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. 2023 Oct;54(5):1396-1403.
doi: 10.1007/s10578-022-01346-3. Epub 2022 Mar 21.

Sleep Disturbances in Pediatric Body-Focused Repetitive Behaviors: A Preliminary Investigation

Sydney D Biscarri Clark  1 , Ashley A Lahoud  2 , Theresa R Gladstone  2 , Emily P Wilton  2 , Christopher A Flessner  2
Affiliations

Sleep Disturbances in Pediatric Body-Focused Repetitive Behaviors: A Preliminary Investigation

Sydney D Biscarri Clark et al. Child Psychiatry Hum Dev. 2023 Oct.

Abstract

Body-focused repetitive behaviors (BFRBs) are repeated actions to one's body resulting in physical damage. Limited research has examined sleep, a known factor in psychological health, within the context of pediatric BFRBs. The current study sought to explore the connection between disordered sleep and BFRBs in a community sample. Aim 1 of the study was to determine the predictive power of group membership [control group (no BFRB symptoms reported), subthreshold BFRB group (mild BFRB symptoms reported; severity score of 2 or less out of 9), and those with symptoms characteristic of BFRBs (more than mild BFRB symptoms reported; severity score of 3 or higher out of 9)] for level of sleep disturbance. A hierarchical regression revealed that there was a significant effect of group membership after controlling for anxiety (F (3, 410) = 152.976, p < .001). Aim 2 of the study was to test whether there was a relationship between sleep disturbance and BFRB severity. The hierarchical regression revealed that at Step 1, anxiety accounted for 23.1% of the variance in BFRB severity (β = 0.48, t = 8.87, p < 0.001). At Step 2, sleep disturbance total score accounted for an additional 7.2% of the variance, suggesting this variable makes a unique contribution to overall BFRB severity (SDSC: β = 0.40, t = 5.18, p < 0.001). The findings of this study suggest that sleep could be a clinical factor to consider when conceptualizing a child with BFRBs.

Keywords: Anxiety; BFRBs; Hair pulling; Skin picking; Sleep.

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