Skip to content

Trichotillomania, Skin Picking, and Other Body-Focused Repetitive Behaviors

Jon E. Grant, M.D., M.P.H., J.D., Dan J. Stein, M.D., Ph.D., Douglas W. Woods, Ph.D., and Nancy J. Keuthen, Ph.D.

  • ISBN 978-1-58562-398-3
  • Item #62398

View Pricing

List Price

APA Members

20% off

APA Resident-Fellow Members

25% off

Buying In Canada or Europe?


Underestimated, under-researched, and often poorly understood, the body-focused repetitive disorders nevertheless cause human suffering that is serious, persistent, and pervasive. These disorders can occur in both adults and children and manifest themselves as hair pulling (trichotillomania), pathologic skin picking, thumb sucking, and nail biting. Although these disorders are common, very few medical students and residents hear them addressed in lectures or know where to begin when confronted with a patient presenting with these behaviors. Trichotillomania, Skin Picking, and Other Body-Focused Repetitive Behaviors seeks to remedy this situation by synthesizing the latest research on body-focused repetitive disorders and presenting it in a systematic, easy-to-grasp manner.

Much has changed in the more than a decade since the last book on this topic was published. This new volume reflects the most current and substantive research into the etiology and symptoms of body-focused repetitive disorders and therapeutic options. Organized in logical fashion, it begins with a review of the clinical characteristics, moves on to diagnosis and evaluation, and concludes with a full review of treatment options. Special features include:

  • Extensive material to help clinicians and patients understand the underlying purpose of engaging in these behaviors, which include, reducing tension, regulating strong emotion, and alleviating boredom.
  • Separate chapters on adults and children, who may have a different presentation and a different set of treatment options. An additional chapter focuses on the role of the child patient's family in the diagnosis and treatment of the disorder.
  • Thorough coverage of the full range of treatments—including psychotherapy, medication, and alternative treatments—which provides the clinician with an evidence-based approach to treating patients.
  • Discussion of the psychobiology of hair pulling and skin picking, which allows the reader to understand and contextualize the disorder from a neurological perspective and offers clues that may assist in optimizing treatment.
  • A presentation style that is detailed enough for clinicians, yet accessible enough for a lay audience, including patients with the disorder and the families who seek to understand and support them.

Trichotillomania, Skin Picking, and Other Body-Focused Repetitive Behaviors fills a critical gap in the literature by addressing this common and frequently debilitating disorder in an utterly current, highly practical, and wholly compassionate manner.


  • Contributors
  • Introduction
  • Part 1: Clinical Characteristics
  • Chapter 1. Trichotillomania: epidemiology and clinical characteristics
  • Chapter 2. Pathologic skin picking
  • Chapter 3. Habitual stereotypic movements: a descriptive analysis of four common types
  • Chapter 4. Psychobiology of hair pulling disorder (trichotillomania) and skin picking disorder
  • Part 2: Diagnosis and Evaluation
  • Chapter 5. Diagnosis and comorbidity
  • Chapter 6. Dermatological assessment of hair pulling, skin picking, and nail biting
  • Chapter 7. Diagnosis and evaluation: trichotillomania, skin picking, and other stereotypic behaviors in children
  • Chapter 8. Assessment of trichotillomania, pathological skin picking, and stereotypic movement disorder
  • Part 3: Treatment
  • Chapter 9. Cognitive-behavioral therapy for pediatric trichotillomania
  • Chapter 10. Cognitive-behavioral therapy in adults
  • Chapter 11. Alternative treatments
  • Chapter 12. Pharmacotherapy
  • Chapter 13. Family involvement in the treatment of children with body-focused repetitive behaviors
  • Index


    Diana Antinoro, Psy.D.
    Kristin Benavides, B.A.
    Samuel R. Chamberlain, M.D., Ph.D.
    Flint M. Espil, M.A.
    Naomi A. Fineberg, M.B.B.S., M.R.C.Psych.
    Christopher A. Flessner, Ph.D.
    Martin E. Franklin, Ph.D.
    Patrick C. Friman, Ph.D., ABPP
    Mayumi Okada Gianoli
    Ruth G. Golomb, M.Ed., LCPC
    Jon E. Grant, M.D., M.P.H., J.D.
    Nancy J. Keuthen, Ph.D.
    Christine Lochner, Ph.D.
    Charles S. Mansueto, Ph.D.
    Ladan Mostaghimi, M.D.
    Suzanne Mouton-Odum, Ph.D.
    Brian L. Odlaug, B.A.
    Hannah Reese, Ph.D.
    Kate E. Rogers, B.A.
    Jedidiah Siev, Ph.D.
    Ivar Snorrason, M.A.
    Greg Snyder, Ph.D.
    Dan J. Stein, M.D., Ph.D.
    David F. Tolin, Ph.D., ABPP
    Douglas W. Woods, Ph.D.

About the Authors

Jon E. Grant, M.D., M.P.H., J.D., is Professor in the Department of Psychiatry at the University of Minnesota in Minneapolis, Minnesota.

Dan J. Stein, M.D., Ph.D., is Professor in the Department of Psychiatry and Mental Health at the University of Cape Town in Cape Town, South Africa.

Douglas Woods, Ph.D., is Professor in the Department of Psychology at the University of Wisconsin—Milwaukee in Milwaukee, Wisconsin.

Nancy J. Keuthen, Ph.D., is Associate Professor of Psychology (Psychiatry) at Harvard Medical School; Co-Director of the Trichotillomania Clinic and Research Unit; and Chief Psychologist in the Obsessive Compulsive Disorder Clinic and Research Unit at Massachusetts General Hospital in Boston, Massachusetts.

While psychiatric books line the shelves of libraries and bookstores, there is a
dearth of books that focus on BFRBs. As the editors poignantly point out, BFRBs
are a key aspect of human suffering yet are an often neglected area of clinical
care. This book answers the call for a publication that gives undivided attention to BFRBs. Clinicians now will be fully prepared with the latest knowledge, proper evaluation techniques, and cutting-edge treatment options for patients with these disorders.—Bradley R. Cutler, M.D.,, Doody's Enterprises, Inc., 8/15/2012

This slim volume is a readable, well-written, and concise manual that includes several important gems in the diagnosis and treatment of trichotillomania, skin picking, and body-focused repetitive behaviors that will be of interest to practitioners from a variety of disciplines. An excellent review of the research to date is accomplished, illustrating that we do know much about these behavioral problems.—Juanita N. Baker and A. Celeste Harvey, PsycCRITIQUES, 8/15/2012

Related Products

Become an APA Member
Join Now