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Body-focused Repetitive Behavior Disorders: From Competing Paradigms Toward Iterative Integration.

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Body-focused Repetitive Behavior Disorders: From Competing Paradigms Toward Iterative Integration.

Related Experiment Video

Marble Burying and Nestlet Shredding as Tests of Repetitive, Compulsive-like Behaviors in Mice

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Published on: December 24, 2013

Body-Focused Repetitive Behavior Disorders: From Competing Paradigms Toward Iterative Integration.

Dan J Stein¹, Christine Lochner²

¹SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa.

Annual Review of Clinical Psychology

|May 7, 2026

View abstract on PubMed

Summary

This summary is machine-generated.

Body-focused repetitive behaviors (BFRBs), like hair-pulling and skin-picking, have been viewed through many lenses. Scientific pluralism, embracing diverse perspectives, offers a path for advancing BFRB knowledge and treatment.

Keywords:

BFRBs body-focused repetitive behaviors conceptual frameworks paradigm shift scientific pluralism

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Area of Science:

Psychiatry and Behavioral Science
Neuroscience
Mental Health Research

Background:

Body-focused repetitive behaviors (BFRBs), including hair-pulling and skin-picking, have a long history of medical description.
Historical and contemporary understanding of BFRBs has been shaped by various theoretical frameworks, not always theory-neutral.

Purpose of the Study:

To review the diverse conceptual frameworks used to understand BFRBs.
To evaluate the strengths and limitations of each framework.
To propose a path forward for BFRB research and clinical practice.

Main Methods:

Literature review and synthesis of historical and current conceptual frameworks applied to BFRBs.
Analysis of theoretical approaches including psychoanalysis, cognitive behaviorism, psychopharmacology, nosology, neuroscience, consumer advocacy, and global mental health.

Critical evaluation of the contributions and limitations of each framework.

Main Results:

BFRB understanding has evolved through multiple paradigms, such as psychoanalysis, cognitive behaviorism, and neuroscience.
Each theoretical approach offers unique insights but also possesses inherent limitations.
No single framework has fully captured the complexity of BFRBs.

Conclusions:

Advocating for a new paradigm is less productive than embracing scientific pluralism for BFRBs.
A pluralistic approach, integrating insights from diverse frameworks, is beneficial for clinicians and researchers.
Scientific pluralism facilitates iterative and integrative progress in understanding and treating BFRBs.