Decoupling for body-focused repetitive behaviors

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Decoupling [1] is a behavioral self-help intervention for Body-focused repetitive behavior (DSM-5) (BFRB) such as trichotillomania, onychophagia (nail biting), skin picking and lip-cheek biting. The user is instructed to modify the original dysfunctional behavioral path by performing a counter-movement shortly before completing the self-injurious behavior (e.g., biting nails, picking skin, pulling hair). This is intended to trigger an irritation, which enables the person to detect and stop the compulsive behavior at an early stage. A systematic review from 2012 suggested some efficacy of decoupling, [2] which was corroborated by Lee et al. [3] in 2019. Decoupling was shown to be superior to Habit Reversal Training in treating BFRB in one direct comparison study [4] in 2021.

References

  1. Moritz, Steffen; Rufer, Michael (2011). "Movement decoupling: A self-help intervention for the treatment of trichotillomania". Journal of Behavior Therapy and Experimental Psychiatry. 42 (1): 74–80. doi:10.1016/j.jbtep.2010.07.001. PMID   20674888.
  2. Sarris, Jerome; Camfield, David; Berk, Michael (2012). "Complementary medicine, self-help, and lifestyle interventions for Obsessive Compulsive Disorder (OCD) and the OCD spectrum: A systematic review". Journal of Affective Disorders. 138 (3): 213–221. doi:10.1016/j.jad.2011.04.051. PMID   21620478.
  3. Lee, Melissa T.; Mpavaenda, Davis N.; Fineberg, Naomi A. (2019-04-24). "Habit Reversal Therapy in Obsessive Compulsive Related Disorders: A Systematic Review of the Evidence and CONSORT Evaluation of Randomized Controlled Trials". Frontiers in Behavioral Neuroscience. 13: 79. doi: 10.3389/fnbeh.2019.00079 . ISSN   1662-5153. PMC   6491945 . PMID   31105537.
  4. Moritz, Steffen; Penny, Danielle N.; Ahmed, Kaser; Schmotz, Stella (2021-04-21). "A Head-to-Head Comparison of Three Self-Help Techniques to Reduce Body-Focused Repetitive Behaviors". Behavior Modification. 46(4): 894–912. doi:10.1177/01454455211010707. PMC   9158250 . PMID   33880943.

https://pubmed.ncbi.nlm.nih.gov/33880943/