Dr John Kruse
@drjohnkruse·16.8K subscribers·484 videos
Body Focused Repetitive Behaviors and ADHD
Posted
October 9, 2025
Views
902
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October 9, 2025
902
59
10
7.65%
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16:29Now PlayingMain Chapters:
The body focused repetitive behaviors (BFRB) of hair pulling (trichotillomania), onychotillomania (nail biting), and excoriation (skin picking) are closely associated with each other and are grouped with obsessive-compulsive disorders. Although only 1-3% of the population meet formal criteria for problematic levels of these behaviors, up to two thirds of people engage in some of these behaviors, some of the time, often during periods of stress. These behaviors closely resemble grooming behaviors in rodents and primates.
A handful of studies find that BFRBs occur more often among those with ADHD, and that ADHD is over-represented in those with BFRBs. There are case reports of stimulant, and non-stimulant ADHD medications making BFRBs worse. But there are also reports of BFRB resolving once these medications are started. The very few studies assessing larger groups of individuals with ADHD have not found a major impact on BFRBs from starting medications to treat ADHD.
The research on what helps improve BFRB is quite scanty. SSRI, lamotrigine, and N-acetyl cysteine have all been successful in at least a few cases, as have behavioral therapy approaches.
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References:
Comorbid trichotillomania and attention-deficit hyperactivity disorder in adults (2023)
Double-Blind Placebo-Controlled Study of Memantine in Trichotillomania and Skin-Picking Disorder (2023)
Characteristics of 262 adults with skin picking disorder (2022)
Prevalence, gender correlates, and co-morbidity of trichotillomania (2020)
Pathological grooming: Evidence for a single factor behind trichotillomania, skin picking and nail biting (2017)
Skin picking disorder comorbid with ADHD successfully treated with methylphenidate (2018)
Full Chapter list:
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Psychiatrist, neuroscientist, and author John Kruse, MD, PhD presents practical, actionable, well-researched information about treatment options that scientists and clinicians recommend for adult ADHD and other mental health conditions.
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