摘要：Trichotillomania (TTM) is a disorder that involves persistent and excessive removal of hair from one’s body (e.g., scalp, eyebrows, eyelashes), resulting in evident hair loss. Accordingly, the illness is associated with low self-esteem, high distress, and severe social and vocational impairment in patients of all ages. The difficulty in treating TTM is due to limited awareness of effective treatment options, which presents a challenge in the dissemination of treatment advances that try to improve outcomes for afflicted individuals. Thus, there are four objectives for this research review. First, a literature review will demonstrate that habit reversal therapy—a common behavioural treatment for TTM—is ineffective and insufficient alone due to low follow-up treatment effect sizes and high relapse rates. Second, given that phenomenological research suggests that TTM is not only characterized by habitual, “automatic” hair pulling, but also by “focused” hair pulling in order to regulate negative internal experiences, this paper will discuss the link of TTM symptoms with experiential avoidance and emotion dysregulation—both of which illustrate maladaptive regulation of internal experiences. Third, research pertaining to the combination of HRT with acceptance and commitment therapy and dialectical behaviour therapy—which address experiential avoidance and emotional dysregulation, respectively—will be examined. A review of randomized control trials will demonstrate that combining these treatments with HRT leads to greater reductions in TTM severity, impairment, experiential avoidance, emotion dysregulation, depressive symptoms, and anxiety symptoms than waitlist and therapeutic comparisons. Finally, limitations and strategies for future research and treatment development will be explored.
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