A family study of trichotillomania and chronic hair pulling

Keuthen, Nancy J.; Altenburger, Erin M.; Pauls, David L.

doi:10.1002/ajmg.b.32218

Cited by 39 publications

(28 citation statements)

References 38 publications

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“…For example, in a family study of OCD patients that investigated the relationship of this condition with others -including behavioural addictions such as gambling disorder, trichotillomania and skin-picking disorder -it was found that any of these behavioural addictions occurred more frequently in first degree relatives of individuals with OCD, irrespective of whether or not cases also had the same diagnosis (Bienvenu et al 2000). The association may be strongest for trichotillomania; a family study investigating the familial aggregation of trichotillomania and co-transmission of OCD and skin-picking disorder suggested that relatives of individuals with trichotillomania had higher recurrence risk estimates for both trichotillomania and OCD (but not skin-picking disorder) compared to control relatives (Keuthen et al 2014). Based on these results, it was argued that there may be a familial subtype of trichotillomania related to OCD.…”

Section: Comorbiditymentioning

confidence: 99%

Behavioural addiction—A rising tide?

Chamberlain

Löchner

Stein

et al. 2016

European Neuropsychopharmacology

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The term 'addiction' was traditionally used in relation to centrally active substances, such as cocaine, alcohol, or nicotine. Addiction is not a unitary construct but rather incorporates a number of features, such as repetitive engagement in behaviours that are rewarding (at least initially), loss of control (spiralling engagement over time), persistence despite untoward functional consequences, and physical dependence (evidenced by withdrawal symptoms when intake of the substance diminishes). It has been suggested that certain psychiatric disorders characterized by maladaptive, repetitive behaviours share parallels with substance addiction and therefore represent 'behavioural addictions'. This perspective has influenced the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which now has a category 'Substance Related and Addictive Disorders', including gambling disorder. Could other disorders characterised by repetitive behaviours, besides gambling disorder, also be considered 'addictions'? Potential examples include kleptomania, compulsive sexual behaviour, 'Internet addiction', trichotillomania (hair pulling disorder), and skin-picking disorder. This paper seeks to define what is meant by 'behavioural addiction', and critically considers the evidence for and against this conceptualisation in respect of the above conditions, from perspectives of aetiology, phenomenology, co-morbidity, neurobiology, and treatment. Research in this area has important implications for future diagnostic classification systems, neurobiological models, and novel treatment directions.

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Section: Comorbiditymentioning

confidence: 99%

Behavioural addiction—A rising tide?

Chamberlain

Löchner

Stein

et al. 2016

European Neuropsychopharmacology

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“…22,27,28 Moreover, it has been shown in two studies that first-degree relatives of individuals with chronic hair pulling have not only an increased risk for hair pulling disorders but also an increased risk for OCD, with recurrence risk estimates of 6.4% and 17%. 29,30 Moreover, one study showed that some relatives of probands with hair pulling and OCD also had both disorders, but no relatives of probands with only hair pulling had both disorders. The authors thus suggest that there may be familial subtypes of OCD that are particularly associated with certain other related disorders.…”

Section: Familial Recurrence Risk In Ocd and Related Disordersmentioning

confidence: 99%

Genetics of Obsessive-Compulsive Disorder and Related Disorders

Browne

Gair

Scharf

et al. 2014

Psychiatric Clinics of North America

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Synopsis Twin and family studies support a significant genetic contribution to obsessive-compulsive disorder (OCD) and related disorders such as chronic tic disorders, trichotillomania, skin picking disorder, body dysmorphic disorder, and hoarding disorder. Recently, population-based studies and novel laboratory-based methods have confirmed substantial heritability in OCD. Genome-wide association studies and candidate gene association studies have provided information on specific genes that may be involved in the pathobiology of OCD and also of related disorders, particularly chronic tic disorders, though these genes each contribute only a small portion of the total genetic risk and a substantial portion of the specific genetic risk profile in OCD is still unknown. Nevertheless, there are some examples of genes for which perturbations produce OCD-like phenotypes in animal model systems, allowing a laboratory platform for investigating the pathobiology of --- and new treatments for --- OCD and related disorders. Future work promises to continue to clarify the specific genes involved in risk for OCD as well as their interaction with environmental variables.

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“…Given elevated rates of comorbid axis I disorders in TTM vs. matched nonclinical controls 16 and the suggestion of higher rates of axis II disorders than expected by chance alone, 2 we hypothesized higher rates of neuroticism and lower rates of extraversion in those with TTM vs. matched controls. After controlling for affective variables, we expected there would no longer be any significant group differences in personality traits.…”

Section: Introductionmentioning

confidence: 99%

Trichotillomania and personality traits from the five-factor model

Keuthen

Tung

Altenburger

et al. 2015

Rev. Bras. Psiquiatr.

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Objective: To examine whether personality traits have predictive validity for trichotillomania (TTM) diagnosis, pulling severity and control, and hair pulling style. Methods: In study 1, logistic regression was used with TTM cases (n=54) and controls (n=25) to determine if NEO Five-Factor Inventory (NEO-FFI) personality domains predicted TTM case vs. control classification. In study 2, hierarchical multiple regression was used with TTM cases (n=164) to determine whether NEO-FFI personality domains predicted hair pulling severity and control as well as focused and automatic pulling styles. Results: TTM case vs. control status was predicted by NEO-FFI neuroticism. Every 1-point increase in neuroticism scores resulted in a 10% greater chance of TTM diagnosis. Higher neuroticism, higher openness, and lower agreeableness were associated with greater pulling severity. Higher neuroticism was also associated with less control over hair pulling. Higher neuroticism and lower openness were associated with greater focused pulling. None of the personality domains predicted automatic hair pulling. Conclusions: Personality traits, especially neuroticism, can predict TTM diagnosis, hair pulling severity and control, and the focused style of pulling. None of the personality traits predicted automatic pulling. Longitudinal studies are needed to determine whether personality variables predispose to TTM onset, impact disorder course, and/or result from hair pulling behavior.

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A family study of trichotillomania and chronic hair pulling

Cited by 39 publications

References 38 publications

Behavioural addiction—A rising tide?

Behavioural addiction—A rising tide?

Genetics of Obsessive-Compulsive Disorder and Related Disorders

Trichotillomania and personality traits from the five-factor model

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