Stop Nail Biting with this Easy Step

Finger and nail biting, also known as onychophagia, is a stubborn habit that afflicts many people, causing embarrassment and health risks. Nail biting is a common stress-relieving habit that occurs in a variety of situations, from the rigors of academic pressures to periods of boredom. At times, finger and nail biting can occur without one even realizing it. Many who are habitual finger and nail biters will engage in this activity while involved at some other task in which their hands are not busy; while watching television, talking on the phone, driving, reading a magazine, even sleeping. While finger and nail biting may seem like a harmless habit, it does introduce health risks. Those who bite their fingers and nails increase their risk for infections in a variety of areas, including their nail beds, gums, and mouth area. Other dental problems can also be caused by habitual finger and nail biting. Many finger and nail biters become embarrassed by the red, sore, and ragged appearance of their fingers and the bleeding cuticles that are indications of the habit. For those who have chronically engaged in this habit, normal nail growth is put at risk and some live with deformed nails (Gabby, 2003).

The participant of this study is a 16 year old male who has engaged in finger and nail biting for three years. Like many other nail biters, he finds his habit most active and problematic during times of stress. Academic activities and activities that require enduring levels of concentration were verbally targeted by the participant as areas in which he finds himself engaging in finger and nail biting. The participant would like to stop engaging in this habit so that his fingers and nails would heal and not look ‘ragged’ and cause him embarrassment.

An ABAB Reversal design was implemented with the use an aversive as a positive punisher in the hopes to reduce and/or stop the finger and nail biting practices of the participant. Data was collected during times that the participant indicated normally caused him the most stress throughout the day, namely during school and homework periods. As the participant is home schooled, recording data during the school day did not prove to be intrusive or problematic. Finger and nail biting was defined as any time the participant was seen chewing on his nails, fingers, or soft tissue areas around the cuticle. Although a single action of finger and nail biting can occur for an extended period of time, much like thumb sucking or other nervous habits, it should be noted that each separate action was measured for frequency and not duration of the action. Thus, even a prolonged engagement in finger or nail biting would only count as one instance, with the next instance occurring after the participant had stopped and then reengaged in the behavior.

Baseline data were collected for a period of 14 days in which the participant was observed during certain school times and homework periods. The participant was also observed during times of homework on weekends. In all, the participant was observed for one hour per day. During this period of initial baseline observation, the participant engaged in finger and nail biting 7.79 times per day.  Figure 1 shows data recorded during this initial baseline observation. Following baseline, a 14-day intervention was introduced in an effort to decrease and/or stop the finger and nail biting behavior. ‘Bite It’, a nail biting deterrent manufactured by Top Ten Cosmetics, was purchased from a CVS Pharmacy and used during both intervention periods of the study. ‘Bite It’ was applied to the entire nail surface using a brush, much like one would apply nail polish. The formula was applied a total of six times during both periods of intervention; on Mondays and Thursdays, as the packaging instructed that the product should be applied twice a week. Although data collection occurred during set periods in the school day and times of homework, continual positive punishment was delivered each time the participant engaged in finger or nail biting, as the aversive remained on his nails throughout the intervention periods. In order to return to baseline between intervention periods, ‘Bite It’ was removed using common polish remover, as indicated on the product packaging.

The introduction of the positive punisher during the intervention periods decreased the number of occurrences of finger and nail biting. During the first phase of intervention, the use of ‘Bite It’ decreased engagement in the behavior from the baseline mean of 7.79 times per day to only 1.93 times per day. Following the 14-day intervention period, the aversive was removed and baseline data were collected for another 7 days. During this period, the finger and nail biting behavior increased to a mean frequency of 5 times per day. Although the behavior increased, it is interesting to note the slight residual effect of the aversive beyond its actual use. Following the second baseline period, ‘Bite It’ was reapplied to the participant’s nails and data were collected for 7 days for the second intervention period. This period found the participant engaging in finger and nail biting behavior on an average of once per day. Data show that use of an aversive as a positive punishment during both periods of intervention decreased finger and nail biting behavior.

The participant was pleased with the decrease in his finger and nail biting behavior and found the gradual healing of his fingertips and nails a reaffirming reminder of his changed behavior. Since the aversive only had to be reapplied twice a week, the only inconvenience ‘Bite It’ presented was the factor that provided its aversive nature: a foul taste. This proved to be an inconspicuous manner in which to decrease the negative behavior. The participant was able to gain hold over his finger and nail biting habit without resorting to visually obvious measures such as band-aids or other physical reminders or barriers. Following the conclusion of the second intervention data collection, use of the aversive ceased. Finger and nail biting behavior increased, but not to the level previously recorded during the initial baseline period. In the future, it may be necessary to periodically reintroduce the aversive in order to deter the unwanted behavior. 

Gabby T (2003). Nail-biting. In CD Rudolph, AM Rudolph, eds., Rudolph's Pediatrics, 21st ed.,  p. 461. New York: McGraw-Hill.Website: http://health.yahoo.com/beauty-overview/nail-biting/healthwise--tw9722spec.html