UnderstandingandTreatingTrichotillomania-Universityof.PDFVIP

Psychiatr Clin N Am 29 (2006) 487–501 Understanding and Treating Trichotillomania: What We Know and What We Don’t Know Douglas W. Woods, PhDa,*, Christopher Flessner, MSa, Martin E. Franklin, PhDb a , Chad T. Wetterneck, MS , Michael R. Walther, BAb c , Emily R. Anderson, MS , Dodanid Cardona, MDd aDepartment of Psychology, 211 Garland Hall, University of Wisconsin – Milwaukee, Milwaukee, WI 53201, USA b University of Pennsylvania School of Medicine, Philadelphia, PA, USA c University of Nebraska–Lincoln, Lincoln, NE, USA d The Children’s Hospital of Philadelphia, Philadelphia, PA, USA Trichotillomania (TTM) is currently classified as an impulse-control disorder, but there has been considerable debate as to whether it would be classified more appropriately as a disorder on the obsessive-compulsive spectrum [1]. In either case, TTM involves repetitive hair pulling that results in significant hair loss (criterion A in the Diagnostic and Statistical Manual of Mental Disorders, fourth edition [DSM-IV]). To receive a diagnosis of TTM, an individual must also meet the following criteria [2]: 1. There is an increasing level of tension immediately before hair pulling or during attempts to avoid pulling 2. There is a sensation of relief, pleasure, or gratification during hair pulling 3. The pulling is not explained better by a general medical condition or other mental disorder 4. Significant distress or impairment in occupational, social, or other areas of functioning is experienced as a res