Hair Pulling in Childhood
Unfortunately, pediatric trichotillomania studies are far and few between. The hair pulling disorder is already understudied, but pediatric-specific research is even harder to find.
The first study of trichotillomania treatment for children found that behavioral therapy may work well specifically for children. Here are some of the study’s results:
1.) Excellent results with behavioral therapy stayed high over the 8-week study and follow-up.
2.) Interestingly, behavior therapy alone had the ability to stop the kids from relapse. This is opposite to current adult practices which also include added behavioral approaches such as awareness training, stimulus control and competing response procedures.
3.) It is possible that trichotillomania treatment during childhood or adolescence may provide “more durable outcomes” than adults treatments.
Why Children Can Overcome Trichotillomania Better than Adults
They also examined hair pulling expression across children, adolescents and adults. They compared age to treatment effectiveness.
The first thing they noticed was that children and adolescents engage in focused pulling, which is not the same pattern seen in adults.
This complete difference in pulling types led researchers to think that hair pulling in children is less developed due to age.
They found that as patients age, their trichotillomania becomes more complex and affects relegation functions differently, which then negatively impacts behavioral therapy effectiveness.
Thus, younger children can be treated more effectively with behavioral therapy because their hair pulling disorder is less developed than in adults — less complex.
Children (7-9 yo) vs. Adolescents (10-17 yo)
Because researchers found that children (7 to 17 years old) had significantly better chances of overcoming trichotillomania than adults due to age making the disorder less complex, the question became: “Are children better able to overcome hair pulling disorder than adolescents because they are younger?”
Q: “Are children better able to overcome hair pulling disorder than adolescents because they are younger?”
Here’s what they found:
1.) Results were mixed.
2.) One study found that children aged 7-9 had the same symptom reduction/treatment effectiveness as those aged 10-17 years old.
3.) However, further analysis of that study suggested a “greater symptom reduction among the younger participants.”
It seems that there are differing opinions on which specific age is the most well-prepared to overcome hair pulling with treatment, although it may be that the younger they are, the better.
Results: What You Need to Know
Here are the key points of what you need to know about children and their hair pulling disorder:
- Behavioral therapy can be a highly effective form of treatment.
- Children are less likely to relapse when using behavioral therapy, compared to adults.
- Studies may suggest that the younger a trichotillomania patient is, the lower their chances are of relapsing after treatment.
- Trichotillomania gets more complex as a person ages, so getting treatment as early as possible is better.
Discussion: Hair Pulling Disorder Treatment
If you’re a parent considering behavioral therapy treatment for your child or teen (or if you’re a teen yourself), it is never too early to do so. In fact, earlier may be better!
If you or your child have/has trichotillomania and are wondering if you should consider behavioral therapy, please do! It has been shown to be very effective!
Remember: Trichotillomania gets more complex over time, so it is best to get help as soon as possible, especially if the person in question is a child or young adult.
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- Christenson GA, Pyle RL, Mitchel JE. Journal of Clinical Psychiatry. “Estimated lifetime prevalence of trichotillomania in college students”
- Tolin DF, Franklin ME, Diefenbach GJ, Anderson E, Meunier SA. Cognitive Behavioral Therapy. “Pediatric trichotillomania: descriptive psychopathology and an open trial of cognitive-behavioral therapy”
- Franklin ME, Edson AL, Ledley DA, Cahill SP. Journal of the American Academy of Child and Adolescent Psychiatry. “Behavior Therapy for Pediatric Trichotillomania: A Randomized Controlled Trial”
- Flessner CA, Woods DW, Franklin ME, Keuthen NJ, Piacentini J. Child Psychiatry and Human Development. “Cross-sectional study of women with trichotillomania: A phenomenology, and functional impact”
- Swedo SE, Leonard HL, Rapoport JL, Lenane M, Goldberger EL, Cheslow D. New England Journal of Medicine. “A double blind comparison of clomipramine and desipramine in the treatment of trichotillomania (hair pulling)”