Which disorder in the OCD spectrum is characterized by recurrent hair pulling leading to distress and impairment?

• A. Trichotillomania
• B. Body Dysmorphic Disorder
• C. Hoarding
• D. Skin Picking

Answer: (A)

Recurrent hair pulling with distress and impairment is trichotillomania, a disorder in the obsessive-compulsive and related disorders family. The defining feature is repetitive, irresistible pulling of hair that leads to hair loss and significant distress or functional impairment. People may pull automatically or in response to a strong urge, often seeking relief after pulling, which reinforces the behavior despite its negative consequences. This pattern separates it from other conditions because the hair-pulling itself is the central problem, not just concerns about appearance or general grooming.

Body dysmorphic disorder centers on a preoccupation with perceived flaws in appearance, not the act of pulling hair. Hoarding involves excessive accumulation and difficulty discarding possessions. Skin picking (excoriation) disorder involves repetitive picking at the skin, which is a different target and pattern from hair pulling.