Pediatric Trichotillomania: Descriptive Psychopathology and an Open Trial of Cognitive Behavioral Therapy

Abstract

In study 1, 46 children and adolescents with trichotillomania who sought treatment at 2 specialty outpatient clinics were assessed. Most children reported pulling hair from multiple sites on the body, presented with readily visible alopecia, reported spending 30–60 minutes per day pulling or thinking about pulling, and reported experiencing significant distress about their symptoms. Most were described by their parents as having significant problems in school functioning. Few children met criteria for obsessive‐compulsive disorder or tic disorder. Child and family rates of other forms of psychopathology were high. In study 2, 22 of these children were enrolled in an open trial of individual cognitive behavioral therapy with particular attention to relapse prevention. Trichotillomania severity decreased significantly and 77% of children were classified as treatment responders at post‐treatment and 64% at 6‐month follow‐up.

Keywords:

• trichotillomania
• cognitive behavioral therapy
• behavior therapy
• children
• hair‐pulling

Acknowledgements

The authors thank Scott Hannan, Nicholas Maltby, Amy Catalano, Diana Turner, Amy Palmer, Elna Yadin, Miles Lawrence, Kelly Chrestman, Deborah Roth Ledley and Amie Alley for serving as study clinicians. DFT, MEF, and GJD also served as study clinicians. The authors also thank Megan Dunbar and Radhika Pasupuleti for their assistance with data entry and management.

This study was funded by NIMH grant number R21 61457 to Dr Franklin and Hartford Hospital grant number 126053 to Dr Tolin.