The impact of family functioning on pulling styles among adolescents with trichotillomania (hair pulling disorder)

- HPD diagnostic status did not predict adolescent report of parenting behaviors.
- Family environment and parental attitudes did not predict HPD pulling styles.
- Majority of adolescents with HPD demonstrated both automatic and focused pulling.
- A large portion of adolescents with HPD demonstrated solely focused pulling.

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.