Psychosocial issues for women with trichotillomania

Trichotillomania, the compulsive urge to pull out one's hair, is a poorly studied chronic condition affecting 2 to 8 million people, 90% of whom are women. Significant gains have been made about the nature and clinical presentation of this disorder, and yet conceptualizations of trichotillomania remain inconsistent and controversial. Consequently, treatments for trichotillomania have proven to be largely ineffective. Anecdotal case studies have provided us with preliminary data about the impact of this condition on emotional, psychological, and social well-being. To date, there are no empirical studies that focus on patients' subjective experiences with their disorder. The purpose of this report is to identify and discuss the concerns of women with trichotillomania. We have also provided clinical examples to highlight how these concerns are evident in the lives of these women. A total of seven women participated in focused interviews which asked them to reflect on their experiences with compulsive hair pulling. The interview transcripts were analyzed for themes using techniques from the constant comparative method. Additionally, women were asked to complete a demographic self-report. Our analysis identified themes pertinent to negative affects, control, and triggering precipitants. We argue that identifying and integrating these themes in current treatment protocols is the first step to improving the efficacy of treatment for trichotillomania.