Browsing by Author "Demetriou, Salome"

Now showing 1 - 2 of 2
  • Thumbnail Image
    Item
    Emotion regulation in trichotillomania (hair-pulling disorder): the role of stress and trauma
    (Stellenbosch : Stellenbosch University, 2019-04) Demetriou, Salome; Lochner, Christine; Coetzee, Bronwyne; Stellenbosch University. Faculty of Arts and Social Sciences. Dept. of Psychology.
    Introduction: Trichotillomania (hair-pulling disorder, or TTM) is characterized by pathological hair-pulling, repeated unsuccessful attempts to stop the behaviour, and significant distress. Various affective states (e.g. tension, stress or pleasure) occur before, during or after hair-pulling, and difficulties in regulating these have been noted in TTM. When applied to TTM, the emotion regulation (ER) model is based on the argument that pulling serves to regulate emotions. However, this appears to be an arduous relationship. For example, stress may increase hair-pulling as a way to assuage feelings of extreme anxiety and depression, whereas hair-pulling and its sequelae may also increase stress levels. There is also evidence to suggest significantly greater severity of childhood trauma in individuals with TTM compared to controls. However, the relationship between stress, childhood trauma and ER in TTM is not yet known. This study aimed to address this gap in our knowledge, by firstly comparing the rates of these variables in TTM with matched healthy controls. A second aim was to investigate whether there was a relationship between hair-pulling severity and difficulties in ER. A third aim was to investigate whether there was a relationship between stress, childhood trauma, and ER difficulties in TTM, while controlling for the presence of mood and anxiety disorders. Methods: The majority of the data included in the study formed part of a larger ongoing study. Fifty-six adults with TTM and 31 sex- and age-matched controls were included. Participants in this study completed a battery of questionnaires, which included the Perceived Stress Scale (PSS), the Childhood Trauma Questionnaire (CTQ) and the Difficulties in Emotion Regulation Scale (DERS). The data were analysed using the Statistical Package for the Social Sciences (SPSS v. 22). Findings: Stress (p = .03), childhood trauma (p = .03), and difficulties in ER (p < .01) were all significantly increased in TTM patients compared to the healthy controls. Second, there was no statistically significant relationship between hair-pulling severity and difficulties in ER. Last, a combination of stress and childhood trauma explained 28.7% of the variance in ER difficulties in TTM [F (2.51) = 7.00, p < .01). However, stress was the only variable that significantly correlated with difficulties in ER in TTM (ß= .47, p < 0.001). Conclusion: As one of the first studies to explore ER in TTM in-depth, the study findings suggested significantly increased stress, childhood trauma, and difficulties in ER in individuals with TTM. While individuals with TTM had greater difficulty in regulating their emotions compared to healthy controls, the data showed no significant relationship between TTM severity and ER difficulties. In keeping with the ER model, one would expect that increased pulling could be used as an attempt to regulate emotions – however this data did not support this hypothesis. Rather, increased stress in TTM individuals significantly explained difficulties in ER. It may be argued that stress and difficulties in ER seem to be more closely related than hair-pulling and difficulties in ER. This suggests that the ER model may not be the best model to explain the phenomenon of pathological hair-pulling. Further research into the underlying mechanisms and dynamics of stress, trauma and ER in TTM may assist in finding a more appropriate explanatory model. In the clinic, emphasis should be placed on the assessment of difficulties in ER in patients with TTM and on addressing modifiable features (such as stress) associated with such difficulties, in addition to reducing hair-pulling.
  • Thumbnail Image
    Item
    Hair-pulling does not necessarily serve an emotion regulation function in adults with trichotillomania
    (Frontiers Media, 2021) Lochner, Christine; Demetriou, Salome; Kidd, Martin; Coetzee, Bronwyne; Stein, Dan J.
    Background: Trichotillomania (TTM) has been associated with childhood trauma and perceived stress. While it has been hypothesized that hair-pulling regulate negative emotions, the relationship between childhood trauma, perceived stress, emotion regulation, and hair-pulling has not been well-studied. Methods: Fifty-six adults with TTM and 31 healthy controls completed the Childhood Trauma Questionnaire (CTQ), Perceived Stress Scale (PSS), and Difficulties in Emotion Regulation Scale (DERS). Hair-pulling severity was measured with the Massachusetts General Hospital-Hair Pulling Scale. CTQ, PSS, and DERS total scores were compared across groups using ANCOVA and the correlation between hair-pulling severity and emotion dysregulation was determined. Regression analyses were used to estimate the association of CTQ and PSS totals with DERS, and to determine whether associations between predictors and dependent variable (DERS) differed across groups. Results: TTM patients reported higher rates of childhood trauma (p <= 0.01), perceived stress (p = 0.03), and emotion dysregulation (p <= 0.01). There was no association between emotion dysregulation and pulling severity (r = −0.02, p = 0.89). Perceived stress was associated with emotion dysregulation in both groups (p < 0.01), and no association between childhood trauma and emotion dysregulation in either group. Perceived stress was the only significant predictor of emotion dysregulation in both groups (F = 28.29, p < 0.01). Conclusion: The association between perceived stress and emotion dysregulation is not specific to TTM, and there is no association between emotion dysregulation and hair-pulling severity, suggesting that key factors other than emotion dysregulation contribute to hair-pulling. Alternative explanatory models are needed.