Trichotillomania, Skin Picking, and Other Body-Focused Repetitive Behaviors

Book excerpt: Underestimated, under-researched, and often poorly understood, the body-focused repetitive disorders nevertheless cause human suffering that is serious, persistent, and pervasive. These disorders can occur in both adults and children and manifest themselves as hair pulling (trichotillomania), pathologic skin picking, thumb sucking, and nail biting. Although these disorders are common, very few medical students and residents hear them addressed in lectures or know where to begin when confronted with a patient presenting with these behaviors. Trichotillomania, Skin Picking, and Other Body-Focused Repetitive Behaviors seeks to remedy this situation by synthesizing the latest research on body-focused repetitive disorders and presenting it in a systematic, easy-to-grasp manner. Much has changed in the more than a decade since the last book on this topic was published. This new volume reflects the most current and substantive research into the etiology and symptoms of body-focused repetitive disorders and therapeutic options. Organized in logical fashion, it begins with a review of the clinical characteristics, moves on to diagnosis and evaluation, and concludes with a full review of treatment options. Special features include: Extensive material to help clinicians and patients understand the underlying purpose of engaging in these behaviors, which include, reducing tension, regulating strong emotion, and alleviating boredom. Separate chapters on adults and children, who may have a different presentation and a different set of treatment options. An additional chapter focuses on the role of the child patient's family in the diagnosis and treatment of the disorder. Thorough coverage of the full range of treatments -- including psychotherapy, medication, and alternative treatments -- which provides the clinician with an evidence-based approach to treating patients. Discussion of the psychobiology of hair pulling and skin picking, which allows the reader to understand and contextualize the disorder from a neurological perspective and offers clues that may assist in optimizing treatment. A presentation style that is detailed enough for clinicians, yet accessible enough for a lay audience, including patients with the disorder and the families who seek to understand and support them. Trichotillomania, Skin Picking, and Other Body-Focused Repetitive Behaviors fills a critical gap in the literature by addressing this common and frequently debilitating disorder in an utterly current, highly practical, and wholly compassionate manner.