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The Phenomenology of Hairpulling in College Students

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Abstract

This study examined the phenomenology of hairpulling in a large nonclinical college student sample. Given that hairpulling is conceptualized as occurring on a continuum of severity, we expected to inform the assessment and treatment of Trichotillomania (TTM) by examining hairpulling behavior across its range of presentation. Hairpulling occurred at a rate of 9.7%, while average age of onset was 13.57 years. Self-reported hairpulling styles were identified with 31.3% endorsing focused hairpulling, while 68.7% endorsed an automatic hairpulling style. The most commonly endorsed ritual was “examine the root (37.3%) while the scalp was the most frequently endorsed hairpulling site (49%). Eyelashes were more frequently endorsed as a pulling site by focused (43.8) compared to automatic (5.7%) hairpullers. The hairpulling environments most often endorsed were “while reading” and “while studying” (75%). Affective states were found to change across the pulling cycle in support of hairpulling serving in an emotion regulation capacity. Focused hairpullers endorsed significantly higher trait anxiety than automatic hairpullers. Depression scores (BDI) were elevated for hairpullers compared to non-hairpullers. Implications for assessment and treatment were discussed and directions for future research were provided.

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Authors and Affiliations

  1. Oregon Health & Science University, Child Development and Rehabilitation Center, P.O. Box 574, Portland, OR, 97207-0574, USA

    Danny C. Duke

  2. Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA

    Mary L. Keeley & Gary R. Geffken

  3. Department of Psychiatry, University of Florida, Gainesville, FL, 32610, USA

    Danny C. Duke, Mary L. Keeley & Gary R. Geffken

  4. Department of Psychology, University of Wisconsin-Milwaukee, 2441 E. Hartford Ave., Milwaukee, WI, 52211, USA

    Emily J. Ricketts

  5. Department of Pediatrics, University of Florida, Gainesville, FL, USA

    Gary R. Geffken

  6. Departments of Pediatrics and Psychiatry, University of South Florida, Tampa, FL, USA

    Eric A. Storch

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  1. Danny C. Duke
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  2. Mary L. Keeley
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  3. Emily J. Ricketts
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  4. Gary R. Geffken
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  5. Eric A. Storch
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Correspondence to Danny C. Duke.

Additional information

We thank Marianna Freddo, Liza Arango, and Andrea Arango for their invaluable assistance on this project.

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Duke, D.C., Keeley, M.L., Ricketts, E.J. et al. The Phenomenology of Hairpulling in College Students. J Psychopathol Behav Assess 32, 281–292 (2010). https://doi.org/10.1007/s10862-009-9150-4

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