Hair pulling in a sample of Turkish university students: prevalence, clinical characteristics, predictors, and sex differences

To examine the prevalence of trichotillomania (TTM) and associated factors in a large non-clinical sample of Turkish university students. The population of the study comprised 862 university students, 596 (69.1%) females and 266 (30.9%) males, aged between 18 and 29 (21.3 ± 1.8) years. In addition to a sociodemographic form, the participants completed the Massachusetts General Hospital Hairpulling Scale and the Brief Symptom Inventory, and the Structured Interview Form based on the DSM 5 criteria for TTM. In the study, lifetime hair-pulling behavior was found in 18.9% of university students, current hair-pulling behavior was found in 10%, and a current diagnosis of TTM was found in 2.3%. The ratio of men to women among those diagnosed as having TTM was determined to be 1.8:1. Women mentioned more stressors that triggered hair-pulling behavior than men. Women showed hair-pulling behavior to reduce tension, whereas men reported that they experienced more pleasure sensations during hair-pulling. Finally, it was determined that those who met the TTM diagnostic criteria showed more persistent pulling patterns, felt more regret, and social avoidance, attempted to camouflage more, and thought their behavior was more likely to be a psychiatric illness than those who did not meet the TTM diagnostic criteria. Unlike the literature, the prevalence of TTM in Turkish university students was found to be almost equal in men and women, but it was determined that the hair-pulling patterns of men and women differed. Therefore, it is thought that rather than sex being a risk factor for TTM, it may differentiate approaches of men and women to hair-pulling and help-seeking behaviors.