The DOI matches its Crossref record; 19 of the 21 references it cites were found in a registry or an index.
The relationship between experiential avoidance and the severity of trichotillomania in a nonreferred sample
Abstract
In this study 436 adults, who reported being diagnosed with trichotillomania (TTM), completed an anonymous survey examining the relationship between experiential avoidance (i.e., escape from or avoidance of unwanted thoughts or emotions) and TTM severity. Results showed a significant positive correlation between measures of experiential avoidance and TTM severity, indicating that more experientially avoidant individuals tended to exhibit more severe TTM. Subsequent analyses found that persons who scored higher on a measure of experiential avoidance reported more frequent and intense urges to pull, were less able to control their urges, and experienced more pulling-related distress than persons who were not experientially avoidant. Conversely, results also showed that individuals who were more experientially avoidant were no more likely to actually pull and were no less successful in actually stopping themselves from pulling than non-avoidant individuals. The results of this study suggest that experiential avoidance may be an important issue in understanding and possibly treating some persons with TTM.
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“In an anonymous Internet survey, Begotka, Woods and Wetterneck (2004) demonstrated that individuals with greater experiential avoidance had more severe hair pulling.”
From Dbt-enhanced cognitive-behavioral treatment for trichotillomania: A randomized controlled trial (2012) · cites this paper as Begotka, Woods and Wetterneck (2004)
In the citing paper
“Experiential avoidance seeks to control the way or frequency of aversive private experiences [37] and has been associated with anxiety [38,39,40,41,42,43,44,45,46,47,48,49,50,51,52,53,54].”
From The Effect of Anxiety and Nutritional Habits on the Body Distortion of Athletes. (2025) · cites this paper as [38]
Citations
Cites
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Measuring experiential avoidance: A preliminary test of a working model
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The Massachusetts General Hospital (MGH) Hairpulling Scale: 1. Development and Factor Analyses
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“89 (Keuthen et al., 1995) and good test-retest reliability, r=0.”
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The Massachusetts General Hospital (MGH) hairpulling scale: 2. Reliability and validity
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“The MGH-HS also has strong convergent validity with other measures of pulling severity, and divergent validity with other measures of psychiatric impairment such as depression and anxiety (O’Sullivan et al., 1995).”
InfluentialThe Demography, Phenomenology, and Family History of 22 Persons with Compulsive Hair Pulling
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Twohig, M. P., & Woods, D. W. (2004) · Behavior Therapy · doi:10.1016/s0005-7894(04)80021-2 · Cited by 141
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2 of the 21 references couldn’t be matched to a known paper.
Research works printed but not linked: 3
- American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.
- Hayes, 1996, Experiential avoidance and behavioral disorders, Journal of Consulting and Clinical Psychology, 64, 1152, 10.1037/0022-006X.64.6.1152 · DOI · Paper page
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Cited by
Sorted by citations
Items 101–132 of 132
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
Emotion Regulation in the Obsessive‐Compulsive Spectrum Disorders
Napolitano, L. A. (2017) · Wiley eBooks · doi:10.1002/9781118890233.ch64 · Cited by 1
An investigation of attitudes and attentional biases in trichotillomania
Stevenson, J. L. (2018) · Enlighten: Theses (The University of Glasgow) · Cited by 1
Evaluating Process Variables in Acceptance and Commitment Therapy
Lugt, A. A. V. (2011) · University of North Texas Digital Library (University of North Texas) · doi:10.12794/metadc84296 · Cited by 1
Keuthen, N., & Usmani, A. (2016) · Springer eBooks · doi:10.1007/978-1-4939-2605-3_9 · Cited by 2
Trauma and psychosis: investigating the role of post-traumatic intrusions, schemas and avoidance
Peach, N. (2016) · Minerva Access (University of Melbourne)
The Assessment and Treatment of Trichotillomania
Christenson, G. (2012) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780195389715.013.0095
Acceptance and Commitment Therapy for OC‐Spectrum Disorders
Morrison, K. L., Smith, B. M., Lee, E. B., & Twohig, M. P. (2017) · Wiley eBooks · doi:10.1002/9781118890233.ch65
Session 8: Practicing Acceptance and Commitment Therapy (ACT)
Woods, D. W., & Twohig, M. P. (2023) · doi:10.1093/med-psych/9780197670309.003.0008
Client Forms, Graphs, and Worksheets
Woods, D. W., & Twohig, M. P. (2023) · doi:10.1093/med-psych/9780197670309.005.0002
Modifications for Working with Adolescents
Petersen, J. M. (2023) · doi:10.1093/med-psych/9780197670309.003.0011
Session 4: Can Pulling-Related Inner Experiences Be Controlled?
Woods, D. W., & Twohig, M. P. (2023) · doi:10.1093/med-psych/9780197670309.003.0005
Woods, D. W., & Twohig, M. P. (2023) · doi:10.1093/med-psych/9780197670309.003.0002
Woods, D. W., & Twohig, M. P. (2023) · doi:10.1093/med-psych/9780197670309.005.0004
Session 2: Habit Reversal Training (HRT) and Trigger Reduction Strategies
Woods, D. W., & Twohig, M. P. (2023) · doi:10.1093/med-psych/9780197670309.003.0003
Woods, D. W., & Twohig, M. P. (2023) · doi:10.1093/med-psych/9780197670309.005.0001
Session 5: Acceptance of Pulling-Related Inner Experiences
Woods, D. W., & Twohig, M. P. (2023) · doi:10.1093/med-psych/9780197670309.003.0006
Sessions 6 and 7: Defusion from Your Inner Experiences: You Are Not Your Urges to Pull
Woods, D. W., & Twohig, M. P. (2023) · doi:10.1093/med-psych/9780197670309.003.0007
Session 9: Practicing Acceptance and Commitment Therapy (ACT) and Review of Treatment
Woods, D. W., & Twohig, M. P. (2023) · doi:10.1093/med-psych/9780197670309.003.0009
Woods, D. W., & Twohig, M. P. (2023) · doi:10.1093/med-psych/9780197670309.005.0003
Session 10: Review and Relapse Prevention
Woods, D. W., & Twohig, M. P. (2023) · doi:10.1093/med-psych/9780197670309.003.0010
Session 3: Increasing Motivation for Treatment Through Values
Woods, D. W., & Twohig, M. P. (2023) · doi:10.1093/med-psych/9780197670309.003.0004
Behavioral Conceptualizations of Obsessive-Compulsive and Related Disorders
Cassin, S. E., Regev, R., Fournier, S., & Rector, N. A. (2023) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780190068752.013.10
Information Processing in Obsessive-Compulsive and Related Disorders
Alcolado, G. M., Giraldo-O’Meara, M., Krause, S. C., Leonhart, M. W., & Radomsky, A. S. (2023) · Oxford University Press eBooks · doi:10.1093/oxfordhb/9780190068752.013.8
A case series of trichotillomania; Impact of therapeutic intervention: Clinical out-turn
Algin, S., Akter, A., Jalil, S., Joti, F. J., Hridi, H. S., Ahmad, R., & Haque, M. (2023) · Advances in Human Biology · doi:10.4103/aihb.aihb_98_23
Trichotillomania: The interplay between emotional states, urges and hair pulling episodes
Gallinat, C., Wilhelm, M., Moessner, M., & Bauer, S. (2026) · Comprehensive Psychiatry · doi:10.1016/j.comppsych.2026.152727
Metadata
- Authors
- Begotka, A. M., Woods, D. W., & Wetterneck, C. T.
- Affiliations
- University of Wisconsin–Milwaukee (US)
- Corresponding author
- Begotka, Andrea M.
- Venue
- Journal of Behavior Therapy and Experimental Psychiatry
- Publisher
- Elsevier BV
- Published
- 2004-03
- Volume
- 35
- Issue
- 1
- Pages
- 17-24
- ISSN
- 0005-7916 (ISSN-L)
- OpenAlex
- W2102461271
- Cited by
- 132
- References
- 21
- Citations by year
- 2026: 1 · 2025: 3 · 2024: 2 · 2023: 26 · 2022: 1 · 2021: 2 · 2020: 2 · 2019: 1 · 2018: 7 · 2017: 8 · 2016: 11 · 2015: 7 · 2014: 8 · 2013: 4 · 2012: 11
- FWCI
- 6.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Behavior Therapy and Experimental Psychiatry (publishedVersion)
- PubMed (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 › Mindfulness and Compassion Interventions
- Keywords
- trichotillomania, experiential avoidance, symptom severity, cognitive behavioral therapy
- MeSH terms
- Adolescent, Adult, Affect, Avoidance Learning, Depression, Female, Humans, Male, Middle Aged, Psychotherapy, Surveys and Questionnaires, Severity of Illness Index, Stress Disorders, Post-Traumatic, Thinking, Trichotillomania, Internet
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