The silent struggle: Barriers, delays, and missed opportunities in the treatment of body-focused repetitive behaviors

IF 4.8 2区医学 Q1 PSYCHIATRY

Comprehensive psychiatry Pub Date : 2026-07-01 Epub Date: 2026-07-02 DOI:10.1016/j.comppsych.2026.152733

Steffen Moritz, Lisa Borgmann, Kim M. Rojahn, Lena Jelinek, Stella Schmotz

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引用次数: 0

Abstract

Background

Despite the high prevalence of body-focused repetitive behaviors (BFRBs; e.g., skin picking, trichotillomania, nail biting, cavitadaxia/lip-cheek biting), many affected individuals neither seek nor receive adequate treatment. This study investigates treatment-seeking behaviors and experience with self-help strategies as well as professional interventions among individuals with BFRBs.

Methods

A total of 971 participants with BFRBs were recruited via online platforms and self-help organizations. Participants completed the Generic Body-Focused Repetitive Behavior Scale (GBS-8) and answered questions regarding age of onset, perceived causes of their condition, prior self-help attempts, professional treatment history, and reasons for not seeking help.

Results

Only 13.5% of participants with BFRBs had sought professional help (mainly psychologists) for their BFRB. Barriers included lack of awareness, perceived low symptom severity, shame, and distrust of treatment. Use of self-help was common (72.2%). However, only a minority used structured and evidence-based techniques like habit reversal training or decoupling. The average duration of untreated BFRBs for those who eventually sought help was approximately 11 years, with cavitadaxia showing the longest delay. Among those who underwent professional care, around 40% received no evidence-based advice. Habit reversal training was the most frequently recommended technique, followed by medication and habit replacement.

Conclusions

Despite the significant burden of BFRBs, treatment-seeking remains low. Shame, misinformation, and limited access to professionals with specific expertise remain key barriers. These findings highlight the urgent need for increased awareness, accessible interventions, and low-threshold professional training opportunities (e.g., www.uke.de/e-bfrb-en) to improve care of individuals with BFRBs.

查看原文本刊更多论文

无声的斗争：在治疗以身体为中心的重复行为时遇到的障碍、延误和错失的机会。

背景：尽管以身体为中心的重复性行为（bfrb，如抠皮、拔毛癖、咬指甲、咬牙/咬唇）的患病率很高，但许多患者既没有寻求也没有得到适当的治疗。本研究探讨了bfrb患者的寻求治疗行为、自助策略和专业干预经验。方法：通过网络平台和自助组织共招募971名bfrb参与者。参与者完成了通用身体聚焦重复行为量表（GBS-8），并回答了有关发病年龄、症状的感知原因、先前的自助尝试、专业治疗史和不寻求帮助的原因等问题。结果：仅有13.5%的BFRB患者曾就其BFRB寻求专业帮助（主要是心理学家）。障碍包括缺乏意识、感觉症状严重程度低、羞耻和对治疗的不信任。自助的使用很常见（72.2%）。然而，只有少数人使用结构化和基于证据的技术，如习惯逆转训练或脱钩。对于那些最终寻求帮助的人来说，未经治疗的bfrb平均持续时间约为11年，其中cavitadaxia显示出最长的延迟。在接受专业护理的患者中，约40%的人没有得到循证建议。习惯逆转训练是最常被推荐的方法，其次是药物治疗和习惯替代。结论：尽管bfrb带来了巨大的负担，但寻求治疗的人数仍然很低。羞耻感、错误信息以及接触专业人士的机会有限仍然是主要障碍。这些发现突出表明，迫切需要提高认识，提供可获得的干预措施和低门槛的专业培训机会（例如www.uke.de/e-bfrb-en），以改善对bfrb患者的护理。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Comprehensive psychiatry 医学-精神病学

CiteScore

12.50

自引率

1.40%

发文量

审稿时长

29 days

期刊介绍： "Comprehensive Psychiatry" is an open access, peer-reviewed journal dedicated to the field of psychiatry and mental health. Its primary mission is to share the latest advancements in knowledge to enhance patient care and deepen the understanding of mental illnesses. The journal is supported by a diverse team of international editors and peer reviewers, ensuring the publication of high-quality research with a strong focus on clinical relevance and the implications for psychopathology. "Comprehensive Psychiatry" encourages authors to present their research in an accessible manner, facilitating engagement with clinicians, policymakers, and the broader public. By embracing an open access policy, the journal aims to maximize the global impact of its content, making it readily available to a wide audience and fostering scientific collaboration and public awareness beyond the traditional academic community. This approach is designed to promote a more inclusive and informed dialogue on mental health, contributing to the overall progress in the field.