Suppression and substitution in the treatment of nailbiting

The effectiveness of a package treatment for reducing nailbiting was studied. The package was composed of both positive procedures aimed at teaching adaptive behavior to substitute for nailbiting and negative procedures aimed at advancing skills for suppressing nailbiting. The design of the study permitted an analysis of the contributions of both positive and negative components of the package. Subjects assigned to combined, positive, negative and placebo groups received four weekly treatment sessions, and changes in their nailbiting behavior were compared with untreated controls. As in previous studies, nonspecific factors such as demand and attention to ones nails were found to be important determinants of outcome. In addition, positive procedures were found to be substantially more important than negative procedures in the maintenance of reductions in nailbiting over a 4-month follow-up period.