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1、PullingHairTrichotillomaniaanditsTreatmentinAdultsAGuideforCliniciansApublicationoftheScientificAdvisoryBoardoftheTrichotillomaniaLearningCenterWhatisTrichotillomania?Trichotillomaniaisadisordercharacterizedbythenon-cosmeticpullingofhair,resultinginsignificanthairloss.ThenameisderivedfromtheGr
2、eektermsforhair(trich),pulling(tillo),andmorbidimpulse(mania).Trichotillo-maniaoccursmorefrequentlyinwomenandiscommonlyassociatedwithconsiderabledistress.Currentestimatesarethatroughly1.5%ofmalesand3.5%offemalesintheU.S.engageinclinicallysignificantnon-cosmetichairpullingintheirlifetime.Hairis
3、mostcommonlypulledfromthescalp,eyelashes,eyebrows,beard,andpubicarea,thoughhairfromanypartofthebodymaybepulled.In-dividualsmaystartwithonesiteofhairpulling,forexampleeyelashes,andlaterstartpullingfromanotherregion,suchasthetopofthehead.Someindividuals,especiallychildren,mayalsopullhairfromothe
4、rpeople,orfrompets.Itiscommonforpersonswithtrichotillomaniatoplaywithand/orin-gestthepulledhairs.Individualswithtrichotillomaniaoftenengageinotherdamagingbody-focusedbehaviorssuchasskinpickingornailbiting.Hairpullingmaybetransient,episodicorcontinuousanditsintensitycanfluctuate.Weeksandmonthsm
5、aypasswithapersonbeingnearlyorcom-pletelyfreeofhairpulling,onlytohaveasuddenandunexplainedrecur-rence.Likeanycondition,thereisarangeofseverity.Forsome,hairlossmaybeminimal,forothers,cosmeticdamagemaybeextensive,eventothepointoftotalbaldness.Themajorityofindividualsstartpullinghairduringchildho
6、odoradoles-cence,thoughhairpullingcanstartatanyage.Thereappearstobeasubsetofveryyoungchildrenwhopullhairasinfantsorpre-schoolers.Ithasbeensuggestedthatperhapstheveryyounghairpullershaveamorebenignandtime-limitedconditionthatdoesnotprogressthrougholderchildhood.3Howdoestrichotillomaniaimpactliv
7、es?Individualswithtrichotillomaniaareoftenembarrassedandashamedoftheirbehaviorandresultingappearance.Theymayhidetheproblemfromeventheirclosestfriendsandfamily,ordenythebehaviorentirely.Theyof-tenresorttoelaboratehairstylesandmake-uptoca
