- Is about Trichotillomania and BFRBs, not About Us
- Outlines what BFRBs and similar conditions are.
- Discusses DSM-V description of Trichotillomania and highlights issues about it which could be resolved in the next manual.
This article explains the criteria for diagnosis and discusses how BFRBs can be better clarified internationally. You will find out why you can trust us to help people affected by hair pulling or other BFRBs.
What are BFRBs
The World Health Organisation lists Body-Focused Repetitive Behaviours (BFRBs) under “Obsessive-Compulsive and Related Disorders”. Trichotillomania (hair-pulling) and skin-picking are recognised in ICD-11 (International Classification of Diseases).
Is BFRB recovery possible?
Yes, pick free IS possible and we are committed to helping to bring out this potential for people with trichotillomania and dermatillomania, as well as other BFRBs. To achieve this, we aim to create awareness, continue valuable research, and support and enable individuals. We have done this by giving talks in school assemblies and to doctors’ surgeries, holding BFRB conferences in London and providing written material to explain how BFRBs feel. Much of our work is talking to parents and reassuring them that their child with a BFRB will live a happy and fulfilled life.
International Classification
The American Psychiatric Association’s DSM 5 Manual describes Trichotillomania and Dermatillomania as mental health disorders characterized by hair pulling and skin picking. They are generally grouped grouped together, with beard hair pulling, biting lips, cheeks and fingers, and nail biting as body focused repetitive behaviour or BFRBs.- To qualify as trichotillomania, hair pulling must be recurrent and repetitive.
- It must cause distress or problems in social or other functional areas of life.
Problems With International Classification
The word “recurring” is used, however there is clearly a compulsive element in most cases. The manual states that it cannot be explained by another condition, but there is very high cross-diagnosis with OCD, social anxiety and generalised anxiety as well as ASD.
Hair pulling is unusual, but it is not madness. It is not a disease but a condition, which at least in some is genetic in origin. Many people pull hair or eyelashes to remedy what they think are flaws and hairs “growing in wrongly”, the “wrong texture” or ingrown hairs, yet the manual states that it is not dysmorphic.
The final criteria for trichotillomania is that it must cause distress or problems in social or other functional areas of life. This is not true in all cases and particularly not in babies, who can also present with trichotillomania.
Most commonly, people pull hair from their eyelashes, eyebrows and/or the scalp, and they can also pull from the pubic region, pets and other people. These conditions are secretive in nature and often attempts will be made to hide signs of hair loss. It can be hard to comprehend what BFRBs are, because it sometimes leads to social withdrawal.