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Brief Treatment and Crisis Intervention 3:339-352 (2003)
© 2003 Oxford University Press

Behavioral and Pharmacological Treatment of Trichotillomania

   Ruth M. T. Stemberger, PhD
   Dan J. Stein, MD, PhD
   Charles S. Mansueto, PhD

From the Behavior Therapy Center of Greater Washington, Silver Spring, Maryland (Stemberger); University of Stellenbosch, Cape Town, and University of Florida, Gainesville (Stein); Behavior Therapy Center of Greater Washington, Silver Spring, Maryland, and Bowie State University, Bowie, Maryland (Mansueto).

Contact author: Ruth M. T. Stemberger, PhD, The Behavior Therapy Center, 11227 Lockwood Drive, Silver Spring, MD 20901. E-mail: rmtstemberger{at}aol.com.

Hair pulling, known as trichotillomania (TTM), has become increasingly recognized as an often chronic problem for a large number of individuals, most of whom are women. This paper discusses current conceptualizations of TTM with particular focus on the medical and behavioral approaches. The relationship of TTM to other disorders is discussed and issues in pharmacotherapy that are unique to TTM are reviewed. A comprehensive behavioral model (ComB) that explains the environmental, motoric, sensory, cognitive, and affective patterns involved in hair pulling is presented. This model is used to describe how a clinician can develop treatment plans tailored to individual patients, including specific strategies for hair pulling reduction. Potential pitfalls and complications that may occur during treatment are also discussed.

KEY WORDS: trichotillomania, hair pulling, obsessive-compulsive spectrum, cognitive behavior therapy






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