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    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 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
    Trichotemnomania, hair cutting
    Trichoteiromania, hair rubbing
    Eyes
    Mucus fishing syndrome - removing or "fishing" strands of mucus from the eye


    Treatment




    = Psychotherapy

    =
    Treatment can include behavior modification therapy, medication, and family therapy. The evidence base criteria for BFRBs is strict and methodical. 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. 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.


    = Pharmacotherapy

    =
    Excoriation disorder and trichotillomania have been treated with inositol and N-acetylcysteine.


    Prevalence


    BFRBs are among the most poorly understood, misdiagnosed, and undertreated groups of disorders. 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.


    See also


    Stereotypic movement disorder
    Rhythmic Movement Disorder
    Body dysmorphic disorder
    Habit reversal training
    Decoupling treatment


    References




    External links

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