Skip to main content
SpringerLink
Log in

Trichotillomania Treatment Manual

  • Chapter
Sourcebook of Psychological Treatment Manuals for Adult Disorders

Abstract

Trichotillomania is a relatively understudied condition characterized by repetitive hair pulling. Diagnostic criteria for this disorder continue to evolve as new information emerges from the phenomenological and treatment literatures. However, in any discussion of pathological hair pulling, it seems important to distinguish between the syndrome of trichotillomania and the symptom of hair pulling per se. Hair pulling, for example, can occur in the context of psychotic processes and developmental disabilities, although current diagnostic criteria suggest that use of the term trichotillomania is not appropriate when the symptoms occur in these contexts. As such, the present chapter addresses only hair pulling that occurs when psychotic or developmental disorders are not present. In addition, the information presented here addresses only the symptoms as they occur in adults. Although trichotillomania also can be a serious disorder in childhood (Reeve, Bernstein, & Christenson, 1992), treatment of these cases is beyond the scope of this chapter. Thus, we will address the descriptive psychopathology, etiology, conceptualization, assessment, and behavioral treatment of adult trichotillomania.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 169.00
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 219.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 219.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  • American Psychiatric Association. (1987). Diagnostic and statistical manual of mental disorders (3rd ed., rev.). Washington, DC: Author.

    Google Scholar 

  • American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author.

    Google Scholar 

  • Azrin, N. H., & Nunn, R. G. (1973). Habit-reversal: A method of eliminating nervous habits and tics. Behaviour Research and Therapy, 11, 619–628.

    Article  PubMed  Google Scholar 

  • Azrin, N. H., & Nunn, R. G. (1977). Habit control in a day. New York: Simon & Schuster.

    Google Scholar 

  • Azrin, N. H., Nunn, R. G., & Frantz, S. E. (1980). Treatment of hairpulling (trichotillomania): A comparative study of habit reversal and negative practice training. Behavior Therapy and Experimental Psychiatry, 11, 13–20.

    Article  Google Scholar 

  • Beck, J. G., Stanley, M. A., Baldwin, L. E., Deagle, E. A., & Averill, P. M. (1994). A comparison of cognitive therapy and relaxation training for panic disorder. Journal of Consulting and Clinical Psychology, 62, 818–826.

    Article  PubMed  Google Scholar 

  • Borkovec, T. D., & Nau, S. D. (1972). Credibility of analogue therapy rationales. Journal of Behavior Therapy and Experimental Psychiatry, 3, 257–260.

    Article  Google Scholar 

  • Christenson, G. A., Chernoff-Clementz, E., & Clementz, B. A. (1992). Personality and clinical characteristics in patients with trichotillomania. Journal of Clinical Psychiatry, 53, 407–413.

    PubMed  Google Scholar 

  • Christenson, G. A., Mackenzie, T. B., & Mitchell, J. E. (1991a). Characteristics of 60 adult chronic hair pullers. American Journal of Psychiatry, 148, 365–370.

    PubMed  Google Scholar 

  • Christenson, G. A., Mackenzie, T. B., & Mitchell, J. E. (1994). Adult men and women with trichotillomania: A comparison of male and female characteristics. Psychosomatics, 35, 142–149.

    Article  PubMed  Google Scholar 

  • Christenson, G. A., Mackenzie, T. B., Mitchell, J. E., & Callies, A. L. (1991b). A placebo-controlled, double-blind crossover study of fluoxetine in trichotillomania. American Journal of Psychiatry, 148, 1566–1571.

    PubMed  Google Scholar 

  • Christenson, G. A., Pyle, R. L., & Mitchell, J. E. (1991c). Estimated lifetime prevalence of trichotillomania in college students. Journal of Clinical Psychiatry, 52, 415–417.

    PubMed  Google Scholar 

  • Christenson, G. A., Ristvedt, S. L., & Mackenzie, T. B. (1993). Identification of trichotillomania cue profiles. Behaviour Research and Therapy, 31, 315–320.

    Article  PubMed  Google Scholar 

  • Dahlquist, L. M., & Kalfus, G. R. (1984). A novel approach to assessment in the treatment of childhood trichotillomania. Journal of Behavior Therapy and Experimental Psychiatry, 15, 47–50.

    Article  PubMed  Google Scholar 

  • DeLuca, R. V., & Holborn, S. W. (1984). A comparison of relaxation training and competing response training to eliminate hair pulling and nail biting. Journal of Behavior Therapy and Experimental Psychiatry, 15, 67–70.

    Article  Google Scholar 

  • DiNardo, P. A., Moras, K., Barlow, D. H., & Rapee, R. M. (1993). Reliability of the DSM-III-R anxiety disorder categories using the Anxiety Disorders Interview Schedule-Revised (ADIS-R). Archives of General Psychiatry, 50, 251–256.

    Article  Google Scholar 

  • Goodman, W. K., Price, L. H., Rasmussen, S. A., et al. (1989). The Yale-Brown Obsessive-Compulsive Scale (YBOCS). Part I., Development, use, and reliability. Archives of General Psychiatry, 46, 1006–1011.

    Article  PubMed  Google Scholar 

  • Graber, J., & Arndt, W. B. (1993). Trichotillomania. Comprehensive Psychiatry, 34, 340–346.

    Article  PubMed  Google Scholar 

  • Greenberg, H. R., & Sarner, C. A. (1965). Trichotillomania: Symptom and syndrome. Archives of General Psychiatry, 12, 482–489.

    Article  PubMed  Google Scholar 

  • Hallopeau, M. (1989). Alopécie par grattage Hrichomanie ou trichotillomaniel. Annales de Dermatologie et de Venerologie, 10, 440–441.

    Google Scholar 

  • Hussain, S. H. (1992). Trichotillomania: Two case reports from a similar cultural background. Psychopathology, 25, 289–293.

    Article  PubMed  Google Scholar 

  • Insel, T. R., & Winslow, J. T. (1990). Neurobiology of obsessive-compulsive disorder. In M. A. Jenike, L. Baer, & W. E. Minichiello (Eds.), Obsessive compulsive disorders: Theory and management (2nd ed., pp: 118–131). Chicago: Year Book Medical Publishers.

    Google Scholar 

  • Jenike, M. A. (1990). Illness related to obsessive-compulsive disorder. In M. A. Jenike, L. Baer, and W. E. Minichiello (Eds.), Obsessive-compulsive disorders: Theory and management (2nd ed., pp. 29–60). Chicago: Year Book Medical Publishers.

    Google Scholar 

  • Ladouceur, R. (1979). Habit reversal treatment: Learning an incompatible response or increasing subject’s awareness? Behaviour Research and Therapy, 17, 313–316.

    Article  PubMed  Google Scholar 

  • Lenane, M. C., Swedo, S. E., Rapoport, J. L., Leonard, H., Sceery, W., & Guroff, J. J. (1992). Rates of obsessive-compulsive disorder in first degree relatives of patients with trichotillomania: A research note. Journal of Child Psychology and Psychiatry, 33, 925–933.

    Article  PubMed  Google Scholar 

  • Mansueto, C. (1991). Trichotillomania in focus. OCD Newsletter, 5, 10–11.

    Google Scholar 

  • Mansueto, C. (1993, April). Trichotillomania and life. Paper presented at the Massachusetts General Hospital Clinic Trichotillomania Conference, Boston, MA.

    Google Scholar 

  • Muller, S. A. (1987). Trichotillomania. Dermatologic Clinics, 5, 595–601.

    PubMed  Google Scholar 

  • Muller, S. A. (1990). Trichotillomania: A histopathologic study in sixty-six patients. Journal of the American Academy of Dermatology, 23, 56–62.

    Article  PubMed  Google Scholar 

  • Oguchi, T., & Miura, S. (1977). Trichotillomania: Its psychopathological aspect. Comprehensive Psychiatry, 18, 177–182.

    Article  PubMed  Google Scholar 

  • Reeve, E. A., Bernstein, G. A., & Christenson, G. A. (1992). Clinical characteristics and psychiatric comorbidity in children with trichotillomania. Journal of American Academy of Child and Adolescent Psychiatry, 31, 132–138.

    Article  Google Scholar 

  • Rettew, D. C., Cheslow, D. L., Rapoport, J. L., Leonard, H. L., & Lenane, M. C. (1991). Neuropsychological test performance in trichotillomania: A further link with obsessive-compulsive disorder. Journal of Anxiety Disorders, 5, 225–235.

    Article  Google Scholar 

  • Rosenbaum, M. S., & Ayllon, T. (1981). The habit-reversal technique in treating trichotillomania. Behavior Therapy, 12, 473–481.

    Article  Google Scholar 

  • Rothbaum, B. O. (1992). The behavioral treatment of trichotillomania. Behavioural Psychotherapy, 20, 1–00.

    Article  Google Scholar 

  • Rothbaum, B. O., & Ninan, P. (1992, November). Treatment of trichotillomania: Behavior therapy versus clomipramine. Paper presented at the Association for the Advancement of Behavior Therapy Annual Convention, Boston, MA.

    Google Scholar 

  • Rothbaum, B. O., Shaw, L., Morris, R., & Ninan, P. T. (1993). Prevalence of trichotillomania in a college freshman population. Letter. Journal of Clinical Psychiatry, 54, 72.

    PubMed  Google Scholar 

  • Shome, S., Bhatia, M. S., Gautam, R. K. (1993). Culture-bound trichotillomania. Letter. American Journal of Psychiatry, 150, 674.

    PubMed  Google Scholar 

  • Spitzer, R. L., Williams, J. B. W., Gibbon, M., & First, M. B. (1992). The Structured Clinical Interview for DSM-III-R (SCID). I. History, rationale, and description. Archives of General Psychiatry, 49, 624–629.

    Article  PubMed  Google Scholar 

  • Stanley, M. A., Borden, J. W., Bell, G. E., & Wagner, A. L. (1994). Nonclinical hair-pulling: Phenomenology and related psychopathology. Journal of Anxiety Disorders, 8, 119–130.

    Article  Google Scholar 

  • Stanley, M. A., Borden, J. W., Mouton, S. G., & Breckenridge, J. (1995). Nonclinical hair-pulling: Affective correlates and a comparison with clinic patients. Behaviour Research and Therapy, 33, 179–186.

    Article  PubMed  Google Scholar 

  • Stanley, M. A., Bowers, T. C., Swann, A. C., & Taylor, D. J. (1991). Treatment of trichotillomania with fluoxetine. Letter. Journal of Clinical Psychiatry, 52, 282.

    PubMed  Google Scholar 

  • Stanley, M. A., & Mouton, S. G. (1994). Affective correlates of trichotillomania. Manuscript in preparation.

    Google Scholar 

  • Stanley, M. A., Prather, R. C., Wagner, A. L., Davis, M. L., & Swann, A. C. (1993a). Can the Yale-Brown Obsessive-Compulsive Scale be used to assess trichotillomania? A preliminary report. Behaviour Research and Therapy, 31, 171–178.

    Article  PubMed  Google Scholar 

  • Stanley, M. A., Swann, A. C., Bowers, T. C., Davis, M. L., & Taylor, D. J. (1992). A comparison of clinical features in trichotillomania and obsessive-compulsive disorder. Behaviour Research and Therapy, 30, 39–44.

    Article  PubMed  Google Scholar 

  • Stanley, M. A., Wagner, A. L., & Davis, M. L. (1993b, November). A comparison of obsessive-compulsive disorder and trichotillomania: Self-reported and cognitive impulsivity. Presented in F. Neziruglu, Chair, Obsessive-Compulsive and Related Disorders, Association for the Advancement of Behavior Therapy, Atlanta, GA.

    Google Scholar 

  • Swedo, S. E., & Leonard, H. L. (1992). Trichotillomania: An obsessive-compulsive spectrum disorder? Psychiatric Clinics of North America, 15, 777–790.

    PubMed  Google Scholar 

  • Swedo, S. E., Leonard, H. L., Rapoport, J. L., Lenane, M. C., Goldberger, B. A., & Cheslow, B. A. (1989). A double-blind comparison of clomipramine and desipramine in the treatment of trichotillomania (hair pulling). New England Journal of Medicine, 321, 497–501.

    Article  PubMed  Google Scholar 

  • Swedo, S. E., Rapoport, J. L., Leonard, H. L., Schapiro, M. B., Rapoport, S. J., & Grady, C. L. (1991). Regional cerebral glucose metabolism of women with trichotillomania. Archives of General Psychiatry, 48, 828–833.

    Article  PubMed  Google Scholar 

  • Tarnowski, K. J., Rosen, L. A., McGrath, M. L., & Drabman, R. S. (1987). A modified habit reversal procedure in a recalcitrant case of trichotillomania. Journal of Behavior Therapy and Experimental Psychiatry, 18, 157–163.

    Article  PubMed  Google Scholar 

  • Tynes, L. L., White, K., & Steketee, G. S. (1990). Toward a nosology of obsessive-compulsive disorder. Comprehensive Psychiatry, 31, 465–480.

    Article  PubMed  Google Scholar 

  • Winchel, R. M., Jones, J. S., Molcho, A., Parsons, B., Stanley, B., & Stanley, M. (1992a). Rating the severity of trichotillomania: Methods and problems. Psychopharmacology Bulletin, 28, 457–462.

    PubMed  Google Scholar 

  • Winchel, R. M., Jones, J. S., Molcho, A., Parsons, B., Stanley, B., & Stanley, M. (1992b). The Psychiatric Institute Trichotillomania Scale (PITS). Psychopharmacology Bulletin, 28, 463–476.

    PubMed  Google Scholar 

  • Winchel, R. M., Jones, J. S., Stanley, B., Molcho, A., & Stanley, M. (1992c). Clinical characteristics of trichotillomania and its response to fluoxetine. Journal of Clinical Psychiatry, 53, 304–308.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Psychiatry and Behavioral Sciences, University of Texas Mental Sciences Institute, Health Science Center at Houston, Houston, Texas, 77030, USA

    Melinda A. Stanley & Suzanne G. Mouton

  2. Department of Educational Psychology, University of Houston, Houston, Texas, 77004, USA

    Suzanne G. Mouton

Authors
  1. Melinda A. Stanley
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Suzanne G. Mouton
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Center for Psychological Studies, Nova Southeastern University, Fort Lauderdale, Florida, 33314, USA

    Vincent B. Van Hasselt  & Michel Hersen  & 

Rights and permissions

Reprints and permissions

Copyright information

© 1996 Springer Science+Business Media New York

About this chapter

Cite this chapter

Stanley, M.A., Mouton, S.G. (1996). Trichotillomania Treatment Manual. In: Van Hasselt, V.B., Hersen, M. (eds) Sourcebook of Psychological Treatment Manuals for Adult Disorders. Springer, Boston, MA. https://doi.org/10.1007/978-1-4899-1528-3_17

Download citation

  • DOI: https://doi.org/10.1007/978-1-4899-1528-3_17

  • Publisher Name: Springer, Boston, MA

  • Print ISBN: 978-1-4899-1530-6

  • Online ISBN: 978-1-4899-1528-3

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation