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The role of emotion regulation in body-focused repetitive behaviours

Published online by Cambridge University Press:  30 March 2016

Sarah Roberts ,
Kieron O'Connor ,
Frederick Aardema ,
Claude Bélanger  and
Catherine Courchesne
Sarah Roberts
Affiliation:
Research Center, University Institute of Mental Health at Montreal, Montreal, Quebec, Canada University of Quebec at Montreal (UQAM), Montreal, Quebec, Canada
Kieron O'Connor*
Affiliation:
Research Center, University Institute of Mental Health at Montreal, Montreal, Quebec, Canada
Frederick Aardema
Affiliation:
Research Center, University Institute of Mental Health at Montreal, Montreal, Quebec, Canada
Claude Bélanger
Affiliation:
University of Quebec at Montreal (UQAM), Montreal, Quebec, Canada McGill University, Montreal, Quebec, Canada
Catherine Courchesne
Affiliation:
University of Quebec at Montreal (UQAM), Montreal, Quebec, Canada
*
*Author for correspondence: K. O'Connor, PhD, Research Center, University Institute of Mental Health at Montreal, 7331 Hochelaga, Montreal, Quebec, Canada, H1N 3V2 (email: [email protected]).
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Abstract

Body-focused repetitive behaviours (BFRBs) including trichotillomania, skin picking, and nail biting, are non-functional self-destructive habits, which have a severe negative impact on everyday functioning. Although BFRBs cause distress, they are maintained by both negative (relief) and positive (stimulation) reinforcement. The emotional regulation (ER) model proposes that people with BFRBs have a general deficit in ER and, as a consequence, engage in BFRBs to alleviate affect and reinforce the behaviour. The current study was designed to explore differences in ER between people with BFRBs and controls to identify specific emotions triggering BFRBs. Forty-eight participants (24 BFRB, 24 controls) completed questionnaires measuring Difficulties in Emotional Regulation (DERS), a Triggers Scale and an Affective Regulation Scale (ARS). Significant differences in people with BFRBs and controls were reported principally on the DERS subscales of lack of emotional clarity, difficulties in impulse control, and access to ER strategies. On the ARS, the BFRB group reported overall difficulty ‘snapping out’ of emotions. The majority of BFRBs were reported to be triggered by anxiety (78%), tension (70%), or boredom (52%). The clinical implication is that ER could be beneficially targeted in therapy for BFRBs.

Keywords

Anxietybodily sensationsCBTemotionperfectionismtics
Type
Original Report
Information
the Cognitive Behaviour Therapist , Volume 9 , 2016 , e7
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2016 

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References

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Keuthen, NJ, Rothbaum, BO, Fama, J, Altenburger, E, Falkenstein, MJ, Sprich, SE, Kearns, M, Meunier, S, Jenike, MA, Welch, SS (2012). DBT-enhanced cognitive-behavioral treatment for trichotillomania: a randomized controlled trial. Journal of Behavioral Additions 1, 106–114.CrossRefGoogle ScholarPubMed
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Rufer, M, Bamert, T, Klaghofer, R, Moritz, S, Schilling, L, Weidt, S (2014). Trichotillomania and emotion regulation: is symptom severity related to alexithymia? Psychiatric Research 218, 161–165.CrossRefGoogle ScholarPubMed

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