Autistic traits in trichotillomania

Introduction: Although many variables have been examined as potentially contributing to the manifestation of trichotillomania (TTM), little research has focused on problems in social interactions. Hair pulling has many similarities to the stereotypies seen in autism spectrum disorders (ASD), and thus the present study examined autistic traits in adults with trichotillomania.

Methods: Fifty nontreatment-seeking adults with DSM-5 TTM were recruited. Participants completed standard diagnostic interviews, basic demographic information, and symptom inventories about TTM. Autistic traits were quantified using the Brief Autism- Spectrum Quotient (AQ-10) which screens for autistic traits.

Results: The sample comprised 50 participants, mean (standard deviation) age of 30.2 (5.6) years, 10% being male, 86% female, and 4% nonbinary. Eight of the participants had a history of major depressive disorder and six had a history of an anxiety disorder. No one had current or lifetime obsessive-compulsive disorder. The mean AQ10 score was 3.5 (2.0), with 14.6% scoring 6 or greater. Autism scores correlated significantly only with family dysfunction and not with symptom severity or impulsivity.

Conclusions: This study examined autistic traits in a community-based sample of adults with TTM and found elevated rates of probable ASD (based on a self-report screening tool) among those with TTM. These results highlight the need to carefully screen for autistic traits in those with TTM. To what extent these traits may influence response to treatment, however, remains unclear.