Trichotillomania (TTM), or compulsive hair pulling, is a disorder that typically onsets
in childhood. It is mistaken to believe that children will “age out” of this behavior,
as pediatric TTM often has a chronic, debilitating course that does not remit without
treatment, resulting in considerable psychological and physical impairment. Because
most children with TTM will be seen initially by nursing professionals in the practices
of dermatologists, pediatricians, gastroenterologists, and other disciplines, raising
nurses' awareness of this disorder is of the utmost importance for accurate nursing
diagnosis and assessment. As the health care providers who spend the greatest amount
of time with patients, nurses' detection and diagnosis of TTM can make a critical
difference in the initiation of early intervention. Therefore, the purpose of this
article is to provide an overview of pediatric TTM, including its epidemiology, clinical
presentation, and treatment options, from the perspective of nurses who may interact
with such patients in their workplace.
Key words
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of Pediatric Nursing: Nursing Care of Children and FamiliesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Diagnostic and statistical manual of mental disorders.4th ed., text revision. Author, Washington, DC2000
- Habit-reversal: A method of eliminating nervous habits and tics.Behavioral Research and Therapy. 1973; 11: 619-628
- The relationship between experiential avoidance and the severity of trichotillomania in a nonreferred sample.Journal of Behavior Therapy and Experential Psychiatry. 2004; 35: 17-24
- Tweede Nationale Studie Naar Ziekten en Verrichtingen in de Huisartspraktijk.De werkbelasting van huisartsen, Nivel, Utrecht2004
- Systematic review: Pharmacological and behavioral treatment for trichotillomania.Biological Psychiatry. 2007; 62: 839-846
- A simplified behavioral treatment for trichotillomania: Report of two cases.Pediatrics. 1993; 91: 993-995
- Negative peer evaluation in adolescents: Effects of tic disorders and trichotillomania.Child and Family Behavior Therapy. 2000; 22: 17-28
- Diagnosis and management of trichotillomania in children and adolescents.Pediatric Drugs. 2005; 7: 365-376
- Treatment of early onset hair pulling as a simple habit.Behavior Modification. 2002; 26: 400-411
- Trichotillomania—From prevalence to comorbidity.Psychiatric Times. 1995; 12: 44-48
- The characterization and treatment of trichotillomania.Journal of Clinical Psychiatry. 1996; 57: 42-49
- Characteristics of 60 adult chronic hair pullers.American Journal of Psychiatry. 1991; 148: 365-370
- Adult men and women with trichotillomania.Psychosomatics. 1994; 35: 142-149
Clark Jr., J., Helm T. N., & Bergfeld, W. F. (1995). Chronic alopecia. Trichotillomania. Archives of Dermatology, 131, 720–721, 723–724.
- Clinical profile, comorbidity, and treatment history in 123 hair pullers: A survey study.Journal of Clinical Psychiatry. 1995; 56: 319-326
- Pathological hair pulling: A review of the literature and case reports.Comprehensive Psychiatry. 1992; 33: 84-91
- Affective correlates of trichotillomania.Behaviour Research and Therapy. 2002; 40: 1305-1315
- Assessment of trichotillomania: A psychometric evaluation of hair-pulling scales.Journal of Psychopathology and Behavioral Assessment. 2005; 27: 169-178
- Characteristics and phenomenology of hair-pulling: An exploration of subtypes.Comprehensive Psychiatry. 2001; 42: 247-256
- Cross-sectional study of women with trichotillomania: A preliminary examination of pulling styles, severity, phenomenology, and functional impact.Child Psychiatry and Human Development. 2009; 40: 153-167
- The Milwaukee Inventory for Styles of Trichotillomania—Child Version (MIST-C): Initial development and psychometric properties.Behavior Modification. 2007; 31: 896-918
- The Child and Adolescent Trichotillomania Impact Project: Descriptive psychopathology, comorbidity, functional impairment, and treatment utilization.Journal of Developmental and Behavioral Pediatrics. 2008; 29: 493-500
- Trichotillomania: Symptom and syndrome.Archives of General Psychiatry. 1965; 12: 482-489
- Alopecia par grattage (trichomania ou trichotillomania).Annales de dermatologie et de syphiligraphie (Paris). 1889; 10: 440-441
- Trichotillomania in childhood.Acta Psychiatrica Scandanavica. 1991; 83: 241-243
- Trichotillomania and related disorders in children and adolescents.Child Psychiatry and Human Development. 1997; 27: 255-268
- Childhood trichotillomania: Clinical phenomenology, comorbidity, and family genetics.Journal of the American Academy of Child and Adolescent Psychiatry. 1995; 34: 1451-1459
- An epidemiological study of trichotillomania in Israeli adolescents.Journal of the American Academy of Child and Adolescent Psychiatry. 1995; 34: 1212-1215
- Indian.Pediatrics. 2008; 45: 403-405
- Trichotillomania.Dermatologic Clinics. 1987; 5: 595-601
- Trichotillomania: A histopathologic study in sixty-six patients.Journal of the American Academy of Dermatology. 1990; 23: 56-62
- Depression, anxiety, and functional impairment in children with trichotillomania.Depression and Anxiety. 2009; 26: 521-527
- Trichotillomania: Behavioral symptom or clinical syndrome?.American Journal of Psychiatry. 1997; 10: 1442-1449
- Trichotillomania and carpal tunnel syndrome.Journal of Clinical Psychiatry. 1996; 57: 174
- Trichotillomania.International Journal of Dermatology. 2003; 42: 330-334
- Behavioral treatment of trichotillomania and trichophagia in a 29-month-old girl.Clinical Pediatrics. 2009; 48: 951-953
- Hair pulling in children and adolescents.in: Stein D.J. Christenson G.A. Hollander E. Trichotillomania. American Psychiatric Press Inc, Washington, DC1999: 201-224
- Clinical characteristics and psychiatric comorbidity in children with trichotillomania.Journal of the American Academy of Child and Adolescent Psychiatry. 1992; 31: 132-138
- Cognitive behavioral treatment of trichotillomania in youth: What went right and what went wrong?.Cognitive and Behavioral Practice. 1999; 6: 154-161
- Trichotillomania. Dermatologic Therapy. 2008; 21: 13-21
- Is it trichotillomania? Hair pulling in childhood: A developmental perspective.Clinical Child Psychology and Psychiatry. 2008; 13: 409-418
- The demography, phenomenology, and family history of 22 persons with compulsive hair pulling.Annals of Clinical Psychiatry. 1994; 6: 147-152
- Broadening the approach to treatment of trichotillomania in youth.Cognitive and Behavioral Practice. 1999; 6: 161-163
- Personal toll of trichotillomania: Behavioral and interpersonal sequelae.Journal of Anxiety Disorders. 2000; 14: 97-104
- Trichotillomania resulting in a trichobezoar: A case report.The Journal of the Louisiana State Medical Society. 1998; 150: 478-481
- Trichotillomania.in: Hollander E. Obsessive–compulsive-related disorders. American Psychiatric Press, Washington, DC1993: 93-111
- Trichotillomania: An obsessive compulsive disorder?.Psychiatric Clinics of North America. 1992; 15: 777-790
- Annotation: Trichotillomania.Journal of Child Psychology and Psychiatry. 1991; 32: 401-409
- Trichotillomania in childhood: Case series and review.Pediatrics. 2004; 113: 494-498
- Pediatric trichotillomania: Descriptive psychopathology and an open trial of cognitive behavioral therapy.Cognitive Behaviour Therapy. 2007; 36: 129-144
- Trichotillomania: Presentation, etiology, diagnosis and therapy.American Journal of Clinical Dermatology. 2001; 2: 327-333
- Treating trichotillomania in a toddler: Variations on effective treatments.Child and Family Behavior Therapy. 2000; 22: 29-40
- Traumatic alopecia.International Journal of Dermatology. 1999; 38: 34-44
- Effects of interventions aimed at changing the length of primary care physicians' consultation.Cochrane Database of Systematic Reviews. 2006; : 1
- Trichotillomania (hair pulling) in toddlers.Psychological Reports. 2003; 92: 228-230
Article info
Publication history
Published online: March 09, 2011
Footnotes
1No previous presentations or publications of this work exist. No extramural funding or commercial financial support aided in the preparation of this article.
Identification
Copyright
© 2012 Elsevier Inc. Published by Elsevier Inc. All rights reserved.