Emotion regulation deficits in persons with body-focused repetitive behavior disorders

Alexander, Jennifer R.; Houghton, David C.; Bauer, Carolyn M.; Lench, Heather C.; Woods, Douglas W.

doi:10.1016/j.jad.2017.11.035

Cited by 24 publications

(12 citation statements)

References 45 publications

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“…Together, these findings may suggest co-occurring internalizing symptoms and emotion dysregulation are key contributing factors to sleep disturbance in individuals with these conditions. Conversely, disturbed sleep may exacerbate internalizing symptoms or emotion regulation difficulties (Gruber and Cassoff, 2014), which in turn may lead to increased hair pulling or skin picking symptoms (Alexander et al, 2018).…”

Section: Discussionmentioning

confidence: 99%

Confirmatory factor analysis of the SLEEP-50 Questionnaire in Trichotillomania (Hair-Pulling Disorder) and Excoriation (Skin-Picking) Disorder

Ricketts

Rozenman

Snorrason

et al. 2019

Psychiatry Research

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The study objective was to perform a confirmatory factor analysis of the SLEEP-50 Questionnaire (SLEEP-50) in Trichotillomania (Hair-Pulling Disorder) and Excoriation (Skin-Picking) Disorder and compare sleep complaints in adults with Trichotillomania, Excoriation Disorder and nonaffected controls. Participants were 234 adults with Trichotillomania, 170 with Excoriation Disorder, and 146 non-affected controls. Participants rated sleep using the SLEEP-50 and Pittsburgh Sleep Quality Index (PSQI). Confirmatory factor analysis was used to assess fit of the originally-proposed SLEEP-50 factors within Trichotillomania and Excoriation Disorder. Findings revealed acceptable to good fit of the original factors. Internal consistency was excellent in Trichotillomania and good in Excoriation Disorder for the total score and poor to good for subscales. Convergent validity was strong for the total and weak to strong for subscales in both groups. Findings suggest greater sleep complaints in Trichotillomania and Excoriation Disorder than in the general population. Trichotillomania and Excoriation Disorder groups reported greater rates of sleep apnea, narcolepsy, restless leg syndrome/periodic limb movement disorder, circadian rhythms sleep disorder, and sleep-related affective disorder relative to controls. There were no significant differences for insomnia, sleep state misperception, sleepwalking, nightmares, or hypersomnia. Results underscore the importance of clinical assessment of sleep disorders in Trichotillomania and Excoriation Disorder.

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Section: Discussionmentioning

confidence: 99%

Confirmatory factor analysis of the SLEEP-50 Questionnaire in Trichotillomania (Hair-Pulling Disorder) and Excoriation (Skin-Picking) Disorder

Ricketts

Rozenman

Snorrason

et al. 2019

Psychiatry Research

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“…For example, longitudinal research has demonstrated that EA predicts Posttraumatic stress disorder (PTSD) symptoms over a 2‐month period (Marx & Sloan, ) and at 1‐ and 8‐month posttrauma (Kumpula, Orcutt, Bardeen, & Varkovitzky, ), and predicts changes in “distress” disorders (i.e., MDD, dysthymia, GAD) and “fear” disorders (i.e., social anxiety disorder, panic disorder with or without agoraphobia, agoraphobia without panic) two years later (Spinhoven, Drost, de Rooij, van Hemert, & Penninx, ). EA has also been found to be relevant to other OCD‐related disorders such as trichotillomania (Arabatzoudis, Rehm, Nedeljkovic, & Moulding, ) and with the body focused repetitive behavior disorders (Alexander, Houghton, Bauer, Lench, & Woods, ).…”

Section: Discussionmentioning

confidence: 99%

A qualitative analysis of emotion and emotion regulation in hoarding disorder

et al. 2018

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Objective: The role of emotion regulation (ER) has been receiving increased attention in relation to various forms of psychopathology including hoarding disorder (HD). However, questionnaire designs are limited to finding associations of ER with symptoms or symptom groups, without finding out how such constructs might be involved in the disorder.Methods: This study was a qualitative investigation of ER in a clinical HD sample (N = 11).Results: Prominent themes provided support for ER difficulties in hoarding. In particular, difficulties with identifying and describing feelings, unhelpful attitudes toward the emotional experience, the use of avoidance-based strategies, and a perceived lack of effective ER strategies were prominent themes. Furthermore, emotional factors were identified as being associated with the onset and/or exacerbation of hoarding behavior, and possessions and acquiring behavior appeared to serve an ER function. Conclusion:The current paper provides a nuanced account of the role of ER in hoarding difficulties. K E Y W O R D S alexithymia, emotion regulation, emotional dysregulation, experiential avoidance, hoarding disorder J. Clin. Psychol. 2019;75:520-545. wileyonlinelibrary.com/journal/jclp 520 |In summary, this investigation revealed a nuanced picture, with evidence for ER difficulties in HD, with regard to difficulties identifying and describing feelings, EA, unhelpful attitudes towards emotions, and a perceived lack of effective ER strategies. Aspects of hoarding behavior (i.e., acquiring and emotional attachment to possessions) appeared to serve an ER function for some participants. It is hoped that these findings serve to increase the detail in individual psychological formulations for individuals with hoarding, as well as improving overall models of the disorder. ORCID Maja Nedeljkovic

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“…Factors specific to TTM might include excess habit formation (Gillan et al, 2016 ), cognitive disinhibition (Chamberlain et al, 2006 ) and dissociation (e.g., Lochner et al, 2004 ; Gupta, 2013 ). Childhood trauma, perceived stressors, and emotion dysregulation may also play a less specific but contributory role (e.g., Lochner et al, 2002 ; Woods et al, 2006a ; Özten et al, 2015 ; Alexander et al, 2018 ). Further work is needed to develop and consolidate a model of hair-pulling.…”

Section: Discussionmentioning

confidence: 99%

Hair-Pulling Does Not Necessarily Serve an Emotion Regulation Function in Adults With Trichotillomania

et al. 2021

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Background: Trichotillomania (TTM) has been associated with childhood trauma and perceived stress. While it has been hypothesized that hair-pulling regulate negative emotions, the relationship between childhood trauma, perceived stress, emotion regulation, and hair-pulling has not been well-studied.Methods: Fifty-six adults with TTM and 31 healthy controls completed the Childhood Trauma Questionnaire (CTQ), Perceived Stress Scale (PSS), and Difficulties in Emotion Regulation Scale (DERS). Hair-pulling severity was measured with the Massachusetts General Hospital-Hair Pulling Scale. CTQ, PSS, and DERS total scores were compared across groups using ANCOVA and the correlation between hair-pulling severity and emotion dysregulation was determined. Regression analyses were used to estimate the association of CTQ and PSS totals with DERS, and to determine whether associations between predictors and dependent variable (DERS) differed across groups.Results: TTM patients reported higher rates of childhood trauma (p <= 0.01), perceived stress (p = 0.03), and emotion dysregulation (p <= 0.01). There was no association between emotion dysregulation and pulling severity (r = −0.02, p = 0.89). Perceived stress was associated with emotion dysregulation in both groups (p < 0.01), and no association between childhood trauma and emotion dysregulation in either group. Perceived stress was the only significant predictor of emotion dysregulation in both groups (F = 28.29, p < 0.01).Conclusion: The association between perceived stress and emotion dysregulation is not specific to TTM, and there is no association between emotion dysregulation and hair-pulling severity, suggesting that key factors other than emotion dysregulation contribute to hair-pulling. Alternative explanatory models are needed.

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Emotion regulation deficits in persons with body-focused repetitive behavior disorders

Cited by 24 publications

References 45 publications

Confirmatory factor analysis of the SLEEP-50 Questionnaire in Trichotillomania (Hair-Pulling Disorder) and Excoriation (Skin-Picking) Disorder

Confirmatory factor analysis of the SLEEP-50 Questionnaire in Trichotillomania (Hair-Pulling Disorder) and Excoriation (Skin-Picking) Disorder

A qualitative analysis of emotion and emotion regulation in hoarding disorder

Hair-Pulling Does Not Necessarily Serve an Emotion Regulation Function in Adults With Trichotillomania

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