Current posttraumatic stress disorder and history of trauma in trichotillomania

Though some researchers and clinicians postulate that trauma and posttraumatic stress disorder (PTSD) may be implicated in the etiologic underpinnings of trichotillomania (TTM), very little research to date has examined such postulations. To address this gap in the literature, the current study assessed the prevalence of trauma and PTSD in 42 individuals seeking treatment for TTM. Relations between symptoms of PTSD and TTM also were examined, as were differences in TTM symptoms between those with and without PTSD. Findings revealed that approximately 76% reported a history of at least one traumatic event, and 19% met criteria for PTSD. Furthermore, negative correlations were demonstrated between symptoms of PTSD and characteristics of TTM, and the PTSD group reported less severe TTM characteristics. Findings suggest that the prevalence of PTSD in TTM may be higher than in the general population and that a history of greater number of types of traumas is associated with a longer duration of hair pulling as well as the scalp as the primary pulling site. The authors also speculate that in traumatized individuals, TTM may represent a form of coping vis-à-vis self-soothing or self-harm.