title: Affective regulation in trichotillomania: Evidence from a large-scale internet survey.
abstract: Trichotillomania (TTM), a repetitive hair-pulling disorder, is underrepresented in the clinical literature. The current project explores the relationship between affective regulation and disordered hair-pulling. Previous research suggests that cycles of emotional states are correlated with the disorder and may induce, reinforce, or otherwise contribute to hair-pulling behavior. We use anonymous internet survey responses from 1162 self-identified hair-pullers to address four questions about affective regulation in people with TTM: (1) Do hair-pullers experience greater difficulty "snapping out" of affective states than non-pullers? (2) Does difficulty with emotional control correlate with TTM severity? (3) Are subtypes identifiable based on the emotions that trigger hair-pulling behavior? (4) Does difficulty "snapping out" of an emotion predict whether that emotion triggers pulling behavior? The results showed a small-to-moderate relationship between affective regulation and problematic hair-pulling. In addition, individual patterns of emotion regulation were systematically related to emotional cues for hair-pulling as well as overall hair-pulling severity. These findings contribute to an understanding of the phenomenology of TTM and provide empirical support for treatments focused on affect regulation.
authors.affiliation: Wesleyan University, Department of Psychology, 207 High St., Middletown, CT 05459, USA. ashusterman@wesleyan.edu
authors.forename: Anna
authors.initials: A
authors.lastname: Shusterman
authors.forename: Lauren
authors.initials: L
authors.lastname: Feld
authors.forename: Lee
authors.initials: L
authors.lastname: Baer
authors.forename: Nancy
authors.initials: N
authors.lastname: Keuthen
mesh_terms: D000293:Adolescent; D000328:Adult; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006306:Health Surveys / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D011795:Surveys and Questionnaires; D014256:Trichotillomania / Q000523:psychology*