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ψ PsychoBabble

August 2007

Special Edition: Nail Biting

This month’s PsychoBabble newsletter reviews the research on the causes, ef-
fects, and potential cures for chronic nail biting.

Nail biting is one of non-nail biters, this does not mean that all nail bit-
those “bad habits” ers have depression or obsessive-compulsive disor-
that many people der, or whatever. Most nail biters are otherwise
have, most people healthy, well-adjusted individuals who just hap-
find disgusting, but pened to pick up a nasty habit. The general consen-
few people really sus - though there are many disagreements on the
know anything details - is that nail biting is (for some, perhaps
about. Sure, every- evolutionary reason associated with self-grooming)
one has opinions a relaxing, stress-reducing behaviour to most.
about why people bite their nails, and how to get Some individuals discover - via imitation or by
them to stop, but familiarity with the research on sheer accident - that nail biting is psychologically
the area is rare, even among clinicians. For this rewarding. The behaviour is thus reinforced over a
month’s edition of the PsychoBabble Newsletter, I long period of time, to the extent that it becomes a
decided to read as many research articles on nail chronic habit.
biting as humanly possible, to enlighten the masses
about the causes and effects of, and treatments for Is nail biting bad? Many people associate
this nasty habit. nail biting with endoparasites, parasitic “worms”
that can infiltrate
What causes nail biting? people’s digestive
Most people think stress systems. Naturally
or anxiety is causally then, nausea, diar-
related to nail biting. rhoea and other
And indeed, psy- related health prob-
chologists have lems are often
found that nail blamed on nail bit-
biting is often ing. While the be-
used as an anxiety- lief that nail biting
reduction strategy. increases the risk of having these parasitic worms
Perhaps more unex- invade one’s stomach has yet to be empirically jus-
pectedly, nail biting has tified, there is evidence that nail biters carry more
also been found to be a boredom-reduction strat- and nastier bacteria in their mouths than non-nail
egy. Nail biters bite their nails, not only when they biters. Perhaps our folk theories about nail biting
feel stressed and nervous, but also when they’re causing nausea and diarrhoea are not so far-fetched
bored! Now, many people will interpret these find- after all. Furthermore,
ings to mean that nail biters are chronically nerv- nail biting has long
ous, anxious, or bored people. Nail biting is there- been known to cause
fore understood as a symptom for underlying anxi- infections of the gums
ety disorders. However, while it is true that more and fingers. While
nail biters do suffer from such disorders than do these infections are

not fatal, they can be painful, replace the maladaptive nail biting behaviour with
inconvenient, and expensive a more adaptive or neutral behaviour. Nail biters
to treat. At a social level, nail are taught to do other things - e.g., give themselves
biting can be the cause of manicures, chew gum, clench on a stress ball -
embarrassment and social whenever they feel the urge to bite their nails.
difficulties. Given that most
people find bitten fingernails
unattractive, this habit might
even decrease one’s reproductive fitness! Far from
being an innocuous habit, nail biting might well be
a evolutionarily maladaptive self-grooming tech-

Furthermore, research on cognitive-behavioural

How to stop nail biting? Everyone
treatments of nail biting strongly affirm the impor-
who has tried to stop biting their nails has at least
tance of social support. Any sort of behaviour
considered the “paint a bitter substance to your
modification is difficult to do alone, and nail biting
nails” approach to the matter, reasoning that (a) the
is no exception. Finally, there have recently been
bitter substance will make them more aware of
some advances in pharmacological treatments of
their behaviour, and that (b) the bitterness will act
nail biting. However, these are difficult to obtain,
as punishment for the behaviour, thereby reducing
and tend to have nasty side effects. Furthermore,
it. This, and other forms of aversion therapy (self-
these drugs do not work on everybody, and only
administered electric
work if the drugs are continually taken. Two of the
shocks, anyone?) have
more established drugs are Clomipramine and N-
been shown to be effective
Acetyl Cysteine (NAC). Clomipramine is more
in the short term, and in
commonly used to treat obsessive-compulsive dis-
highly motivated individu-
order, but in this context is administered at much
als. However, drop-out
smaller dosages. Still, the side effects - drowsiness,
rates for this sort of ther-
nausea, and diarrhoea among the milder ones - are
apy are understandably
formidable. The research on NAC much more
high. More common
promising: It’s effective on 60% of chronic nail bit-
nowadays, cognitive-behavioural package pro-
ers and people with other similar habits, and has no
grammes are used to treat chronic nail biters. As
known side effects, except possible increased flatu-
the name suggests, these programmes usually in-
lence. That’s right: Flatulence. However, these
clude cognitive (i.e., educational or informational)
drugs have not yet been approved by the US Food
components and behavioural (i.e., operant learning)
and Drug Administration as a treatment for nail bit-
components. The aim of the cognitive component is
ing, and are therefore difficult to obtain. The best
often to inform nail biters about the negative side
bet then, it seems, is cognitive-behavioural therapy
effects associated with nail biting, and the positive
(CBT) or socially-supported, self-help programmes
effects of having neat, unbitten nails, in order to
based on CBT principles.
motivate nail biters
to kick the habit.
They might also For more information on nail biting, visit our we-
included courses blog at As al-
on self-grooming ways, if there are any psychological phenomena
and manicuring. you wish the PsychoBabble team to investigate,
The most well- send an e-mail to our Editor-in-Chief, Jonathan
established behavioural technique is the habit- Jong, at
reversal treatment, the main point of which is to