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TB 2022, 21(2): 99-113 |
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Garavand H, Sabzian S. Evaluation of the effectiveness of habit reversal techniques on reducing nail biting disorder and state/trait anxiety of male high school Students in khorramabad. TB 2022; 21 (2) :99-113
URL: http://tbj.ssu.ac.ir/article-1-1417-en.html
URL: http://tbj.ssu.ac.ir/article-1-1417-en.html
Hazrat-e Masoumeh University , sabzian1989@yahoo.com
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Evaluation of the effectiveness of habit reversal techniques on reducing nail biting disorder and state/trait anxiety of male high school Students in khorramabad
Houshang Garavand (Ph.D.)1 , Saeideh Sabzian (Ph.D.)2
1.Corresponding Author: Assistant Professor, Psychology Department, Faculty of Literature and Humanities, Lorestan University, Khorramabad, Iran. Email: garavand.h@lu.ac.ir Tel: 09187255874
2. Assistant Professor, Department of Counseling, School of Humanities, Hazrate Masoumeh University, Qom, Iran.
Abstract
Introduction: Nail biting is an inappropriate habit and its exact cause is debatable. Researchers believe that nail biting disorder is often associated with psychiatric disorders, including anxiety. State/trait anxiety can be considered an unstable emotional state reflecting the individual's interpretation of a stressful situation in a particular time frame and varies depending on the degree to which the situation is perceived threatening. This study aims to determine the evaluation of the effectiveness of habit reversal techniques on reducing nail biting disorder and state/trait anxiety in students.
Methods: The present semi-experimental study with pretest, post-test, and follow-up was conducted on six junior high school male students in the age range of 13-15 years, who asked for help by referring to the school counseling and were selected by convenience sampling method. They received a program of habit reversal techniques individually in 6 sessions for 1 month. Clinical interviewing, frequency recording of nail biting per day, and state/trait anxiety test were used to measure the variables.
Results: Data analysis showed that habit reversal techniques reduce nail biting and students' state/trait anxiety. Follow-up one month after the end of treatment indicated the persistence of these results.
Conclusion: The habit reversal training is effective on treating nail biting, reducing anxiety, and promoting the person life quality and symptoms from nail biting. Due the low sample size, it is suggested that while repeating the study in a larger sample, its effectiveness on the treatment of other habitual disorders be studied.
Keywords: Nail Biting, Habit Reversal Techniques, State/Trait Anxiety
References
1-Baghchechi M, Pelletier JL, Jacob SE. Art of Prevention: The importance of tackling the nail biting habit. International journal of women's dermatology. 2021;7(3):309-13.
2-Halteh P, Scher RK, Lipner SR. Onychophagia: A nail-biting conundrum for physicians. Journal of dermatological treatment. 2017;28(2):166-72.
3-Pacan P, Grzesiak M, Reich A, Kantorska-Janiec M, Szepietowski JC. Onychophagia and onychotillomania: prevalence, clinical picture and comorbidities.Acta Derm Venereol. 2014;94(1):67-71.
4-Winebrake JP, Grover K, Halteh P, Lipner SR. Pediatric onychophagia: a survey-based study of prevalence, etiologies, and co-morbidities. American journal of clinical dermatology. 2018;19(6):887-91.
5-Leung AK, Robson LM. Nailbiting. Clinical Pediatrics. 1990;29(12):690-2.
6-Ooki S. Genetic and environmental influences on finger-sucking and nail-biting in Japanese twin children. Twin Research and Human Genetics. 2005;8(4):320-7.
7-Ghanizadeh A. Nail biting; etiology, consequences and management. Iranian journal of medical sciences. 2011;36(2):73-9.
8-American Psychiatric Association. 5th Edition. American Psychiatric Association; Arlington, VA: 2013. Diagnostic and statistical manual of mental disorders.
9-Ghanizadeh A. Association of nail biting and psychiatric disorders in children and their parents in a psychiatrically referred sample of children. Child Adolesc Psychiatry Ment Health. 2008;2(1):13.
10-Ghanizadeh A, Shekoohi H. Prevalence of nail biting and its association with mental health in a community sample of children. BMC Res Notes. 2011;4:116.
11-Koritzky G, Yechiam E. On the value of nonremovable reminders for behavior modification: An application to nail-biting (onychophagia) Behav Modif. 2011;35(6):511–530.
12-Tosti A,Piraccini BM.Treatment of common nail disorders. Dermatol Clin. 2000;18(2):339–48.
13-Durdu M, Ruocco V. Clinical and cytologic features of antibiotic-resistant acute paronychia. J Am Acad Dermatol. 2014;70(1): 120–6.
14-Rothbaum BO, Meadows EA, Resick P, Foy DW.Cognitive-behavioral therapy. In: Foa EB, Keane TM, Friedman MJ. Effective treatments for PTSD: Practice guidelines from the International Society for Traumatic Stress Studies. Guilford Press; New York, NY: 2000: 320–5.
15-Bornstein PH, Rychtarik RG, McFall ME, Winegardner J, Winnett RL, Paris DA. Hypnobehavioral treatment of chronic nailbiting: a multiple baseline analysis. International Journal of Clinical and Experimental Hypnosis.1980;28(3):208-17.
16-Ivy JW, Meindl JN, Overley E, Robson KM. Token economy: A systematic review of procedural descriptions. Behavior Modification. 2017;41(5):708-37.
17- Ghanizadeh A, Derakhshan N, Berk M. N-acetylcysteine versus placebo for treating nail biting, a double blind randomized placebo controlled clinical trial. Antiinflamm Antiallergy Agents Med Chem.2013;12(3):223–8.
18-Sani G, Gualtieri I, Paolini M, Bonanni L, Spinazzola E, Maggiora M, et al. Drug treatment of trichotillomania (hair-pulling disorder), excoriation (skin-picking) disorder, and nail-biting (onychophagia). Current Neuropharmacology. 2019;17(8):775-86.
19-Azrin NH, Nunn RG, Frantz S. Treatment of hairpulling (trichotillomania): A comparative study of habit reversal and negative practice training. Journal of Behavior Therapy and Experimental Psychiatry.1980;11(1):13-20.
20-Miltenberger RG. Habit reversal treatment manual for trichotillomania. Tic Disorders, Trichotillomania, and Other Repetitive Behavior Disorders: 2001; 171-95.
21-Miltenberger R. Behavior modification: Principles and procedures. Pacific Grove, CA: Brooks. Cole Publishing Company. 1997.
22-Woods DW, Murray LK, Fuqua RW, Seif TA, Boyer LJ, Siah A. Comparing the effectiveness of similar and dissimilar competing responses in evaluating the habit reversal treatment for oral–digital habits in children. Journal of behavior therapy and experimental psychiatry.1999;30(4):289-300.
23-Magid M, Mennella C, Kuhn H, Stamu-OBrien C, Kroumpouzos G. Onychophagia and onychotillomania can be effectively managed. J Am Acad Dermatol.2017;77(5):143- 4.
24-Twohig MP, Woods DW, Marcks BA, Teng EJ. Evaluating the efficacy of habit reversal: Comparison with a placebo control. Journal of Clinical Psychiatry.2003;64(1):40-8.
25-Salimi H, Sabzian S, Jozai SK. The Effectiveness of Habit Reversal Training on the Nail-Biting Disorder. Socialworkmag. 2016; 4 (4) :29-34.[Persian]
26-Soruri M, Khanjani Z, Babapour-Kheiroddin J, Noorazar SGR. The Effectiveness of Habit Reversal Techniques Training for Treatment of Motor tics in Children. Journal of Clinical Psychology.2016;8(3):77-88.[Persian]
27-Jamshidian Qaleh Shahi P. Investigating the Effectiveness of Combination of Acceptance and Commitment Therapy with Habit Reversal Training in Reduction of Trichotillomania Symptoms. Jundishapur Scientific Medical Journal.2015;14(4):456-66. [Persian]
28-Mahram B. (1993). The guidance of Spilberger obvious and hide anxiety test. College of psychology and educational science, Mashhad University. [Persian]
29-Register AC, Beckham JC, May JG, Gustafson DJ. Stress inoculation bibliotherapy in the treatment of test anxiety. Journal of Counseling Psychology. 1991;38(2):115-16.
30-Diefenbach GJ, Reitman D, Williamson DA. Trichotillomania: a challenge to research and practice. Clinical psychology review. 2000;20(3):289-309.
Houshang Garavand (Ph.D.)1 , Saeideh Sabzian (Ph.D.)2
1.Corresponding Author: Assistant Professor, Psychology Department, Faculty of Literature and Humanities, Lorestan University, Khorramabad, Iran. Email: garavand.h@lu.ac.ir Tel: 09187255874
2. Assistant Professor, Department of Counseling, School of Humanities, Hazrate Masoumeh University, Qom, Iran.
Abstract
Introduction: Nail biting is an inappropriate habit and its exact cause is debatable. Researchers believe that nail biting disorder is often associated with psychiatric disorders, including anxiety. State/trait anxiety can be considered an unstable emotional state reflecting the individual's interpretation of a stressful situation in a particular time frame and varies depending on the degree to which the situation is perceived threatening. This study aims to determine the evaluation of the effectiveness of habit reversal techniques on reducing nail biting disorder and state/trait anxiety in students.
Methods: The present semi-experimental study with pretest, post-test, and follow-up was conducted on six junior high school male students in the age range of 13-15 years, who asked for help by referring to the school counseling and were selected by convenience sampling method. They received a program of habit reversal techniques individually in 6 sessions for 1 month. Clinical interviewing, frequency recording of nail biting per day, and state/trait anxiety test were used to measure the variables.
Results: Data analysis showed that habit reversal techniques reduce nail biting and students' state/trait anxiety. Follow-up one month after the end of treatment indicated the persistence of these results.
Conclusion: The habit reversal training is effective on treating nail biting, reducing anxiety, and promoting the person life quality and symptoms from nail biting. Due the low sample size, it is suggested that while repeating the study in a larger sample, its effectiveness on the treatment of other habitual disorders be studied.
Keywords: Nail Biting, Habit Reversal Techniques, State/Trait Anxiety
References
1-Baghchechi M, Pelletier JL, Jacob SE. Art of Prevention: The importance of tackling the nail biting habit. International journal of women's dermatology. 2021;7(3):309-13.
2-Halteh P, Scher RK, Lipner SR. Onychophagia: A nail-biting conundrum for physicians. Journal of dermatological treatment. 2017;28(2):166-72.
3-Pacan P, Grzesiak M, Reich A, Kantorska-Janiec M, Szepietowski JC. Onychophagia and onychotillomania: prevalence, clinical picture and comorbidities.Acta Derm Venereol. 2014;94(1):67-71.
4-Winebrake JP, Grover K, Halteh P, Lipner SR. Pediatric onychophagia: a survey-based study of prevalence, etiologies, and co-morbidities. American journal of clinical dermatology. 2018;19(6):887-91.
5-Leung AK, Robson LM. Nailbiting. Clinical Pediatrics. 1990;29(12):690-2.
6-Ooki S. Genetic and environmental influences on finger-sucking and nail-biting in Japanese twin children. Twin Research and Human Genetics. 2005;8(4):320-7.
7-Ghanizadeh A. Nail biting; etiology, consequences and management. Iranian journal of medical sciences. 2011;36(2):73-9.
8-American Psychiatric Association. 5th Edition. American Psychiatric Association; Arlington, VA: 2013. Diagnostic and statistical manual of mental disorders.
9-Ghanizadeh A. Association of nail biting and psychiatric disorders in children and their parents in a psychiatrically referred sample of children. Child Adolesc Psychiatry Ment Health. 2008;2(1):13.
10-Ghanizadeh A, Shekoohi H. Prevalence of nail biting and its association with mental health in a community sample of children. BMC Res Notes. 2011;4:116.
11-Koritzky G, Yechiam E. On the value of nonremovable reminders for behavior modification: An application to nail-biting (onychophagia) Behav Modif. 2011;35(6):511–530.
12-Tosti A,Piraccini BM.Treatment of common nail disorders. Dermatol Clin. 2000;18(2):339–48.
13-Durdu M, Ruocco V. Clinical and cytologic features of antibiotic-resistant acute paronychia. J Am Acad Dermatol. 2014;70(1): 120–6.
14-Rothbaum BO, Meadows EA, Resick P, Foy DW.Cognitive-behavioral therapy. In: Foa EB, Keane TM, Friedman MJ. Effective treatments for PTSD: Practice guidelines from the International Society for Traumatic Stress Studies. Guilford Press; New York, NY: 2000: 320–5.
15-Bornstein PH, Rychtarik RG, McFall ME, Winegardner J, Winnett RL, Paris DA. Hypnobehavioral treatment of chronic nailbiting: a multiple baseline analysis. International Journal of Clinical and Experimental Hypnosis.1980;28(3):208-17.
16-Ivy JW, Meindl JN, Overley E, Robson KM. Token economy: A systematic review of procedural descriptions. Behavior Modification. 2017;41(5):708-37.
17- Ghanizadeh A, Derakhshan N, Berk M. N-acetylcysteine versus placebo for treating nail biting, a double blind randomized placebo controlled clinical trial. Antiinflamm Antiallergy Agents Med Chem.2013;12(3):223–8.
18-Sani G, Gualtieri I, Paolini M, Bonanni L, Spinazzola E, Maggiora M, et al. Drug treatment of trichotillomania (hair-pulling disorder), excoriation (skin-picking) disorder, and nail-biting (onychophagia). Current Neuropharmacology. 2019;17(8):775-86.
19-Azrin NH, Nunn RG, Frantz S. Treatment of hairpulling (trichotillomania): A comparative study of habit reversal and negative practice training. Journal of Behavior Therapy and Experimental Psychiatry.1980;11(1):13-20.
20-Miltenberger RG. Habit reversal treatment manual for trichotillomania. Tic Disorders, Trichotillomania, and Other Repetitive Behavior Disorders: 2001; 171-95.
21-Miltenberger R. Behavior modification: Principles and procedures. Pacific Grove, CA: Brooks. Cole Publishing Company. 1997.
22-Woods DW, Murray LK, Fuqua RW, Seif TA, Boyer LJ, Siah A. Comparing the effectiveness of similar and dissimilar competing responses in evaluating the habit reversal treatment for oral–digital habits in children. Journal of behavior therapy and experimental psychiatry.1999;30(4):289-300.
23-Magid M, Mennella C, Kuhn H, Stamu-OBrien C, Kroumpouzos G. Onychophagia and onychotillomania can be effectively managed. J Am Acad Dermatol.2017;77(5):143- 4.
24-Twohig MP, Woods DW, Marcks BA, Teng EJ. Evaluating the efficacy of habit reversal: Comparison with a placebo control. Journal of Clinical Psychiatry.2003;64(1):40-8.
25-Salimi H, Sabzian S, Jozai SK. The Effectiveness of Habit Reversal Training on the Nail-Biting Disorder. Socialworkmag. 2016; 4 (4) :29-34.[Persian]
26-Soruri M, Khanjani Z, Babapour-Kheiroddin J, Noorazar SGR. The Effectiveness of Habit Reversal Techniques Training for Treatment of Motor tics in Children. Journal of Clinical Psychology.2016;8(3):77-88.[Persian]
27-Jamshidian Qaleh Shahi P. Investigating the Effectiveness of Combination of Acceptance and Commitment Therapy with Habit Reversal Training in Reduction of Trichotillomania Symptoms. Jundishapur Scientific Medical Journal.2015;14(4):456-66. [Persian]
28-Mahram B. (1993). The guidance of Spilberger obvious and hide anxiety test. College of psychology and educational science, Mashhad University. [Persian]
29-Register AC, Beckham JC, May JG, Gustafson DJ. Stress inoculation bibliotherapy in the treatment of test anxiety. Journal of Counseling Psychology. 1991;38(2):115-16.
30-Diefenbach GJ, Reitman D, Williamson DA. Trichotillomania: a challenge to research and practice. Clinical psychology review. 2000;20(3):289-309.
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Received: 2015/04/17 | Accepted: 2022/08/1 | Published: 2022/08/1
Received: 2015/04/17 | Accepted: 2022/08/1 | Published: 2022/08/1
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