The Development, Affect Regulation, and Style of Pulling of Trichotillomania
The present study aims to contribute to the growing body of Trichotillomania (TTM) literature by evaluating the role of three important developmental variables - age of onset, current age, and duration of illness. This study also evaluates the utility of an affect regulation model of TTM and the influence of style of pulling. All participants were drawn from users of the StopPulling.com website, an interactive Internet program for TTM. A total population of 1,523 users was recruited. Aggregate data on multiple episodes of hair pulling from 597-609 participants who completed a baseline assessment (pre-intervention) were used in this study. The sample had an average age of 29.7 years, the majority was female (94%), Caucasian (87.2%), and U.S. residents (87%). Pearson's product moment correlation, T-tests, and multiple regression were used to evaluate hypotheses involving relationships between variables and determine key predictors of TTM symptom urge severity. Findings indicate the most important factor in predicting the urge severity of TTM was the duration of illness. Negative affect before pulling and style of pulling also predicted urge severity. Adults (aged 18 and older) reported more negative affect before pulling than youth (aged 17 and younger). As duration of illness and age increased, participants reported less positive affect during hair pulling. Positive affect after pulling was related to a focused style of pulling while negative affect after pulling was related to an automatic style of pulling. An earlier onset of TTM was related with more focused pulling while later onset was associated with more automatic pulling. Research and treatment implications of these findings are discussed as well as limitations of this study.
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