Body-focused Repetitive Behavior
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Body-focused Repetitive Behavior
Body-focused repetitive behavior (BFRB) is an umbrella name for impulse control behaviors involving compulsively damaging one's physical appearance or causing physical injury. Body-focused repetitive behavior disorders (BFRBDs) in ICD-11 is in development. BFRB disorders are currently estimated to be under the obsessive-compulsive spectrum. They are also associated with ADHD and anxiety. Causes The cause of BFRBs is unknown. Emotional variables may have a differential impact on the expression of BFRBs. 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. Researchers are investigating a possible genetic component. Onset BFRBs most often begin in late childhood or in the early teens. Diagnosis Types The main BFRB disorders are: * Skin ** Dermatillomania (excoriation disorder), skin picking ** Dermatophagia, skin nibblin ...
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Rhinotillexomania
Nose-picking is the act of extracting nasal mucus with one's finger (rhinotillexis) and may include the subsequent ingestion of the extracted mucus (mucophagy). In Western cultures, this act is generally considered to be social deviant; parents and pediatricians have historically tried to prevent development of the habit and attempt to break it if already established. Mucophagy is a source of mockery and entertainment in the media. Prevalence Nose-picking is an extremely widespread habit: some surveys indicate that it is almost universal, with people picking their nose on average about four times a day. Reviewed in: * * A 1995 study of nose-picking, requesting information from 1,000 randomly selected adults from Wisconsin USA gathered 254 responses. It defined nose-picking as "the insertion of a finger (or other object) into the nose with the intention of removing dried nasal secretions". Of those who responded, 91% said they were current nose-pickers (but only 75% of these b ...
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Stereotypic Movement Disorder
Stereotypic movement disorder (SMD) is a motor disorder with onset in childhood involving restrictive and/or repetitive, nonfunctional motor behavior (e.g., hand waving or head banging), that markedly interferes with normal activities or results in bodily injury. To be classified as SMD, the behavior in question must not be due to the direct effects of a substance, autism, or another medical condition. The cause of this disorder is not known. Signs and symptoms Common repetitive movements of SMD include head banging, arm waving, hand shaking, rocking and rhythmic movements, self-biting, self-hitting, and skin-picking; other stereotypies are thumb-sucking, dermatophagia, nail biting, trichotillomania, bruxism and abnormal running or skipping. Cause The cause of stereotypic movement disorder is unknown. Diagnosis Stereotyped movements are common in infants and young children; if the child is not distressed by movements and daily activities are not impaired, diagnosis is not warr ...
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N-acetylcysteine
Acetylcysteine, also known as ''N''-acetylcysteine (NAC), is a medication that is used to treat paracetamol overdose and to loosen thick mucus in individuals with chronic bronchopulmonary disorders like pneumonia and bronchitis. It has been used to treat lactobezoar in infants. It can be taken intravenously, by mouth, or inhaled as a mist. Some people use it as a dietary supplement. Common side effects include nausea and vomiting when taken by mouth. The skin may occasionally become red and itchy with any route of administration. A non-immune type of anaphylaxis may also occur. It appears to be safe in pregnancy. For paracetamol overdose, it works by increasing the level of glutathione, an antioxidant that can neutralise the toxic breakdown products of paracetamol. When inhaled, it acts as a mucolytic by decreasing the thickness of mucus. Acetylcysteine was initially patented in 1960 and came into medical use in 1968. It is on the World Health Organization's List of Essential ...
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Inositol
Inositol, or more precisely ''myo''-inositol, is a carbocyclic sugar that is abundant in the brain and other mammalian tissues; it mediates cell signal transduction in response to a variety of hormones, neurotransmitters, and growth factors and participates in osmoregulation. It is a sugar alcohol with half the sweetness of sucrose (table sugar). It is made naturally in the human body from glucose. A human kidney makes about two grams per day. Other tissues synthesize it too, and the highest concentration is in the brain, where it plays an important role by making other neurotransmitters and some steroid hormones bind to their receptors. Inositol is promoted as a dietary supplement in the management of polycystic ovary syndrome (PCOS). However, there is only evidence of very low quality for its efficacy in increasing fertility for IVF in women with PCOS. Overview ''myo''-Inositol plays an important role as the structural basis for a number of secondary messengers in eukaryotic ...
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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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Excoriation Disorder
Excoriation disorder, more commonly known as dermatillomania, is a mental disorder on the obsessive–compulsive spectrum that is characterized by the repeated urge or impulse to pick at one's own skin, to the extent that either psychological or physical damage is caused. Signs and symptoms Episodes of skin picking are often preceded or accompanied by tension, anxiety, or stress. In some cases, following picking, the affected person may feel depressed. During these moments, there is commonly a compulsive urge to pick, squeeze, or scratch at a surface or region of the body, often at the location of a perceived skin defect. When picking, one may feel a sense of relief or satisfaction. The region most commonly picked is the face, but other frequent locations include the arms, legs, back, gums, neck, shoulders, scalp, abdomen, chest, and extremities such as the fingernails, cuticles, toenails, etc. Most patients with excoriation disorder report having a primary area of the body ...
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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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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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Cognitive Behavioral Therapy
Cognitive behavioral therapy (CBT) is a psycho-social intervention that aims to reduce symptoms of various mental health conditions, primarily depression and anxiety disorders. CBT focuses on challenging and changing cognitive distortions (such as thoughts, beliefs, and attitudes) and their associated behaviors to improve emotional regulation and develop personal coping strategies that target solving current problems. Though it was originally designed to treat depression, its uses have been expanded to include the treatment of many mental health conditions, including anxiety, substance use disorders, marital problems, and eating disorders. CBT includes a number of cognitive or behavioral psychotherapies that treat defined psychopathologies using evidence-based techniques and strategies. CBT is a common form of talk therapy based on the combination of the basic principles from behavioral and cognitive psychology. It is different from historical approaches to psychotherapy, s ...
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Family Therapy
Family therapy (also referred to as family counseling, family systems therapy, marriage and family therapy, couple and family therapy) is a branch of psychology and clinical social work that works with families and couples in intimate relationships to nurture change and development. It tends to view change in terms of the systems of interaction between family members. The different schools of family therapy have in common a belief that, regardless of the origin of the problem, and regardless of whether the clients consider it an "individual" or "family" issue, involving families in solutions often benefits clients. This involvement of families is commonly accomplished by their direct participation in the therapy session. The skills of the family therapist thus include the ability to influence conversations in a way that catalyses the strengths, wisdom, and support of the wider system. In the field's early years, many clinicians defined the family in a narrow, traditional manner ...
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Behavior Modification Therapy
Behavior modification is an early approach that used respondent and operant conditioning to change behavior. Based on methodological behaviorism, overt behavior was modified with consequences, including positive and negative reinforcement contingencies to increase desirable behavior, or administering positive and negative punishment and/or extinction to reduce problematic behavior. It also used Flooding desensitization to combat phobias. Applied behavior analysis (ABA)—the application of behavior analysis—is the current term and is based on radical behaviorism, which refers to B. F. Skinner's viewpoint that cognition and emotions are covert behavior that are to be subjected to the same conditions as overt behavior. Description The first use of the term behavior modification appears to have been by Edward Thorndike in 1911. His article ''Provisional Laws of Acquired Behavior or Learning'' makes frequent use of the term "modifying behavior". Through early research i ...
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