Trichotillomania (Hair Pulling Disorder)

While there is a great deal of information regarding Trichotillomania that may be easily accessed via our Links page and Internet search engines, we wanted to call your attention to why we feel that comprehensive cognitive behavior therapy and Habit Reversal Training are options you should consider on your journey to recovery. We are also hopping to provide you with resources currently available in researching the cognitive behavioral procedure known as Habit Reversal Training.


Trichotillomania is a disorder of chronic hair pulling of neurological etiology resulting in alopecia. Prior to 1950, reports of the disorder appeared in the dermatology literature. Interest in the psychological nature of the behavior first appeared in the psychoanalytic literature in the 1950’s (Greenberg, 1969). More recently, a variety of behavioral approaches have been published reporting successful treatment of the condition. (Friman et al, 1984)The primary clinical features of this disorder include pulling hair from the scalp, eyebrows, eyelashes, and at times other parts of the body to various degrees. More often then not, the hair pulling is symmetrical and it is common for the self-inflicted nature of the hair loss to be denied (Muller, 1987). It is estimated that hair pulling most frequently occurs to the scalp and then less so in other areas.


Few patients report experiencing pain from the pulling but a good deal indicate increased gratification with pulling out the “right” hair. The activity has been noted to occur most frequently at times of sedentary activities, such as watching television, reading, talking on the telephone and lying in bed with frequency of pulling increasing during the evening or prior to falling asleep (Jillson, 1983).


Trichotillomania has been associated with a number of psychiatric conditions, including obsessive-compulsive disorders (OCD), mental retardation, schizophrenia, and depression and self mutilation. Research has also suggested that approximately 70 percent of patients develop moderate to severe school problems subsequent to hair pulling.



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