Trichotillomania Diagnosis Study

She has tried stopping the habit before, and she keeps promising herself that she can stop again. Symptoms and behaviors exhibited by the patient 1. The feeling of embarrassment and that she is going crazy 2. The feeling that Suzanne needs help to stop the habit because she had stopped before 3. Persistent and recurrent thoughts that she does not meet the high expectations of the mother and thus feels like a complete failure 4. Persistent and recurrent thoughts that she does not meet the high expectations of the mother and thus feels like a complete failure- OCD 4. Pulling out the eyelashes, whenever stressed or overwhelmed- TTM 5. Pulling out hair that is resulting to baldness- TTM 6. Constant worry on the need to get good grades- TTI/OCD Diagnosis Following the match of the diagnostic manual and the symptoms presented by the patient, Suzanne is probably suffering from trichotillomania.

The patient met the five criterion set in the diagnosis of TTM and failed the OCD diagnostic manual since OCD is not better explained by the symptoms of another disease such as TTM. Suzanne reports to have had trails to stop pulling the hair before and she succeeded, she also she reports to have been trying time and again to stop the behavior. Criterion C indicates theta the pulling of hair leads to clinically substantial impairment or distress in the work-related, social or other functional parts of life like the dermatological condition. For Suzanne, the impairment is seen in her academic. The distress is associated with the feeling of shame, embarrassment, and loss of control. Suzanne is embarrassed of the current condition she is in and she feels like though she is no longer in control where she feels as though she is a total failure because she cannot meet the high expectations of the mother to get good grades in school.

Humanistic views psychopathology as the as the reason of the deviation of individuals from the drive geared towards self-actualization (Bennett, 2011). Cognitive or cognitive-behavioral makes the assumption that the major element of psychopathology is the dysfunction and inappropriate cognitions. Lastly, behavioral views the psychopathy to be brought about by conditioning processes. From these theories, trichotillomania is both a cognitive-behavioral as a patients actions focused on both the thoughts and the behavior. The symptoms of TTM involves the behavior of pulling of hair deliberately in regions such as the beard, eyelashes, eyebrows, scalp hair, or pubic hair (Walker, 2016). Important to note, in the genders affected during the preadolescent period, the gender representation is almost equal. However, from preadolescent to young adults, more females are affected and about 70% to 93% of the patients are usually female (Shukla, Padhi, Chaudhury & Sengar, 2014).

TTM can be diagnosed in all age groups. However, most of the onset occurs in the young adulthood and pre-adolescence with the mean age of occurrence being between 9 and 13 years and 12 to years being the peak of the behavior (Kar & Kumar, 2012). There is no ethnic or racial preference noted in TTM Risk factors Psychological factors • People with other mental disorder such as OCD and those with any first degree relative having OCD, PTSD, depression or anxiety are at high risk of TTM • Stressful situations or events can trigger TTM be it either mental, emotional or physical. The patient was put through an awareness training and identification of the precursors that precede the act of pulling the hair. Next, situations that preceded the act were identified and the patient was put through a training on competing reaction to avoid hair pulling an example being any physically inconspicuous activities such as clenching on an object, tightening muscles or grasping of hands.

The patient was trained on relaxation like deep breathes whenever the stress was high and taught to try prevent the act by using competing responds whenever the urge to pull hair came (Shukla, Padhi, Chaudhury, & Sengar, 2014). After any hair puling episode, the patient was needed to create an overcorrection like brushing their hair. The patient kept a record of the episodes of hair pulling and the urges for awareness and improvement. Following the treatment, both groups in BT and CT had reductions in their TTM symptoms including the negative effects, the severity, the urge and the inability to resist. The symptoms re-occurred after some period of no treatment but there was no evidence that CT in comparison to BT led to lower relapse rates after the period of no treatment.

Habit reversal therapy (HRT) is showed to be the most effective behavioral technique but most trials have been done among adults’ than pediatricians. In combination with pharmacological therapy, such as SSRIs such as paroxetine or fluoxetine. in this case report, HRT was used in combination with Escitalopram and it was found to be effective on the girl with TTM. , van Opdorp, A. , & van Minnen, A. Addressing self-control cognitions in the treatment of trichotillomania: A randomized controlled trial comparing cognitive therapy to behavior therapy.  Cognitive therapy and research, 40(4), 522-531. The psychologist does not base the intervention and assessment on outdated data. The instruments used are reliable and valid. Rozenman, M. , Peris, T. S. , Gonzalez, A. Behavioral Treatment of Trichotillomania: A Case Report.