Severe Morbid Onychophagia: The Classification as Self-Mutilation and a Proposed Model of Maintenance

Abstract

There is a need for empirical research as to the tension-reducing nature of severe onychophagia.

The impact of emotions on body-Focused repetitive behaviors: Evidence from a non-treatment-seeking sample

“…Many individuals occasionally use the teeth to replace nail clippers in grooming, but NB as a BFRB involves biting past the nail bed and cuticles, drawing blood, and resulting in chronic scarring, or in red, sore, and infected fingers (Penzel, 1995;Wells, Haines, & Williams, 1998). Reports of NB prevalence are limited by dated research and inconsistent operational definitions across studies.…”

Pathologic Hairpulling, Skin Picking, and Nail Biting

“…Like OCD, these disorders are characterized by the repetitive, intentional performance of behavior, which sufferers perceive as difficult to resist despite knowledge of potential adverse consequences. Furthermore, the compulsions in OCD, as well as the pathologic behaviors in HP, SP, and NB, appear related to negative affective states (7,8,11). In addition, there is evidence that the neurotransmitter serotonin plays a role in each of these disorders, given their similar responses to the class of medications known as serotonin reuptake inhibitors (1,7,12,13).…”

“…Moreover, NB, SP, and HP have also been conceptualized as mild forms of self-mutilation (8). Favazza and colleagues have considered these behaviors to be superficial, compulsive self-mutilations, that are repetitive, ritualistic, and typically occur in multiple episodes (15).…”

“…As a form of self-grooming behavior, the length of nails is controlled by the teeth rather than nail scissors. In its severe forms nails are bitten frequently and high in intensity "beyond the free edge, with the nail margin below the soft tissue border," which can lead to serious morbidity (8).…”

Brittle nail syndrome: A pathogenesis-based approach with a proposed grading system

“…The majority of cases are considered mild and cosmetic, but nevertheless lead to serious morbidity. 37 Nail damage such as scarring, infection, and bleeding may result in brittle nails. The cause of this condition is usually psychogenic.…”