Sensory and physiological dimensions of cold pressor pain in trichotillomania

- People with trichotillomania often do not report pain during pulling episodes.
- Adults with trichotillomania failed to exhibit analgesia to cold pressor pain.
- There was no relationship between pain measures and hair pulling severity.

BackgroundTrichotillomania (TTM) is characterized by hair pulling resulting in hair loss. It has long been perceived that people with TTM may have different pain thresholds or pain tolerances than healthy counterparts. This study sought to examine whether TTM was associated with reductions in sensory or physiological components of cold pressor pain.MethodAdults with TTM were examined on clinical measures including symptom severity and functioning. All participants underwent the cold pressor test. Heart rate, blood pressure, and self-reported pain were compared between TTM participants (N=19) and controls (N=14).ResultsThere were no differences in pain tolerance between TTM participants and controls. The TTM group did not show faster recovery time nor exhibit lower pain ratings. Systolic blood pressure was significantly lower in the TTM group before immersion, though differences did not exist at pain tolerance or after the recovery period. TTM participants had a lower heart rate at all time points, but this difference was statistically significant only at 90 s (p=.046).ConclusionsIn this study, adults with TTM failed to exhibit analgesia to cold pressor pain as compared with healthy controls. No association appears to exist between pain and TTM symptom severity.