Trichotillomania: Its Classification and Treatment

By Adams, Kim; Jones, John V., Jr. | TCA Journal, Spring 1998 | Go to article overview

Trichotillomania: Its Classification and Treatment


Adams, Kim, Jones, John V., Jr., TCA Journal


Trichotillomania is categorized as an Impulse-Control Disorder. The following article brings to light that this disorder man not be as rare as some clinicians think. The following discussion delineates Trichotillomania in terms of its descriptive characteristics, onset and course, associated disorders, relationship to Obsessive-Compulsive Disorder, and treatment. Research indicates a combination of psychopharmacology and cognitive-behavioral therapy as the choice of treatment for this disorder. Following the content discussion of Trichotillomania is a transcript of an interview with one of the authors (K. A.) who was previously diagnosed with Trichotillomania.

INTRODUCTION

Trichotillomania is categorized as an Impulse-Control Disorder and is defined by the following five criteria listed in the DSM-IV (1994):

a) recurrent pulling of one's hair resulting in noticeable hair loss, b) an increasing sense of tension immediately before pulling out the hair or when attempting to resist the behavior, c) pleasure, gratification, or relief when pulling out the hair, d) the disturbance is not better accounted for by another mental disorder and is not due to a general medical condition, e) the disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. (p. 621) This article seeks to provide an overview of Trichotillomania in terms of its history and descriptive characteristics, onset and course of illness, associated disorders, its relationship to Obsessive-Compulsive Disorder, and the treatment of choice for Trichotillomania.

HISTORY AND DESCRIPTIVE CHARACTERISTICS

History

In 1889 a French dermatologist, Hallopeau, described a man who pulled out his hair in large amounts (Swedo, 1993). Hallopeau used the term "trichotillomania" to describe this behavior. Before Hallopeau's encounter with his client, references to hair-pulling had already been documented. In 1779, Baudament reported on a 16-year-old boy who pulled out his hair and actually ate it. Eventually, this ingestion of hair led to gastrointestinal problems because the boy developed hair balls in his stomach (Christenson & Mackenzie, 1994).

Once thought to be rare, this disorder is far from uncommon. It has been estimated that approximately eight million Americans are afflicted with this disorder (Azrin & Nunn, 1978). A survey conducted by Rothbaum, Shaw, Morris, and Ninan (1993) revealed that of the 490 college freshman respondents, 10% reported compulsive hair-pulling. Despite these statistics, the literature is very scarce regarding this disorder.

Characteristics

Trichotillomania is predominately found in the female population. Christenson, Mackenzie, and Mitchell (1991) found that 93% of 60 adult chronic hair-pullers were women. Likewise, Swedo and Leonard (1992) found that 70% of 43 sampled children, adolescents, and adults who were chronic hair-pullers were female. Christenson and Mackenzie (1994) found a more equal sex ratio in children under the age of six.

Hair-pulling can occur from many different body locations. A study done by Swedo and Leonard (1992) found that the most common area from which hair is pulled is the scalp, followed by eyelashes, eyebrows, pubis, body (arm/leg), and face (beard). Most individuals pluck hair from at least two sites, with sites varying over time. Those diagnosed with this disorder typically think that the hair that is pulled is somehow "different" from other hair. For example, chronic hair-pullers may pluck kinky or course hair so that they may "feel right" about their hair, thus reducing anxiety (Swedo & Rapoport, 1991.).

After the hair is pulled, other ritualistic acts can follow. For instance, some individuals will play with or twirl their extracted hair, while others may brush it against their cheeks or lips. Some individuals will even go as far as ingesting their hair (trichophagia), possibly leading to gastrointestinal difficulties or even death (Swedo & Leonard, 1992). …

The rest of this article is only available to active members of Questia

Sign up now for a free, 1-day trial and receive full access to:

  • Questia's entire collection
  • Automatic bibliography creation
  • More helpful research tools like notes, citations, and highlights
  • Ad-free environment

Already a member? Log in now.

Notes for this article

Add a new note
If you are trying to select text to create highlights or citations, remember that you must now click or tap on the first word, and then click or tap on the last word.
One moment ...
Default project is now your active project.
Project items

Items saved from this article

This article has been saved
Highlights (0)
Some of your highlights are legacy items.

Highlights saved before July 30, 2012 will not be displayed on their respective source pages.

You can easily re-create the highlights by opening the book page or article, selecting the text, and clicking “Highlight.”

Citations (0)
Some of your citations are legacy items.

Any citation created before July 30, 2012 will labeled as a “Cited page.” New citations will be saved as cited passages, pages or articles.

We also added the ability to view new citations from your projects or the book or article where you created them.

Notes (0)
Bookmarks (0)

You have no saved items from this article

Project items include:
  • Saved book/article
  • Highlights
  • Quotes/citations
  • Notes
  • Bookmarks
Notes
Cite this article

Cited article

Style
Citations are available only to our active members.
Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

(Einhorn, 1992, p. 25)

(Einhorn 25)

1

1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

Cited article

Trichotillomania: Its Classification and Treatment
Settings

Settings

Typeface
Text size Smaller Larger Reset View mode
Search within

Search within this article

Look up

Look up a word

  • Dictionary
  • Thesaurus
Please submit a word or phrase above.
Print this page

Print this page

Why can't I print more than one page at a time?

Help
Full screen

matching results for page

    Questia reader help

    How to highlight and cite specific passages

    1. Click or tap the first word you want to select.
    2. Click or tap the last word you want to select, and you’ll see everything in between get selected.
    3. You’ll then get a menu of options like creating a highlight or a citation from that passage of text.

    OK, got it!

    Cited passage

    Style
    Citations are available only to our active members.
    Sign up now to cite pages or passages in MLA, APA and Chicago citation styles.

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn, 1992, p. 25).

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences." (Einhorn 25)

    "Portraying himself as an honest, ordinary person helped Lincoln identify with his audiences."1

    1. Lois J. Einhorn, Abraham Lincoln, the Orator: Penetrating the Lincoln Legend (Westport, CT: Greenwood Press, 1992), 25, http://www.questia.com/read/27419298.

    Cited passage

    Thanks for trying Questia!

    Please continue trying out our research tools, but please note, full functionality is available only to our active members.

    Your work will be lost once you leave this Web page.

    For full access in an ad-free environment, sign up now for a FREE, 1-day trial.

    Already a member? Log in now.