge or sensation in the affected muscles known as a premonitory urge, can sometimes be suppressed temporarily, and characteristically change in location, strength, and frequency. Tourette's is at the more severe end of a spectrum of tic disorders. The tics often go unnoticed by casual observers. Tourette's was once regarded as a rare and bizarre syndrome and has popularly been associated with coprolalia (the utterance of obscene words or socially inappropriate and derogatory remarks). It is no longer considered rare; about 1% of school-age children and adolescents are estimated to have Tourette's, and ...
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Tic Disorder
Tic disorders are defined in the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM) based on type (motor or phonic) and duration of tics (sudden, rapid, nonrhythmic movements). Tic disorders are defined similarly by the World Health Organization (ICD-10 codes). Classification DSM-5 The fifth revision of the ''Diagnostic and Statistical Manual of Mental Disorders'' (DSM-5), published in May 2013, classifies Tourette syndrome and tic disorders as motor disorders listed in the neurodevelopmental disorder category. Tic disorders, in ascending order of severity, are: * 307.20 Other specified tic disorder (specify reason) * 307.20 Unspecified tic disorder * 307.21 Provisional tic disorder * 307.22 Persistent (chronic) motor or vocal tic disorder (specify motor or vocal) * 307.23 Tourette's disorder Developmental coordination disorder and stereotypic movement disorder are also classified as motor disorders. ICD-10 ICD10 diagnosis codes are: * F95.0 Transient tic disor ...
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