<div style="text-align: justify;">As much as everyone likes caffeinated products such as coffee, or chocolate to consume while we are studying or rushing to work to keep us awake, it is however not the best for human consumption. The research and examinations by ScienceDirect unpack the effects of caffeine on the human body. The reason behind the research is that caffeine causes body-focused repetitive behaviours.&nbsp;</div><h2 style="text-align: justify;" class=""><span style="color: inherit; font-family: inherit; font-size: 12px;">An overview of the research by ScienceDirect</span></h2><div style="text-align: justify;"><span style="font-size: 12px;">An article by ScienceDirect written by Chesivoir and Grant mentions that moderate caffeine, which is about 3 to 5 cups of coffee a day, relates to lower-body focused repetitive behaviour severity. The quality of life is not affected by coffee consumption, however, caffeine that causes stimulating effects averts subconscious repetitive behaviours. Moreover, picking and pulling as well as overstimulation might be prevented by the consumption of moderate caffeine. Hence, caffeine has been known to affect body focused repetitive behaviours, which are compulsive disorders such as a skin picking disorder (SPD), trichotillomania (TTM), which are signs that trigger potential worsening symptoms. The experiment of caffeine was conducted on several participants to achieve accurate results.</span></div><div style="text-align: justify;"><span style="font-size: 12px; color: inherit; font-family: inherit;"><br></span></div><h2 style="text-align: justify;" class=""><span style="font-size: 12px; color: inherit; font-family: inherit;">All about caffeine&nbsp;</span></h2><div style="text-align: justify;"><br></div><div style="text-align: justify;"><span style="font-size: 12px;">Methylxanthine, which is also known as caffeine, is the most used psychostimulant, which enables the central nervous system to keep the body awake and functioning. Therefore, people with busy schedules or students who are studying, generally use caffeine to help them be productive and awake. This has become a human habit that the negative effects of caffeine have been ignored. As a result, caffeine exerts most of its effects as an adenosine antagonist. Another article by ScienceDirect mentions that adenosine antagonist is a mood-altering drug that is most widely used on humans. Caffeine stimulates the A2A receptor from an antagonistic action that inhibits the release of GABA, which activates neurons which inhibits indosene. Consequently, this caffeine stimulation promotes the feeling of being awake and alert. Caffeine does not just shock agonistic action but serotonin, norepinephrine and dopamine activity.</span><br></div><div style="text-align: justify;"><br></div><div style="text-align: justify;"><span style="font-size: 12px;">Although caffeine can make one feel more alert and awake, the effects can, however, worsen any pre-existing mental health disorders. For instance, panic attacks were stimulated in an individual after consuming caffeine and also making one even more anxious about the consumption of caffeine. Simultaneously together with anxiogenic effects, caffeine affects both impulsive and compulsive behaviours which exacerbate further. If an individual has a caffeine consumption of moderate to high the individual will experience a binge eating disorder. Additionally, young adults can experience a gambling disorder. Moreover, body-focused repetitive behaviours (BFRBs) are formed by pulling out one's hair or skin, which is known as Trichotillomania (TTM). These signs are generally shown in the population around the world. Alternatively, other signs of deteriorating health include: a low quality of life, psychiatric comorbidity, and high levels of functional impairment. Further, during the COVID-19 pandemic research shows that BFRBs were more prevalent and severe as there was chronic stress, the urge to frequently wash hands and boredom. There are however different types of BFRBs that result in different actions.</span></div><div style="text-align: justify;"><span style="font-size: 12px; color: inherit; font-family: inherit;"><br></span></div><h2 style="text-align: justify;" class=""><span style="font-size: 12px; color: inherit; font-family: inherit;">The different types of BFRBs</span></h2><div style="text-align: justify;"><br></div><div style="text-align: justify;"><span style="font-size: 12px;">Body-focused repetitive behaviours (BFRBs) are heterogenous and have various types. Type 1 is a repetitive behaviour that occurs unknowingly in a human such as pulling while endorsed in sedentary activities such as studying, driving or watching TV. This repetitive behaviour in type 1 is known as “automatic” BFRBs. Secondly, a goal directed “focused” style of BFRB, which intentionally lands up with negative effects of stress or anxiety is Type 2.&nbsp;</span></div><div style="text-align: justify;"><span style="font-size: 12px; color: inherit; font-family: inherit;"><br></span></div><h2 style="text-align: justify;" class=""><span style="font-size: 12px; color: inherit; font-family: inherit;">The solution for BFRBs</span></h2><div style="text-align: justify;"><br></div><div style="text-align: justify;"><span style="font-size: 12px;">At the moment, there is a lack of FDA-approved BFRBs, which is reflected in the lack of knowledge by professionals to further FDA-approved approaches. This is where individuals are looking online for treatment advice with regards to the effect of BFRBs. In relieving the burden of BFRBs, many online sources give tips and strategies as recommendations but the concluded result is to reduce caffeine intake. Moreover, the BFRBs online communities stated, “The r/Trichotillomania and r/CompulsiveSkinPicking communities on social media site Reddit, which collectively boast over 75,000 members, are littered with hundreds of posts and comments recommending reducing caffeine consumption as a means of symptom relief.” In summary, with all the research and recommendations that are given online, the fact that caffeine worsens BFRBs being the hypothesis of this study should not be neglected.&nbsp;</span></div><div style="text-align: justify;"><br></div><div style="text-align: justify;"><span style="font-size: 12px;">On the flip side, research shows that caffeine may reduce symptoms of certain disorders. For instance, research from the study mentions, “when used as an adjunctive treatment for treatment-resistant OCD, subjects saw a 12% decrease in Yale-Brown Obsessive Compulsive Scale (Y-BOCS) scores after 8 weeks of treatment with 300 ​mg caffeine daily (Shams et al., 2019).” Further, “results from a small, double-blind crossover study revealed that caffeine produced higher response rates and greater decreases in Y–BOCs scores in individuals with moderate to severe OCD compared to placebo and d-amphetamine treatment (Koran et al., 2009).” These two scenarious improve OCD symptoms but the action of the mechanism still has gaps that need to be filled. Since the results of OCD and caffeine are very unclear, this creates an unstable grounding to predict how caffeine influences BFRBs. This is especially when neuropsychological and pharmacodynamic effects of caffeine are not understood well.&nbsp;</span></div><div style="text-align: justify;"><span style="font-size: 12px; color: inherit; font-family: inherit;"><br></span></div><h2 style="text-align: justify;" class=""><span style="font-size: 12px; color: inherit; font-family: inherit;">The aims of the study</span></h2><div style="text-align: justify;"><br></div><div style="text-align: justify;"><span style="font-size: 12px;">&nbsp;</span><span style="font-size: 12px;">The study aims to fill in the gaps of empirical research surrounding a discussion around caffeine use within the BFRB patient community. The study has three objectives to reach:</span></div><div style="text-align: justify;"><br></div><div style="text-align: justify;"><span style="font-size: 12px;">1) “Uncover the influence of caffeine consumption on BFRB severity, functional impairment, quality of life, impulsivity, and compulsivity”.</span></div><div style="text-align: justify;"><span style="font-size: 12px;">2) “Determine if caffeine use affects individuals with different types of BFRB (TTM vs. SPD) differently”.</span></div><div style="text-align: justify;"><span style="font-size: 12px;">3) “Discern the influence of caffeine on different BFRB styles (primarily automatic vs. primarily focused).”</span></div><h2 style="text-align: justify;" class=""><span style="font-size: 12px; color: inherit; font-family: inherit;"><br></span><h2 class=""><span style="font-size: 12px;">The methods of the study</span><br></h2></h2><div style="text-align: justify;"><br></div><div style="text-align: justify;"><span style="font-size: 12px;">The methods of the study involved adult women between the ages 18–69 years and assessments were taken out on the selected participants. The assessment was through an instrument that determines the characteristics of an individual such as self-reported gender and pulling and picking behaviours. The primary triggers that were reported were those who have negative emotion, anxiety or stress. Those who showed symptoms of boredom or sedentary tasks were categorised under automatic. In order to achieve an accurate data collection various sources where referred to such as:</span></div><ul><li style="text-align: justify;"><span style="font-size: 12px;">National Institutes of Mental Health Trichotillomania/Skin Picking Severity Scale</span></li><li style="text-align: justify;"><span style="font-size: 12px;">Massachusetts General Hospital Hairpulling/Skin Picking Scale</span></li><li style="text-align: justify;"><span style="font-size: 12px;">&nbsp;Cambridge Caffeine Use Questionnaire</span></li><li style="text-align: justify;"><span style="font-size: 12px;">Quality of life inventory</span></li><li style="text-align: justify;"><span style="font-size: 12px;">Sheehan disability scale</span></li><li style="text-align: justify;"><span style="font-size: 12px;">Barratt impulsiveness scale</span></li><li style="text-align: justify;"><span style="font-size: 12px;">Cambridge-chicago compulsivity trait scale</span></li></ul><div style="text-align: justify;"><br></div><div style="text-align: justify;"><span style="font-size: 12px;">Further, the results showed, “ In total, 97 adults with BFRBs were included in the analysis (77 [79.4%] female, mean age ​= ​31.24, SD ​= ​10.2). Most of the subjects included in the analysis were Caucasian (76.3%) and possessed at least a bachelor's degree (69.0%). Of the 97 subjects, 53 (54.6%) met DSM-5 criteria for TTM and 44 (45.4%) met criteria for SPD.”</span></div><div><h2 style="text-align: justify;" class=""><span style="font-size: 12px;"><br></span><h2 class=""><span style="color: inherit; font-family: inherit;">The conclusion of the study&nbsp;</span></h2></h2></div><div style="text-align: justify;"><span style="font-size: 12px; color: inherit; font-family: inherit;"><br></span></div><div style="text-align: justify;"><span style="font-size: 12px;">The study of caffeine on BFRBs needs more accurate results and research done, as FDA medications have also not yet been approved for BFRBs. Further, the findings support a heterogenous model of BFRBs. The article further mentions, “future research should aim to characterize the neural mechanisms of BFRBs to better understand the root of these seemingly opposing forces. Moderate doses of caffeine or psychostimulants, such as those used for ADHD, may be interesting medications to study for BFRBs in well-controlled clinical trials.”</span></div><div style="text-align: justify;"><span style="font-size: 12px; color: inherit; font-family: inherit;"><br></span></div><h2 style="text-align: justify;" class=""><span style="font-size: 12px; color: inherit; font-family: inherit;">A personal viewpoint on caffeine and BFRBs</span></h2><div style="text-align: justify;"><br></div><div style="text-align: justify;"><span style="font-size: 12px;">As a student and workaholic, one does have its rough days or are extremely exhausted and a quix-fix is to grab a coffee to make your life a whole much better and awake. I do agree with the article that the effects of BFRBs are worsened by the consumption of caffeine and this fact can not be neglected. From a personal point of view there are alternatives such as exercise, having a balanced lifestyle and getting enough sleep to feel more alert and awake without coffee. Do you still choose caffeine or natural methods after reading this article?</span><br></div><div><div style="text-align: justify;"><br></div></div>