Body focused repetitive disorders

Body-focused repetitive disorders is an umbrella term in the DSM-5 for disorders where individuals compulsively damage their physical appearance.

These used to be classified as impulse-control disorders, but now belong in the family of obsessive-compulsive disorders.

Two of the more well-known ones are trichotillomania, which is a hair-pulling disorder, and excoriation, which is a skin-picking disorder.

Obsessive-compulsive disorders are usually defined by psychological obsessions—thoughts, urges, and images that are unwanted, intrusive, and recurrent—as well as behavioral compulsions exhibited physically in response to the obsessions.

For body-focused repetitive disorders, though, the self-damaging behavior isn’t usually related to a conscious psychological obsession, but occurs instead when a person feels stressed, anxious, or even bored.

Once a person starts engaging in the self-damaging behavior, there’s usually a strong urge to keep doing it over and over again.

This can happen in multiple short episodes throughout the day, or during single long sessions that can last for hours at a time.

People with body-focused repetitive disorders aren’t always fully aware of their behavior while engaged in the compulsion, making it difficult to stop.

These behaviors are distinct from intentional behaviors aimed at improving physical appearance, like plucking one’s eyebrows.

They’re also not attributable to problems stemming from disorders like substance abuse, like, for example, the skin-picking associated with amphetamine or cocaine use.

Body-focused repetitive disorders don’t include compulsions resulting from other mental disorders, like picking at skin during a tactile hallucination, when someone thinks bugs are crawling under their skin.

They’re unrelated to behaviours made in response to irritating stimuli from other illnesses, like scratching at an itchy scabies rash.

Finally, body-focused repetitive disorders aren’t related to side-effects from medication.