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Comorbidity and Quality of Life in Adults with Hair Pulling Disorder
Psychiatric Research
  • David C. Houghton, Texas A&M University - College Station
  • Joyce Maas, Radboud University Nijmegen
  • Michael P. Twohig, Utah State University
  • Stephen M. Saunders, Marquette University
  • Scott N. Compton, Duke University School of Medicine
  • Angela M. Neal-Barnett, Kent State University
  • Martin E. Franklin, University of Pennsylvania
  • Douglas W. Woods, Marquette University
Document Type
Format of Original
8 p.
Publication Date
Original Item ID
DOI: 10.1016/j.psychres.2016.02.063; PubMed Central PMCID: PMC4855296

Hair pulling disorder (HPD; trichotillomania) is thought to be associated with significant psychiatric comorbidity and functional impairment. However, few methodologically rigorous studies of HPD have been conducted, rendering such conclusions tenuous. The following study examined comorbidity and psychosocial functioning in a well-characterized sample of adults with HPD (N=85) who met DSM-IV criteria, had at least moderate hair pulling severity, and participated in a clinical trial. Results revealed that 38.8% of individuals with HPD had another current psychiatric diagnosis and 78.8% had another lifetime (present and/or past) psychiatric diagnosis. Specifically, HPD showed substantial overlap with depressive, anxiety, addictive, and other body-focused repetitive behavior disorders. The relationships between certain comorbidity patterns, hair pulling severity, current mood and anxiety symptoms, and quality of life were also examined. Results showed that current depressive symptoms were the only predictor of quality of life deficits. Implications of these findings for the conceptualization and treatment of HPD are discussed.


Accepted version. Psychiatric Research, Vol. 239 (May 30, 2016): 12-19. DOI. © 2016 Elsevier Ireland Ltd. Used with permission.

Douglas W. Woods was affiliated with Texas A & M University at the time of publication.

Citation Information
David C. Houghton, Joyce Maas, Michael P. Twohig, Stephen M. Saunders, et al.. "Comorbidity and Quality of Life in Adults with Hair Pulling Disorder" Psychiatric Research (2016) ISSN: 0165-1781
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