Examination of the relationship between internalized stigma and coping strategies in patients with trichotillomania

This study aimed to examine the relationship between internalized stigma and coping strategies in patients with trichotillomania (TTM).

The study included 34 patients with TTM and 34 healthy controls. The Sociodemographic Data Form, Beck Depression Inventory (BDI), and the Revised Coping Orientations to Problems Experienced (R-COPE) were administered to the TTM and control groups. In addition, the Massachusetts General Hospital Hair Pulling Scale (MGH-HPS) and the Internalized Stigma of Mental Illness Scale (ISMI) were administered to the TTM group.

The scores of patients with TTM from the R-COPE self-help subscale were significantly lower than those of the control group, and the scores of the R-COPE avoidance and self-punishment subscales were significantly higher. A negative relationship was found between the R-COPE accommodation scores of patients with TTM and ISMI-discrimination experience scores. A positive relationship was found between R-COPE avoidance and ISMI-total scores, stereotype endorsement, and discrimination experience subscale scores. A positive relationship was found between the R-COPE self-punishment score and ISMI-total score, alienation, and social withdrawal scores.

It was observed that the TTM group used maladaptive coping strategies more in the face of stressors than the control group and that they resorted to maladaptive coping attitudes more as their internalized stigma levels increased. These results show that more attention should be paid to the thoughts and coping attitudes of people with TTM regarding their disorder.