title: The relationship of psychological trauma with trichotillomania and skin picking.
abstract: OBJECTIVE
  Interactions between psychological, biological and environmental factors are important in development of trichotillomania and skin picking. The aim of this study is to determine the relationship of traumatic life events, symptoms of post-traumatic stress disorder and dissociation in patients with diagnoses of trichotillomania and skin picking disorder.
  
  
  METHODS
  The study included patients who was diagnosed with trichotillomania (n=23) or skin picking disorder (n=44), and healthy controls (n=37). Beck Depression Inventory, Traumatic Stress Symptoms Scale and Dissociative Experiences Scale were administered. All groups checked a list of traumatic life events to determine the exposed traumatic events.
  
  
  RESULTS
  There was no statistical significance between three groups in terms of Dissociative Experiences Scale scores (P=0.07). But Beck Depression Inventory and Traumatic Stress Symptoms Scale scores of trichotillomania and skin picking groups were significantly higher than the control group. Subjects with a diagnosis of trichotillomania and skin picking reported statistically significantly higher numbers of traumatic and negative events in childhood compared to healthy subjects.
  
  
  CONCLUSIONS
  We can conclude that trauma may play a role in development of both trichotillomania and skin picking. Increased duration of trichotillomania or skin picking was correlated with decreased presence of post-traumatic stress symptoms. The reason for the negatively correlation of severity of post-traumatic stress symptoms and self-harming behavior may be speculated as developing trichotillomania or skin picking symptoms helps the patient to cope with intrusive thoughts related to trauma. Future longitudinal research must focus on whether trauma and post-traumatic stress or trichotillomania and skin picking precede the development of mental disorder.
authors.affiliation: Neuropsychiatry Health, Practice, and Research Center, Üsküdar University, Istanbul, Turkey.
authors.forename: Eylem
authors.initials: E
authors.lastname: Özten
authors.affiliation: Neuropsychiatry Health, Practice, and Research Center, Üsküdar University, Istanbul, Turkey.
authors.forename: Gökben Hızlı
authors.initials: GH
authors.lastname: Sayar
authors.affiliation: Neuropsychiatry Health, Practice, and Research Center, Üsküdar University, Istanbul, Turkey.
authors.forename: Gül
authors.initials: G
authors.lastname: Eryılmaz
authors.affiliation: Istanbul Neuropsychiatry Hospital, Üsküdar University, Istanbul, Turkey.
authors.forename: Gaye
authors.initials: G
authors.lastname: Kağan
authors.affiliation: Turkish Red Crescent Altıntepe Medical Center, Üsküdar University, Istanbul, Turkey.
authors.forename: Sibel
authors.initials: S
authors.lastname: Işık
authors.affiliation: Department of Psychology, Faculty of Human and Social Sciences, Üsküdar University, Istanbul, Turkey.
authors.forename: Oğuz
authors.initials: O
authors.lastname: Karamustafalıoğlu
keywords: psychological trauma; skin picking; trichotillomania