(PS3-C72) Clinical Correlates of Pediatric Trichotillomania

Clinical Correlates of Pediatric Trichotillomania

Mary Gray Stolz¹, M.A., Rachel M. Canella, M.S.¹, Hilary E. Kratz, Ph.D.¹, Hana F. Zickgraf, Ph.D.², and Martin E. Franklin, Ph.D.³

¹  La Salle University, School of Arts and Sciences, Department of Psychology, Philadelphia, PA

²  University of South Alabama, College of Arts and Sciences, Psychology Department, Mobile, AL

³  Rogers Behavioral Health, Philadelphia, PA

Abstract

Objective. Clinical correlates of pediatric trichotillomania-related severity and impairment among youth remain understudied, which presents a challenge in informing effective treatments for pediatric trichotillomania (TTM) (Harris & Franklin, 2013). Research from adults with TTM suggests that premonitory urges (feelings of tension or other unpleasant sensations that precede their pulling behaviors) have been related to hair pulling severity, intensity and impairment (Kyriazi et al., 2019). Few studies have examined premonitory urges among youth with TTM. Pulling styles and comorbidities also represent two other factors that have received limited attention in the pediatric TTM literature (Peris et al., 2019). To our knowledge, no study to date has examined associations between premonitory urges, pulling sites, and comorbidities among youth with TTM.

Method.  The present study used baseline data from the Behavior Therapy for Pediatric TTM study, an efficacy study conducted at the University of Pennsylvania. 53 youth ages 10-17 (M = 13.32, SD = 2.4) with a primary DSM-5 diagnosis of TTM with complete baseline data on all key covariates were included in the current study. The sample primarily identified as white (84.9%) girls (80%). The bivariate associations between strength of premonitory urges, number of pulling sites, total number of comorbidities, clinician-rated TTM severity and TTM impairment were examined using Pearson correlations.

Results.  Results indicated a statistically significant positive relationship between strength of premonitory urges and TTM impairment (r(42) = .10, p < .05). Results also indicated a statistically significant positive relationship between focused pulling style and TTM severity (r(42) = .45, p < .01) and total number of psychiatric comorbidities and TTM severity (r(42) = .32, p < .05). No significant findings were found for relations between strength of premonitory urges and TTM severity, focused and automatic pulling and TTM severity, automatic pulling and TTM impairment, and comorbidities and TTM impairment.

Conclusions.  Preliminary results suggest that strength of premonitory urges is positively associated with TTM impairment, while a focused pulling style and more comorbidities are associated with greater clinical TTM severity. Thus, it is important to assess for premonitory urges in youth, as children with greater premonitory urges might be more susceptible to greater TTM impairment. It is also important to explore the different mechanisms underlying the association between premonitory urges and TTM impairment. Premonitory urges might be more closely related to the emotional aspects of TTM impairment (e.g., embarrassment). Further examining these relationships is important to enhancing our understanding of TTM and informing interventions for TTM.