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Behavior Modification
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Affective and Sensory Correlates of Hair Pulling in Pediatric Trichotillomania

Suzanne A. Meunier

Anxiety Disorders Center, The Institute of Living/Hartford Hospital, smeunie{at}harthosp.org

David F. Tolin

Yale University School of Medicine

Martin Franklin

University of Pennsylvania School of Medicine

Hair pulling in pediatric populations has not received adequate empirical study. Investigations of the affective and sensory states contributing to the etiology and maintenance of hair pulling may help to elucidate the classification of trichotillomania (TTM) as an impulse control disorder or obsessive-compulsive spectrum disorder. The current study aimed to examine children's self-reported affective and sensory states associated with hair pulling. Fifteen participants completed a questionnaire assessing children's experiences during first and recent hair pulling episodes. Results revealed that pulling hair for the first time was associated with pleasure and pain whereas recent hair pulling was associated with pleasure only, suggesting that the punishing quality of hair pulling may diminish over time. The findings also support the notion that hair pulling may be maintained primarily through positive reinforcement, which is consistent with its classification as an impulse control disorder.

Key Words: trichotillomania • hair pulling • children • pediatric

This version was published on May 1, 2009

Behavior Modification, Vol. 33, No. 3, 396-407 (2009)
DOI: 10.1177/0145445508326260
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