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Body-Focused Repetitive Behaviors: Understanding BFRBs in Children

Trichotillomania and excoriation disorder occur in 1 to 3 percent of children and adults, more commonly in females than in males. Chances are that several students at your child’s school have either (or both) of these disorders, or perhaps another BFRB like teeth grinding, nail biting, or lip biting.

Though the scientific link between BFRBs and ADHD remains undetermined, anecdotal evidence suggests a connection.BFRBs are clinical disorders, but only trichotillomania and excoriation have their own standalone diagnostic classifications. Diagnoses for other BFRBs are often subsumed under the unspecific catchall classification “other specific obsessive-compulsive and related disorder.”Consider the following behaviors and collateral effects if you suspect your child is engaging in skin picking, hair pulling, or any other BFRB:Teenagers pluck their eyebrows, pop zits, or change hairstyles all the time.

These behaviors are normal; taken to the extreme, however, hair pulling and skin picking are problematic.[Take This Test: Obsessive-Compulsive Disorder in Children]A child with BFRBs may pull out  eyelashes or eyebrow hairs, or create bald patches on her head. By picking her skin, she may create or worsen bleeding, scarring, or infections.Children with chronic hair pulling or skin picking disorders do not engage in these behaviors to maintain personal hygiene or appearance, or to express their individuality.

These behaviors happen again and again — and with enough intensity and frequency to produce clear physical consequences.Though not a formal symptom of hair pulling or skin picking disorder, secrecy is common to BFRBs. Pulling and picking are often done in private, and effort is taken to hide them.The physical consequences of

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treating kids: Readers Choice

Trichotillomania and excoriation disorder occur in 1 to 3 percent of children and adults, more commonly in females than in males. Chances are that several students at your child’s school have either (or both) of these disorders, or perhaps another BFRB like teeth grinding, nail biting, or lip biting.
January 20, 2021Just 19% of American youth diagnosed with ADHD are receiving medication treatment, according to a review and meta-analysis published in The Journal of Attention Disorders.1 Findings from the study suggest that, for every overtreated or improperly treated American youth, there are three more undertreated youths with ADHD.The study rose from a debate over whether pharmacological treatment for youths with ADHD is overused or underused in the U.S. Researchers screened more than 25,000 potentially relevant studies, and retained 36 studies of 104,305 individuals.

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