title: Trichotillomania and Trauma: Dissociation and Alexithymia in a Case of Pregnancy Denial.
abstract: Pregnancy denial is rare yet reported and is often the result of complex psychosocial circumstances. We present an unusual case of pregnancy denial associated directly with both remote and ongoing trauma. A woman suddenly gave birth to a child in a hospital while visiting her other daughter, resulting in emergent labor and delivery as well as social work and psychiatric evaluation. Various atypical findings were noted, including pathological hair-pulling, alexithymia, indifference, and pregnancy denial. We offer a biopsychosocial conceptualization of the case, commenting on various possible processes including dissociation. The case also explores current states of knowledge regarding the interaction between impulse control disorders such as trichotillomania, dissociation, and trauma, with a call for future clinical and investigational attention to these interactions.
authors.affiliation: Department of Psychiatry and Psychology, Cleveland Clinic, OH.
authors.forename: Xavier F
authors.initials: XF
authors.lastname: Jimenez
authors.forename: Karen E
authors.initials: KE
authors.lastname: Salerno
authors.forename: Margo C
authors.initials: MC
authors.lastname: Funk