Current Treatment Practices for Children and Adults With Trichotillomania: Consensus Among Experts
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Cognitive-behavioral treatment is the first-line treatment intervention for trichotillomania.
“Meta-analytic research (Bloch et al., 2007) and expert clinician consensus (Flessner, Penzel, Trichotillomania Learning Center Scientific Advisory Board & Keuthen, 2010) have identified cognitive-behavioral treatment as the first-line treatment intervention for trichotillomania (TTM).”
From Dbt-enhanced cognitive-behavioral treatment for trichotillomania: A randomized controlled trial (2012) · cites this paper as Flessner, Penzel, Trichotillomania Learning Center Scientific Advisory Board & Keuthen, 2010
Cites
Diagnostic and Statistical Manual of Mental Disorders
Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,841 · see citing works
Gosling, S. D., Vazire, S., Srivastava, S., & John, O. P. (2004) · American Psychologist · doi:10.1037/0003-066x.59.2.93 · Cited by 2,932 · see citing works
A Method for the Detailed Assessment of the Appropriateness of Medical Technologies
Brook, R. H., Chassin, M. R., Fink, A., Solomon, D. H., Kosecoff, J., & Park, R. E. (1986) · International Journal of Technology Assessment in Health Care · doi:10.1017/s0266462300002774 · Cited by 762 · see citing works
A survey of psychologists’ attitudes towards and utilization of exposure therapy for PTSD
Becker, C. B., Zayfert, C., & Anderson, E. (2004) · Behaviour Research and Therapy · doi:10.1016/s0005-7967(03)00138-4 · Cited by 759 · see citing works
Swedo, S. E., Leonard, H. L., Rapoport, J. L., Lenane, M. C., Goldberger, E. L., & Cheslow, D. L. (1989) · New England Journal of Medicine · doi:10.1056/nejm198908243210803 · Cited by 601 · see citing works
Grant, J. E., Odlaug, B. L., & Won Kim, S. (2009) · Archives of General Psychiatry · doi:10.1001/archgenpsychiatry.2009.60 · Cited by 424 · see citing works
(1991) · PubMed · Cited by 398 · see citing works
Woods, D. W., Wetterneck, C. T., & Flessner, C. A. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.05.006 · Cited by 381 · cited 3× · see citing works
“Recent adult TTM research suggests that CBT is superior to wait-list (Van Minnen et al., 2003; Woods et al., 2006), pharmacotherapy (Ninan et al., 2000; Van Minnen et al., 2003), pill placebo (Ninan et al.)”
BackgroundResultSelf-citationWoods, D. W., Flessner, C. A., Franklin, M. E., Keuthen, N. J., Goodwin, R. D., Stein, D. J., Walther, M. R., & Trichotillomania Learning Center-Scientific Advisory Board (2006) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v67n1207 · Cited by 317 · cited 3× · see citing works
“Recent adult TTM research suggests that CBT is superior to wait-list (Van Minnen et al., 2003; Woods et al., 2006), pharmacotherapy (Ninan et al., 2000; Van Minnen et al., 2003), pill placebo (Ninan et al.)”
BackgroundResultSelf-citationSystematic Review: Pharmacological and Behavioral Treatment for Trichotillomania
Bloch, M. H., Landeros-Weisenberger, A., Dombrowski, P., Kelmendi, B., Wegner, R., Nudel, J., Pittenger, C., Leckman, J. F., & Coric, V. (2007) · Biological Psychiatry · doi:10.1016/j.biopsych.2007.05.019 · Cited by 280 · cited 3× · see citing works
“At best, findings have been mixed regarding efficacy and a recent meta-analysis suggested that only clomipramine has demonstrated efficacy greater than placebo (Bloch et al., 2007).”
InfluentialA placebo-controlled, double-blind crossover study of fluoxetine in trichotillomania
Christenson, G., Mackenzie, T. B., Mitchell, J. E., & Callies, A. L. (1991) · American Journal of Psychiatry · doi:10.1176/ajp.148.11.1566 · Cited by 250 · see citing works
Azrin, N. H., Nunn, R. G., & Frantz, S. E. (1980) · Journal of Behavior Therapy and Experimental Psychiatry · doi:10.1016/0005-7916(80)90045-2 · Cited by 249 · see citing works
van Minnen, A., Hoogduin, K. A. L., Keijsers, G. P. J., Hellenbrand, I., & Hendriks, G.-J. (2003) · Archives of General Psychiatry · doi:10.1001/archpsyc.60.5.517 · Cited by 234 · cited 5× · see citing works
“This finding is in line with preliminary evidence from the child TTM literature (Tolin et al., 2007) and a larger, though still small, body of adult TTM research (Diefenbach et al., 2006; Van Minnen et al., 2003; Woods et al., 2006).”
BackgroundResultInfluentialClinical profile, comorbidity, and treatment history in 123 hair pullers: a survey study.
Cohen, L. J., Stein, D. J., Simeon, D., Spadaccini, E., Rosen, J., Aronowitz, B., & Hollander, E. (1995) · PubMed · Cited by 230 · see citing works
Streichenwein, S. M., & Ji, T. (1995) · American Journal of Psychiatry · doi:10.1176/ajp.152.8.1192 · Cited by 192 · see citing works
Franklin, M. E., Flessner, C. A., Woods, D. W., Keuthen, N. J., Piacentini, J. C., Moore, P. S., Stein, D. J., Cohen, S. B., & Wilson, M. A. (2008) · Journal of Developmental & Behavioral Pediatrics · doi:10.1097/dbp.0b013e31818d4328 · Cited by 167 · see citing works
Self-citationTrichotillomania: a comprehensive behavioral model.
Mansueto, C., Stemberger, R. M. T., Thomas, A. M., & Golomb, R. (1997) · Clinical Psychology Review · doi:10.1016/s0272-7358(97)00028-7 · Cited by 152 · see citing works
Identification of trichotillomania cue profiles.
Christenson, G., Ristvedt, S. L., & Mackenzie, T. (1993) · Behaviour Research and Therapy · doi:10.1016/0005-7967(93)90030-x · Cited by 114 · see citing works
Acceptance-Enhanced Behavior Therapy (AEBT) for Trichotillomania and Chronic Skin Picking
Flessner, C. A., Busch, A. M., Heideman, P. W., & Woods, D. W. (2008) · Behavior Modification · doi:10.1177/0145445507313800 · Cited by 112 · see citing works
Self-citationTolin, D. F., Franklin, M. E., Diefenbach, G. J., Anderson, E. R., & Meunier, S. A. (2007) · Cognitive Behaviour Therapy · doi:10.1080/16506070701223230 · Cited by 108 · see citing works
Long-Term Treatment of Trichotillomania (Hair Pulling)
Swedo, S. E., Lenane, M., & Leonard, H. L. (1993) · New England Journal of Medicine · doi:10.1056/nejm199307083290220 · Cited by 102 · see citing works
Single Modality Versus Dual Modality Treatment for Trichotillomania
Dougherty, D. D., Loh, R., Jenike, M. A., & Keuthen, N. J. (2006) · The Journal of Clinical Psychiatry · doi:10.4088/jcp.v67n0711 · Cited by 101 · see citing works
Self-citationMarcks, B. A., Woods, D. W., Teng, E. J., & Twohig, M. P. (2004) · Cognitive and Behavioral Practice · doi:10.1016/s1077-7229(04)80044-0 · Cited by 85 · see citing works
Mehregan, A. H. (1970) · Archives of Dermatology · doi:10.1001/archderm.1970.04000080001001 · Cited by 84 · see citing works
Rapp, J. T., Miltenberger, R. G., Long, E. S., Elliott, A. J., & Lumley, V. A. (1998) · Journal of Applied Behavior Analysis · doi:10.1901/jaba.1998.31-299 · Cited by 77 · see citing works
Group treatment for trichotillomania: behavior therapy versus supportive therapy
Diefenbach, G. J., Tolin, D. F., Hannan, S., Maltby, N., & Crocetto, J. (2006) · Behavior Therapy · doi:10.1016/j.beth.2006.01.006 · Cited by 73 · cited 2× · see citing works
“, 2007) and a larger, though still small, body of adult TTM research (Diefenbach et al., 2006; Van Minnen et al., 2003; Woods et al., 2006).”
BackgroundResultFrom mirror self‐recognition to the looking‐glass self: Exploring the Justification Hypothesis
Shaffer, L. S. (2004) · Journal of Clinical Psychology · doi:10.1002/jclp.20090 · Cited by 52 · see citing works
Clinicians’ views on management of obsessive–compulsive disorders in children and adolescents
Valderhaug, R., Götestam, K. G., & Larsson, B. S. (2004) · Nordic Journal of Psychiatry · doi:10.1080/08039480410005503 · Cited by 50 · see citing works
Trichotillomania: Conceptualization, measurement, and treatment
Elliott, A., & Fuqua, R. (2000) · Behavior Therapy · doi:10.1016/s0005-7894(00)80029-5 · Cited by 43 · see citing works
Intensive Cognitive Behavioural Group Treatment for Social Phobia: a Pilot Study
Mörtberg, E., Berglund, G., & Sundin, Ö. (2005) · Cognitive Behaviour Therapy · doi:10.1080/16506070510010657 · Cited by 40 · see citing works
Investigating healthcare providers' knowledge of trichotillomania and its treatment
Marcks, B. A., Wetterneck, C. T., & Woods, D. W. (2006) · Cognitive Behaviour Therapy · doi:10.1080/16506070510010657a · Cited by 32 · see citing works
Trichotillomania. A clinicopathologic study
Mehregan, A. H. (1970) · Archives of Dermatology · doi:10.1001/archderm.102.2.129 · Cited by 21 · see citing works
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2 of the 34 references couldn’t be matched to a known paper.
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McGuire, J. F., Ung, D., Selles, R. R., Rahman, O., Lewin, A. B., Murphy, T. K., & Storch, E. A. (2014) · Journal of Psychiatric Research · doi:10.1016/j.jpsychires.2014.07.015 · Cited by 142 · see citing works
Trichotillomania and its treatment: a review and recommendations
Franklin, M., Zagrabbe, K., & Benavides, K. L. (2011) · Expert Review of Neurotherapeutics · doi:10.1586/ern.11.93 · Cited by 130 · see citing works
Dbt-enhanced cognitive-behavioral treatment for trichotillomania: A randomized controlled trial
Keuthen, N. J., Rothbaum, B. O., Fama, J., Altenburger, E., Falkenstein, M. J., Sprich, S. E., Kearns, M., Meunier, S., Jenike, M. A., & Welch, S. S. (2012) · Journal of Behavioral Addictions · doi:10.1556/jba.1.2012.003 · Cited by 124 · see citing works
Self-citationLee, E. B., Homan, K. J., Morrison, K. L., Ong, C. W., Levin, M. E., & Twohig, M. P. (2018) · Behavior Modification · doi:10.1177/0145445518794366 · Cited by 88 · see citing works
Pilot trial of dialectical behavior therapy-enhanced habit reversal for trichotillomania
Keuthen, N. J., Rothbaum, B. O., Welch, S. S., Taylor, C., Falkenstein, M., Heekin, M., Jordan, C. A., Timpano, K., Meunier, S., Fama, J., et al. (2010) · Depression and Anxiety · doi:10.1002/da.20732 · Cited by 81 · see citing works
Self-citationGallinat, C., Moessner, M., Haenssle, H. A., Winkler, J. K., Backenstrass, M., & Bauer, S. (2019) · Journal of Medical Internet Research · doi:10.2196/15011 · Cited by 38 · see citing works
Snorrason, Í., Berlin, G. S., & Lee, H. (2015) · Psychology Research and Behavior Management · doi:10.2147/prbm.s53977 · Cited by 36 · see citing works
Shareh, H. (2018) · Behavioural and Cognitive Psychotherapy · doi:10.1017/s1352465817000546 · Cited by 25 · see citing works
Slikboer, R., Nedeljkovic, M., Bowe, S., & Moulding, R. (2017) · Clinical Psychologist · doi:10.1111/cp.12074 · Cited by 26 · see citing works
Flessner, C. (2011) · Child and Adolescent Psychiatric Clinics of North America · doi:10.1016/j.chc.2011.01.007 · Cited by 19 · see citing works
Self-citationUtilizing DBT Skills to Augment Traditional CBT for Trichotillomania: An Adult Case Study
Keuthen, N. J., & Sprich, S. E. (2012) · Cognitive and Behavioral Practice · doi:10.1016/j.cbpra.2011.02.004 · Cited by 19 · see citing works
Self-citationPsychological treatments for trichotillomania: Update and future directions
Rehm, I., Moulding, R., & Nedeljkovic, M. (2015) · Australasian Psychiatry · doi:10.1177/1039856215590029 · Cited by 16 · see citing works
Moritz, S., Müller, K., & Schmotz, S. (2020) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2020.100530 · Cited by 16 · see citing works
Pharmacotherapy for trichotillomania in adults
Baczynski, C., & Sharma, V. (2020) · Expert Opinion on Pharmacotherapy · doi:10.1080/14656566.2020.1761324 · Cited by 5 · see citing works
IMPAIRED EXECUTIVE FUNCTIONING IN PEDIATRIC TRICHOTILLOMANIA (HAIR PULLING DISORDER)
Flessner, C. A., Brennan, E., Murphy, Y. E., & Francazio, S. K. (2015) · Depression and Anxiety · doi:10.1002/da.22450 · Cited by 14 · see citing works
Self-citationClinical Management of Trichotillomania With Bimatoprost
Peabody, T. D., Reitz, S. C., Smith, J., & Teti, B. (2013) · Optometry and Vision Science · doi:10.1097/opx.0b013e318294c158 · Cited by 10 · see citing works
Bupropion for the treatment of fluoxetine non-responsive trichotillomania: a case report
Bipeta, R., & Yerramilli, S. S. (2011) · Journal of Medical Case Reports · doi:10.1186/1752-1947-5-557 · Cited by 9 · see citing works
Phillips, K., & Stein, D. J. (2015) · doi:10.1002/9781118753378.ch58 · Cited by 4 · see citing works
Psychological Treatment of Excoriation Disorder
Snorrason, Í., Goetz, A. R., & Lee, H. (2017) · doi:10.1002/9781118890233.ch56 · Cited by 6 · see citing works
Shamsudeen, S., & Kannekanti, P. (2023) · Clinical Case Studies · doi:10.1177/15346501231189552 · Cited by 5 · see citing works
Treatment of Obsessive-Compulsive and Related Disorders
Löchner, C., & Stein, D. J. (2014) · Current Treatment Options in Psychiatry · doi:10.1007/s40501-014-0021-6 · Cited by 5 · see citing works
Trichotillomania and its treatment: an updated review and recommendations
DuBois, M. C., Feler, B., Flessner, C., & Franklin, M. E. (2025) · Expert Review of Neurotherapeutics · doi:10.1080/14737175.2025.2557395 · Cited by 5 · see citing works
Self-citationMorris, S. H., Kratz, H. E., Antinoro, D., Zickgraf, H. F., Coogan, C., Woods, D., & Franklin, M. E. (2016) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2016.04.004 · Cited by 4 · see citing works
Targeting the function of inner experiences in obsessive compulsive and related disorders
Twohig, M. P., & Smith, B. M. (2015) · Current Opinion in Psychology · doi:10.1016/j.copsyc.2014.12.033 · Cited by 3 · see citing works
Trichotillomania: Identification and Treatment
McDonald, K. (2012) · Journal of Counseling & Development · doi:10.1002/j.1556-6676.2012.00053.x · Cited by 4 · see citing works
Parent Coping With Adolescent Trichotillomania
Stevens, M. S., & O'Conner-Von, S. (2016) · Journal of School Nursing · doi:10.1177/1059840516658332 · Cited by 2 · see citing works
Franklin, M. E., Budzyn, S., & Freeman, H. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108140416.030 · Cited by 2 · see citing works
Psychological Impact of Hair Loss
FARRANT, P. B. J., & McHale, S. (2014) · doi:10.1002/9781118560648.ch10 · Cited by 2 · see citing works
Psychological Treatment of Trichotillomania
Francazio, S., Murphy, Y. E., & Flessner, C. (2017) · doi:10.1002/9781118890233.ch57 · Cited by 1 · see citing works
Self-citationNagda, A. L., Shetty, J., & Datar, M. C. (2022) · Bharati Vidyapeeth Medical Journal · doi:10.56136/bvmj/2021_00045 · Cited by 1 · see citing works
Mechanisms of Treatments for Trichotillomania (Hair Pulling Disorder)
Brennan, E., Francazio, S., Murphy, Y. E., & Flessner, C. (2017) · doi:10.1002/9781118877142.ch20 · Cited by 1 · see citing works
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Franklin, M., & Silber, M. (2016) · Springer eBooks · doi:10.1007/978-3-319-17139-5_16
Treatment of Obsessive- Compulsive and Related
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Siek, A., Makarewicz, A., Łobejko, Ł., Gralewska, A., Tomaka, J., Szymańska-Piekarczyk, J., Siembida, J. M., & Juchnowicz, H. (2017) · Current Problems of Psychiatry · doi:10.1515/cpp-2017-0029
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Fischer, A. R., Regino, C. M., Grzybowski, L. M. C., Rostey, R. R. L., & Carvalho, M. F. C. M. (2018) · Ensaios e Ciência C Biológicas Agrárias e da Saúde · doi:10.17921/1415-6938.2018v22n1p27-32
Buchholz, J. L., Reuman, L., Blakey, S. M., & Abramowitz, J. S. (2018) · Cambridge University Press eBooks · doi:10.1017/9781108164313.017
Franklin, M. E., & Morris, S. H. (2017) · Springer eBooks · doi:10.1007/978-3-319-57196-6_12
Miltenberger, R. G., & Spieler, C. A. (2018) · Springer eBooks · doi:10.1007/978-3-319-97529-0_9
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Reichenberg, L. W., & Seligman, L. (2016) · doi:10.1002/9781394259465.ch7
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Neer, S. M., Gramlich, M. A., & Ragsdale, K. A. (2018) · Wiley eBooks · doi:10.1002/9781394258970.ch10
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Feler, B., DuBois, M., Pritchard, J., Weingarden, H., Crupi, E., Idnani, A. K., Kumar, S., & Flessner, C. A. (2026) · Journal of Obsessive-Compulsive and Related Disorders · doi:10.1016/j.jocrd.2026.101049
Self-citation
- Authors
- Flessner, C. A., Penzel, F., & Keuthen, N. J.
- Affiliations
- Brown University (US)
- Harvard University (US)
- Corresponding author
- Flessner, Christopher A.
- Venue
- Cognitive and Behavioral Practice
- Publisher
- Elsevier BV
- Published
- 2010-08
- Volume
- 17
- Issue
- 3
- Pages
- 290-300
- ISSN
- 1077-7229 (ISSN-L)
- OpenAlex
- W2088429302
- Cited by
- 42
- References
- 34
- Citations by year
- 2026: 1 · 2025: 2 · 2023: 1 · 2022: 1 · 2020: 2 · 2019: 1 · 2018: 6 · 2017: 6 · 2016: 3 · 2015: 7 · 2014: 4 · 2013: 1 · 2012: 2
- FWCI
- 2.82
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Cognitive and Behavioral Practice (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Keywords
- trichotillomania, treatment patterns, cognitive behavioral therapy, habit reversal training, self-monitoring, awareness training, stimulus control, selective serotonin reuptake inhibitors, serotonin-norepinephrine reuptake inhibitors, pharmacotherapy, psychosocial interventions, children and adults, expert consensus
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