title: Comorbidity and quality of life in adults with hair pulling disorder.
abstract: Hair pulling disorder (HPD; trichotillomania) is thought to be associated with significant psychiatric comorbidity and functional impairment. However, few methodologically rigorous studies of HPD have been conducted, rendering such conclusions tenuous. The following study examined comorbidity and psychosocial functioning in a well-characterized sample of adults with HPD (N=85) who met DSM-IV criteria, had at least moderate hair pulling severity, and participated in a clinical trial. Results revealed that 38.8% of individuals with HPD had another current psychiatric diagnosis and 78.8% had another lifetime (present and/or past) psychiatric diagnosis. Specifically, HPD showed substantial overlap with depressive, anxiety, addictive, and other body-focused repetitive behavior disorders. The relationships between certain comorbidity patterns, hair pulling severity, current mood and anxiety symptoms, and quality of life were also examined. Results showed that current depressive symptoms were the only predictor of quality of life deficits. Implications of these findings for the conceptualization and treatment of HPD are discussed.
authors.affiliation: Texas A&M University, Department of Psychology, 4235 TAMU, College Station, TX 77843-4235, United States. Electronic address: davidhoughton@tamu.edu.
authors.forename: David C
authors.initials: DC
authors.lastname: Houghton
authors.affiliation: Radboud University-Nijmegen, Department of Clinical Psychology, P.O. Box 9104, NL-6500 HE Nijmegen, The Netherlands. Electronic address: j.maas@psych.ru.nl.
authors.forename: Joyce
authors.initials: J
authors.lastname: Maas
authors.affiliation: Utah State University, Department of Psychology, 2810 Old Main Hill, Logan, UT 84322-2810, United States. Electronic address: michael.twohig@usu.edu.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Twohig
authors.affiliation: Marquette University, Department of Psychology, 328E Cramer Hall, Milwaukee, WI 53233, United States. Electronic address: stephen.saunders@marquette.edu.
authors.forename: Stephen M
authors.initials: SM
authors.lastname: Saunders
authors.affiliation: Duke University School of Medicine, Department of Psychiatry and Behavioral Sciences, DUMC 3527, Durham, NC 27710, United States. Electronic address: scompton@duke.edu.
authors.forename: Scott N
authors.initials: SN
authors.lastname: Compton
authors.affiliation: Kent State University, Department of Psychological Sciences, 203 Kent Hall Addition, Kent, OH 44242, United States. Electronic address: aneal@kent.edu.
authors.forename: Angela M
authors.initials: AM
authors.lastname: Neal-Barnett
authors.affiliation: University of Pennsylvania School of Medicine, Department of Psychiatry, 3535 Market Street, 6th Floor, Philadelphia, PA 19104, United States. Electronic address: marty@mail.med.upenn.edu.
authors.forename: Martin E
authors.initials: ME
authors.lastname: Franklin
authors.affiliation: Texas A&M University, Department of Psychology, 4235 TAMU, College Station, TX 77843-4235, United States. Electronic address: dowoods@tamu.edu.
authors.forename: Douglas W
authors.initials: DW
authors.lastname: Woods
mesh_terms: D064869:Acceptance and Commitment Therapy / Q000379:methods; D000328:Adult; D001007:Anxiety / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D015897:Comorbidity; D003863:Depression / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life / Q000523:psychology*; D014256:Trichotillomania / Q000453:epidemiology / Q000523:psychology* / Q000628:therapy
keywords: Comorbidity; Depression; Obsessive-Compulsive Disorder; Quality of life; Trichotillomania