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Clinical Characteristics, Sleep, and Temperament in Infants and Young Children with Problematic Hair Pulling and Skin

Kevin Pendo1, Valerie S Swisher2, Talia Y Leman2

  • 1Herbert Wertheim College of Medicine, Florida International University.

Cognitive Therapy and Research
|March 7, 2024
PubMed

Insights

Problematic hair pulling (HP) and skin picking (SP) in young children are linked to sleep disturbances and specific temperaments. Interventions should target contextual factors, sleep, and sensory sensitivities.

Area of Science:

  • Pediatric psychology
  • Dermatology
  • Child development

Background:

  • Problematic hair pulling (HP) and skin picking (SP) are understudied in infants and young children.
  • Understanding the clinical characteristics of these behaviors in early childhood is crucial for effective intervention.

Purpose of the Study:

  • To examine the clinical characteristics of HP and SP in children aged 0-5 years.
  • To investigate the association of HP and SP with self-soothing, sleep patterns, and temperament.
  • To identify potential targets for behavioral interventions.

Main Methods:

  • An internet survey was administered to parents/caregivers of 384 children (0-5 years old).
  • The survey assessed demographics, medical history, HP/SP characteristics, contextual factors, self-soothing, sleep, and temperament.
  • Statistical analyses included descriptive statistics, chi-square tests, t-tests, logistic regression, and ANCOVA.

Main Results:

  • HP and SP rates were 6.1% and 14.5%, respectively, with some overlap between the two conditions.
  • Common triggers included boredom, upset, and being awake in bed; caregiver responses were often reactive.
  • Children with HP showed more hair twirling and sleep disturbance, while those with SP exhibited more nail biting and low persistence. Both groups displayed a serious, observant mood and sensory sensitivity.

Conclusions:

  • Findings enhance the clinical understanding of HP and SP in young children.
  • Identified targets for intervention include contextual factors, sleep, sensory sensitivity, persistence, and mood.
  • Low rates of professional help-seeking indicate a need to expand clinical guidelines for HP and SP in this age group.
Abstract

Keywords:
hair pullinginfantself-soothingskin pickingsleeptemperament

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