title: Cross-sectional study of women with trichotillomania: a preliminary examination of pulling styles, severity, phenomenology, and functional impact.
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.
authors.affiliation: Department of Psychology, Bradley/Hasbro Research Clinic, University of Wisconsin-Milwaukee, Coro West Building, 2nd floor, 1 Hoppin St., Providence, RI 02915, USA. christopher_flessner@brown.edu
authors.forename: Christopher A
authors.initials: CA
authors.lastname: Flessner
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Woods
authors.forename: Martin E
authors.initials: ME
authors.lastname: Franklin
authors.forename: Nancy J
authors.initials: NJ
authors.lastname: Keuthen
authors.forename: John
authors.initials: J
authors.lastname: Piacentini
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D001288:Attention; D001364:Awareness; D002648:Child; D015331:Cohort Studies; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006801:Humans; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology; D010555:Personality Inventory / Q000706:statistics & numerical data; D011594:Psychometrics; D013315:Stress, Psychological / Q000150:complications; D014256:Trichotillomania / Q000145:classification / Q000175:diagnosis* / Q000453:epidemiology / Q000523:psychology; D055815:Young Adult
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