Child Psychiatry and Human Development

, Volume 40, Issue 1, pp 153–167

Cross-Sectional Study of Women with Trichotillomania: A Preliminary Examination of Pulling Styles, Severity, Phenomenology, and Functional Impact

  • Christopher A. Flessner
  • Douglas W. Woods
  • Martin E. Franklin
  • Nancy J. Keuthen
  • John Piacentini
Original Article

DOI: 10.1007/s10578-008-0118-5

Cite this article as:
Flessner, C.A., Woods, D.W., Franklin, M.E. et al. Child Psychiatry Hum Dev (2009) 40: 153. doi:10.1007/s10578-008-0118-5

Abstract

The current study utilized a cross-sectional design to examine pulling severity, phenomenology, functional impact, and “focused” and “automatic” pulling styles in women with TTM across a wide age spectrum. “Automatic” pulling refers to pulling occurring primarily out of one’s awareness, while “focused” pulling refers to pulling with a compulsive quality that may include pulling in response to a negative emotional state (e.g., anxiety, stress, anger, etc.), an intense thought or urge, or in an attempt to establish symmetry. In the present study, data were collected from 1,471 female participants (age 10–69) meeting modified diagnostic criteria for TTM via two separate online surveys (one for children/adolescents, one for adults). Pulling severity remained stable across the different developmental cohorts. However, fluctuations in functional impact (e.g., social and interpersonal impairment) were noted. “Automatic” pulling showed relatively little fluctuation from adolescence to adulthood, while “focused” pulling demonstrated considerable fluctuation coinciding with psychological distress and typical ages of important biological changes (e.g., pubertal onset) in children/adolescents and adults (e.g., perimenopause). Conclusions, treatment implications, limitations, and future areas of research are discussed.

Keywords

Pulling styles Severity Phenomenology Functional impact 

Copyright information

© Springer Science+Business Media, LLC 2008

Authors and Affiliations

  • Christopher A. Flessner
    • 1
  • Douglas W. Woods
    • 1
  • Martin E. Franklin
    • 2
  • Nancy J. Keuthen
    • 3
  • John Piacentini
    • 4
  1. 1.Department of Psychology, Bradley/Hasbro Research ClinicUniversity of Wisconsin-MilwaukeeProvidenceUSA
  2. 2.Department of Psychiatry, School of MedicineUniversity of PennsylvaniaPhiladelphiaUSA
  3. 3.Massachusetts General Hospital/Harvard Medical SchoolBostonUSA
  4. 4.Semel Institute for Neuroscience and Human BehaviorUniversity of California-Los AngelesLos AngelesUSA