Nail biting in children with ADHD: exploring its clinical correlates, psychiatric comorbidities and association with other body-focused repetitive behaviors
- 1Department of Child and Adolescent Psychiatry, Etlik City Hospital, Ankara, Turkey
- 2Department of Child and Adolescent Psychiatry, Faculty of Medicine, Kastamonu University, 37150 Kastamonu, Turkey
Abstract
Objective: This study investigated whether children with ADHD who engage in nail-biting (NB) differ clinically and cognitively from those who do not, focusing on body-focused repetitive behaviors (BFRBs), psychiatric comorbidities, and cognitive profiles.
Methods: In this retrospective, cross-sectional chart-review study, 250 medication-naive children aged 8–12 years with ADHD were grouped by the presence (n = 100) or absence (n = 150) of NB. Co-occurring BFRBs, psychiatric comorbidities, cognitive performance (WISC-R subtest scaled scores) and symptom severity (RCADS-P, CPRS-R: S) were compared using Mann–Whitney U and chi-square tests, followed by multivariable binary logistic regression.
Results: Compared with children with ADHD without NB, those with NB showed higher rates of co-occurring BFRBs (thumb sucking, lip or cheek biting, bruxism), anxiety disorders, obsessive–compulsive disorder and speech disorders, and substantially higher parent-rated internalizing symptoms (RCADS-P Total Anxiety and Depression, rrb = 0.55). They also obtained lower scores on selected WISC-R subtests, most consistently Vocabulary, Comprehension, Picture Completion and Picture Arrangement. In multivariable analysis, older age, higher internalizing symptoms and lower scores on these subtests were independently associated with NB.
Conclusion: In children with ADHD, NB and co-occurring BFRBs were associated with a greater burden of internalizing symptoms and with lower performance on selected verbal and perceptual WISC-R subtests, and may correspond to a distinct clinical profile. These associations are cross-sectional and correlational and do not imply causality.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s40359-026-05343-2.
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BibTeX
@article{devecioglu2026nail,
title = {{Nail biting in children with ADHD: exploring its clinical correlates, psychiatric comorbidities and association with other body-focused repetitive behaviors}},
author = {Huriye Berna Devecioğlu and Makbule Esen Öksüzoğlu},
journal = {BMC Psychology},
year = {2026},
month = aug,
doi = {10.1186/s40359-026-05343-2},
url = {https://doi.org/10.1186/s40359-026-05343-2},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - JOUR
TI - Nail biting in children with ADHD: exploring its clinical correlates, psychiatric comorbidities and association with other body-focused repetitive behaviors
AU - Huriye Berna Devecioğlu
AU - Makbule Esen Öksüzoğlu
PY - 2026
DA - 2026/08/10
JO - BMC Psychology
DO - 10.1186/s40359-026-05343-2
UR - https://doi.org/10.1186/s40359-026-05343-2
AB - Objective: This study investigated whether children with ADHD who engage in nail-biting (NB) differ clinically and cognitively from those who do not, focusing on body-focused repetitive behaviors (BFRBs), psychiatric comorbidities, and cognitive profiles. Methods: In this retrospective, cross-sectional chart-review study, 250 medication-naive children aged 8–12 years with ADHD were grouped by the presence (n = 100) or absence (n = 150) of NB. Co-occurring BFRBs, psychiatric comorbidities, cognitive performance (WISC-R subtest scaled scores) and symptom severity (RCADS-P, CPRS-R: S) were compared using Mann–Whitney U and chi-square tests, followed by multivariable binary logistic regression. Results: Compared with children with ADHD without NB, those with NB showed higher rates of co-occurring BFRBs (thumb sucking, lip or cheek biting, bruxism), anxiety disorders, obsessive–compulsive disorder and speech disorders, and substantially higher parent-rated internalizing symptoms (RCADS-P Total Anxiety and Depression, rrb = 0.55). They also obtained lower scores on selected WISC-R subtests, most consistently Vocabulary, Comprehension, Picture Completion and Picture Arrangement. In multivariable analysis, older age, higher internalizing symptoms and lower scores on these subtests were independently associated with NB. Conclusion: In children with ADHD, NB and co-occurring BFRBs were associated with a greater burden of internalizing symptoms and with lower performance on selected verbal and perceptual WISC-R subtests, and may correspond to a distinct clinical profile. These associations are cross-sectional and correlational and do not imply causality. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s40359-026-05343-2.
SN - 2050-7283
ER -