The Trichotillomania Impact Project (TIP): Exploring Phenomenology, Functional Impairment, and Treatment Utilization.[CME]
J Clin Psychiatry 2006;67(12):1877-1888
© Copyright 2014 Physicians Postgraduate Press, Inc.
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Background: Trichotillomania (TTM)
occurs in 0.6% to 3.4% of adults. Questions remain about phenomenological features of the
disorder, its impact on functioning, and treatment
utilization. The current study (i.e., The
Trichotillomania Impact Project) was designed to provide
initial information regarding these issues.
Method: An Internet-based survey was
completed by 1697 individuals who self-reported symptoms consistent with a diagnosis of
TTM (DSM-IV-TR). The survey assessed phenomenological experiences; social, occupational,
academic, and psychological impact; as well as
treatment-seeking experiences. The survey link operated from April 2005 through May 2005.
Results: Survey results suggest
considerable variability in TTM phenomenology.
Individuals with more severe TTM symptoms endorsed
more frequent phenomenological experiences of
physical or mental anxiety prior to pulling and
relief, pleasure, or gratification after pulling. Mild
to moderate life impairment in social,
occupational, academic, and psychological functioning
was reported for the entire study sample. These impairments were more pronounced as TTM
symptoms became more severe. A summary of treatment seeking in the sample suggests
that pharmacotherapy was the most commonly received treatment, followed by behavior
therapy. Unfortunately, treatment in general was
perceived as relatively ineffective.
Conclusion: This study underscores the
clinical significance of severe hair pulling and
highlights the need for research on its
pathogenesis and treatment.