This study examines the childhood and social experiences of 10 women with trichotillomania (compulsive hair pulling) and the various pathways that led them to the discovery of trichotillomania. Trichotillomania is a chronic and devastating condition that affects a significant number of women, which has long-term consequences that can be debilitating and psychologically and emotionally scarring. The 10 women participated in semi-structured interviews during which they were asked to describe their childhood and social experiences. This is the first study that has attempted to understand childhood and social experiences from the perspective of women living with trichotillomania. Utilizing a grounded theory approach (Strauss & Corbin, 1998), the interviews were transcribed, coded, and analyzed. A model, based on the core category, The Road to Discovering Trichotillomania: The Issue of Control, was developed to reflect the experiences of these women. The model is constructed on five major themes: Looking Back: How It All Began; Childhood Environment; Relationship Between Specific Experiences and the Discovery of Hair Pulling; The Role of Hair Pulling; and The Journey of Hair Pulling. The women identified the events (both internal and external) that precipitated the first episode of hair pulling. The underlying theme of these events was the perception that things were out of their control. The discovery of trichotillomania came about as a result of the women’s attempts to regain control of their experiences and environment. The findings of this study make an important contribution to the current literature on trichotillomania by attempting to understand the complexities of the factors involved in the discovery of this condition. In presenting the lived experiences of these 10 women, this study moves the discussion beyond the pathology and towards a richer understanding of trichotillomania. The study’s limitations, implications for future research, and final thoughts are also discussed.

This study examines the childhood and social experiences of 10 women with trichotillomania (compulsive hair pulling) and the various pathways that led them to the discovery of trichotillomania. Trichotillomania is a chronic and devastating condition that affects a significant number of women, which has long-term consequences that can be debilitating and psychologically and emotionally scarring. The 10 women participated in semi-structured interviews during which they were asked to describe their childhood and social experiences. This is the first study that has attempted to understand childhood and social experiences from the perspective of women living with trichotillomania. Utilizing a grounded theory approach (Strauss & Corbin, 1998), the interviews were transcribed, coded, and analyzed. A model, based on the core category, The Road to Discovering Trichotillomania: The Issue of Control, was developed to reflect the experiences of these women. The model is constructed on five major themes: Looking Back: How It All Began; Childhood Environment; Relationship Between Specific Experiences and the Discovery of Hair Pulling; The Role of Hair Pulling; and The Journey of Hair Pulling. The women identified the events (both internal and external) that precipitated the first episode of hair pulling. The underlying theme of these events was the perception that things were out of their control. The discovery of trichotillomania came about as a result of the women’s attempts to regain control of their experiences and environment. The findings of this study make an important contribution to the current literature on trichotillomania by attempting to understand the complexities of the factors involved in the discovery of this condition. In presenting the lived experiences of these 10 women, this study moves the discussion beyond the pathology and towards a richer understanding of trichotillomania. The study’s limitations, implications for future research, and final thoughts are also discussed.

The purpose of this study was to explore the relationship between multidimensional perfectionism, shame and Trichotillomania (TTM) symptom severity in a sample of college students and a clinical sample of individuals with TTM. A total of 286 college students were recruited from a large, Southeastern public University and 114 individuals with TTM were recruited across at a conference for individuals with TTM and TTM-focused social media communities. The study sought to explore whether shame (characterological, behavioral or bodily) mediated the relationship between wither adaptive or maladaptive perfectionism and TTM symptom severity. Correlations and tests of means were conducted and the Preacher and Hayes macro with bootstrapping was utilized to test mediation and moderation with the following measures: the Almost Perfect Scale-Revised (APS-R; Slaney et al., 2001), the Massachusetts General Hairpulling Scale (MGH-HPS; Keuthen et al., 1995, and the Experience of Shame Scale (ESS; Andrews, Qian, & Valentine, 2002). Results suggested that the clinical sample reported significantly higher levels of all three types of shame, as well as significantly higher scores for TTM severity than the student sample. No mediation or moderation was found among the variables for the student sample. In the clinical sample, no significant moderation was found, but behavioral shame was significantly mediated the relationship between maladaptive perfectionism and TTM severity. A discussion of limitations, implications for practitioners, and directions for future research were provided.

ABSTRACT Trichotillomania was first defined over a hundred years ago as a self inflicted alopecia resulting from avulsion of hair. Previous Positron Emission Tomography (PET) studies have shown increased count density in the right superior parietal region of patients suffering from trichotillomania. It is unclear if this increase in count density might be a state or trait related marker of the disease. Research has indicated that Cognitive Behaviour Therapy can systematically modify cerebral metabolic activity which is significantly related to clinical outcome. In the case of Obsessive Compulsive Disorder (OCD), a decrease of metabolic activity has been demonstrated using Pet. The present study was undertaken to investigate whether similar metabolic changes as indicated by Single Beam Positron Emission Computerised Tomography. (SPECT), will be found in trichotillomania after Cognitive Behaviour Therapy. Twelve patients diagnosed as suffering from trichotillomania, using DSM-IV criteria, underwent brain SPECT scanning using 99mTc-HMPAO. Scanning was performed before and after Cognitive Behaviour Therapy intervention. The psychotherapy was conducted in 12-16 sessions. The response to Cognitive Behaviour Therapy was assessed using the Psychiatric Institute Trichotillomania Scale and the Hamilton Anxiety Rating Scale. Ratings were completed at the beginning and end of the trial. The analysis of the scan data was done by comparing the left to the right superior parietal region. For each patient the region of interest was applied on the superior transaxial brain slices where the cingulate gyrus fully appeared. Each region of interest had the average number of counts normalised to the maximal cerebellar uptake. Baseline studies showed a significant increased count of 99mTc-HMPAO in the right superior parietal areas compared to the same areas on the left (p<0.0003). This pattern normalised after Cognitive Behaviour Therapy, such that there was no significant difference between the right and left superior parietal areas in those patients who responded (n=9) to therapy. In the non-responder group (n=3), the pattern remained unchanged. Using SPECT this study confirms previous reports of increased density in the right superior parietal lobe. In addition, it suggests that the increased count of 99mTc-HMPAO in the right parietal area is a state related disturbance in neurophysiology in this disorder, as it resolves with successful treatment. Of substantial importance is the fact that this study demonstrates a neurophysiological substrate and impact of psychotherapy. In conclusion this data suggests that the increased count density in the right superior parietal area is a state related marker of trichotillomania. 99mTc-HMPAO brain SPECT can therefore be used to monitor therapy of patients suffering from this disease.

Thesis (MA(Clinical Psychology)--University of Pretoria, 2002. / Includes bibliographical references.

Indiana University-Purdue University Indianapolis (IUPUI) / Compulsive and repetitive behaviors in obsessive-compulsive spectrum disorders (OCSDs) are associated with perturbations in the sensorimotor striatum. Repetitive behaviors are associated with cell type-specific adaptations in striatal direct- and indirect-pathway medium spiny neurons (dMSNs and iMSNs, respectively). Furthermore, preclinical models for understanding OCSDs, such as constitutive knockout of disks large associated protein 3 (SAPAP3), suggest repetitive motor dysfunction, such as excessive grooming, is associated with increased metabotropic glutamate receptor 5 (mGluR5) activity that increases dMSN function relative to iMSNs in the sensorimotor striatum. However, MSN subtype-specific signaling mechanisms that mediate mGluR5-dependent adaptations underlying excessive grooming are not fully understood. Reversible phosphorylation of mGluR5’s C-terminal domain is one mechanism to regulate mGluR5 signaling, however, unlike kinases, promiscuous phosphatases require targeting proteins to shuttle them into contact with their targets. Therefore, phosphatase targeting proteins may be intimately involved in mediating mGluR5-dependent striatal adaptions underlying repetitive behaviors, such as excessive grooming in SAPAP3 deficient mice. Spinophilin, a major striatal postsynaptic phosphatase targeting protein, regulates striatal function, mGluR5 signaling, and forms a protein-protein interaction with SAPAP3 that is increased by mGluR5 co-expression. Therefore, we hypothesized that spinophilin expression in striatal medium spiny neurons mediates mGluR5-dependent excessive grooming. To test this, we used a novel conditional spinophilin mouse line combined with functional, behavioral, and molecular approaches to elucidate spinophilin's MSN subtype-specific contributions to rodent excessive grooming behavior associated with increased mGluR5 function. We found that loss of spinophilin in either MSN subtype abrogated plasticity in the sensorimotor striatum associated with increased mGluR5 function and decreased two models of excessive grooming associated with increased mGluR5 function—SAPAP3 deficient mice and global administration of a mGluR5-specific positive allosteric modulator (VU0360172). Additionally, we found that spinophilin’s protein interaction with mGluR5 correlates with grooming behavior and loss of spinophilin shifts mGluR5 interactions from lipid-raft associated proteins toward postsynaptic density proteins implicated in psychiatric disorders. Collectively, these results identify spinophilin as a novel striatal signaling hub molecule in MSNs that MSN subtype-specifically mediates striatal adaptations associated with repetitive motor dysfunction in psychiatric disorders. / 2023-10-03

No description available.

Self-injury is a significant issue with a variety of psychological, social, legal and ethical consequences and implications (Froeschle & Moyer, 2004; McAllister, 2003; Nock & Mendes, 2008; White Kress, Drouhard, & Costin, 2006). Self-injurious behavior is commonly associated with the cutting, bruising or burning of the skin. It also can include trichotillomania, interfering with wound healing and extreme nail biting (Klonsky & Olino, 2008; Zila & Kiselica, 2001). In assessing severity, it is important to note that self-inflicted wounds typically do not require any medical attention, as those who engage in self-injury will usually care for any open wounds in order to prevent infection (Walsh, 2006). The typical duration of a self-injurious act is usually less than 30 minutes, resulting in immediate relief from the emotional turmoil precipitating the behavior (Alderman, 1997; Gratz, 2007). It is difficult to estimate the prevalence of self-injury for many reasons. Nock (2009) noted that reports indicating increased estimates in this behavior derive from “anecdotal reports and estimates from small cross-sectional studies” (p. 81). Given the many ethical and legal ramifications involved in working with clients that self-injure, it is important to understand how self-injury typically manifests itself, how it affects differing populations based on gender and cultural differences, and the level of danger it truly represents to the person choosing to utilize it.

Fifteen adult women (mean age 34.5 years) participated in this exploratory study. The study aimed to identify commonalities in trichotillomania patients’ personality structure and psychological functioning. Relevant historical data were obtained, the Massachusetts General Hospital Hairpulling Scale was completed, and a Rorschach test in terms of the Comprehensive System was administered. The results point to an innate vulnerability in the sample’s personality structure that impedes their capacity for efficient problem-solving, decision-making, and coping behaviour. Other key findings include a distorted perception of themselves, a limited capacity for control and stress tolerance, difficulty in modulating and expressing emotions, the interference of primary process thinking in ideational activity, and the effects of these factors on their interpersonal relationships. Theoretical inferences are made about the probable aetiological roots of these findings. As the subjects’ level of functioning was unexpectedly high in the light of their deep-rooted pathology, the dynamic role and function of self-induced hair pulling as a symptom were considered. Suggestions are made to improve the treatment prognosis of the disorder. / Dissertation (MA (Clinical Psychology))--University of Pretoria, 2006. / Psychology / unrestricted

Trichotillomania is defined as recurrent pulling of one’s hair that results in distress and negative effects on general functioning and quality of life. Estimates of trichotillomania lifetime prevalence generally range from approximately 1% to 3% and it is likely as common as disorders such as obsessive-compulsive disorder and agoraphobia. Yet, quality treatment for trichotillomania is often difficult to find as many mental health professionals are uninformed about the disorder and its treatment. Moreover, mental health services in general are inaccessible to many with estimates suggesting that 96.5 million people do not have access to adequate services. The use of telepsychology has been an effective method for disseminating treatment services for a variety of mental health conditions. However, no research has examined the effectiveness of telepsychology to treat trichotillomania. The current study reports the results of a randomized clinical trial of Acceptance and Commitment Therapy Enhanced Behavior Therapy for the treatment of trichotillomania delivered by way of telepsychology. The study compared an active treatment condition (n = 12) to a waitlist control condition (n = 10). Results showed significant reductions in hair pulling severity from pre- to post-treatment compared to the waitlist condition. Participants in the waitlist condition received the same treatment as participants in the treatment condition following the waitlist period. All participants were then combined to examine overall treatment effects from pre-treatment to a 12-week follow-up. The effect of treatment on hair pulling severity was still significant at follow-up, however the effect was not as strong as at post-treatment. Conversely, the effect on quality of life was maintained and even increased following post-treatment. Additional measures of psychological flexibility, perceived shame, and valued action also saw significant changes from pre-treatment to follow-up. The findings demonstrate that telepsychology is a viable option to disseminate treatment for trichotillomania. Implications, limitations, and future research directions are discussed.