Aug 23, 2018 02:52 PM
https://mosaicscience.com/story/compulsi...bfrbs-ocd/
EXCERPT: . . . Step into any classroom or coffee shop and, the odds are, at least one person in the room has a body-focused repetitive behaviour (BFRB), such as trichotillomania or skin picking disorder. People with BFRBs perform repetitive self-grooming activities such as picking, pulling or biting. These can cause emotional distress and damage to the body, but the people performing the behaviours can’t stop. At their most extreme, these conditions are life-threatening. A significant minority of people with trichotillomania (commonly called ‘trich’) ingest their pulled hairs. Over time, the hair can block the intestine and require surgical removal. Skin picking can lead to infections that require intravenous antibiotics and skin grafting.
More commonly, BFRBs take an emotional and social toll. They often begin in late childhood or early adolescence, making kids vulnerable to bullies. Echoing the experiences of many, a man in his late 20s described middle school as “absolute hell” because kids perceived him as “the weird kid with missing eyelashes”. Another woman, now 30, recalled watching her classmates play keep-away with the wig they had snatched off her head. Furthermore, BFRBs are often a source of conflict between child and parent, which can heighten a child’s feelings of shame and isolation. Meanwhile, in adults the condition can lead to fear of intimacy, missed job interviews, and hours lost each day to picking and pulling.
Individuals living with BFRBs often keep their condition a secret, hiding the physical effects with make-up, wigs and layers of clothing. As a result, many are surprised to learn just how common these disorders are. Some experts estimate that 2–5 per cent of people have trich and roughly 5 per cent of people have skin picking disorder, also referred to as ‘dermatillomania’ or ‘excoriation disorder’. Precise numbers are not available, however, because there has been no large-scale global study of BFRBs.
Although trich has appeared in the medical literature for over a century, it was not officially included in the DSM (the Diagnostic and Statistical Manual of Mental Disorders, published periodically by the American Psychiatric Association) until 1987 [...]
Currently, the treatment for BFRBs with the most empirical support is a type of cognitive behavioural therapy called habit reversal training, developed in the 1970s as a treatment for tics. During this therapy, a person learns to recognise the context in which pulling or picking is most likely to occur. With this awareness, people can then plan to substitute a competing response. For example, when faced with an urge to pick, someone might instead make a fist, or play with a fidget toy. In some studies, more than half of adults with trich achieve short-term improvement. However, some find it difficult to maintain the results over time.
Psychologist Omar Rahman recently conducted a promising study of habit reversal training in kids with trich. He says that the goal of the therapy is to give the brain an opportunity to become habituated to the urge, meaning you can ignore it or respond with a substitute behaviour. Over the years, Rahman has come to believe that there’s really no real way around this if you can’t learn to manage the urge, which may explain why habit reversal training doesn’t help everyone, or why improvement doesn’t always last. For this reason, researchers and clinicians have increasingly sought to augment habit reversal training with other means of helping people with their urges....
MORE: https://mosaicscience.com/story/compulsi...bfrbs-ocd/
EXCERPT: . . . Step into any classroom or coffee shop and, the odds are, at least one person in the room has a body-focused repetitive behaviour (BFRB), such as trichotillomania or skin picking disorder. People with BFRBs perform repetitive self-grooming activities such as picking, pulling or biting. These can cause emotional distress and damage to the body, but the people performing the behaviours can’t stop. At their most extreme, these conditions are life-threatening. A significant minority of people with trichotillomania (commonly called ‘trich’) ingest their pulled hairs. Over time, the hair can block the intestine and require surgical removal. Skin picking can lead to infections that require intravenous antibiotics and skin grafting.
More commonly, BFRBs take an emotional and social toll. They often begin in late childhood or early adolescence, making kids vulnerable to bullies. Echoing the experiences of many, a man in his late 20s described middle school as “absolute hell” because kids perceived him as “the weird kid with missing eyelashes”. Another woman, now 30, recalled watching her classmates play keep-away with the wig they had snatched off her head. Furthermore, BFRBs are often a source of conflict between child and parent, which can heighten a child’s feelings of shame and isolation. Meanwhile, in adults the condition can lead to fear of intimacy, missed job interviews, and hours lost each day to picking and pulling.
Individuals living with BFRBs often keep their condition a secret, hiding the physical effects with make-up, wigs and layers of clothing. As a result, many are surprised to learn just how common these disorders are. Some experts estimate that 2–5 per cent of people have trich and roughly 5 per cent of people have skin picking disorder, also referred to as ‘dermatillomania’ or ‘excoriation disorder’. Precise numbers are not available, however, because there has been no large-scale global study of BFRBs.
Although trich has appeared in the medical literature for over a century, it was not officially included in the DSM (the Diagnostic and Statistical Manual of Mental Disorders, published periodically by the American Psychiatric Association) until 1987 [...]
Currently, the treatment for BFRBs with the most empirical support is a type of cognitive behavioural therapy called habit reversal training, developed in the 1970s as a treatment for tics. During this therapy, a person learns to recognise the context in which pulling or picking is most likely to occur. With this awareness, people can then plan to substitute a competing response. For example, when faced with an urge to pick, someone might instead make a fist, or play with a fidget toy. In some studies, more than half of adults with trich achieve short-term improvement. However, some find it difficult to maintain the results over time.
Psychologist Omar Rahman recently conducted a promising study of habit reversal training in kids with trich. He says that the goal of the therapy is to give the brain an opportunity to become habituated to the urge, meaning you can ignore it or respond with a substitute behaviour. Over the years, Rahman has come to believe that there’s really no real way around this if you can’t learn to manage the urge, which may explain why habit reversal training doesn’t help everyone, or why improvement doesn’t always last. For this reason, researchers and clinicians have increasingly sought to augment habit reversal training with other means of helping people with their urges....
MORE: https://mosaicscience.com/story/compulsi...bfrbs-ocd/