Comorbid Conditions Symptom Tests

[Self-Test] Nail Biting Disorder: Symptoms of Onychophagia in Children

Concerned about your child’s nail-biting habit? Take this test to see if your child may be showing signs of onychophagia, a treatable body-focused repetitive behavior (BFRB).

By ADDitude Editors Verified Medically reviewed by Suzanne Mouton-Odum, Ph.D. Reviewed on September 20, 2023
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Young boy is playing games at his tablet and biting his nail
Young boy is playing games at his tablet and biting his nail

Nail biting is a common behavior that typically begins in childhood. For most children, nail biting is a harmless habit. A small portion of children, however, exhibit chronic and compulsive nail biting. They bite their fingernails, cuticles, and skin surrounding their nails to the point of bleeding and soreness. They also continue to engage in nail biting despite its consequences to health, functioning, and wellbeing.

Nail biting disorder, also known as onychophagia, is a body-focused repetitive behavior (BFRB) — a self-grooming, self-soothing behavior that is difficult to control or stop. Children with BFRBs often deal with other co-occurring conditions, including anxiety, depression, and attention deficit hyperactivity disorder (ADHD).1 2 3

Chronic nail biting, especially if untreated, can lead to health complications like dental problems, recurring infections, and permanent damage to the nails.4 Children with nail-biting disorder may feel embarrassed or ashamed about their condition, and may struggle to attend school and other social settings as a result.

Answer the questions below to see if your child may be showing signs of onychophagia. Share your results with your child’s pediatrician or a licensed mental health professional.

This self-test, drafted by ADDitude editors, is informed in part by criteria outlined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) and research findings on onychophagia. (See sources section below for more information.) This self-test is designed to screen for the possibility of onychophagia, and it is intended for personal use only. This self-test is not intended as a diagnostic tool.

My child habitually bites their fingernails and/or toenails (including nail plates, nail folds, nail beds, and/or cuticles).

My child often bites their nails to the point of bleeding and soreness.

My child has made repeated attempts to reduce or stop biting their nails.

Feelings of anxiety or boredom seem to precede my child’s nail-biting episodes.

My child reports feeling an increasing sense of tension immediately before biting their nails or when resisting the urge to bite.

My child reports feeling a sense of relief or pleasure when biting their nails.

My child chews on and/or eats their nails after biting them.

My child doesn’t always seem aware that they are biting their nails.

My child’s damaged nails as a result of nail biting cause them significant distress.

My child spends a lot of time trying to hide and/or camouflage their nails.

My child avoids school and other social settings because of their nail biting or how their nails look as a result of nail biting.

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Nail Biting Disorder in Children: Next Steps

View Article Sources

1 Ghanizadeh A. (2008). Association of nail biting and psychiatric disorders in children and their parents in a psychiatrically referred sample of children. Child and Adolescent Psychiatry and Mental Health, 2(1), 13. https://doi.org/10.1186/1753-2000-2-13

2 Gu, L., Pathoulas, J. T., Widge, A. S., Idnani, A., & Lipner, S. R. (2022). Exacerbation of onychophagia and onychotillomania during the COVID-19 pandemic: a survey-based study. International Journal of Dermatology, 61(11), e412–e414. https://doi.org/10.1111/ijd.16395

3 Sampaio, D. G., & Grant, J. E. (2018). Body-focused repetitive behaviors and the dermatology patient. Clinics in Dermatology, 36(6), 723–727. https://doi.org/10.1016/j.clindermatol.2018.08.004

4 Lee, D. K., & Lipner, S. R. (2022). Update on Diagnosis and Management of Onychophagia and Onychotillomania. International Journal of Environmental Research and Public Health, 19(6), 3392. https://doi.org/10.3390/ijerph19063392