ISLAMABAD, July 21 (Online):For people who can\u2019t stop biting their nails or picking at their skin, a new study suggests that a simple technique could help. <\/p>\n
Body-focused repetitive behaviors \u2014 compulsively pulling or picking at your hair or skin, unable to stop yourself even if the behavior leads to scabs, scars and bald spots \u2014 affects about 5% of people worldwide, according to the TLC Foundation for Body-Focused Repetitive Behaviors, an advocacy group for people with the conditions. (One common repetitive behavior is nail-biting.)<\/p>\n
The research, published Wednesday in JAMA Dermatology, found that an approach called habit replacement may help reduce these behaviors.
\nWhile the new technique \u2014 which involves gently rubbing the fingertips, palm or back of the arm at least twice a day \u2014 didn\u2019t help everyone, about 53% of people in the study said they had at least some improvement compared with about 20% of people in a control group. (A video here shows some of the variations people can try.) <\/p>\n
\u201cThe rule is just to touch your body lightly,\u201d said lead study author Steffen Moritz, head of the clinical neuropsychology working group at University Medical Center Hamburg-Eppendorf, in Hamburg, Germany. \u201cIf you\u2019re under stress, you might perform the movements faster, but not with more self-applied pressure.\u201d<\/p>\n
The study was considered \u201cproof-of-concept\u201d research \u2014 early research that needs further confirmation. Still, experts said the results were encouraging.<\/p>\n
In the six-week study, Moritz and colleagues looked at 268 people who had trichotillomania (a condition in which people pluck out hair in response to stress or to self-soothe) or repeatedly bit their nails or the inside of their cheek. <\/p>\n
The researchers randomly assigned the volunteers into two groups. One group was given a manual and video that showed them how to form the new, less harmful habit by gently rubbing their fingertips, palm, or arm any time they felt the urge to bite their nails or engage in the harmful behavior. They were also instructed to practice the new habit when they weren\u2019t feeling the urge to pull, pick or bite.<\/p>\n
People in the control group were told that they were put on a waitlist for treatment, and only got the habit replacement training after the study was concluded.<\/p>\n
Overall, nearly 80% of the people in the treatment group said they were satisfied with the training and 86% said they would recommend it to a friend. People who bit their nails seemed to benefit the most from the habit replacement technique.<\/p>\n
How can rubbing your arm stop you from biting your nails?
\nThe new approach is a variation of other behavioral techniques for body-focused repetitive behaviors, which include habit reversal training and something called decoupling. While some medications, including antidepressants are prescribed off-label to people with body-focused repetitive behavior, there are no FDA-approved drugs specifically for the condition. Cognitive behavioral therapy is thought to be the most effective approach.<\/p>\n
In habit reversal training, people are taught \u201ccompeting responses,\u201d said Natasha Bailen, a clinical psychologist at the Center for OCD and Related Disorders at Massachusetts General Hospital and Harvard Medical School. <\/p>\n
\u201cSo they might involve, for example, clenching your fists really tight when you have an urge to pull your hair or pick your skin. It might be sitting on your hands,\u201d she said. The aim is to use a group of muscles so that you can\u2019t physically perform the harmful behavior. <\/p>\n
In decoupling, a habit is unlearned by performing a similar movement but switching it up at the last minute. For example, if you bite your nails, you might put your hand to your face but touch an earlobe instead of your mouth.<\/p>\n
Moritz said that the study\u2019s habit replacement training differs in that it aims to replace the sometimes pleasurable sensation of picking and pulling with something that also feels good but won\u2019t be harmful \u2014 gentle touch. <\/p>\n
In fact, the training manual in the study recommends that people avoid touching their bodies in ways that are rough or apply too much pressure, like scrubbing their skin in the shower or brushing their teeth too hard. <\/p>\n
\u201cI would say one-third to half of the patients with BFRB [body-focused repetitive behavior] benefit from decoupling, but the rest do not,\u201d Moritz said. \u201cAnd so the idea was to find another technique that is perhaps more suitable for these nonresponders.\u201d<\/p>\n
The training also recommends that people treat themselves to things like a massage, a warm bath, or applying lotion \u201cboth consciously and, ideally, lovingly.\u201d <\/p>\n
John Piacentini, president of the board of directors of the TLC Foundation for Body-Focused Repetitive Behaviors, said it \u201cis fantastic that this study will raise awareness of BFRBs because they\u2019re really poorly understood, oftentimes misdiagnosed or missed completely.\u201d<\/p>\n
\u201cThere are reasonably good treatments out there that most clinicians aren\u2019t aware of or don\u2019t do,\u201d he said.<\/p>\n
However, he did note some of the study\u2019s limitations, including that the control group wasn\u2019t undergoing some type of alternative treatment, the study was relatively short at only six weeks, and it wasn\u2019t clear if the intervention was affected by other conditions like anxiety or depression or helped reduce impairment.<\/p>\n
\u201cIn this population, we\u2019re really looking for treatments that are going to really impact or really reduce the severity of these specific symptoms,\u201d he said. <\/p>\n
The study authors also listed several limitations, including that the participants were recruited from social media, lacked diversity (most were white women in their 30s), and did not have their diagnoses confirmed. <\/p>\n
\u201cI was very excited that there\u2019s more work that\u2019s being done in this self-help area,\u201d Bailen said, adding that habit replacement techniques might be helpful for those who are waiting for treatment, or in combination with other therapies.<\/p>\n
\u201cGetting access to mental health services can be a real challenge these days and waitlists can be incredibly long,\u201d she said. \u201cBut I think that the more research that we\u2019re able to do, and the more we\u2019re able to develop these self-help materials, we can help narrow that treatment gap. And that\u2019s definitely important.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"
ISLAMABAD, July 21 (Online):For people who can\u2019t stop biting their nails or picking at their skin, a new study suggests that a simple technique could help. Body-focused repetitive behaviors \u2014 compulsively pulling or picking at your hair or skin, unable to stop yourself even if […]<\/p>\n
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