Category: Parenting / Families
Body-focused repetitive behaviors (BFRBs; e.g. hair pulling, nail biting) are conceptualized as a cluster of maladaptive repetitive behaviors directed towards the body and are believed to share biological and phenomenological overlap. Collectively, BFRBs demonstrate significant prevalence within childhood along with considerable impairment (e.g., bleeding, infection, embarrassment, social isolation), yet their etiology is poorly understood. Research has begun to focus on psychosocial factors – particularly within the family – as risk and protective factors of child psychopathology. Anxiogenic (anxiety-promoting) parenting has been linked with anxiety-related diagnoses (e.g., generalized anxiety disorder, hair pulling disorder). In particular, pediatric hair pulling research indicates family functioning (e.g. limited independence, family aggression) as a potential etiological and/or maintenance factor. Given functional overlap between hair pulling and other BFRBs, parenting may be implicated within other BFRBs in children. As such research is currently non-existent, this study examined the relationship between anxiogenic parenting and pediatric BFRBs.
As part of a larger investigation, this study utilized online data gathered about 530 children ages 7 to 17. Parents/caregivers completed a self-report battery including items assessing child BFRB presence (i.e., yes or no to skin picking, hair pulling, nail biting, lip/cheek biting, and/or nose picking), frequency and associated impairment (both rated from mild to severe), as well as parenting practices. Two hundred and sixty-eight children were identified as exhibiting BFRBs, some of whom engaged in multiple presentations.
Utilizing the entire sample, logistic regression was used to determine the effects of parenting on child BFRBs. The model was significant, χ2(1)=30.37, p<0.001, explaining 7.4% (Nagelkerke R2) of the variance. An examination of the resultant odds ratio revealed that for each unit increase in anxiogenic parenting scores, parents were 2.1 times more likely to report that their child engages in a BFRB. Further, amongst youths who engage in BFRBs, linear regression also suggested that higher anxiogenic parenting was predictive of both higher parent-reported frequency (β=0.32; F(1,249)=28.23, p < 0.001) and impairment (β=0.31; F(1,247)=26.38, p < 0.001) with both models accounting for 10% of the variance in the respective outcomes.
In sum, anxiogenic parenting appears to be highly related to pediatric BFRBs. This is unsurprising given the connection between anxiety and BFRBs in the literature. As the first examination of parenting in BFRBs, this study provides preliminary insights into etiological and/or maintenance factors of these behaviors and warrants further research in these domains.