Clarifying the relationship between Trichotillomania and anxiety

Abstract

Although research has consistently linked unidimensional anxiety with Trichotillomania (TTM) severity, the relationships between TTM severity and anxiety dimensions (i.e., cognitive and somatic anxiety) are unknown. This knowledge gap limits current TTM conceptualization and treatment. The current study examined these relationships with data collected from ninety-one adults who participated in a randomized clinical trial for TTM treatment. To examine whether the Beck Anxiety Inventory (BAI; Beck, Epstein, Brown, & Steer, 1988) could be used to measure multidimensional anxiety in TTM samples, we conducted a factor analysis. Results showed four emergent factors, including a cognitive factor and three somatic factors (neurophysiological, autonomic, and panic). Based on prior research, it was hypothesized that TTM severity would be related to the cognitive anxiety dimension and that psychological inflexibility would mediate the association. Hypotheses were not made regarding the relationship between TTM severity and somatic anxiety. Regression analyses indicated that only cognitive dimensions of anxiety predicted TTM severity and that psychological inflexibility mediated this relationship. Implications for the conceptualization and treatment of TTM are discussed.

How reward and punishment are viewed by individuals experiencing trichotillomania according to revised reinforcement sensitivity theory

“…A circular pattern of thoughts and behaviours described the relationship between hair‐pulling and anxiety; hair‐pulling was used to regulate anxiety and distress; hair loss led to worry about appearance and being negatively evaluated, which in turn increased anxiety and the need to manage the anxiety by hair‐pulling. This description has been proposed elsewhere (Alexander et al, ; Arabatzoudis, Rehm, Nedeljkovic, & Moulding, ; Mansueto, Stemberger, Thomas, & Golomb, ; Norberg, Wetterneck, Woods, & Conelea, ; Roberts et al, ). The experience of depression with hair‐pulling was more idiosyncratic, with causal, cyclical, and no relationships described.…”

Concurrent Treatment of Intimate Partner Violence and Trichotillomania From an Emotion Regulation Framework: A Case Study

“…Trichotillomania severity has been linked in several studies to the experience of heightened anxiety (Hajcak et al, 2006; Lootens & Nelson-Gray, 2016; Roberts et al, 2013). A recent investigation found that symptom severity had a significant positive relationship with cognitive anxiety, such as the experience of worry and fear, but was not significantly related to somatic anxiety symptoms (Alexander et al, 2017).…”

Hair pulling antecedents in trichotillomania: Their relationship with experiential avoidance

“…As noted earlier, the TTM-specific version of the AAQ (Houghton et al, 2014) was not available at the time of our data collection. To date, to our knowledge, only one study (Alexander et al, 2017) has utilized the AAQ-TTM (the researchers found that it mediated the relation between cognitive dimensions of anxiety and TTM symptom severity). So, although this measure does exist, its use has been limited.…”