Introduction
Trichotillomania is a heterogeneous disorder with a wide range of presentations. Past studies have described the phenomenology of trichotillomania, but individual differences based on the body site from which hair is pulled have not been thoroughly explored. Contextual variables relevant to pulling (e.g., settings, tool use) may vary as a function of pulling site. We constructed a detailed profile of individual and clinical characteristics based on pulling site and describe contextual factors associated with different pulling sites.
Methods
Data were drawn from two randomized control trials of psychotherapy for trichotillomania. Participants included treatment-seeking adults with trichotillomania (N = 153; 89% women; Mage=33.41) who took part in either a face-to-face (n = 92) or an online (n = 61) trial. Study 1 explored differences in age, gender, trichotillomania symptom severity, and levels of automatic and focused pulling as a function of pulling site. Study 2 included a subset of Study 1 participants (n = 65) and examined pulling site differences for relevant contextual variables.
Results
Study 1 revealed differences in age, gender, and level of automatic vs. focused pulling based on pulling site. Study 2 showed that pulling from different bodily sites was more likely to occur in specific settings and with certain tools.
Discussion
These results reflect considerable variability in the phenomenology of trichotillomania across pulling sites and contribute to the overall understanding of trichotillomania. A clearer picture of contextual cues and clinical characteristics for different hair pulling sites has treatment implications. Clinical applications and future research directions are discussed.