Materiały źródłowe

• #1 Trichotillomania – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493186/

  Trichotillomania is part of OCD and is thought to be largely related to anxiety disorders. There have been twin studies that have demonstrated genetic anomalies associated with trichotillomania and other OCD-related disorders. Some imaging studies have shown thickening of the right inferior frontal gyrus, and others have shown reduced cerebellar volumes. The more recent focus has been on the grey and white matter tracts. One study found the reduced integrity of the white matter within the anterior cingulate, pre-supplementary motor area, and the right and left temporal cortex in people with a diagnosis of TTM. Studies have shown a significantly increased diffusivity in the tracts of the frontostriatal-thalamic pathway with more severe and longer cases of TTM. Studies like these demonstrate that structural abnormalities may be present in those with TTM. Positron emission tomography (PET), and single-photon emission computed tomography (SPECT) studies have shown higher cerebral glucose metabolic rates in the cerebellum and right parietal cortex. SPECT studies have shown decreased perfusion of the temporal lobes.

• #2 Trichotillomania (Hair-Pulling Disorder) – MD Searchlight

  https://mdsearchlight.com/mental-health/trichotillomania-hair-pulling-disorder/?utm_source=pubmedlink&utm_campaign=MDS&utm_content=30593

  Trichotillomania is a condition connected to Obsessive Compulsive Disorder (OCD), rooted mainly in anxiety disorders. Its believed to be inherited, as evidence has been found in genetic studies. Some research has also discovered brain structure changes linked to Trichotillomania. […] More recent research has focused on certain parts of the brain, particularly the grey and white areas. Its been found that people diagnosed with Trichotillomania may have a reduction in the quality of white matter. This is especially seen in areas related to actions and emotions such as the anterior cingulate, the pre-supplementary motor area, and the right and left temporal cortex. It has also been noted that certain brain changes may become even more severe with longer and severe cases of the condition. Some imaging tests like PET and SPECT have shown increased metabolic rates in the cerebellum and the right parietal cortex, and decreased blood flow in the temporal lobes.

• #3 Trichotillomania (hair-pulling disorder) – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/trichotillomania/symptoms-causes/syc-20355188

  The cause of trichotillomania is not clear. But like many complex disorders, trichotillomania likely results from a combination of genetic and learned factors. […] Genetics may play a role in the development of trichotillomania. You may be more likely to have the condition if you have a close relative with trichotillomania. […] Other conditions, such as depression, anxiety or obsessive-compulsive disorder (OCD) may occur along with trichotillomania.

• #4 Trichotillomania: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1071854-overview

  Trichotillomania (hair-pulling disorder) is characterized by the persistent and excessive pulling of ones own hair, resulting in noticeable hair loss. […] From a dermatologic standpoint, trichotillomania is a form of traumatic alopecia. The trauma to the follicle occurs as a result of the patients repetitive hair-pulling behavior. The hair pulling may present in conjunction with other repetitive grooming behaviors, such as nail biting and skin picking. […] The etiology of trichotillomania is largely unknown, though both environmental and genetic causes have been suspected. Explanations that have been proposed for the onset and maintenance of the hair-pulling behavior include the following: […] Serotonin deficiency – A link may exist between a deficiency of the neurotransmitter serotonin (5-hydroxytryptamine [5-HT]) and trichotillomania; the hypothesized connection is based on the success of selective serotonin reuptake inhibitors (SSRIs) in treating some people with trichotillomania.

• #5 Trichotillomania – Wikipedia

  https://en.wikipedia.org/wiki/Trichotillomania

  As of 2023, the specific cause or causes of trichotillomania are unclear. Trichotillomania is probably due to a combination of genetic and environmental factors. […] A neurocognitive model the notion that the basal ganglia play a role in habit formation and that the frontal lobes are critical for normally suppressing or inhibiting such habits sees trichotillomania as a habit disorder. […] In several MRI studies, it has been found that people with trichotillomania have more gray matter on average than those who do not have the disorder. […] One study found that individuals with trichotillomania have decreased cerebellar volume on average, which suggests some differences between OCD and trichotillomania. […] An fMRI study reported decreased activation in the basal ganglia, dorsolateral prefrontal cortex, and dorsal anterior cingulate cortex in people with trichotillomania. […] It is likely that a combination of multiple genes confers vulnerability to trichotillomania. […] Mutations in the SLITRK1, 5HT2A, SAPAP3, and FOXP1 genes have been associated with trichotillomania.

• #6

  https://journals.lww.com/indianjpsychiatry/fulltext/2019/61001/trichotillomania__hair_pulling_disorder_.18.aspx

  Trichotillomania is characterized by the repetitive pulling out of one’s own hair leading to hair loss and possibly functional impairment. […] Data regarding the pathophysiology of trichotillomania are limited, but there is a familial component. Several family studies have reported elevated rates of trichotillomania in first-degree relatives of probands with trichotillomania, along with elevated rates of mood and anxiety disorders. […] Animal models represent useful tools for investigating the pathophysiology of trichotillomania particularly those which mimic the behavioral and clinical manifestations of the disorder. […] The potential relevance of SAPAP3, in particular, to trichotillomania, is reinforced by the finding that rare variations in the SAPAP3 gene are associated with human disorders such as hair pulling.

• #7 Trichotillomania | Fact Sheet – ABCT – Association for Behavioral and Cognitive Therapies

  https://www.abct.org/fact-sheets/trichotillomania/

  There is no single known cause for trichotillomania. Genetics, as well as environmental factors, likely play a role in the development of the disorder. […] Cognitive behavioral approaches are the first-line treatment for trichotillomania and have consistently demonstrated efficacy in research trials. Specifically, Habit Reversal Therapy (HRT) in tandem with stimulus control is utilized. […] Other behavioral therapy techniques, such as Acceptance and Commitment Therapy (ACT) and Dialectical Behavior Therapy (DBT), likely enhance treatment outcomes by facilitating acceptance of the negative and aversive feelings that give rise to pulling and improved emotion regulation. […] Finally, some medications have been shown to be helpful in treating trichotillomania, although the research is limited. N-acetylcysteine (NAC), a health supplement that can be purchased over the counter and has minimal side effects, has been shown to be effective in treating hair pulling. Antipsychotic medications have also been shown to be effective in some studies; however, given the fact that these medications often have significant side effects, they should typically be utilized only in cases where other treatments have not been helpful. Finally, the type of antidepressants known as SSRIs are often used for individuals with trichotillomania; although they have not necessarily been shown to be effective in cases where hair pulling is the only problem, they can be useful in cases where the individual is also suffering from depression or anxiety, or in cases of treatment failure.

• #8 Trichotillomania (Hair-Pulling Disorder) DSM-5 312. 39 (F63.2)

  https://www.theravive.com/therapedia/trichotillomania-(hair–pulling-disorder)-dsm–5-312.-39-(f63.2)

  Trichotillomania is an impulse control psychiatric disorder within the group of conditions known as body-focused repetitive behaviors (BFRBs). […] An individual with trichotillomania experiences an irresistible urge to pull out hair from the scalp or other places, such as the eyelashes or eyebrows. […] There is no single known cause of trichotillomania but research suggests a number of factors may contribute to onset of the disorder. […] Scientists have identified that some people may be genetically predisposed to developing trichotillomania, while individuals with obsessive compulsive disorder (OCD) – or whose first-degree relatives have OCD – are more likely to be diagnosed with trichotillomania than other people. […] Other factors that may contribute to the onset of trichotillomania include: A chemical imbalance in the brain, Hormonal changes during puberty, A coping mechanism for dealing with stress, A form of self-harm to relieve distress.

• #9

  https://journals.lww.com/indianjpsychiatry/fulltext/2019/61001/trichotillomania__hair_pulling_disorder_.18.aspx

  A recent multi-site international study of cortical thickness and sub-cortical volumes found that trichotillomania patients showed excess cortical thickness in a cluster maximal at right inferior frontal gyrus and appear to play a central role in the pathophysiology of trichotillomania and to be a trait in nature. […] These structural abnormalities of subcortical regions appear to be involved in affect regulation, inhibitory control, and habit generation. […] In addition, several years ago, Keuthen et al. found that 53.3% of a sample of 45 adults with trichotillomania reported that they experienced symptom exacerbation of pulling the week before menstruation. […] Control of the hair pulling appears to be critical for maintaining long-term health and quality of life. Based on research findings, NAC in doses of 1200 mg twice a day appears to be the most promising option without significant side effects.

• #10 Trichotillomania – wikidoc

  https://www.wikidoc.org/index.php/Trichotillomania

  The pathophysiology of trichotillomania (TTM) is proposed to be due to the dysregulation of the glutaminergic system. […] Similar to body dysmorphic disorder, impulse control disorder, kleptomania, and tourette’s syndrome, individuals with TTM have a reduced ability to transport serotonin at the presynaptic level. […] The patients with trichotillomania have subcortical brain abnormalities on Magnetic Resonance Imaging (MRI Scan). Decreased putamen and amygdala volumes as well as variation in curvature of caudate and nucleus accumbens have been noted. These areas are involved in affect modulation and reward processing, the basis of trichotillomania pathophysiology. […] MRI findings suggest a reduced volume of both right and left cerebellar cortices. It is further substantiated by the motor involvement in the symptomatology of this disorder. […] The white matter tracts are also affected in this condition. These tracts have a role in habit formation and suppression as well as affect regulation. […] Therefore, this disorder has complex pathophysiology with the involvement of multiple brain areas on neuroimaging.

• #11 Trichotillomania: Background, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/1071854-overview

  Structural brain abnormalities – On magnetic resonance imaging (MRI), some individuals with trichotillomania have abnormalities of subcortical regions involved in habit generation, inhibitory control, and regulation of affect. […] Disordered reward processing – Preliminary data have suggested that trichotillomania may represent a disorder of altered reward processing within the central nervous system (CNS); a study of reward processing in trichotillomania patients demonstrated altered nucleus accumbens activations and a decreased functional connection between the dorsal anterior cingulate and nucleus accumbens and basolateral amygdala and reward network.

• #12 Trichotillomania (Hair Pulling Disorder) – The Complete Guide | TrichStop.com

  https://www.trichstop.com/info

  The onset of trichotillomania is also associated with physical injury to some regions of the brain. […] A recent brain imaging study found significantly increased cortical thickness in a right frontal cluster. This region of the brain suppresses inappropriate motor responses. […] Studies using brain imaging show people with trich have structural brain abnormalities in the lenticulate and the volume of the left putamen. […] Research of people who develop trich with dementia suggests brain atrophy as a cause. […] There is evidence suggesting that people with trich have high metabolic glucose rates in several parts of the brain. […] The rewards processing theory suggests that those who pull hair experience a reward from it thereby creating an altered reward feedback loop associated with the behavior. […] New research using brain imaging has provided evidence that trichotillomania results from impairment in response inhibition.

• #13 Trichotillomania – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493186/

  Studies focusing on neurochemistry have shown a relationship with the serotonin 2A receptor. Most studies that focus on neurotransmitters or neurochemistry are based on the patient’s response to therapy that modulates these neurotransmitters. For example, multiple randomized controlled studies look at treatment with selective serotonin reuptake inhibitors (SSRIs). Some have yielded positive results, and some have been equivocal. One meta-analysis that looked at SSRIs showed moderate effects on patient symptoms, compared to more sizeable effects of behavior therapy. Other studies suggest that the dopamine system is also involved. There have been double-blind, placebo-controlled trials that have shown positive effects with olanzapine, and the reversal of TTM has been shown with aripiprazole treatment. There have been studies that have shown clomipramine also can be effective. Generally, these studies suggest the involvement of the monoamine system with serotonin, norepinephrine, and dopamine receptors. Data in these studies are often not robust and need to be replicated.

• #14 Trichotillomania (Hair-Pulling Disorder) – MD Searchlight

  https://mdsearchlight.com/mental-health/trichotillomania-hair-pulling-disorder/?utm_source=pubmedlink&utm_campaign=MDS&utm_content=30593

  When it comes to understanding the chemicals in the brain related to Trichotillomania, researchers have seen a relationship with a specific brain receptor called serotonin 2A receptor. Most of this research is drawn from observing how patients react to therapies that adjust these brain chemicals. For instance, therapies involving Selective Serotonin Reuptake Inhibitors (SSRIs, a type of antidepressant) have shown mixed results. Other brain chemicals like dopamine also seem involved. Some studies have shown improvements with medications like olanzapine and aripiprazole, as well as with an antidepressant called clomipramine. […] Besides these biological factors, Trichotillomania is also influenced by psychological aspects. Many patients report going through a stressful situation before they started pulling their hair. Some also say that they felt bored before showing this behavior. This points to a pattern where negative emotions like stress or boredom leads to hair-pulling, which gives relief, reinforcing the hair-pulling behavior. Some also connect Trichotillomania to depression symptoms, since some people respond to SSRI treatment. However, its difficult to point out one specific psychological trigger for everyone with this condition. Currently, the main approach to treat Trichotillomania is through behavioral therapy.

• #15 Therapeutic Aspects of Trichotillomania: A Review of Current Treatment Options

  https://www.psychiatrist.com/pcc/trichotillomania-therapy/

  Proposed mechanisms indicate that since NAC is a precursor to the primary antioxidant made to protect the brain against reactive oxygen species (ROS), TTM may be caused by excessive oxidative stress. Specifically, accumulation of ROS from loss of antioxidants in the brain lead to neuronal damage that induces hair-pulling behavior. […] The overall lack of ability to identify effective pharmacologic treatments for TTM may be a result of unknown predictors of placebo response, which are poorly understood when compared to responses in other psychiatric conditions.

• #16 Trichotillomania: Compulsive hair-pulling | Psychlinks Forum — Archive Only (2004-2022)

  https://forum.psychlinks.ca/threads/trichotillomania-compulsive-hair-pulling.12024/

  Sometimes elements of other therapies may be blended with CBT. For instance, acceptance and commitment therapy (ACT) helps people learn to accept their hair-pulling urges while at the same time teaching them how to avoid acting on their impulses. […] Based on several functional MRI studies, that CSP and Trich may be due to abnormalities in the brain’s processing of glutamate, which is why NAC is so often helpful.

• #17 Trichotillomania – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK493186/

  Other factors in the etiology are neuropsychology and the cognitive components. Many patients with trichotillomania report that there was a stressful situation that occurred before the hair-pulling behavior. Others describe boredom before hair-pulling. These feelings of boredom or stress are negative effects, or internal feelings or emotions, which have been shown in research to correlate to the increased behavior of pulling hair. If we examine the action in behavioral terms, there is a sense of tension that precedes hair-pulling behavior. This tension is then relieved by the hair pulling itself. This creates a cycle of learned and reinforced behavioral activity. The negative effect, or emotion, is paired with the behavior which relieves the negative effect and thus is reinforced and repeated. For example, the patient feels stressed, pulls hair, stress goes away, and thus the alleviation of the stress reinforces the behavior of hair-pulling. Some patients report an association of depressive symptoms likely resulting in some response of TTM to SSRI treatment. Since the psychiatric and psychological symptomatology is diverse, no single predictor can be named at this time. Currently, it is accepted that behavioral therapy is the mainstay of treatment and that the neuropsychology of TTM is the greater of the etiological components.

• #18 Trichotillomania – Psychiatric Disorders – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/psychiatric-disorders/obsessive-compulsive-and-related-disorders/trichotillomania

  In trichotillomania, hair pulling is not triggered by obsessions or concerns about appearance but may be preceded by a feeling of tension or anxiety that is relieved by the hair pulling, often followed by a feeling of gratification. […] Patients with trichotillomania try to stop pulling their hair out or to do it less often, but they cannot. […] Treat using cognitive-behavioral therapy that is tailored to treat specific trichotillomania symptoms (specifically habit reversal training) and possibly an SSRI or clomipramine, N-acetylcysteine, or memantine.

• #19 Trichotillomania: Causes, Symptoms, and Treatment

  https://www.webmd.com/anxiety-panic/trichotillomania

  Doctors use a guidebook called the Diagnostic and Statistical Manual of Mental Disorders, Fifth edition (DSM-5), to diagnose mental health conditions, including trichotillomania. According to the DSM-5, people with trichotillomania have these five things in common: […] There are no FDA-approved medications for trichotillomania, but these drugs may control symptoms in some people: […] Treatment options for trichotillomania include: […] Many types of therapy can support people with trichotillomania and even help them stop hairpulling completely. […] Some people with trichotillomania have rituals or routines related to hairpulling, like choosing which hair to pull or smelling, looking at, playing with, or eating hair you pull out. […] Hairpulling can become a habit. This creates a cycle in your brain where you think about the habit and feel the urge to do it. When you do, your brain releases reward chemicals like dopamine, which makes you feel happy and calm. Your body then connects doing the habit with feeling good, which in turn strengthens the habit and makes the urge to do it more intense. […] Trichotillomania is an impulse control disorder sometimes caused by anxiety or stress. This condition can start in childhood and last a lifetime.

• #20 Trichotillomania – PsychDB

  https://www.psychdb.com/ocd/trichotillomania

  Data regarding the pathophysiology of trichotillomania are limited. Animal models of trichotillomania show that certain genes may be associated with excessive grooming behaviours. […] From a psychopathology perspective, hair pulling may help regulate emotional states or stressful events. Hair pulling may function as a means of escaping from or avoiding aversive experiences, and provide temporary relief from negative emotions. These behaviours may be maintained through a negative reinforcement cycle.

• #21 Trichotillomania (Hairpulling Disorder) | Abnormal Psychology

  https://courses.lumenlearning.com/wm-abnormalpsych/chapter/trichotillomania-hair-pulling-disorder/

  Additionally, other studies examine the negative reinforcement people have when pulling; when emotional regulation is measured, those with trichotillomania have a harder time with emotional control than those without the disorder. Triggers for pulling include boredom, perfectionism, and frustration, and hairpulling may be a way of relieving some of the stress and tension associated with these negative feelings.

• #21 Trichotillomania (Hairpulling Disorder) | Abnormal Psychology

  https://courses.lumenlearning.com/wm-abnormalpsych/chapter/trichotillomania-hair-pulling-disorder/

  Trichotillomania (TTM), or human compulsive hairpulling, is one of the most common psychiatric disorders, affecting approximately 3.5% of women, or 3.7 million people in the United States. TTM patients experience pronounced psychological distress with considerable negative impact in their quality of life. […] Very little is known about the neurobiological basis of this disorder in humans, but in one study that reviewed available clinical and imaging studies of trichotillomania, previous work suggested an ABC model of trichotillomania, emphasizing the dysfunction of pathways involved in affect regulation, behavioral control, and cognition. […] One study suggests that hormones may be a potential cause. In a study of adolescent girls with trichotillomania, researchers found that lower progesterone was associated with worse hairpulling severity, and that lower levels of all three hormones were associated with greater psychosocial dysfunction.

• #22 Trichotillomania (Hair-Pulling Disorder) (F63.3) – Introduction to Psychological Disorders

  https://csi.pressbooks.pub/introtopsychdisorders/chapter/trichotillomania-312-39/

  Trichotillomania, also known as trich, is a poorly understood disorder characterized by the recurrent pulling out of ones own hair that results in noticeable hair loss (Chamberlain, Menzies, Sahakian Fineberg, 2007). […] Some researchers suggest that trich is a compulsive behavior. […] Trichotillomania is linked to obsessive-compulsive disorder; often, both disorders are present in younger females. […] There is evidence of a genetic predisposition. Hair pulling and similar grooming phenomena often occur in family members of people with trich (Chamberlain et al., 2007). Mutations in a gene called SLITRK1 have been linked to trichotillomania as well as to Tourette syndrome, a neurological disorder that causes a person to make unusual movements and sounds. […] Neurochemical problems can also play a role in trichotillomania. Some studies suggest that abnormalities in the natural brain chemicals serotonin and dopamine may play a role. […] There are two types of trichotillomania that have been described: focused pulling and non-focused pulling. The focused pulling is used to control negative emotions, such as anger. The non-focused pulling is a nonintentional type of pulling that occurs without the patients complete awareness.

• #23 Defining Trichotillomania—A Compulsive Hair-Pulling Disorder

  https://www.hairmd.com/blog/trichotillomania

  Some patients will pull their hair to alleviate stress, anxiety, or other negative stimuli, which is referred to as Focused Trichotillomania. […] Patients that are entirely unaware or only partially aware of their hair pulling habit are considered to have Automatic Trichotillomania. […] Although no one medication has been approved for the treatment of TTM, psychiatrists have experimented with Selective Serotonin Reuptake Inhibitors (SSRI), which have shown signs of varying success so far. […] While no treatment is perfect, not getting treatment can have devastating effects. […] Trichotillomania can cause very real physical damage by way of permanently inhibiting your bodys hair growth phases, scarring, infection, and a host of other issues.

• #24 Trichotillomania (TTM): Definition, Symptoms, Traits, Causes, Treatment

  https://www.verywellmind.com/trichotillomania-2510662

  An estimated 20% of people with trichotillomania also have trichophagia, which involves consuming the hair they have pulled, resulting in gastrointestinal problems that necessitate surgical treatment. […] Cognitive behavioral techniques have demonstrated some efficacy in treating trichotillomania. […] Currently, there is limited evidence that medications such as selective serotonin reuptake inhibitors (SSRIs) or tricyclic antidepressants (TCAs) are consistently effective in treating trichotillomania, so the FDA has not approved any medications for specifically treating the condition.

• #25 An Alzheimer’s Drug Might Ease Hair-Pulling Disorder – Southern Iowa Mental Health Center

  https://simhcottumwa.org/an-alzheimers-drug-might-ease-hair-pulling-disorder/

  An Alzheimers Drug Might Ease Hair-Pulling Disorder […] A long-established Alzheimers drug can help people with a disorder that causes them to compulsively pull at their hair or pick at their skin, a new clinical trial has concluded. […] Memantine considerably improved symptoms in 3 out of 5 patients with either trichotillomania (hair-pulling disorder) or excoriation (skin-picking) disorder, researchers reported in the American Journal of Psychiatry. […] It gives me the idea that perhaps we’re onto the right underlying mechanism that might be happening here. […] Memantine inhibits the activity of glutamate, one of the most abundant neurotransmitters in the brain. […] These positive results give a good sign that glutamate is involved in these disorders, but more work needs to be done to find the best treatment, he said.

• #26 An Alzheimer’s Drug Might Ease Hair-Pulling Disorder – Southern Iowa Mental Health Center

  https://simhcottumwa.org/an-alzheimers-drug-might-ease-hair-pulling-disorder/

  Dr. Katharine Phillips, a professor of psychiatry at New York Presbyterian and Weill Cornell Medicine in New York City, agrees that controlling glutamate could be key to treating hair-pulling and skin-picking disorders. […] It’s one of my two first-line medications for both trichotillomania and skin-picking disorder, she said. […] Memantine also can be used in combination with habit-reversal training, which is the best-proven treatment for hair pulling and skin picking, she said.

• #27 Trichotillomania: Causes, Symptoms, Treatment, & More

  https://www.healthline.com/health/anxiety/trichotillomania

  Trichotillomania (TTM) is sometimes related to certain mental health conditions, such as anxiety and depression. […] Researchers aren’t sure what causes trichotillomania. There may be a genetic reason why people develop it. Environmental factors may also play a role. […] Trichotillomania is a mental health condition that is sometimes related to other conditions such as obsessive-compulsive disorder (OCD), anxiety, depression, autism, and attention deficit hyperactivity disorder (ADHD). […] Many people don’t even notice themselves pulling their hair. The realization that they are pulling out hair can lead to more feelings of anxiety and embarrassment. This creates a cycle of anxiety, hair pulling, temporary relief then anxiety, embarrassment, and hair pulling again. […] A 2014 study showed the benefits of habit reversal training (HRT) and stimulus control in treating TTM. HRT works by increasing a person’s awareness about TTM symptoms and triggers, replacing the hair pulling behavior with another behavior, finding ways to stay motivated to stop hair pulling behavior, and practicing the new learned skills in different situations. […] Researchers did note that the clinical trials with these drugs had very small sample sizes. More studies are needed to support the results.

• #28 Trichotillomania: hair-pulling disorder – The Diamond Rehab Thailand

  https://diamondrehabthailand.com/what-is-trichotillomania-disorder/

  A 2012 case study on habit reversal training for trichotillomania from the International Journal of Trichology found that habit reversal training helped a 22-year-old woman with trichotillomania attain complete remission. This type of therapy could work through the reduction of emotional discomfort and alleviation of self-judgments associated with experiencing psychiatric symptoms. […] A 2020 paper by Heinicke et al., published in the Journal of Applied Behavior Analysis confirmed that habit reversal training reduces risky behaviors. A major advantage of this therapy is that it puts a strong emphasis on the strong support system that helps patients manage their disorder. […] While trichotillomania is strongly associated with emotions in most cases, sometimes it doesnt relate to the emotional aspect. A study by Lochner et al., published in the 2021 issue of Frontiers in Psychology found other factors besides emotion dysregulation that are involved in this disorder, such as habit-forming, cognitive disinhibition, and dissociation.

• #29 Trichotillomania (Hair Pulling) (for Teens) | Nemours KidsHealth

  https://kidshealth.org/en/teens/trichotillomania.html

  Trichotillomania (pronounced: trik-eh-til-eh-MAY-nee-uh) is a strong habit that causes people to pull out their own hair. […] It’s not clear why some people do hair pulling but others don’t. Experts think that genes, hormones, and habit learning all play a role. […] People who do hair pulling may have genes that make it more likely. […] Puberty hormones and stress hormones may prompt hair pulling to start in those who have the genes for it. […] Many people with trichotillomania feel an itch, tingling, or an urge to do it. When they pull hair, they get a brief sense of relief. To the brain, this relief is a reward. The brain releases reward hormones, such as dopamine. This links hair pulling with the reward. It causes a hair-pulling habit to form. […] Each time the person pulls hair, the brain releases a small burst of reward hormone. The person feels rewarded with a brief sense of relief. This makes the urge harder to resist. Doing the habit makes it stronger. […] To unlearn hair pulling, people need to resist the urge to pull hair. When they resist the urge, the reward hormone doesn’t get released. This breaks the cycle of hair pulling. Without the reward, the habit can start to fade on its own.

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