{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:46:23Z","timestamp":1793119583111,"version":"4.5.0"},"reference-count":34,"publisher":"SAGE Publications","issue":"4","license":[{"start":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T00:00:00Z","timestamp":1618963200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Behav Modif"],"published-print":{"date-parts":[[2022,7]]},"abstract":"<jats:p>Body-focused repetitive behaviors (BFRBs) include skin picking, trichotillomania, nail biting and cavitadaxia\/lip-cheek biting, among other behaviors. For the first time, we compared three different self-help techniques aimed at reducing BFRBs. We explored the acceptance and preliminary efficacy of the approaches and whether the techniques exerted differential effects depending on BFRB-type.<\/jats:p>\n                  <jats:p>A total of 113 participants with at least one BFRB were randomly allocated to either habit reversal training (HRT; active elements: awareness and competing response training), decoupling (DC) or decoupling in sensu (DC-is). Reassessment was conducted 4\u2009weeks later. The Generic Body-Focused Repetitive Behavior Scale (GBS) served as the primary outcome. The completion rate was best for DC-is (68.6%) as compared to HRT (57.1%) and DC (53.5%). A total of 34.8% of completers in the DC group showed an improvement of at least 35% on the GBS compared to 10.0% in the HRT and 23.3% in the DC-is group. In accordance with previous work, moderator analyses showed that improvement under DC is best for non-skin-pickers. A dose-effect relationship emerged, particularly for HRT. Subjective appraisal ratings were more favorable for DC-is and HRT than for DC. With respect to completion rate, subjective appraisal and symptom improvement, DC-is yielded consistently satisfactory results, whereas HRT showed good subjective but rather poor objective improvement. Those who performed DC, especially non-skin-pickers, showed good improvement but overall completion and subjective efficacy were low. Future studies should investigate whether the three techniques exert add-on effects when combined and whether demonstration via new media (e.g., video) will augment comprehensibility and thus efficacy of the techniques.<\/jats:p>","DOI":"10.1177\/01454455211010707","type":"journal-article","created":{"date-parts":[[2021,4,21]],"date-time":"2021-04-21T12:15:40Z","timestamp":1619007340000},"page":"894-912","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":27,"title":["A Head-to-Head Comparison of Three Self-Help Techniques to Reduce Body-Focused Repetitive Behaviors"],"prefix":"10.1177","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8601-0143","authenticated-orcid":false,"given":"Steffen","family":"Moritz","sequence":"first","affiliation":[{"name":"University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Danielle","family":"Penney","sequence":"additional","affiliation":[{"name":"Centre Int\u00e9gr\u00e9 Universitaire de Sant\u00e9 et de Services Sociaux de l\u2019Ouest-de-l\u2019\u00cele-de-Montr\u00e9al, Douglas Mental Health University Institute, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaser","family":"Ahmed","sequence":"additional","affiliation":[{"name":"University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stella","family":"Schmotz","sequence":"additional","affiliation":[{"name":"University Medical Center Hamburg-Eppendorf, Hamburg, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,4,21]]},"reference":[{"key":"bibr1-01454455211010707","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"bibr2-01454455211010707","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7967(73)90119-8"},{"key":"bibr3-01454455211010707","doi-asserted-by":"publisher","DOI":"10.1016\/0005-7916(82)90035-0"},{"key":"bibr4-01454455211010707","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2011.03.013"},{"key":"bibr5-01454455211010707","doi-asserted-by":"publisher","DOI":"10.1007\/978-0-387-70883-6"},{"key":"bibr6-01454455211010707","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1989.01810110048007"},{"key":"bibr7-01454455211010707","volume-title":"Introduction to mediation, moderation, and conditional process analysis: A regression-based approach","author":"Hayes A. 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