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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 5 of 5. This is the beginning of the thread.
Posted by noa on October 12, 2000, at 15:11:14
The child of someone I know has behaviors that are socially very noxious--his peers (he's a young adolescent) are grossed out by these behaviors, on top of rejecting him for immature social skills.
It seems like these behaviors (nose picking, scalp and skin picking, collecting hair and dandruff on his school desk, blowing his nose into the air, or into a tissue and then looking at the results, touching his ears and then smelling his fingers, etc.) are akin to trichotillomania in the sense that behavioral techniques help him SUPPRESS them for a while, but not for long. And, he does them less when he is more actively engaged in something that is interesting to him.
It doesn't seem like OCD in the sense that there is no "forbidden thoughts" to trigger the behaviors, and there is no ritual patterns. It seems automatic and hard to suppress.
Any ideas of what kinds of medications would work for this type of problem? He takes adderall for adhd and that seems to be helping with the attention, etc. (academically he is doing better this year).
Posted by stjames on October 12, 2000, at 18:46:06
In reply to Body Focused Symptoms--any med. ideas?, posted by noa on October 12, 2000, at 15:11:14
>
> Any ideas of what kinds of medications would work for this type of problem? He takes adderall for adhd and that seems to be helping with the attention, etc. (academically he is doing better this year).James here....
Some of the behaviors, like picking, could be the Adderall while others strike me as learning what is socially OK, a common problem in ADD. I use Inderal to calm my ADD tic's, that might be a possibility. A coach to work on these behaviors would be helpful, too.
james
Posted by Noa on October 13, 2000, at 9:09:03
In reply to Re: Body Focused Symptoms--any med. ideas?, posted by stjames on October 12, 2000, at 18:46:06
Thanks, James, but the behaviors preceeded the adderall, and he has had a ton of behavioral work, which supressed the behaviors for a while.
Posted by medlib on October 15, 2000, at 0:56:57
In reply to Body Focused Symptoms--any med. ideas?, posted by noa on October 12, 2000, at 15:11:14
Noa--
OCD that shows up in childhood often manifests as compulsions without obsessions. There's a pretty high comorbidity with Tourettes and/or ADHD. Adolescence can make complex tic-like behavior worse in males (testosterone surge). Tenex might be worth a try, or Halcion plus an antidepressant.
These rxs are prescribed for Tourettes. TD is a problem with Halcion, of course. His preoccupation with body sensations seems significant to me.Interesting that all of his compulsions have a socially-distancing effect and he has problems with social skills. If you drive people away with noxious behaviors, you sure don/t have to deal with the anxieties of trying to relate to them. Such (probably) unconscious anxiety-avoidance can be powerfully reinforcing and may partially account for CBT's limited effectiveness.
If I were his parent, I think I'd take him to a pediatric neurologist who specializes in these areas next. And I'd pray for a giant-sized helping of patience.
Well wishes--medlib
> The child of someone I know has behaviors that are socially very noxious--his peers (he's a young adolescent) are grossed out by these behaviors, on top of rejecting him for immature social skills.
>
> It seems like these behaviors (nose picking, scalp and skin picking, collecting hair and dandruff on his school desk, blowing his nose into the air, or into a tissue and then looking at the results, touching his ears and then smelling his fingers, etc.) are akin to trichotillomania in the sense that behavioral techniques help him SUPPRESS them for a while, but not for long. And, he does them less when he is more actively engaged in something that is interesting to him.
>
> It doesn't seem like OCD in the sense that there is no "forbidden thoughts" to trigger the behaviors, and there is no ritual patterns. It seems automatic and hard to suppress.
>
> Any ideas of what kinds of medications would work for this type of problem? He takes adderall for adhd and that seems to be helping with the attention, etc. (academically he is doing better this year).
Posted by noa on October 16, 2000, at 8:03:07
In reply to Re: Body Focused Symptoms--any med. ideas?, posted by medlib on October 15, 2000, at 0:56:57
Thanks, Medlib. I was thinking it is in the OCD-tourettes family, it just isn't as clear cut as other ocd or tic symptoms.
This is the end of the thread.
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