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Clinical Child Psychology and Psychiatry
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Is it Trichotillomania? Hair Pulling in Childhood: A Developmental Perspective

Radhika Santhanam

University of Queensland, Australia, Radhika_Santhanam{at}health.qld.gov.au

Michael Fairley

Sydney Children's Hospital and Prince of Wales Hospital, Australia

Maureen Rogers

The Children's Hospital at Westmead, Australia

A cohort of children with hair pulling as the presenting symptom was followed up to enhance clinical understanding of the nature of hair-pulling behaviour in childhood. Thirty-eight children were clinically assessed for a diagnosis of trichotillomania, co-morbidity, co-existing habits and other relevant factors. Intervention consisted of a combination of behavioural strategies, self-esteem work, supportive family approaches, attachment-focused parenting models and medication. In this group of children it was difficult to define their symptoms as a clinical diagnosis of trichotillomania, using ICD-10/DSM-IV. This article concludes that hair pulling, as a symptom in children, is a heterogeneous condition. It is useful to approach this issue from a developmental perspective. Our data warrant reappraisal of the diagnosis of trichotillomania in childhood. We explore the framework of a developmental continuum to understand and manage the problem of hair pulling in childhood.

Key Words: childhood trichotillomania • hair-pulling behaviour

Clinical Child Psychology and Psychiatry, Vol. 13, No. 3, 409-418 (2008)
DOI: 10.1177/1359104508090604
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