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Body-focused Repetitive Behavior Disorders (RBD)

May 09, 2012  by: Sarika  Points: 12   Category: Health  Earning $1.10   Views: 1658

It is an article about habits which if left unchecked can give rise to many serious medical complications.


Body-focused Repetitive Behavior Disorders (RBD)

It is well-known that if petty habits are unchecked and go out of control then they can turn into some dreadful diseases. Uncontrolled habits can, with time, become obsession and give rise to obsessive compulsive disorders. Body-focused repetitive behavior disorders or RBD is a group of behaviors which are compulsive in nature and leads to damage in physical appearance of physical injury. These behaviors are referred to as “nervous habits” but they become problematic when they start to interfere in the daily routine and proper functioning of a person. The causes of RBD are unknown but studies have revealed that people suffering from behavioral disorders of RBD have higher levels of stress and depression as compared to their normal counterparts. The characteristic feature of RBD is inability or difficulty in resisting the urge or impulse to perform a certain behavior and control it which in the end provides certain comfort, relief and/or a feeling of satisfaction. Cognitive behavioral therapy, stimulus control therapy, family therapy and habit reversal trainings are some of the methods used to treat these disorders. Some of the most common body-focused repetitive behavior disorders are:


Compulsive nail biting or Onychophagia is a very common repetitive behavior disorder occurring both in children and adults. It is estimated that around 33% of children and 45% of adolescents are nail biters. Nail biting is mostly confined to finger nails but in extreme cases a person can turn to toenails biting. The nails of all the 10 fingers are bitten without any preference to any particular finger. The reasons for onychophagia are not known but stress, imitation of other family members, heredity and transference from thumb sucking habit cannot be ruled out as some causes. Complications arising due to this disorder include damaged cuticle and nails, secondary bacterial and viral infections and dental problems. Years of nail biting can severely deform and damage the nails.


Trichotillomania is derived from Greek language which literally means Hair Pulling Madness. It is a disorder in which persons consciously or unconsciously pulls out their own hairs leading to severe hair loss, distress and social problems. In some cases people even consume the hairs they pull out (Trichophagia). The disorder could be present in infants but the peak age of reported occurrences is between 9 to 13 years. The sites of hair pulling could be limited in number or could be multiple sites. The most common site is scalp followed by eyebrows, eyelashes, hairs on hand and other body parts and also pubic hairs. Anxiety, depression, post-traumatic stress disorder and stress are some of the reasons leading to trichotillomania. Permanent loss of hairs, secondary infections due to scratching and pulling, Carpal tunnel syndrome and socio-psychological disorders are some of the medical conditions that can follow trichotillomania. The disorder is often chronic and difficult to treat but cognitive behavioral therapy and habit reversal training techniques have shown promising results.


Dermatillomania is also a Greek language derived word which means Skin Pulling Madness . People suffering from this disorder have a repetitive and compulsive habit of picking their own skin which often results in tissue damage. It is also known as neurotic excoriation, psychological excoriation or pathological skin picking. It is more common in females than in males and starts with the onset of acne in adolescence. This disorder is characterized by the compulsive and obsessive urge to pick skin and acnes to the extent that the skin is damaged followed by scar development. The most commonly picked body region is face but other areas such as arms, legs, stomach, chest, back and shoulders are also picked. People usually are selective and pick a particular region. The picking sessions can be of few minutes duration repeated multiple times a day or can last for hours at a stretch. People usually use their fingernails to pick the skin but some of them use instruments also like tweezers. Secondary infections, tissue damage, sores, scars and in extreme cases life threatening injuries can be caused due to this habit. The exact causes of this disorder are not known but a common hypothesis suggests it to be a coping mechanism for elevated levels of arousal and stress. Dermatillomania is also looked upon as an expression of repressed rage felt towards authoritarian parents. Treatment involves administration of certain drugs like opioid antagonists, behavioral therapy and habit reversal training.


Dermatophagia is an obsessive compulsive disorder in which people repeatedly bite their own skin mostly around the nails leading to bleeding and discoloration over time. It can be painful and leads to secondary infections. Although area around the nails is the most common skin area that is chewed however other areas like inside of cheeks, mouth and lips have also been reported to be chewed by people suffering from this disorder. If left unchecked for long periods calluses can develop at the damaged area and destroy the tissue structure. Exact causes of this disorder are not known but the role of stress, anxiety and nervousness cannot be ruled out.


Rhinotillexis is the Latin name for nose picking which is used to describe the medical condition of rhinotillexomania which means Nose Picking Madness . Although nose picking is universal with an average rate of four times a day for a normal person, in some rare cases it can become a compulsive disorder and people can spend hours picking their nose. Nose picking is described as a behavior of inserting one’s finger in nose to remove the dried mucus. In some cases people not only remove the dried mucus from the nasal cavity but also eat it (Automucophagy) which can lead to medical complications due to infections. In most cultures it is a mildly taboo activity and considered a private act. Almost everywhere nose picking in public is considered as a humiliating and disgusting behavior. Apart from occasional nose bleeds and secondary infections no serious medical complications have been reported except in one rare extreme case when a person resulted in the perforation of the nasal septum.


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