The who, what, where, when, why and how of picking, pulling and biting behaviors

This chapter outlines critical elements of the development of BFRBDs from an attachment-based and trauma-informed perspective. In it, the author reviews the factors that create vulnerability to BFRBDs. Genetic predisposition and physiological sensitivity create vulnerability to any number of psychosocial stressors, eventually leading to engagement with picking, pulling and/or biting behaviors. This chapter includes demographic information, common comorbid conditions and information about the medical, emotional and social consequences of the disorders. Case examples are woven into this chapter to illuminate these concepts, helping the reader build a foundational knowledge of BFRBDs.