The OCD Spectrum of Disorders
The following are diagnostic categories that are related to OCD. They can occur alone or they can occur along with OCD, which is referred to as co-morbid or co-existing with OCD.
Body-Focused Repetitive Behaviors
Body-focused Repetitive Behaviors (BFRB’s) include:
Trichotillomania (Hair Pulling Disorder)
A condition whereby a person compulsively pulls their hair out. This can lead to bald patches or total baldness. The hair may be from the head, eyebrows, eyelashes or from any other part of the body. The treatment for this is called ComB or Comprehensive Behavioral Model, along with Habit Reversal Training (HRT) which involves awareness training and competing muscular responses. In addition strategies/interventions are used to help the patient resist the urge to pull.
Dermatillomania (a/k/a Excoriation Disorder or Compulsive Skin Picking)
People who suffer from this behavior have an urge to pick at their skin, which they have trouble resisting. They may experience bleeding, infections, bruises, or even permanent damage to the skin. The behavior is often unconscious, and if unaware of their actions, people with this compulsion may have difficulty stopping.
Nail Biting (Onychophagia) and Nail Picking (Onychotillomania)
People who bite their nails or pick at their nails experience bleeding, bruises, infections, and even permanent damage to the fingers, toes, or skin.
This disorder involves repetitive, stereotyped, involuntary movements and vocalizations called tics. Vocal tics include coprolalia (uttering swear words) or echolalia (repeating the words or phrases of others). Some of the more common physical tics include eye blinking, facial grimacing, shoulder shrugging, and head or shoulder jerking.
Those who struggle with this disorder have a very hard time parting with or discarding useless possessions because they believe they may need them at some time in the future, even though they really have no intrinsic value. Just the thought of throwing out these items causes tremendous distress. As a result, the person ends up with excessive accumulation of items that can cause dangerous clutter in their home, and a possibly dangerous fire hazard.
Body Dysmorphic Disorders (BDD)
This is defined as not perceiving the objective reality or a misperception of one’s body. An example of this is a person seeing a body part as being ugly, defected or deformed. This is either a gross exaggeration of the body imperfection or seeing a problem that does not exist at all. Compulsions involved may include checking, seeking repetitive reassurance or covering the area from public view.
An eating disorder characterized by extremely low body weight, body image distortion, and an obsessive fear of gaining weight. Individuals with anorexia nervosa are known to control body weight commonly through the means of voluntary starvation.
Bulimia or Bulimia Nervosa is an eating disorder characterized by recurrent binge eating, followed by vomiting (purging), fasting, or the use of enemas, laxatives, or diuretics. Over-exercising is also very common with this disorder.