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The Psychology Behind Nail Biting

AHA Publisher — Fri, 19 Aug 2022 07:00:56 +0000

Dr. Nicola Williams, Ph.D. via News-Medical – Nail biting is a common behavior often viewed as nothing more than an annoying habit. The behavior is all too often ignored. However, nail biting can be serious and it is a misunderstood and misdiagnosed disorder. This article probes nail-biting as a medical condition, seeks to understand who is most likely to be afflicted by the distressing condition, and looks at its association with mental health conditions. Is Nail Biting Actually a Medical Condition? Nail biting is known medically as onychophagia. It is a type of self-grooming behavior involving biting and chewing the nails, including the toenails. It is a destructive habit, especially when it is repeated and exhibited in response to stressful circumstances. Nail biting can lead to serious problems such as infection and mental health conditions. And yet onychophagia currently resides as a non-official diagnostic entity. In recent years the problem has been receiving an increasing amount of scientific attention. And several articles have appeared in popular media attesting to the potential gravity of the condition if it is left untreated. Nail biting sits among other conditions such as trichotillomania (skin picking) under the umbrella of pathological grooming. Research has been carried out to try to understand whether these conditions all stem from similar underlying tendencies. A related psychiatric disorder is known as onychotillomania and is associated with chronic picking and manicuring the nails. Nail Biting and Young People Nail biting is prevalent in children and adolescents. It occurs in 20-33% of children and nearly half of teenagers ––a whopping 45% (Siddiqui et al., 2020). Although the problem is much reduced approaching adulthood, in some it does unfortunately persist. In the US, research has shown that up to one in three people meet the clinical diagnostic criteria for the presence of at least one pathological grooming behavior. This statistic is rather surprising given the figures are greater than those for depression, anxiety, and alcohol abuse (Maraz, et al. 2017; Bijil et al., 1998; Offord, et al., 1996). What are the reasons behind nail biting? Research has revealed the following common reasons for the behavior (Siddiqui et al., 2020): Nervousness: Due to stress and anxiety. In this instance, nail biting is temporarily appealing due to the calming effect it has on the nervous system Emotions: Our emotional make-up is integral to why we turn to nail biting. Shyness and low self-esteem can have an effect in addition to the pain caused by highly traumatic life events such as death or divorce Perfectionism: As discussed above those with this trait exhibit a low tolerance for boredom and frustration that is alleviated by nail-biting Boredom: due to inactivity/for want of finding something better to do Imitation: Children copying adult behavior Psychosomatic: This is usually seen in aggressive families And this list brings us to the psychology of nail-biting, a behavior frequently associated with mental health conditions and, less obviously, with a particular type of personality. The Psychology of Nail Biting Mental health conditions associated with nail biting can involve severe emotional distress, depression, and anxiety. In the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM–5), NB is classified as an “Other specified obsessive-compulsive and related disorder” with the specification of “body-focused repetitive behavior (BFRBs),” whereas the International Statistical Classification of Diseases and Related Health Problems ICD-10 classifies the practice as “other specified behavioral and emotional disorders with onset usually occurring in childhood and adolescence” (Siddiqui et al., 2020). Common psychiatric conditions linked to nail biting in children are attention deficit hyperactivity disorder, oppositional defiant disorder, and separation anxiety disorder. In addition, some other co-morbid disorders include major depressive disorder, tic disorder, forms of obsessive-compulsive disorder, enuresis (involuntary urination), mental retardation, pervasive developmental disorder and sometimes also generalized anxiety disorder and panic disorder. There is a classification system linked with nail biting as follows (Siddiqui et al., 2020): Nail biters who do it without realizing Nail biting to control anxiety Nail biting for the purposes of attention seeking Self-injurious nail biting to control aggression Nail biting as part of the obsessive-compulsive disorder spectrum Nail biting according to the DSM-5: other specified obsessive-compulsive and related disorder Nail biting according to the ICD-10: other specified behavioral and emotional disorders with onset usually occurring in childhood and adolescence Nail biting that is classified as Pathological and Non-pathological It is thought that nail biting may also be linked with having a perfectionist personality type. Perfectionism is associated with a low boredom threshold and a much-reduced tolerance for frustration. So, what can be done for those suffering from this all-too-common disorder? To begin with, raising awareness about the condition and its impact seems to be a good place to start. In terms of dealing with the condition, certainly in children, admonishment is completely ineffective. However, positive reinforcement and behavioral modification techniques have so far shown much promise. References Bijl, R. et al. 1998. Prevalence of psychiatric disorder in the general population: results of The Netherlands Mental Health Survey and Incidence Study (NEMESIS). Soc Psychiatry Psychiatric Epidem. Doi: 10.1007/s001270050098 Maraz, A. et al. 2017. Pathological grooming: Evidence for a single factor behind trichotillomania, skin picking and nail biting. PLoS One. Doi: 10.1371/journal.pone.0183806 Offord, D. et al. 1996. One-year prevalence of psychiatric disorder in Ontarians 15 to 64 years of age. Can J Psychiatry. Doi: 10.1177/070674379604100904 Siddiqui, J. 2020. Onychophagia (Nail Biting): an overview. Indian Journal of Mental Health. 7: 97. To read the original article click here.

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Gene Discovery May Hold Key to Better Therapies for OCD

AHA Publisher — Fri, 16 Jul 2021 07:00:18 +0000

Columbia University Irving Medical Center via EurekAlert – NEW YORK, NY (June 28, 2021)–In the first analysis of its kind, researchers at Columbia University Vagelos College of Physicians and Surgeons and several other institutions have linked distinct patterns of genetic mutations with obsessive-compulsive disorder (OCD) in humans. The work, published online June 28 in Nature Neuroscience, confirms the validity of targeting specific genes to develop new OCD treatments and points toward novel avenues for studying this often debilitating condition. OCD, which affects 1% to 2% of the population, often runs in families and genes are known to play a large role in determining who develops the disease. However, the identity of many OCD genes remains unknown. “Many neurological diseases are influenced by strongly acting mutations which can cause disease by themselves,” says David Goldstein, PhD, director of the Institute for Genomic Medicine at Columbia and a senior author on the new paper. “These mutations are individually very rare but important to find because they can provide a starting point for the development of therapeutics that target precise underlying causes of disease.” Although strongly acting mutations have been hypothesized to exist in OCD, statistically reliable evidence has been difficult to obtain. Most previous studies on the genetics of OCD have used a “candidate gene” approach, in which researchers focus on plausible genes that might be involved in pathogenesis and look for genetic signatures of risk. Although that approach has had some successes, it can lead to challenges in statistical interpretation and can miss unexpected genes. As a result, both funding agencies and the pharmaceutical industry increasingly focus on genome-wide analyses that can securely implicate genes in disease risk. “The solution to the problem is to study all the genes in the genome at the same time and ask whether any of them have significant evidence of influencing risk. That had not been done yet at scale in OCD,” says Goldstein. In collaboration with Gerald Nestadt, MBBCh, a psychiatrist at Johns Hopkins University with access to a cohort of OCD patients, Goldstein’s team took this genome wide approach, which uses high-throughput sequencing and computational biology techniques to identify relevant genes anywhere in the genome. The investigators looked at genes that encode protein using whole exome sequencing in more than 1,300 OCD patients and compared them to similarly large control groups. The multi-institution collaboration also included scientists from the University of North Carolina at Chapel Hill, the David Geffen School of Medicine in Los Angeles, Harvard Medical School, and SUNY Downstate Medical Center in Brooklyn. The analysis showed a strong correlation between OCD and rare mutations, particularly in a gene called SLITRK5 that had been previously linked to OCD in candidate-gene studies. Goldstein expects that the new data on SLITRK5 will encourage pharmaceutical companies and translational researchers to develop drugs that target this gene. The study also identified a specific pattern of variation in other genes. “When you look at genes that do not tolerate variation in the human population, those are the genes most likely to cause disease, and with OCD, we see an overall increased burden of damaging mutations in those genes compared to controls,” Goldstein says. “That’s telling us that there are more OCD genes to be found and where to find them.” For patients suffering from OCD and their doctors, new treatments can’t come too soon. OCD causes uncontrollable, recurring thought patterns and behaviors that interfere with patients’ daily lives. “OCD is a disabling disorder that is twice as common as schizophrenia,” says H. Blair Simpson, MD, PhD, professor of psychiatry at Columbia University Vagelos College of Physicians and Surgeons and director of the Center for OCD & Related Disorders at New York State Psychiatric Institute, who was not involved with the new study. Two available treatments, serotonin reuptake inhibiting drugs and cognitive-behavioral therapy, are highly effective, Simpson adds, but only work on about half of patients. “Thus, these genetic findings are very exciting; they indicate that the promise of precision medicine could include OCD, ultimately transforming how we diagnose and treat this disorder.” To read the original article click here.

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How to Use the Neurocycle to Break the Cycle of OCD Thinking

AHA Publisher — Tue, 16 Mar 2021 07:00:38 +0000

Dr. Caroline Leaf – In this podcast (episode #262) and blog, I talk about how to Neurocycle to break the cycles of OCD (obsessive-compulsive thinking) and avoid getting stuck in toxic thinking patterns and rumination. Let’s start with getting stuck in our thoughts. OCD is often defined as an anxiety disorder characterized by uncontrollable, unwanted thoughts and ritualized, repetitive behaviors someone feels compelled to perform. If you battle with OCD, you probably recognize that many of your obsessive thoughts and compulsive behaviors are irrational—but even so, you feel unable to resist them and break free. I see OCD-type thinking as a way of coping with an underlying unresolved issue. It’s not always the most effective or sustainable way to deal with pain or trauma, but it’s a coping mechanism—a type of distraction you use to try to manage or keep the source of your pain bearable. It’s not “brain damage”; it is a pattern that is set up to help you cope in a situation that is threatening your safety or survival in some way, which can develop into a toxic habit that takes over your life. With OCD-type thinking, there is an underlying cause that needs to be identified and reconceptualized, as I discuss in my most recent book, Cleaning Up Your Mental Mess. You can’t just condition yourself to stop because the automatized driving force is still there—you must get to the root of this type of thinking using self-regulation and mind-management techniques, as I talk about in my book. You need to observe the pattern of your thoughts and behaviors, discover what the activator is and reconceptualize this using what I call the Neurocycle, which is a 5 step, scientifically-based process that helps you manage your mind and change your thinking. Over a period of at least 63 days, you can perform the Neurocycle steps to find and address the root cause(s) of this type of thinking: Gather awareness of what you are feeling emotionally and physically and your perceptions as you work on your OCD thinking. Reflect on why you feel and act the way you do—be as specific as possible. Write this down—this is way to help organize your thinking and gain clarity into your thought patterns and behaviors. Recheck what you have written. Look for patterns and triggers (or activators) in your work life, your relationships, your responses, your attitudes and so on. Take action. I call this step an “active reach”. It is essentially an action you take to reinforce the new, reconceptualized pattern of thinking and behaving you want in your life (which is replacing the old, toxic OCD cycle). To read the original article click here. For more articles by Dr. Leaf click here.

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Scientists Discover Link Between Unique Brain Cells and OCD and Anxiety

AHA Publisher — Mon, 28 Oct 2019 07:00:54 +0000

University of Utah via Newswise – Mice with dysfunctional microglia exhibited OCD behaviors, and female sex hormones drove symptom severity and added anxiety. Newswise — According to the National Institute of Mental Health, 1 in 3 people experience debilitating anxiety—the kind that prevents someone from going about their normal life. Women are also more at risk to suffer from anxiety. Yet the roots of anxiety and other anxiety-related diseases, such as Obsessive Compulsive Disorder (OCD), are still unclear. In a new study, University of Utah scientists discovered a new lineage of specialized brain cells, called Hoxb8-lineage microglia, and established a link between the lineage and OCD and anxiety in mice. Mice with disabled Hoxb8-lineage microglia exhibited excessive overgrooming behavior. The symptom resembles behavior in humans with a type of OCD called trichotillomania, a disorder that causes people to obsessively pluck out their own hair. Their experiments proved that Hoxb8-lineage microglia prevent mice from displaying OCD behaviors. Additionally, they found that female sex hormones caused more severe OCD behaviors and induced added anxiety in the mice. “More women than men experience debilitating anxiety at some point in their lives. Scientists want help these people to get their lives back. In this study were able to link anxiety to a dysfunction in a type of microglia, and to female sex hormones,” said lead author Dimitri Traenkner, research assistant professor in the School of Biological Sciences at the University of Utah. “It opens up a new avenue for thinking about anxiety. Since we have this model, we have a way to test new drugs to help these mice and hopefully at some point, this will help people.” The study published today in Cell Reports. Discovery of a New Microglia Lineage Microglia are crucial during brain development in the womb—they ensure that brain structures and neural circuitry all wire together correctly. Traenkner and colleagues showed that microglia belong to least two distinct sub-lineages of cells. One lineage called Hoxb8-lineage microglia makes up about 30% of all microglia in the brain but until now, no one knew whether they had any unique function. Mario Capecchi, Nobel laureate and senior author of the study, had long suspected that Hoxb8-microglia were special. In previous research, he disabled Hoxb8-lineage microglia expecting some impact on development. But the mice seemed fine. ‘We didn’t really know what to make of the fact that mice without Hoxb8 appear so normal, until we noticed that they groom significantly more and longer than what would be considered healthy. And that’s how the whole thing started,” said Capecchi, who is also a distinguished professor of human genetics at the University of Utah Health. This is the first study to describe microglia’s role in OCD and anxiety behaviors in mice. “Researchers have long suspected that microglia have a role in anxiety and neuropsychological disorders in humans because this cell type can release substances that may harm neurons. So, we were surprised to find that microglia actually protect from anxiety, they don’t cause it,” added Traenkner. Female Sex Hormones Drive Symptom Severity The mice showed sex-linked severity in their symptoms; female mice’s OCD symptoms were consistently more dramatic than in the males. Females also exhibited an additional anxiety symptom that was lacking in male mice—the researchers designed and validated a new test showing that the pupils of female mice dilated dramatically, triggered by a fight-or-flight stress response. To test whether sex hormones drove OCD and anxiety symptoms, Traenkner and colleagues manipulated estrogen and progesterone levels in the mice. They found that at male-levels, female mice’s OCD and anxiety behaviors resembled the male response, and at female hormone levels, male mice’s OCD behaviors looked more like the female’s severe symptoms, and showed signs of anxiety. “Our findings strongly argue for a mechanistic link between biological sex and genetic family history in the risk to develop an anxiety disorders,” said Traenkner. What Does This Mean for Humans? For many, anxiety drastically impacts their work, friends, family and lifestyle. Scientists and health care professionals are always looking for ways to help people get their lives back. This study of mouse models links anxiety to dysfunctional microglia. Down the line, the findings could spark new microglia-focused studies in patients with anxiety and, eventually, help to better treat this debilitating disorder. “It’s not that we discovered how to fix anxiety in humans, but we constructed a platform for the discovery of new drugs against anxiety,” Traenkner said. Anne Boulet, Erik Peden, Richard Focht and Donn Van Deren of the Department of Human Genetics at U of U Health were coauthors on the paper. The National Institutes of Health funded the research. To read the original article click here.

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