This study was designed to detail the demographic and phenomenological feat
ures of adult chronic hairpullers. Key possible subtypes were identified a
priori. On the basis of the phenomenological data, differences between the
following possible subtypes were investigated: hair-pullers with and withou
t DSM-IV trichotillomania (TTM), oral habits, automatic versus focused hair
-pulling, positive versus negative affective cues prior to hair-pulling, co
morbid self-injurious habits, obsessive-compulsive disorder (OCD), and ties
. Forty-seven participants were drawn from an outpatient population of chro
nic adult hair-pullers. A structured interview that focused on hair-pulling
and associated behaviors was administered to participants. Six of the part
icipants (12.8%) were male, and 41 (87.7%) were female. A large number of h
air-pullers (63.8%) had comorbid self-injurious habits. A greater proportio
n of male hair-pullers had comorbid ties when compared with females. Certai
n subgroups of chronic hair-pullers (e.g., hairpullers with or without auto
matic/focused hair-pulling, comorbid self-injurious habits, and oral habits
) were found to differ on a number of phenomenological and hair-pulling cha
racteristics. However, differences between other possible subgroups (e.g.,
hair-pullers with or without DSM-IV TTM, comorbid OCD, and negative versus
positive affective cues) may reflect greater severity in hair-pulling sympt
omatology rather than distinct subtypes of chronic hair-pulling. The findin
gs of the present study also indicated that chronic hair-pulling (even in c
ases where DSM-IV criteria for TTM were not met) has a significant impact o
n quality of life. The present study provided limited support for the exist
ence of possible subtypes of chronic hair-pulling. Recommendations are made
for further investigations into such subtypes. Copyright (C) 2001 by W.B.
Saunders Company.