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OBJECTIVE: Enhanced odor sensitivity is a phenomenon that potentially underlies conditions such as multiple chemical sensitivity (MCS). Currently, there are no treatments that have been shown to effectively decrease odor sensitivity. Given similarities of odor hypersensitivity/MCS to pain sensitization disorders such as fibromyalgia, there may be a potential for interventions that improve pain tolerance to modulate odor sensitivity. METHODS: This exploratory study randomized 72 healthy community adult volunteers to receive one of six treatments in between two assessments of thermal pain tolerance and odor threshold. Participants were randomized to receive either cathodal, anodal, or sham transcranial direct current stimulation (tDCS) aimed at dorsolateral prefrontal cortex. In addition, participants were provided a brief cognitive behavioral intervention (CBI) for pain consisting of task framing, cognitive restructuring, and distraction technique training, or a control intervention consisting of information about pain. RESULTS: Persons who received a brief CBI showed significantly increased odor thresholds (reduced sensitivity) during intervention (F (1,62) = 7.29, p = .009, ηp = .11), whereas the control intervention was not associated with altered odor thresholds. Moreover, in those who received brief CBI, more severe anxiety associated with larger reductions in odor sensitivity (ρ = .364, p = .035). There was no effect of tDCS (F (2,62) = .11, p = .90) nor interaction between tDCS and CBI (F (2,62) = .32, p = .73). CONCLUSIONS: Given the connection between anxiety and MCS, results suggest that CBT techniques for somatic processes may show promise in treating conditions characterized by increased sensitivity to odors (e.g., MCS).
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Terapia Cognitivo-Comportamental , Transtornos do Olfato/terapia , Estimulação Transcraniana por Corrente Contínua , Adulto , Idoso , Terapia Cognitivo-Comportamental/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Odorantes , Limiar da Dor , Limiar Sensorial , Olfato , Estimulação Transcraniana por Corrente Contínua/métodos , Adulto JovemRESUMO
OBJECTIVE: Enhanced odor sensitivity, particularly toward threat-related cues, may be adaptive during periods of danger. Research also suggests that chronic psychological distress may lead to functional changes in the olfactory system that cause heightened sensitivity to odors. Yet, the association between self-reported odor sensitivity, objective odor detection, and affective psychopathology is currently unclear, and research suggests that persons with affective problems may only be sensitive to specific, threat-related odors. METHODS: The current study compared adults with self-reported odor sensitivity that was described as functionally impairing (OSI; n = 32) to those who reported odor sensitivity that was non-impairing (OS; n = 17) on affective variables as well as quantitative odor detection. RESULTS: Increased anxiety sensitivity, trait anxiety, depression, and life stress, even while controlling for comorbid anxiety and depressive disorders, was found for OSI compared to OS. While OSI, compared to OS, demonstrated only a trend increase in objective odor detection of a smoke-like, but not rose-like, odor, further analysis revealed that increased detection of that smoke-like odor was positively correlated with anxiety sensitivity. CONCLUSION: These findings suggest that persons with various forms of psychological distress may find themselves significantly impaired by an intolerance of odors, but that self-reported odor sensitivity does not necessarily relate to enhanced odor detection ability. However, increased sensitivity to a smoke-like odor appears to be associated with sensitivity to aversive anxiogenic stimuli. Implications for the pathophysiology of fear- and anxiety-related disorders are discussed.
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Ansiedade/diagnóstico , Transtorno Depressivo/diagnóstico , Percepção Olfatória , Angústia Psicológica , Olfato , Adulto , Idoso , Ansiedade/psicologia , Transtorno Depressivo/psicologia , Autoavaliação Diagnóstica , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
OBJECTIVE: Several compulsive grooming habits such as hair pulling, skin picking, and nail biting are collectively known as body-focused repetitive behaviors (BFRBs). Although subclinical BFRBs are common and benign, more severe and damaging manifestations exist that are difficult to manage. Researchers have suggested that BFRBs are maintained by various cognitive, affective, and sensory contingencies. Although the involvement of cognitive and affective processes in BFRBs has been studied, there is a paucity of research on sensory processes. METHODS: The current study tested whether adults with subclinical or clinical BFRBs would report abnormal patterns of sensory processing as compared to a healthy control sample. RESULTS: Adults with clinical BFRBs (nâ¯=â¯26) reported increased sensory sensitivity as compared to persons with subclinical BFRBs (nâ¯=â¯48) and healthy individuals (nâ¯=â¯33). Elevations in sensation avoidance differentiated persons with clinical versus subclinical BFRBs. Sensation seeking patterns were not different between groups. Unexpectedly, BFRB severity was associated with lower registration of sensory stimuli, but this finding may be due to high psychiatric comorbidity rates in the BFRB groups. CONCLUSIONS: These findings suggest that several sensory abnormalities may underlie BFRBs. Implications for the etiology and treatment of BFRBs are discussed.
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Entrevista Psicológica , Hábito de Roer Unhas/psicologia , Comportamento Autodestrutivo/psicologia , Tricotilomania/psicologia , Adulto , Comorbidade , Transtornos Disruptivos, de Controle do Impulso e da Conduta/diagnóstico , Transtornos Disruptivos, de Controle do Impulso e da Conduta/epidemiologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/psicologia , Feminino , Humanos , Entrevista Psicológica/métodos , Masculino , Comportamento Autodestrutivo/diagnóstico , Comportamento Autodestrutivo/epidemiologia , Transtornos de Sensação/diagnóstico , Transtornos de Sensação/epidemiologia , Transtornos de Sensação/psicologia , Tricotilomania/diagnóstico , Tricotilomania/epidemiologiaRESUMO
Habits, such as hair pulling and thumb sucking, have recently been grouped into a category of clinical conditions called body-focused repetitive behavior disorders (BFRBDs). These behaviors are common in children and, at extreme levels, can cause physical and psychological damage. This article reviews the evidence base for psychosocial treatment of pediatric BFRBDs. A review of academic databases and published reviews revealed 60 studies on psychosocial treatments for pediatric BFRBDs, 23 of which were deemed suitable for review. Based on stringent methodological and evidence base criteria, we provided recommendations for each specific BFRBD. Individual behavior therapy proved probably efficacious for thumb sucking, possibly efficacious for several conditions, and experimental for nail biting. Individual and multicomponent cognitive-behavioral therapy was named experimental for trichotillomania and nail biting, respectively. No treatment met criteria for well-established status in the treatment of any BFRBD. Recommendations for clinicians are discussed. Reasons for the limitations of existing research in children and adolescents are explored. Several recommendations are presented for future pediatric treatment research on BFRBDs.
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Terapia Cognitivo-Comportamental/métodos , Medicina Baseada em Evidências , Sucção de Dedo/terapia , Hábitos , Hábito de Roer Unhas/terapia , Tricotilomania/terapia , Adolescente , Criança , Sucção de Dedo/psicologia , Humanos , Hábito de Roer Unhas/psicologia , Resultado do Tratamento , Tricotilomania/psicologiaRESUMO
BACKGROUND: Diagnosis of trichotillomania (TTM) requires meeting several criteria that aim to embody the core pathology of the disorder. These criteria are traditionally interpreted monothetically, in that they are all equally necessary for diagnosis. Alternatively, a dimensional conceptualization of psychopathology allows for examination of the relatedness of each criterion to the TTM latent continuum. OBJECTIVES: First, to examine the ability of recently removed criteria (B and C) to identify the latent dimensions of TTM psychopathology, such that they discriminate between individuals with low and high degrees of hair pulling severity. Second, to determine the impact of removing criteria B and C on the information content of remaining diagnostic criteria. Third, to determine the psychometric properties of remaining TTM diagnostic criteria that remain largely unchanged in DSM-5; that is, whether they measure distinct or overlapping levels of TTM psychopathology. Fourth, to determine whether information content derived from diagnostic criteria aid in the prediction of disease trajectory (i.e., can relapse propensity be predicted from criteria endorsement patterns). METHOD: Statistics derived from item response theory were used to examine diagnostic criteria endorsement in 91 adults with TTM who underwent psychotherapy. RESULTS: The removal of two criteria in DSM-5 and psychometric validity of remaining criteria was supported. Additionally, individual trait parameters were used to predict treatment progress, uncovering predictive power where none previously existed. CONCLUSIONS: Diagnostic criteria for TTM should be examined in dimensional models, which allow for nuanced and sensitive measurement of core symptomology in treatment contexts.
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Sintomas Comportamentais/diagnóstico , Manual Diagnóstico e Estatístico de Transtornos Mentais , Tricotilomania/diagnóstico , Adulto , Feminino , Humanos , Masculino , Psicometria , RecidivaRESUMO
Background: Pain management physicians are increasingly focused on limiting prescription opioid abuse, yet existing tools for monitoring adherence have limited accuracy. Medication event monitoring system (MEMS) is an emerging technology for tracking medication usage in real-time but has not been tested in chronic pain patients on long-term opioid regimens. Objective: We conducted a pilot clinical trial to investigate the utility of MEMS for monitoring opioid adherence and compared to traditional methods including self-report diaries, urine drug screen (UDS), and physicians' opinions. Methods: Opioid-maintained chronic pain patients were recruited from a pain management clinic. Participants (n=28) were randomly assigned to either receive MEMS bottles containing their opioid medication for a 90-day period or to continue using standard medication bottles. MEMS bottles were configured to record and timestamp all bottle openings and the number of pills that were removed from the bottle (via measurement of weight change). Results: Participants who received MEMS demonstrated highly heterogenous dosing patterns, with a substantial number of patients rapidly removing excessive amounts of medication and/or "stockpiling" medication. By comparison, physicians rated all participants as either "totally compliant" or "mostly compliant". UDS results did not reveal any illicit drug use, but 25% of participants (n=7) tested negative for their prescribed opioid metabolite. MEMS data did not correlate with physician-rated adherence (P=0.24) and UDS results (P=0.77). MEMS data consistently revealed greater non-adherence than self-report data (P<0.001). Conclusion: These results highlight the limits in our understanding of naturalistic patterns of daily opioid use in chronic pain patients as well as support the use of MEMS for detecting potential misuse as compared to routine adherence monitoring methods. Future research directions include the need to determine how MEMS could be used to improve patient outcomes, minimize harm, and aid in clinical decision-making. Trial Registration: This study was preregistered on ClinicalTrials.gov (NCT03752411).
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Significant trauma histories and post-traumatic stress disorder (PTSD) are common in persons with substance use disorders (SUD) and often associate with increased SUD severity and poorer response to SUD treatment. As such, this sub-population has been associated with unique risk factors and treatment needs. Understanding the distinct etiological profile of persons with co-occurring SUD and PTSD is therefore crucial for advancing our knowledge of underlying mechanisms and the development of precision treatments. To this end, we employed supervised machine learning algorithms to interrogate the responses of 160 participants with SUD on the multidimensional NIDA Phenotyping Assessment Battery. Significant PTSD symptomatology was correctly predicted in 75% of participants (sensitivity: 80%; specificity: 72.22%) using a classification-based model based on anxiety and depressive symptoms, perseverative thinking styles, and interoceptive awareness. A regression-based machine learning model also utilized similar predictors, but failed to accurately predict severity of PTSD symptoms. These data indicate that even in a population already characterized by elevated negative affect (individuals with SUD), especially severe negative affect was predictive of PTSD symptomatology. In a follow-up analysis of a subset of 102 participants who also completed neurocognitive tasks, comorbidity status was correctly predicted in 86.67% of participants (sensitivity: 91.67%; specificity: 66.67%) based on depressive symptoms and fear-related attentional bias. However, a regression-based analysis did not identify fear-related attentional bias as a splitting factor, but instead split and categorized the sample based on indices of aggression, metacognition, distress tolerance, and interoceptive awareness. These data indicate that within a population of individuals with SUD, aberrations in tolerating and regulating aversive internal experiences may also characterize those with significant trauma histories, akin to findings in persons with anxiety without SUD. The results also highlight the need for further research on PTSD-SUD comorbidity that includes additional comparison groups (i.e., persons with only PTSD), captures additional comorbid diagnoses that may influence the PTSD-SUD relationship, examines additional types of SUDs (e.g., alcohol use disorder), and differentiates between subtypes of PTSD.
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Transtornos de Estresse Pós-Traumáticos , Transtornos Relacionados ao Uso de Substâncias , Humanos , Transtornos de Estresse Pós-Traumáticos/diagnóstico , Transtornos de Estresse Pós-Traumáticos/epidemiologia , Comorbidade , Ansiedade , Agressão , Transtornos Relacionados ao Uso de Substâncias/diagnóstico , Transtornos Relacionados ao Uso de Substâncias/epidemiologiaRESUMO
The caddisfly assemblages of six lakes and 12 1st-4th order streams of the Huron Mountains of northern Upper Michigan (USA) were sampled monthly with ultraviolet lights during June-September 2019. A total of 169 species representing 63 genera and 19 families was collected, including five species not found elsewhere in Michigan and two species endemic to the state. Species assemblages between lotic and lentic habitats were distinct from each other, with 11 species indicating lakes and 23 indicating rivers. Despite the taxonomic differences, biomass of functional feeding groups (FFGs) was similar between lakes and rivers, except for higher biomass of predators in the former and higher biomass of filtering collectors in the latter. The FFG biomass of both habitat types was dominated (50-70%) by shredders. Considering the undisturbed condition of the habitats, the caddisfly assemblages and FFG biomass of the Huron Mountains can serve as regional biological monitoring reference conditions.
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Attentional function in substance use disorder (SUD) is not well understood. To probe attentional function in SUD as a function of primary substance of abuse, we administered the attentional network task (ANT) to 44 individuals with Cocaine Use Disorder (CoUD), 49 individuals with Cannabis Use Disorder (CaUD), 86 individuals with Opioid Use Disorder (OUD), and 107 controls with no SUD, along with the stop-signal task (SST). The ANT quantifies the effects of (temporal) alerting cues and (spatial) orienting cues to reduce reaction time (RT) to targets, as well as probing how conflicting (target-incongruent) stimuli slow RT. The SST quantifies individuals' ability to inhibit already-initiated motor responses. After controlling for sex representation and age, OUD and CaUD participants showed blunted alerting effects compared to controls, whereas CaUD and CoUD participants showed greater stimulus conflict (flanker) effects. Finally, CoUD participants showed a trend toward increased orienting ability. In SST performance, no SUD group showed a prolonged stop-signal reaction compared to controls. However, the OUD group (and CoUD group at trend level) showed prolonged "go" RT to targets and reduced hit rates. These data indicate differences in attentional function in persons with SUD as a function of the primary substance use.
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Atenção , Transtornos Relacionados ao Uso de Opioides , Atenção/fisiologia , Sinais (Psicologia) , Função Executiva/fisiologia , Humanos , Tempo de Reação/fisiologiaRESUMO
Five hundred and fifty-two caddisfly species are reported from the Upper Midwest region of the United States, an area that includes 13 states and ~ 2 million km2. Of these, 62 species are reported for the first time from the state of Iowa, 25 from Wisconsin, 18 from South Dakota, 12 from Illinois, five from Indiana, four from North Dakota, four from Minnesota, and one from Nebraska. The Upper Midwest fauna contains nearly 40% of all species known from the United States and Canada, as well as 22 species endemic to the region. Overall species richness was highest in Michigan (319 species), Kentucky (296), Minnesota (292), and Wisconsin (284). Differences in state species assemblages within the region largely followed a geographic pattern, with species richness declining in the western prairie states. There are almost certainly further species remaining to be found in this large region.
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The effects of plants on insects are not completely clear due to potential covariation of weather or location affecting both assemblages. To address this question, plant and insect assemblages were described during summer 2019 and 2020 in two different forest habitats of northern Lower Michigan. The first habitat was a hardwood forest typical of secondary succession in the region. The second was a hydric forest located ~20 m from the hardwood forest which developed after lake sediment was deposited into a 10-ha area in the early 2000s. Reflecting this sediment deposition, soil of the hydric forest had higher water content and organic matter, and was dominated by the plant genera Solidago (Asterales: Asteraceae), Rubus (Rosales: Rosaceae), and Salix (Malpighiales: Salicaceae). In contrast, the hardwood forest had greater inorganic sediment and was dominated by Pteridium (Polypodiales: Dennstaedtiaceae), Carex (Poales: Cyperaceae), and Acer. Nearly 140,000 insect specimens were sampled using pitfall trapping, sweep netting, flight intercept trapping, ultraviolet light trapping, and yellow and blue pan trapping. The first three methods each sampled a unique insect assemblage, whereas the last three overlapped in taxa sampled. Insect assemblages of the two forests were distinct from each other using any of the six methods, with abundance of Pteridium and Salix (Sapindales: Sapindaceae) generally associating with changes in insect composition. A total of 41 insect taxa indicated the hydric forest and 14 indicated the hardwood forest. Insect richness increased with that of plants. These results demonstrate that differences in soil composition and plant assemblages associate with differences in forest insect assemblages, even of forests in very close proximity.
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Ecossistema , Florestas , Animais , Insetos , Michigan , Plantas , Solo , Estados UnidosRESUMO
Setodes truncatus n. sp. is illustrated and described herein based on specimens collected from 2 adjacent watersheds of the Huron Mountains in northern Michigan (USA). Both known populations inhabit undisturbed sandy rivers. Males of S. truncatus appear most similar to those of S. incertus (Walker) but can be separated based on their short and truncate inferior appendages and by other differences in the genitalia. The larva and female both remain unknown. A revised key to males of the 10 North American species of Setodes is provided.
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Holometábolos/anatomia & histologia , Holometábolos/classificação , Animais , Extremidades , Feminino , Larva , Masculino , MichiganRESUMO
Positive social connections are crucial for recovery from Substance Use Disorder (SUD). Of interest is understanding potential social information processing (SIP) mediators of this effect. To explore whether persons with different SUD show idiosyncratic biases toward social signals, we administered an emotional go-nogo task (EGNG) to 31 individuals with Cocaine Use Disorder (CoUD), 31 with Cannabis Use Disorder (CaUD), 79 with Opioid Use Disorder (OUD), and 58 controls. Participants were instructed to respond to emotional faces (Fear/Happy) but withhold responses to expressionless faces in two task blocks, with the reverse instruction in the other two blocks. Emotional faces as non-targets elicited more "false alarm" (FA) commission errors as a main effect. Groups did not differ in overall rates of hits (correct responses to target faces), but participants with CaUD and CoUD showed reduced rates of hits (relative to controls) when expressionless faces were targets. OUD participants had worse hit rates [and slower reaction times (RT)] when fearful faces (but not happy faces) were targets. CaUD participants were most affected by instruction effects (respond/"go" vs withhold response/"no-go" to emotional face) on discriminability statistic A. Participants were faster to respond to happy face targets than to expressionless faces. However, this pattern was reversed in fearful face blocks in OUD and CoUD participants. This experiment replicated previous findings of the greater salience of expressive face images, and extends this finding to SUD, where persons with CaUD may show even greater bias toward emotional faces. Conversely, OUD participants showed idiosyncratic behavior in response to fearful faces suggestive of increased attentional disruption by fear. These data suggest a mechanism by which positive social signals may contribute to recovery.
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Ash-free dry mass (AFDM) values are presented for the adult stage of 63 caddisfly species commonly found throughout the northcentral US. Weights ranged from 0.01 mg for the smallest species to 7.22 mg for the largest. These values represent the first published data on the AFDM of the adult stage of Trichoptera, and can be used in other studies for more precise assessments of stream conditions without destruction of specimens. This increased precision is demonstrated herein by re-analyzing a previously published data set.
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OBJECTIVE: Childhood anxiety and obsessive-compulsive disorder (OCD) are defined by fear, worry, and uncertainty, but there is also evidence that affected children possess exteroceptive sensory abnormalities. These sensory features may often instigate symptoms and cause significant distress and functional impairment. In addition, a purported class of conditions known as "sensory processing disorders" may significantly overlap with childhood anxiety and OCD, which provides further support for a connection between abnormal sensation and fear-based psychopathology. METHOD: The current review was conducted to synthesize and to critically evaluate the existing research on exteroceptive sensory abnormalities in childhood anxiety and OCD. Because of the paucity of research in this area, studies with adult populations were also briefly reviewed. RESULTS: The review found significant support for the notion that sensory abnormalities are common in children with anxiety disorders and OCD, but there are significant limitations to research in this area that prevent firm conclusions. CONCLUSION: Potential avenues for future research on sensory features of pediatric anxiety and OCD are discussed.
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Ansiedade/complicações , Ansiedade/fisiopatologia , Transtorno Obsessivo-Compulsivo/complicações , Transtorno Obsessivo-Compulsivo/fisiopatologia , Transtornos da Percepção/complicações , Transtornos da Percepção/fisiopatologia , Adolescente , Ansiedade/psicologia , Criança , Transtornos do Comportamento Infantil/fisiopatologia , Transtornos do Comportamento Infantil/psicologia , Medo , Humanos , Transtorno Obsessivo-Compulsivo/psicologia , Transtornos da Percepção/psicologiaRESUMO
Body-focused repetitive behaviors (BFRBs) and non-suicidal self-injury (NSSI) are recognized as distinct categories in the DSM-5. However, definitions and assessment of NSSI sometimes encompasses behaviors similar to BFRBs, and little data exist about their clinical differences. The current study examined clinical characteristics and symptom features associated with NSSI vs. BFRBs. The current sample included 1523 individuals who endorsed moderate to severe NSSI (n = 165) or BFRBs: hair pulling group (n = 102), skin picking group (n = 216), nail picking group (n = 253), nail biting group (n = 487), and cheek biting group (n = 300). Responders were asked to complete questionnaires on clinical features relevant for BFRBs and NSSI. NSSI and BFRBs had significant differences on several clinical features. Individuals in the NSSI group were more likely than individuals with BFRBs to report engaging in the behavior for social-affective reasons (i.e., to get out of doing something, or receive attention from others). Individuals in the NSSI group were also more likely to engage in the behavior to regulate tension and feelings of emptiness, and to experience relief during the act. In contrast, individuals in the BFRB groups were more likely to engage in the behavior automatically without reflective awareness, to reduce boredom, or to fix appearance. The NSSI group obtained significantly higher scores on questionnaires assessing stress, anxiety, depression, and harm avoidance. Overall, the results showed several notable differences between NSSI and BFRBs that are consistent with clinical literature and definitions of these problems in the DSM-5.
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Comportamento Autodestrutivo , Tricotilomania , Transtornos de Ansiedade , Emoções , Humanos , Comportamento Autodestrutivo/diagnóstico , Inquéritos e QuestionáriosRESUMO
An increasing body of evidence has linked pathological body-focused repetitive behaviors (BFRBs) to excessive sensory sensitivity and difficulty modulating sensory inputs. Likewise, neurobiological evidence points to deficits in feed-forward inhibition and sensory habituation in conditions with similar symptomatology. There is currently little evidence regarding potential physiological sensory abnormalities in BFRBs. The current study compared 46 adults with pathological hair pulling and/or skin picking to 46 age-matched healthy control participants on a series of self-report measures and objective psychophysical tests of neurophysiological sensory functions. Persons in the BFRB group reported increased scores on the Sensory Gating Inventory (Uâ¯=â¯320.50, pâ¯<â¯.001) and all of its subscales (all p-valuesâ¯<â¯.001), reflecting abnormal sensory experiences. The BFRB group also showed decreased tactile thresholds (increased sensitivity) (F[1, 76]â¯=â¯10.65, pâ¯=â¯.002, ηp2 = .12) and deficient feed-forward inhibition (F[1, 76]â¯=â¯5.18, pâ¯=â¯.026, ηp2 = .064), but no abnormalities in quickly-adapting sensory habituation were detected on an amplitude discrimination task. Performance on objective psychophysical tests was not associated with self-reported sensory gating symptoms or symptom severity. Implications of these results for the pathophysiology of BFRBs and related disorders are discussed.
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Retroalimentação Fisiológica/fisiologia , Hiperestesia/fisiopatologia , Inibição Psicológica , Tricotilomania/fisiopatologia , Adolescente , Adulto , Estudos de Casos e Controles , Transtornos Disruptivos, de Controle do Impulso e da Conduta/fisiopatologia , Transtornos Disruptivos, de Controle do Impulso e da Conduta/psicologia , Feminino , Habituação Psicofisiológica/fisiologia , Humanos , Masculino , Tempo de Reação , Filtro Sensorial , Limiar Sensorial , Índice de Gravidade de Doença , Tricotilomania/psicologia , Adulto JovemRESUMO
Trichotillomania (TTM) is a poorly understood condition that causes significant impairment, but effective behavioral management strategies exist. The phenomenology of TTM is complex and requires an individualized treatment approach, and there are some important facets of TTM that have only recently been recognized. Specifically, contemporary research indicates that hair pulling is often performed to regulate aversive sensations and provide somatosensory reward. In this article, we describe the complex phenomenology of TTM, evidence-based treatment options, and illustrate a case of sensory-based TTM treated effectively with a comprehensive behavioral intervention.
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Terapia Comportamental/métodos , Transtorno Obsessivo-Compulsivo/terapia , Tricotilomania/terapia , Adulto , Feminino , HumanosRESUMO
Body-focused repetitive behaviors (BFRBs), such as hair pulling, skin picking, and nail biting are common habits, but their pathological manifestations have been considered rare. Growing evidence suggests pathological forms of these behaviors can be conceptualized as a class of related disorders. However, few previous studies have examined the collective prevalence of related pathological BFRBs. The current study examined the self-reported prevalence of current (past month) subclinical and pathological BFRBs in a large (nâ¯=â¯4335) sample of college students. The study also examined the chronicity and impact of these behaviors. Results showed that 59.55% of the sample reported occasionally engaging in subclinical BFRBs, and 12.27% met criteria for a pathological BFRB, suggesting these conditions may be quite common. Of the various BFRB topographies, cheek biting was the most common. Both subclinical and pathological BFRBs tended to be chronic (i.e., occurring for longer than 1 year). Although persons with pathological BFRBs were distressed about their behavior, few experienced functional impairment or sought help for the behavior. Implications of these findings for the conceptualization and treatment of body-focused repetitive behaviors are discussed.