Trichotillomania: An overview and guide to understanding

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Tichotillomania presents challenges to clinicians in various areas including assessment, treatment, and research. Characterized by an irresistible urge to pull out one's hair, which is preceded by tension and followed by relief or pleasure, trichotillomania can cause significant impairment and distress to those who suffer from it. Possible hypothesized causes include a biological basis for hair-pulling, as well as pulling in response to stressors in life. Several assessment techniques to measure the severity of trichotillomania exist, each of which has advantages and disadvantages in establishing a diagnosis. Because it is still a relatively poorly understood disorder, treatment options for patients reporting these behaviors are limited and generally are confined to pharmacological therapy and habit-reversal behavior therapy. Mansueto, Stemberger, Thomas, and Golomb have published a compelling comprehensive behavioral model that attempts to explain the various cues and factors in trichotillomania. It is useful to consider trichotillomania a biological, psychological, and social phenomenon requiring further research regarding the interaction of these variables in advancing the understanding of the disorder.