Trichotillomania: Neurobiology and treatment

Samuel R. Chamberlain, Brian L. Odlaug, Vasileios Boulougouris, Naomi A. Fineberg, Jon E. Grant

Research output: Contribution to journalReview articlepeer-review

91 Scopus citations


Trichotillomania is a disorder characterized by repetitive hair pulling, leading to noticeable hair loss and functional impairment. This paper provides an overview of what is known of trichotillomania from several perspectives. We begin by considering historical descriptions of hair pulling that ultimately contributed to the inclusion of trichotillomania as a formal diagnostic entity in the Diagnostic and Statistical Manual. Psychological factors involved in the mediation of symptoms are examined, including positive and negative reinforcement. The relationships between trichotillomania, other body-focused repetitive behaviours, and disorders of the putative obsessive-compulsive (OC) spectrum are surveyed. The review then explores findings from the available controlled treatment trials that utilized psychotherapy, pharmacotherapy, or both. Neural circuitry involved in the manifestation of hair pulling is then identified by considering data from animal models of the condition, along with neurocognitive and neuroimaging results from patients. Finally, we highlight important areas for future neurobiological and treatment research.

Original languageEnglish (US)
Pages (from-to)831-842
Number of pages12
JournalNeuroscience and Biobehavioral Reviews
Issue number6
StatePublished - Jun 2009

Bibliographical note

Funding Information:
The BCNI is supported by a joint award from the Medical Research Council (MRC) and Wellcome Trust. Dr Chamberlain consults for Cambridge Cognition, Shire, and P1Vital. This research was supported in part by a Career Development Award (K23 MH069754-01A1) to Dr. Grant. Dr. Grant has received research grants from Forest Pharmaceuticals, GlaxoSmithKline, and Somaxon Pharmaceuticals. Dr. Grant has also been a consultant to Somaxon Pharmaceuticals and has consulted for law offices as an expert in pathological gambling. Dr. Fineberg has received research grants from H Lundbeck A/S, GlaxoSmithKline and Astra Zeneca and meetings support from H Lundbeck A/S, Wyeth, Bristol Myers Squibb, Servier and Janssen. Dr. Fineberg has also been a consultant to GlaxoSmithKline and H Lundbeck A/S. The authors would like to thank the anonymous reviewers for very helpful suggestions on previous versions of the manuscript.

Copyright 2009 Elsevier B.V., All rights reserved.


  • Addiction
  • Compulsive
  • Grooming
  • Habit
  • Impulsivity
  • OCD
  • Trichotillomania


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