Body-focused repetitive behavior disorders (RBD) refer to a group of behaviors that includes skin picking, hair pulling, skin biting, and nail biting, which result in physical and psychological difficulties. These behaviors for some individuals are simply referred to as “nervous habits”. However, these “nervous habits” become problematic when they interfere with the person’s everyday functioning. When these RBDs cross this line, then they are classified as Impulse Control Disorders according to the DSM-IV-TR. The key factor underlying RBDs is difficulty resisting the urge or impulse to perform a certain behavior that causes a degree of relief. The behavior continues because the RBD results in a more pleasant state; therefore, it is negatively reinforced.

Repetitive behavior disorders may lead to a number of physical problems. For example, repetitive skin picking can lead to sores, permanent scars, and skin infections. In addition, people with RBDs begin to feel embarrassed and ashamed about the effect of their RBDs that they may begin to avoid friends and family. The sad part about this situation is that these feelings may lead to the exact negative state that may lead them to engage in more RBDs.

In the case of compulsive skin picking (also known as dermatillomania), people may pick skin in any part of their body in an effort to reduce stimulation, such as when a person feels “stressed”, or in an attempt to increase stimulation, such as when a person feels “bored”. Compulsive skin picking may also be a result of a person’s maladaptive tendency to seek perfection in all areas of their life, including their physical appearance. People with compulsive skin picking may pick at parts of their body in an attempt to correct a possible flaw.

There tends to be a sensory component to RBDs. People with RBD tend to seek to find an area either of their skin or a hair that “feels” right or “feels” different. Once they have zeroed in on this area, they engage in their repetitive behavior in an almost unconscious manner. People with RBD also inspect their body in an effort to visually identify a location to engage in the repetitive behavior or in an effort to see what they have done.

The treatment for RBDs may include a combination of psychotropic medications and cognitive behavioral therapy (CBT). CBT often involves Habit Reversal Training and Exposure and Response Prevention (aka Exposure and Ritual Prevention).