Body focused repetitive behaviors among Salvadorian youth: Incidence and clinical correlates

• Body focused repetitive behaviors are common among Salvadorian children.
• Nail biting was common (34.6%), as was skin picking (24.8%) and hair pulling (10.5%).
• Many youth experienced significant distress and/or interference due to BFRBs.
• Skin picking and hair pulling were related to behavioral and emotional functioning.

Body-focused repetitive behaviors (BFRBs; e.g., hair pulling, skin picking, and nail biting) can cause significant physical and psychological distress. However, data examining BFRBs in non-clinical youth is limited. This study examined parent-reports of the incidence and clinical correlates of BFRBs in 315 Salvadorian children (4–17 years). Forty-six percent had at least one BFRB; nail biting was commonly reported (34.6%), followed by skin picking (24.8%), and hair pulling (10.5%). Of those endorsing BFRBs, 13.7% reported elevated distress and/or interference due to these behaviors, including approximately one-third of skin pickers and hair pullers (8.3% and 2.9% of the total sample) and one-fifth of nail biters (7.3% of the total sample). Skin pickers and hair pullers, but not nail biters, had higher levels of internalizing and externalizing behaviors, poorer adaptive functioning, and more difficulties with inattention, compared to those who reported no BFRBs. Skin picking symptom severity was positively correlated with externalizing and internalizing behaviors. Nail biting symptom severity was associated with increased internalizing symptoms, while severity of hair pulling was not significantly associated with behavioral and emotional functioning. These data suggest that BFRBs are commonplace and may be associated with behavioral and emotional functioning.