title: The significance of repetitive hair-pulling behaviors in eating disorders.
abstract: We studied the relation between intrusive and repetitive hair pulling, the defining feature of trichotillomania, and compulsive and impulsive features in 1,453 individuals with anorexia nervosa and bulimia nervosa. We conducted a series of regression models examining the relative influence of compulsive features associated with obsessive-compulsive disorder, compulsive features associated with eating disorders, trait features related to harm avoidance, perfectionism, and novelty seeking, and self harm. A final model with a reduced sample (n = 928) examined the additional contribution of impulsive attributes. One of 20 individuals endorsed hair pulling. Evidence of a positive association with endorsement of compulsive behavior of the obsessive-compulsive spectrum emerged. Hair pulling may be more consonant with ritualistic compulsions than impulsive urges in those with eating disorders.
authors.affiliation: Duke University Medical Center, Chapel Hill, NC, USA.
authors.forename: Nancy
authors.initials: N
authors.lastname: Zucker
authors.forename: Ann
authors.initials: A
authors.lastname: Von Holle
authors.forename: Laura M
authors.initials: LM
authors.lastname: Thornton
authors.forename: Michael
authors.initials: M
authors.lastname: Strober
authors.forename: Kathy
authors.initials: K
authors.lastname: Plotnicov
authors.forename: Kelly L
authors.initials: KL
authors.lastname: Klump
authors.forename: Harry
authors.initials: H
authors.lastname: Brandt
authors.forename: Steve
authors.initials: S
authors.lastname: Crawford
authors.forename: Scott
authors.initials: S
authors.lastname: Crow
authors.forename: Manfred M
authors.initials: MM
authors.lastname: Fichter
authors.forename: Katherine A
authors.initials: KA
authors.lastname: Halmi
authors.forename: Craig
authors.initials: C
authors.lastname: Johnson
authors.forename: Allan S
authors.initials: AS
authors.lastname: Kaplan
authors.forename: Pamela
authors.initials: P
authors.lastname: Keel
authors.forename: Maria
authors.initials: M
authors.lastname: LaVia
authors.forename: James E
authors.initials: JE
authors.lastname: Mitchell
authors.forename: Alessandro
authors.initials: A
authors.lastname: Rotondo
authors.forename: D Blake
authors.initials: DB
authors.lastname: Woodside
authors.forename: Wade H
authors.initials: WH
authors.lastname: Berrettini
authors.forename: Walter H
authors.initials: WH
authors.lastname: Kaye
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Bulik
mesh_terms: D000293:Adolescent; D000328:Adult; D015897:Comorbidity; D003192:Compulsive Behavior; D005060:Europe / Q000453:epidemiology; D001068:Feeding and Eating Disorders / Q000523:psychology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D009656:North America / Q000453:epidemiology; D014256:Trichotillomania / Q000453:epidemiology / Q000523:psychology*; D055815:Young Adult