What causes a child to develop a body-focused repetitive behavior (BFRB) like skin picking, hair pulling, or nail-biting? It’s the question that every parent of a child with a BFRB asks.
It’s also a question that researchers have asked too. To date, studies have largely focused on adults with BFRBs and the role of factors such as temperament, environment, emotional or medical issues, and even genetics. Those studies suggest that there are certainly biological and environmental influences at play. What isn’t so clear is what factors are at play in the development of BRFBs in children.
It is well established that early childhood experiences and modeling play a key role in a child’s psychological development. Factors such as parental warmth, parenting style, and other parenting behaviors have been linked to the development of maintenance of mental health issues in children. So, it’s not surprising that since BFRBs often emerge in childhood, researchers would be interested in understanding more about how, or if, certain parenting practices can influence the development or maintenance of BFRBs in children. And a new study does just that.
Therapy works. There’s no doubt about that. The data is overwhelmingly positive. There’s no shortage of evidence-based treatments, meaning that their efficacy has been clinically and scientifically verified. But the technical part of therapy is only half of the story.
We also know that therapy doesn’t work for everyone. Much attention has been paid to techniques, treatments, and therapist qualities. However, less attention has been given to perhaps the most important factor of all: the client. The client is the reason for the engagement and the focus of the process. But the therapeutic experience is unique to each person. Things like expectations, commitment, and engagement vary from person to person. Just how these factors affect the person’s experience with therapy and the chances of successful treatment.
In a recent SkinPick.com webinar, Dr. Vladimir Miletic delved into the psychological meaning of dermatillomania or skin picking symptoms.
Skin picking is a common behavior but is more than just picking. It is a behavior that holds tremendous meaning for those who pick. Each person has a unique set of reasons and meanings attached to their picking. While there is no universal meaning behind picking, there are some general psychological themes that emerge. To understand the meaning picking holds for someone, you have to understand the picking behavior. Using a framework for seeking meaning and a case study, Dr. Miletic takes a closer look at the meaning that skin picking holds.
Dermatillomania, also known as excoriation disorder or skin picking, is the repeated urge to pick one’s skin. This picking causes physical injury and psychological damage. For some who pick, their urge is preceded by a sense of mounting tension which culminates with the urge to pick. Picking then brings a sense of release. Along with that sense of release often comes a complex interplay of feelings of guilt and shame, sometimes even a sense of gratification.
Skin picking is classified as an obsessive-compulsive and related disorder in the DSM5. The picking causes significant emotional distress and impairment.
Smartphone technology has given us access to the world in ways we never dreamed of. You can order food, shop for groceries, or go to work, or attend school. With the rise of telehealth, you can even see your healthcare provider. As more and more people come to rely on mobile technology, apps are now the dominant way of connecting. Just about anything you want to do, there’s probably an app for that!
One particular area that is rapidly emerging is Mobile Health (mHealth). It is becoming a driving force in the healthcare arena. The National Institutes of Health define mHealth as “the use of mobile and wireless devices (cell phones, tablets, etc.) to improve health outcomes, health care services, and health research.” Essentially, mHealth is a unique, consumer-driven type of telehealth that relies on the use of apps to manage healthcare.
Everyone has pulled at a scab or picked at a pimple just a little too much leaving them with an angry, red mark and feeling self-conscious. For people with skin picking disorder (SPD), that experience is intensified and becomes a compulsion that touches every aspect of life. It’s a disorder that is more common than you might expect. It is estimated to affect about 1 in 20 people or between 1.4% and 5.4% of the population. Although it can emerge at any age, onset generally occurs in adolescence, often coinciding with the onset of puberty. Women are much more likely to be affected.
The wait is over! The TLCs Annual Conference on Body-focused Repetitive Behaviors is April 8-11, 2021, and this year, #BFRBcon is going virtual! You’ll be able to attend from the safety of your home or office while learning about the latest in research, treatment, and living with a BFRB.
#BFRBcon is for anyone affected by trichotillomania, dermatillomania, and related behaviors, their family members, and clinicians and researchers working in the field of mental health. The only event of its kind, #BFRBcon brings together BFRB experts, community leaders, and changemakers to lead a weekend of education, support, and most importantly, healing.
For those living with a BFRB, this conference is about so much more than learning to not pick or pull. The conference is also about:
The conference will include special programming for kids and teens, and parents.
2021 is off to an exciting start for the BFRB Precision Medicine Initiative! Even with the restrictions resulting from the coronavirus pandemic, researchers remain committed to the precision medicine approach and advancing the goals of the BPMI. Projects are awaiting publication, data analysis is revealing new insights into BFRBs, research is continuing, and support for treatment advancement remains strong. The TLC Foundation for BFRBs has released updates over the past few months. Here are the highlights of what’s been happening with the BPMI:
When it comes to mental health disorders, one thing is true. While there are specific diagnostic criteria used to make a diagnosis, how those behaviors and traits are manifested can vary. Rarely is a diagnosis a “one-size-fits-all.” Skin picking disorder (SPD) is no exception. It has not gone unnoticed by the clinical community that picking behavior and its associated traits don’t always look the same from person to person. In fact, research has looked at how people engage in picking and, it turns out that there is not a single type of picking but rather distinct subtypes.
Most people have on occasion engaged in nail-biting or even picked at a scab a little too much. But sometimes, these behaviors become too frequent and the urge too much to resist. Why does that happen?
Habitual nail-biting, hair pulling, and skin picking are collectively referred to as body-focused repetitive behaviors (BFRBs). These actions are recurrent, problematic, destructive behaviors directed toward the body and are thought to be triggered by some unpleasant emotional state. Many people engage in these behaviors from time to time (e.g., nail-biting) but do so at subclinical levels that create little or no functional impairment. For some people, they can manage their emotional triggers and responses in healthy, non-injurious ways. For others, however, their emotional responses somehow get misdirected and the result is destructive body-focused behaviors like skin-picking and hair-pulling.
How that works isn’t exactly clear and researchers have turned to various psychological models to try and understand how and why BFRBs occur. What seems to be clear is that these behaviors seem to emerge in response to emotional triggers and serve to help alleviate emotional distress.
For people struggling with skin picking, finding adequate treatment can be a challenge. While classified as an obsessive-compulsive disorder by the APA’s Diagnostic and Statistical Manual (DSM-5), the disorder also results in physical injury to the skin sometimes requiring medical attention. Deciding what type of clinician to see can be confusing. Is it medical? Is it psychiatric? Skin picking also carries a degree of embarrassment for many people. Asking for help can be hard, leaving many to choose to delay treatment. A new study published in The Journal of Obsessive-Compulsive and Related Disorders sheds new light on the attitudes and experiences of people seeking treatment for skin picking and offers recommendations for improving the treatment experience.