Comorbid Conditions Symptom Tests

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

Take this test to see if you may be showing signs of onychophagia, a type of body-focused repetitive behavior characterized by compulsive nail biting.

Nail biting is, for most people, simply a bad habit that’s hard to break. Then there are individuals for whom nail biting is chronic, compulsive, and significantly impacts their wellbeing.

Onychophagia, the medical term for nail biting, is a type of body-focused repetitive behavior (BFRB). Individuals with chronic and compulsive onychophagia will often bite the nails on their hands and/or toes to the point of causing visible damage to their nails. Chronic nail biting, like any BFRB, is difficult to control. Some individuals with onychophagia describe the behavior as automatic.

Chronic nail biting is associated with increased risk for ungual infections and dental problems.1 Onychophagia often co-occurs with other BFRBs, including trichotillomania (hair-pulling disorder) and excoriation (skin-picking disorder).2 As a whole, BFRBs are also linked to conditions like depression, anxiety, and attention deficit hyperactivity disorder (ADHD).3 4 5 Onychophagia is treatable, and managed with psychotherapy and medication.

Answer the questions below to see if you may be showing signs of onychophagia. Share your results with a licensed clinician and/or 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.

I habitually bite my nails (including the nail plates, nail folds, nail beds, and/or cuticles) on my hands and/or toes.

I’ve made repeated attempts to decrease or stop biting my nails.

Feelings of tension, anxiety, or boredom often precede my nail biting.

I feel an increasing sense of tension immediately before biting my nails or when resisting the urge to bite.

I feel a sense of relief or pleasure after biting my nails.

I chew on and/or eat my nails after biting them.

Sometimes I am not even aware that I am biting my nails, until it is too late.

My nail biting causes me significant distress.

I spend a lot of time and energy trying to hide and/or camouflage my nails.

I avoid work, social settings, and other public situations because of how my nails look as a result of nail biting.

I often bite my nails until they bleed and are sore.

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Nail Biting Disorder (Onychophagia): Next Steps

View Article Sources

Lee, D. K., & Lipner, S. R. (2022). Update on Diagnosis and Management of Onychophagia and Onychotillomania. International journal of environmental research and public health19(6), 3392.

2 The TLC Foundation for Body-Focused Repetitive Behaviors. Nail biting.

3 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.

4 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.

5 Sampaio, D. G., & Grant, J. E. (2018). Body-focused repetitive behaviors and the dermatology patient. Clinics in Dermatology, 36(6), 723–727.