Adaptation of movement decoupling for compulsive joint cracking: A case report

Compulsive joint cracking is a body-focused repetitive behavior (BFRB), which often results in negative social feedback due to its characteristic sound. While behavioral techniques are recommended in BFRBs, no published studies or case reports exist specifically for compulsive joint cracking. The authors report the case of DZ, who engaged in severe joint cracking of his knuckles and, at times, his back. The individual was assessed with an adapted version of the Generic BFRB Scale (GBS). DZ was instructed on how to perform decoupling, a technique that has shown efficacy in other BFRBs. He was also advised to use "fidget devices" that mimic aspects of the dysfunctional behavior in a less conspicuous way. Scores on the GBS were reduced by almost 50%, which corresponded with DZ's subjective appraisal of feeling more in control. Randomized controlled trials are needed to assess the (differential) efficacy these techniques to ameliorate compulsive joint cracking.