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Previous research on pediatric trichotillomania (TTM) has focused on the difference between two different subgroups of hair-pullers: “focused” pullers (i.e. those who pull within their awareness) and “automatic” pullers (i.e. those who pull outside of their awareness; Christenson et al., 1992; Flessner et al., 2008; Penzel, 2003). To date, only one other study has examined how sensory processing may differ between these two groups, or how these differences may impact these groups’ hair-pulling triggers (Falkenstein et al., 2018). Thus, the aim of the current study was to analyze how sensory processing patterns may differ between predominantly focused pullers and predominantly automatic pullers ages 7–17. The current study also examined how differences in sensory processing relate to hair-pulling triggers. I utilized a parent-report survey, which included (a) demographic questions, (b) a modified version of the Milwaukee Inventory for Subtypes of Trichotillomania-Child version (MIST-C), (c) Christenson and colleagues’ Cues Checklist (CCL; Christenson et al., 1992), and (d) a sensory processing scale. I then used parents’ ratings on the MIST-C to categorize their children into four different subgroups, based on their pulling styles: high focused/high automatic pullers (HFHA), high focused/low automatic pullers (HFLA), low focused/high automatic pullers (LFHA), and low focused/low automatic pullers (LFLA). The results did not support my original hypotheses that the main sensory processing and hair-pulling trigger differences would be between HFLA (i.e. predominantly focused pullers) and LFHA pullers (i.e. predominantly automatic pullers). However, the results did reveal differences in sensory processing between LFHA and LFLA pullers and differences in hair pulling triggers between HFLA and LFLA pullers. I discuss how these findings may reveal a need for an augmented version of Habit Reversal Therapy (HRT) that includes sensory regulation skills. I also discuss the limitations of the current study, which include (a) the small sample size, (b) the parent-report format, (c) the unvalidated nature of many of the measures, (d) comorbidity, and (e) the recruitment strategies.
Keywords: trichotillomania, hair-pulling, focused, automatic, pulling styles, sensory processing, children
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Lee, Tia Rose, "Stimulus Regulation in Pediatric Trichotillomania" (2019). Senior Projects Spring 2019. 92.