Clinical presentation of body-focused repetitive behaviors in minority ethnic groups

Prevalence of body-focused repetitive behaviors in a diverse population sample - rates across age, gender, race and education

BACKGROUND

Prevalence estimates for body-focused repetitive behaviors (BFRBs) such as trichotillomania differ greatly across studies owing to several confounding factors (e.g. different criteria). For the present study, we recruited a diverse online sample to provide estimates for nine subtypes of BFRBs and body-focused repetitive disorders (BFRDs).

METHODS

The final sample comprised 1481 individuals from the general population. Several precautions were taken to recruit a diverse sample and to exclude participants with low reliability. We matched participants on gender, race, education and age range to allow unbiased interpretation.

RESULTS

While almost all participants acknowledged at least one BFRB in their lifetime (97.1%), the rate for BFRDs was 24%. Nail biting (11.4%), dermatophagia (8.7%), skin picking (8.2%), and lip-cheek biting (7.9%) were the most frequent BFRDs. Whereas men showed more lifetime BFRBs, the rate of BFRDs was higher in women than in men. Rates of BFRDs were low in older participants, especially after the age of 40. Overall, BFRBs and BFRDs were more prevalent in White than in non-White individuals. Education did not show a strong association with BFRB/BFRDs.

DISCUSSION

BFRBs are ubiquitous. More severe forms, BFRDs, manifest in approximately one out of four people. In view of the often-irreversible somatic sequelae (e.g. scars) BFRBs/BFRDs deserve greater diagnostic and therapeutic attention by clinicians working in both psychology/psychiatry and somatic medicine (especially dermatology and dentistry).

No One-Size-Fits-All: Critical Narrative Intervention and Archeology of Self as Anti-Racist and Anti-Colonial Practices in Body-Focused Repetitive Behaviors

Health education and research has historically relied on partnerships between institutions that focus on prescribing interventions rather than working with communities to identify and address systemic violence and oppression as root causes of health inequity. This perpetuates harmful colonial paradigms in health education. We present an autoethnographic perspective of our experiences as Black women with Body-Focused Repetitive Behaviors to reexamine harmful assumptions and practices underpinning the field. Through digital storytelling, a qualitative research method, we explore Critical Narrative Intervention (CNI) and the Archeology of Self (AOS) as key methodological frameworks in decolonizing health education. Using our experiences of navigating complex mental health education and care, we highlight CNI and AOS as creative, asset-based, narrative, and participatory approaches to addressing health inequity and promoting an anti-colonist and anti-racist public health paradigm. We call practitioners to explore these methodologies in reimagining how we engage with diverse, historically excluded communities, while critically interrogating our own biases as we move toward equitable partnerships and caring relationships.

Characteristics and treatment seeking in an adult Hispanic population with trichotillomania and skin picking disorder

This study reports on characteristics of trichotillomania (TTM) and skin picking disorder (SPD) in an international Hispanic sample of adults. The survey was distributed online globally to a Hispanic population with TTM and SPD. 166 Hispanic adults with TTM (n = 127) or SPD (n = 39) reported moderate levels of symptom severity and low or very low quality of life. Anxiety disorders and OCD were common comorbidities. Hispanic adults with TTM and SPD were more impulsive and compulsive compared to non-Hispanic speaking adults (n = 92). Of the 166 subjects, 129 (77.7%) reported previously seeking treatment. When asked about the challenges they faced in seeking help, 67 (40.4%) identified a lack of therapists, psychologists, and psychiatrists who were knowledgeable about these disorders.