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Despite aversive impact amongst youths, trichotillomania (hair pulling disorder, HPD) literature demonstrates a lack of research in several critical domains including adolescent HPD, HPD pulling styles (i.e. focused and automatic pulling) and family functioning. The present study sought to address these limitations through the examination of (1) family functioning within the context of adolescent HPD, (2) family functioning in relation to adolescent pulling styles, and (3) characteristics of an HPD adolescent sample relative to pulling styles. In total, fifty-seven adolescent-parent dyads (41 adolescents with HPD and 16 matched controls) from a larger investigation were included. Participants completed an assessment battery including diagnostic interviews and self-report measures pertaining to comorbidity, pulling styles and family functioning. Regression analyses indicated that diagnostic status (i.e. HPD adolescent or control) failed to predict family functioning. Family functioning also failed to predict the degree to which adolescents reported engaging in focused or automatic pulling. Examination of sample characteristics indicated both focused and automatic pulling styles to some extent, with a large portion of individuals (compared to prior research) demonstrating solely focused pulling behavior. Implications for these findings, as well as limitations and avenues for further research are discussed. [ABSTRACT FROM AUTHOR]

Abstract: We examined family environment variables and parenting stress in a cohort of adolescents with trichotillomania (TTM; N=49), their parents (N=55) and matched control adolescents (N=23) and their parents (N=23). TTM youth vs. controls endorsed significantly more expression of anger, aggression and conflict in their families and less family support on the Family Relationship Index (FRI) of the Family Environment Scale (FES). Pulling distress but not severity was correlated with these variables. Greater pulling severity, distress or both were correlated with impairment on the cohesion subscale of the FES and the task accomplishment and affective expression subscales of the Family Assessment Measure (FAM). Mothers of TTM youth vs. controls endorsed more anxiety, depression and anger, plus more total parenting stress and problems in their offspring on the Stress Index for Parents of Adolescents (SIPA). On the FES, mothers of TTM youth vs. controls reported less emphasis on intellectual and cultural orientation and less organization in the family. TTM youth and their mothers were discordant in their ratings of several family environment variables. These findings warrant further study and merit attention when designing treatment interventions for adolescents with TTM. [Copyright &y& Elsevier]