Body-focused repetitive behaviors (BFRBs) are repeated actions to one's body resulting in physical damage. Limited research has examined sleep, a known factor in psychological health, within the context of pediatric BFRBs. The current study sought to explore the connection between disordered sleep and BFRBs in a community sample. Aim 1 of the study was to determine the predictive power of group membership [control group (no BFRB symptoms reported), subthreshold BFRB group (mild BFRB symptoms reported; severity score of 2 or less out of 9), and those with symptoms characteristic of BFRBs (more than mild BFRB symptoms reported; severity score of 3 or higher out of 9)] for level of sleep disturbance. A hierarchical regression revealed that there was a significant effect of group membership after controlling for anxiety (F (3, 410) = 152.976, p < .001). Aim 2 of the study was to test whether there was a relationship between sleep disturbance and BFRB severity. The hierarchical regression revealed that at Step 1, anxiety accounted for 23.1% of the variance in BFRB severity (β = 0.48, t = 8.87, p < 0.001). At Step 2, sleep disturbance total score accounted for an additional 7.2% of the variance, suggesting this variable makes a unique contribution to overall BFRB severity (SDSC: β = 0.40, t = 5.18, p < 0.001). The findings of this study suggest that sleep could be a clinical factor to consider when conceptualizing a child with BFRBs.

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http://dx.doi.org/10.1007/s10578-022-01346-3DOI Listing

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Article Synopsis
  • - The study explores the relationship between body-focused repetitive behavior (BFRB) disorders, like trichotillomania and skin picking, and anxiety disorders, finding that comorbidity is common, with notable prevalence rates for various anxiety disorders.
  • - A meta-analysis of 119 studies revealed that current and lifetime prevalence rates for anxiety disorders among individuals with BFRBs are significant, such as 19.2% for generalized anxiety disorder and 27.5% for any anxiety disorder.
  • - Although comorbid anxiety is frequent in BFRB cases, the correlation between anxiety severity and BFRB severity is only low to moderate, indicating a complex relationship that warrants further research and consideration in clinical practice. *
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Background: Many conditions we now call body-focused repetitive behaviors (BFRBs) have been subject to research for several decades, most notably trichotillomania and skin picking. However, the American Psychiatric Association did not combine these conditions into a single category, body-focused repetitive behavior disorders (BFRBDs), until the fifth edition of the DSM (2013). Several aspects of the disorder remain uncertain and controversial.

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