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Characteristics of 60 adult chronic hair pullers
Abstract
Objective This study was constructed to detail the demographic and phenomenological features of chronic hair pullers as well as to assess psychiatric comorbidity in a sizable study group. Method Subjects were drawn from an outpatient population of chronic hair pullers who had been referred to a trichotillomania clinic or had responded to a newspaper advertisement announcing a treatment study of adults who pull out their hair. Sixty adult chronic hair pullers completed a semistructured interview that focused on their hair-pulling behavior and demographic characteristics and that incorporated screening questions for DSM-III-R axis I disorders. The data were tabulated to derive a comprehensive picture of this group. Results The typical subject was a 34-year-old woman who had pulled hair from two or more sites for 21 years. All subjects described either tension before or relief/gratification after pulling hair from the primary site, but 17% (N = 10) failed to describe both of these characteristics and thus failed to fulfill the DMS-III-R criteria for trichotillomania. Forty-nine subjects (82%) qualified for past or current axis I diagnoses other than trichotillomania. Several characteristics of the study group suggested phenomenological differences between obsessive-compulsive disorder and trichotillomania. Conclusions Adult trichotillomania is a chronic disorder, frequently involving multiple hair sites, and is associated with high rates of psychiatric comorbidity. Its relation…
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“Christenson et al. (1991) observed similar results among an outpatient group diagnosed with trichotillomania; whereas Stein et al. (2008) using a web-based sample, noted the presence of both trichotillomania and other BFRBs such as onychophagia and skin excoriation.”
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“Ingestion of the hair can be preceded by oral manipulation, licking, or chewing of the ends (Christenson et al., 1991).”
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“Alternatively, because hair pulling usually begins during puberty, when a person’s sexual orientation is beginning to form, 18 the hair pulling in some people might be a response to both internal states such as internalized homonegativity and anxiety as well as external stressors such as social…”
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“HPD is a chronic disorder that has an average age onset of 11 to 13 years and often oscillates in severity (Christenson et al. 1991).”
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Diagnosis and treatment of trichotillomania
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“Pulling of the scalp hair is most frequently observed in cases of TTM, whereas pulling the hair from other regions, such as the eyebrows, eyelashes, beard-mustache, axilla, and inguinal region, is less common.(2,3) Although there is no consensus on the cause of TTM, various etiological models have been proposed based…”
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“Trichobezoar is commonly associated with trichotillomania and trichophagia, usually relating to an underlying psychiatric disorder.(1) There are no previous reports of human trichobezoar due to the consumption of animal hair as part of a perceived normal diet in the absence of a psychiatric condition.”
Trikotillomani: Tanı, Farmakoterapi ve Kognitif Davranışçı Terapisi
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Cognitive behavioral treatment of trichotillomania
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“The disorder is usually accompanied by certain hair rituals, such as biting, chewing, swallowing, or playing with the hair (2).”
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“Our results complement those of some previous cross-sectional studies based on population-based or help-seeking samples (10,16,17,36,37), which reported conflicting findings regarding an increased risk of SUDs or harmful and substance-related problems in the entire cohort (top) and in a subcohort…”
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“15 Elevated harm avoidance scores have been consistently seen in individuals with OCD.”
Monoamine Oxidase Inhibitors for Trichotillomania
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Patel, A., Kim, A., Loomis, J., Okwara, T., & Miller, M. (2022) · Discover Psychology · doi:10.1007/s44202-022-00053-3 · Cited by 1
Examining the effects of caffeine consumption on the severity of body-focused repetitive behaviors
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Gastric trichobezoar and Rapunzel syndrome: a case report
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“The site of hair pulling is most commonly from the scalp, but can occur from the eyelashes, eyebrows, and pubic area.(7) The first description of a post mortem human bezoar was by Swain in 1854.”
BackgroundFunctional Assessment of Obsessive‐Compulsive Related Disorders
Holman, C. S., Rohl, B., & Andover, M. S. (2017) · doi:10.1002/9781118890233.ch51 · Cited by 1
Phenomenology of Trichotillomania
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Tricotilomanía y otras alopecias autoinducidas
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The Biopsychosocial Aspects of Hair Disease
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Giant Trichobezoar Induced Intestinal Obstruction in a Child-A Case Report
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"Transtornos do espectro obsessivo-compulsivo e febre reumática : um estudo de transmissão familiar"
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Long-Term Maintenance Following Habit Reversal and Adjunct Treatment for Trichotillomania
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“Christenson et al. (1991) report that the prevalence rate for TCM as defined in the DSM-IV is about 0.6% in males and females whereas the lifetime prevalence for chronic hair pulling with hair loss is 1.5% for males and 3.4% for females.”
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Stereotyped Movement Disorders: A Key To Understanding the OCD Spectrum?
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La trichotillomanie du jeune enfant
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Hair Prostheses as a Complementary Therapeutic Option for Female Patients With Trichotillomania
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Hormonal Medication Effects on Trichotillomania and Skin Picking Disorder
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“In a sample of 56 women with trichotillomania, 20% of them reported fluctuations in their symptoms based on their menstrual cycle [13], and in another sample, 16 of 32 women (50”
Body-Focused Repetitive Behavior Disorders: From Competing Paradigms Toward Iterative Integration
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An observational study on prevalence of skin diseases in psychiatric patients
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“Additionally, comorbid psychiatric conditions, such as depression, anxiety, and body dysmorphic disorder, are common among individuals with trichotillomania, further complicating clinical management [11,12].”
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Skin Picking and Trichotillomania Disorders in the Era of COVID-19: Cross-Sectional Study
Alhetheli, G., Alhammad, S., Almazyad, F., Algosair, I., Bukhari, A., Alayidi, S., & Almishali, F. (2022) · Journal of Pharmaceutical Negative Results · doi:10.47750/pnr.2022.13.s08.234
“Classically, tension before hair pulling or gratification after is described by trichotillomania patients(4).”
BackgroundTricotilomanía: un trastorno psicodermatológico incapacitante
García-Cárdenas, C., Carrasco-Cancino, C., & Arceu-Ojeda, M. (2020) · Piel · doi:10.1016/j.piel.2020.05.004
Ileal Trichobezoar Causing Small Intestinal Obstruction: A Rare Variant
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“The underlying psychopathic conditions associated with the occurrence of trichotillomania in adulthood include obsessive-compulsive disorder (OCD), attention deficit hyperactivity disorder (ADHD), tic disorder, and major depression (Christenson et al, 1991; King et al, 1995).”
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As, M. (2018) · doi:10.26502/jppd.2572-519x0044
“Usual onset is around 13yrs of age [7].”
BackgroundGastric Outlet Obstruction by Trichobezoar, A Case Report
Akhter, S. Q., Reza, S. M., Ahmad, S., Lima, I. J., Sony, F. C., Gupta, A., & Islam, M. S. (2018) · Journal of Shaheed Suhrawardy Medical College · doi:10.3329/jssmc.v9i2.37270
Khanjani, Z., Hashemi, T., mahmodailou, M., & faroghi, P. (2018) · Pars of Jahrom University of Medical Sciences · doi:10.52547/jmj.16.1.49
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
“Głównymi miejscami wyrywania włosów są :1) głowa (86%),2) rzęsy (52%) ,3) brwi (38%), 4) region łonowy (27%) , 5) nogi (18%) [17].”
Emotion Regulation in the Obsessive‐Compulsive Spectrum Disorders
Napolitano, L. A. (2017) · Wiley eBooks · doi:10.1002/9781118890233.ch64 · Cited by 1
Metadata
- Authors
- Christenson, G., Mackenzie, T. B., & Mitchell, J. E.
- Affiliations
- University of Minnesota (US)
- ORCID
- James Earl Mitchell
- Venue
- American Journal of Psychiatry
- Published
- 1991-03-01
- Volume
- 148
- Issue
- 3
- Pages
- 365-370
- ISSN
- 0002-953X (ISSN-L)
- 1535-7228
- OpenAlex
- W2205524029
- Cited by
- 570
- References
- 0
- Citations by year
- 2026: 4 · 2025: 9 · 2024: 7 · 2023: 37 · 2022: 15 · 2021: 10 · 2020: 12 · 2019: 9 · 2018: 12 · 2017: 26 · 2016: 22 · 2015: 16 · 2014: 11 · 2013: 12 · 2012: 48
- FWCI
- 19.38
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Obsessive-Compulsive Spectrum Disorders
- Health Sciences › Medicine › Dermatology › Hair Growth and Disorders
- Social Sciences › Psychology › Clinical Psychology › Body Image and Dysmorphia Studies
- Keywords
- trichotillomania, hair pulling, psychiatric comorbidity, obsessive-compulsive disorder, DSM-III-R criteria
- MeSH terms
- Adult, Age Factors, Mental Disorders, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Self Mutilation, Trichotillomania, Comorbidity
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