Understanding the Difference Between OCD and BFRBs

"Body-focused repetitive behaviors (BFRBs) and obsessive-compulsive disorder (OCD) are often confused. Both conditions can cause significant distress and impairment to daily functioning, and both often involve repetitive actions that feel difficult or impossible to stop. Yet there are important differences in their underlying mechanisms, functions, and treatments. Let's explore what connects these two and what sets them apart. The Overlap: Why They're Sometimes Confused"

"1. Repetitive behaviors that feel compulsive At first glance, both BFRBs and OCD involve behaviors that are repeated and hard to control. Someone may repeatedly pull out hair (trichotillomania), pick at skin (excoriation disorder), or check the locks on the door dozens of times (OCD). This can understandably seem similar to an outside observer. 2. Tension and relief cycles Many people with BFRBs or OCD describe feeling a build-up of internal tension, discomfort, or distress that is only relieved by performing the behavior. In both cases, the action may offer temporary relief, but often at the cost of longer-term distress or impairment."

"3. Co-occurrence It's not uncommon for individuals to experience both OCD and a BFRB. For example, a person with contamination-related OCD, marked by fears of illness and cleaning rituals, may also struggle with compulsive skin picking. 4. Neurobiological overlap Emerging research suggests that there is shared brain circuitry involved in OCD and BFRBs, particularly in regions related to habit formation, impulse control, and emotional regulation."

BFRBs and OCD both produce repetitive, hard-to-control behaviors that cause distress and impairment. Both conditions often involve a tension–relief cycle where performing the behavior reduces internal tension temporarily but increases long-term impairment. Co-occurrence of OCD and BFRBs is common, and overlap in brain circuitry implicates habit formation, impulse control, and emotional regulation systems. DSM-5-TR places BFRBs and OCD within Obsessive-Compulsive and Related Disorders while listing distinct diagnoses such as trichotillomania and excoriation disorder. BFRBs tend to be more automatic and sensory-driven, whereas OCD compulsions often respond to intrusive thoughts or feared outcomes. Treatment differs, with habit-reversal therapies often used for BFRBs and exposure-based therapies and medications commonly applied for OCD.

Read at Psychology Today