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Edited by Dan J. Stein, M.D., Ph.D., Gary Christenson, M.D., and Eric Hollander, M.D.

  • ISBN 978-0-88048-759-7
  • Item #8759

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The phenomenon of trichotillomania, or hair pulling, has been observed for centuries. The ancient Greek physician Hippocrates noted hair pulling as one of the many symptoms that the physician was advised to assess as a routine matter. In our present time and culture, pulling one's hair out is more typically referred to in the context of depression, frustration, boredom, or other emotional turmoil.

In truth, hair pulling is a highly prevalent behavior that may be associated with significant morbidity.

Edited by experts in the field, Trichotillomania addresses the importance of the study of hair pulling from both a clinical and a research perspective. Documenting the clinical phenomenology, morbidity, and management of trichotillomania, it discusses the phenomenology of childhood trichotillomania, providing a comprehensive description of its symptoms and sequelae. Of particular value for the clinician are contributions on the assessment of trichotillomania and a detailed cognitive-behavioral treatment plan. The uses of medication, the place of a psychodynamic perspective, the value of behavioral interventions, and the role of hypnotherapy are also thoroughly discussed.

This discerning text further documents the significance of research on trichotillomania for obtaining a broader understanding of complex brain-behavior relationships. While recent research has suggested that hair pulling lies on the spectrum of obsessive-compulsive disorder, a range of evidence is presented that indicates important differences between trichotillomania and OCD. As such, attention by clinicians to hair pulling may be of enormous value to patients, whose condition was previously unrecognized, while leading to a better understanding of the range of OCD-like disorders.


  • Introduction: why trichotillomania? Trichotillomania: descriptive characteristics and phenomenology. The neurobiology of trichotillomania. Veterinary models of compulsive self-grooming: parallels with trichotillomania. Pharmacotherapy of trichotillomania. Psychoanalytic perspectives on trichotillomania. Behavioral treatment for trichotillomania. Hypnosis in the treatment of trichotillomania. Hair pulling in children and adolescents. Trichotillomania and obsessive-compulsive disorder. Manual for the cognitive-behavioral treatment of trichotillomania. Assessment of trichotillomania. Index.

About the Authors

Dan J. Stein, M.B., is Director of the MRC Research Unit on Anxiety and Stress Disorders in the Department of Psychiatry at the University of Stellenbosch in Cape Town, South Africa.

Gary A. Christenson, M.D., is Director of the Mental Health Clinic, Boynton Health Service at the University of Minnesota , and Clinical Associate Professor of Psychiatry in the Department of Psychiatry at the University of Minnesota Medical School in Minneapolis, Minnesota.

Eric Hollander, M.D., is Professor of Psychiatry in the Department of Psychiatry at the Mt. Sinai School of Medicine in New York, New York.

Overall, this is a solid review of relevant empirical data, and many readers will find it a useful introduction to trichotillomania, albeit with a strong psychiatric flavor.—Readings: A Journal of Reviews and Commentary in Mental Health

The greatest strength of Trichotillomania is the section on treatment. The editors sought out the world's experts on pharmacologic, behavioral, hypnotic, and psychotherapeutic treatments for trichotillomania. Each of these experts gives a clear, concise description of the methods used in the treatment of compulsive hair pulling. . . . Given the fact that 1 percent of Americans have trichotillomania, every health care professional should read this clear, concise guidebook.—The New England Journal of Medicine

In this first textbook devoted exclusively to trichotillomania, the editors provide us with a timely and comprehensive review of this interesting disorder. . . This book is a must-read for psychiatrists who treat or are planning to treat these interesting and challenging patients.—Psychiatric Times

In this marvelous book, Dr. Stein has brought together a group of experts who together capture the clinical and research complexities of trichotillomania across the lifespan. For the researcher interested in trichotillomania per se, or obsessive compulsive spectrum disorders more generally, this work will serve as an exceptionally rich introduction to the field. For the clinician interested in how to approach this often difficult-to-treat disorders, Dr. Stein's book provides a reliable guide to pharmacotherapy and psychotherapy as applied to trichotillomania. Dr. Barbara Rothbaum's chapter on cognitive-behavioral treatment alone is worth the price of the book.—John S. March, M.D., M.P.H., Associate Professor, Department of Psychiatry and Psychology, Director, Program in Child and Adolescent Anxiety Disorders, Duke University Medical Center

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