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General/Aetiology The following papers are represent different perspectives on the aetiology of chronic nail biting. Bohne et al. (2005) argue that pathologic hairpulling, skin picking, and nailbiting share a common aetiology, as dysfunctional, learnt stresscoping behaviours. Cavaggioni and Romano (2003) take a psychodynamic perspective, arguing that like self-mutilation and eating disorders, nail biting is symptomatic for latent unhealthy sexual and otherwise aggressive struggles. Teng et al. (2002) and Williams et al. (2006) both take a functional approach, arguing, like Bohne et al. (2005), that nail biting is rewarding because it reduces anxiety and/or reduces feelings of boredom. Bohne, A., Keuthen, N., & Wilhelm, S. (2005). Pathologic hairpulling, skin picking, and nail biting. Annals of Clinical Psychiatry, 17, 227-232. Cavaggioni, G., & Romano, F. (2003). Psychodynamics of onychophagia. Eating and Weight Disorders, 8, 62-67. Teng, E. J., Woods, D. W., Twohig, M. P., & Marcks, B. A. (2002). Body-focused repetitive behavior problems: Prevalence in a nonreferred population and differences in perceived somatic activity. Behavior Modification, 26, 340-360. Williams, T. I., Rose, R., & Chisholm, S. (2006). What is the function of nail biting: An analog assessment study. Behaviour Research and Therapy, 45, 989-995.
Effects These two papers demonstrate the negative physical effects of nail biting. Baydas et al. (2007) discuss their finding that nail biting increases the amount of
potentially harmful bacteria in nail biters’ mouths. Krejci (2000) discusses a case of gum-related injury caused by nail biting. Baydas, B., Uslu, H., Yavuz, I., Ceylan, I., Dagsuyu, I. (2007). Effect of a chronic nail-biting habit on the oral carriage of Enterobacteriaceae. Oral Microbiology and Immunology, 22, 1-4. Krejci, C. B. (2000). Self-inflicted gingival injury due to habitual fingernail biting. Journal of Periodontology, 71, 1029-1031.
Treatment The following papers are seminal works in the treatment of nail biting, and other related health-compromising habits. Allen (1995) compares Azrin and Nunn’s (1973) habit-reversal technique with a mild aversion treatment (i.e., applying a bitter substance to fingernails). Bucher (1968) argues for self-administered shock as an effective aversion therapeutic technique. Odlaug et al. (2007) introduce NAcetyl Cysteine as an effective drug for nail biting and related disorders, that is free of nasty side-effects. Ronon and Rosenbaum (2001) outline a self-help system for children. Allen, K. W. (1995). Chronic nailbiting: A controlled comparison of competing response and mild aversion treatments. Behaviour Research and Therapy, 34, 269-272. Azrin, N. H., & Nunn, R. G. (1973). Habit-reversal: A method of eliminating nervous habits and tics. Behaviour Research and Therapy, 11, 619-628. Bucher, B. D. (1968). A pocket-portable shock device with application to nailbiting. Behaviour Research and Therapy, 6, 389-392.
Odlaug, B. L., & Grant, J. E. G. (2007). N-Acetyl Cysteine in the treatment of grooming disorders. Journal of Clinical Psychopharmacology, 27, 227-229. Ronon, T., & Rosenbaum, M. (2001). Helping children to help themselves: A case study of enuresis and nail biting. Research on Social Work Practice, 11, 338356.