Hair-pulling in African Americans—Only your hairdresser knows for sure: An exploratory study.

Abstract

The authors examined whether African American hair care professionals saw individuals who met general criteria for trichotillomania, chronic hair pulling that results in significant hair loss. Thirty-eight African American hair care professionals and 1 Caucasian hair care professional were interviewed about their customers' hair-pulling behavior and condition of their hair. Sixteen African American hair care professionals saw 21 individuals who met general criteria for trichotillomania and reportedly perceived the behavior to be problematic. Four African American hair care professionals saw 6 individuals who met general criteria for trichotillomania but did not reportedly perceive the behavior to be problematic. Hair care professionals attributed most customers' hair-pulling behavior to bad nerves, stress, habit, and worry. Hair care professionals appeared adept at treating the consequences of chronic hair pulling but offered little assistance for the actual pulling behavior. Hair care professionals' contact with individuals who engage in chronic hair pulling raises interesting implications for prevention.

Hair pulling and its affective correlates in an African-American university sample

“…Both Hollander and Cohen (1994) and Neighbors, Caldwell, Thompson, and Jackson (1994) suggested that African-Americans are less likely to seek help from traditional mental health providers and may instead be more likely to seek help from nonprofessional sources. Neal-Barnett, Ward-Brown, Mitchell, and Knownapple (2000) confirmed that in her sample, hair care professionals with a primarily African-American clientele did in fact provide assistance to their customers who chronically pulled out their hair. While this would contribute to the general underutilization of mental health service by African-American hair pullers, this does not preclude the possibility that other factors, such as resilience, may also operate.…”

Ethnic differences in trichotillomania: Phenomenology, interference, impairment, and treatment efficacy

“…The available literature on help-seeking behavior in minority communities (U.S. Department of Health and Human Services, 2001), suggests group differences in treatment received and treatment outcome. Although little is known about TTM and Latinos, data on African Americans (Neal-Barnett et al, 2000;Neal-Barnett & Stadulis, 2006) suggest higher perceptions of interference with daily functioning; therefore, we predict our minority sample will report higher interference scores than their Caucasian counterparts. For the purpose of this study, the term minority refers to African Americans and Latinos.…”

“…Unlike Caucasian hair, it is more difficult to pass a comb through wet Black hair than through dry Black hair (Franbourg, Hallegot, Baltenneck, Totain, & Leroy, 2003;Lindelof, Forslind, Hedblad, & Kaveus, 1988;Menkart, Wolfram, & Mao, 1966;Wolfram, 2001). This simple fact has sparked a 15-billion dollar hair care industry, influenced perceptions of Black and Latino attractiveness, and for some, has an emotional impact (Neal-Barnett et al, 2000;Neal-Barnett & Stadulis, 2006;Neal-Barnett, Statom, & Stadulis, in press). The difference in hair may affect pulling sites, with minorities being less likely to pull from the scalp than other sites.…”

“…In these accounts, the theme of stigma is repeated as the individual struggles to cope with a psychological disorder poorly understood by one's community (Milchorena, 2005). Shame, guilt, and depression are often consequences of minorities' hair pulling behavior (Milchorena, 2005;Neal-Barnett et al, 2000;Neal-Barnett & Stadulis, 2006). These themes mirror those contained in reports on Caucasian samples (Casati, Toner, & Yu, 2000;Woods et al, 2006).…”

“…Trichotillomania (TTM) is defined as the recurrent pulling out of one's own hair that results in noticeable hair loss (American Psychiatric Association, 2000;Christenson & Mackenzie, 1994;Neal-Barnett, Ward-Brown, Mitchell, & Krownapple, 2000;Woods et al, 2006). Hair pulling may occur sporadically throughout the day or in sustained periods that may last for hours.…”