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== Cause ==
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=== Presenza di altri disturbi psicologici ===
Quando due o più disturbi psicologici ossessivi-compulsivi, questi si dicono comorbidi. La tricotillomania tende a presentarsi in comorbidità: poichè molti disturbi mentali hanno precise cause anatomiche, fisiologiche e psicologico -sociali che presentano similarità, è evidente che il fatto di avere una patologia aumenti le possibilità che se ne presentino altre.
La tricotillomania è particolarmente frequente in individui che hanno o hanno avuti disturbi ossessivo-compulsivi, come anche in individui che soffrono di ansia o depressione. Poichè l'
Trichotillomania is closely related to obsessive-compulsive disorder, so individuals who have or have had OCD are more likely to develop this disorder. Having an anxiety disorder also increases the risk that someone will develop trichotillomania. Anxiety disorders and OCD have similar biological and psychological causes, and they both respond to similar treatments. Mood disorders have also been found to increase risk, but less severely than other obsessive-compulsive or anxiety disorders.
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Numerosi studi hanno messo in evidenza come la tricotillomania tenda a ripresentarmi all'interno di una stessa famiglia: individui che hanno genitori o fratelli tricotillomani hanno una maggior tendenza a sviluppare il disturbo essi stessi.
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Anche se il gene SLITRK1 è stato il primo ad essere collegato alla tricotillomania, riercatori tra cui Allison Ashley-Koch (PhD, assistente di medical genetics presso la Duke University) sostengono non si tratti del solo gene coinvolto.
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Stress can be good, but it can also do a lot of harm to the body. In fact, psychologists refer to negative stress as distress. Distress occurs when a stressor causes an individual to react with fearful or avoidant behavior, physical symptoms like increased heart rate, and a negative mood. Distress is something that contributes to the development of trichotillomania in a few ways. One, distress from the unwanted thoughts about hair pulling pushes the person to compulsively pull their hair. Hair pulling causes the distress to vanish, further compelling an individual to hair pull in response to the obsession. Two, distress may cause the obsession to form in response to negative events or stressors that happen to a person. Once the obsession with pulling hair is present, the patient may feel compelled to pull their hair by the previously described mechanism.
=== anomalie cerebrali funzionali o strutturali ===
There are many psychologists and scientists who believe functional or structural brain abnormalities may cause trichotillomania. Studies have found the orbital frontal cortex, caudate nucleus, and thalamus could potentially cause trichotillomania if they become structurally or functionally abnormal because each plays a key role in suppressing and controlling unwanted, obsessive thoughts. Data in this field of study is still in its infancy, so the specific regions of the brain that may or may not be involved are still somewhat uncertain. Additionally, the mechanism through with these structural or functional abnormalities may contribute to trichotillomania are still unknown. More research is still needed, and the research currently out is conflicting in regards to this mechanism.
== '''Imbalance In Brain Chemicals''' ==
There is some evidence trichotillomania may be caused, in part, by an imbalance in brain chemicals. Neurons interact with each other and other cells through the use of electrochemical signals, so an imbalance of the chemicals used to communicate can cause many problems. Some scientists theorize individuals with trichotillomania have too little serotonin, which is largely responsible for making have a pleasant feeling. This theory stems from the fact patients with trichotillomania tend to respond well to selective serotonin reuptake inhibitors, but when the use of the drug stops, the individual typically will have a strong relapse in symptoms. Hormonal imbalance may also influence this disorder because it commonly presents itself in times when hormone levels are changing.
. In alcuni casi, la tricodinia, disturbo che si manifesta con persistente dolore al cuoio capelluto, può costituire la causa scatenante della tricotillomania.
Tratto da <nowiki>https://www.my-personaltrainer.it/salute-benessere/tricotillomania.html</nowiki>
== Gesto dello strappare ==
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A livello emozionale i soggetti molto spesso provano vergogna per il loro comportamento e l’aspetto estetico che ne risulta, e questo ha come conseguenza più immediata la chiusura rispetto ai rapporti sociali e un calo dell’autostima.
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== Sintomatologia ==
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* Alopecia, notevole perdita di capelli, capelli più corti o radi
* Preferenze per alcuni tipi di peli e rituali associati allo strappo
*Talvolta, il tricotillomane si sofferma ad esaminare i capelli estirpati, osservandone la forma, la dimensione del bulbo ecc. oppure li dispone in ordine su una superficie sulla base di criteri soggettivi. Tratto da <nowiki>https://www.my-personaltrainer.it/salute-benessere/tricotillomania.html</nowiki>
* Comportamenti orali (mordere, masticare o mangiare i peli strappati - [[tricofagia]])
* Giocare con i peli strappati o passarli sulle labbra
* Problemi significativi al lavoro, a scuola o nelle situazioni sociali a causa del disagio creato dal bisogno di strapparsi peli, o dalle conseguenze estetiche del gesto
*SIGNNIFICANT HAIR LOSS Rather than being an overall thinning of the hair, trichotillomania hair loss tends to look more patchy. Certain areas of the scalp may have thinned hair, shortened hair, or be entirely bald. When individuals pull their eyebrows and eyelashes, these features might appear sparse or missing.
*CHEWING AND EATING HAIR Not everyone with trichotillomania has oral symptoms, but a good portion of affected individuals will chew and eat their hair. Some of them may simply bite the ends and snap the strands with their teeth rather than swallowing, but others go through the full digestive process. This is often accompanied by playing with the strands of pulled-out hair and running them across the face or lips. Hair isn’t meant to be digested, and it can cause serious health problems if it becomes tangled in the digestive tract. If patients eat a significant amount of hair over a large amount of time, a matted hairball called a trichobezoar may form in their digestive system. Slowly, over multiple years, this hairball can lead to weight loss, vomiting, digestive problems, obstruction of the intestines, and if not diagnosed and treated, even death.
*Constant hair pulling is one of the main symptoms of trichotillomania. Some patients engage in the behaviors much more often than others, but all individuals with trichotillomania pull their hair on at least a semi-consistent and repeated basis. The most common sites for hair pulling are the eyelashes, eyebrows, and scalp, but patients might pull hair from other areas of the body as well. They may pull their leg hair, arm hair, or pubic hair. Affected individuals don’t always use the same site; some change their hair-pulling sites over time. Another significant factor is patients repeatedly try to lessen their hair pulling or stop it entirely, but they aren’t successful in controlling it.
*Individuals with trichotillomania may feel relief or pleasure after they pull their hair. This is especially true of focused hair pulling. The process of pulling the hair out might bring a feeling of satisfaction. This positive association between hair pulling and good feelings makes it even more difficult to stop. They may continue pulling their hair so they can experience the good feelings. The behavior shares many similarities with substance use disorders, including the affected individual not feeling in control of their behavior and experiencing positivity or euphoria when engaging in the behavior. Even if they feel pleasure in the moment, though, they’ll still often experience distress and impaired social functioning regarding their hair loss.
*significant stress before pulling With focused hair pulling, the behavior is done intentionally as a response to negative emotions. Hair pulling might be a coping mechanism to release feelings of frustration, fatigue, loneliness, boredom, tension, anxiety, or stress. Many patients describe feeling a tension that steadily increases the more they try not to pull, and they can’t find release until they give in. For some individuals, trichotillomania is a manifestation of obsessive-compulsive disorder. With this condition, affected individuals feel the need to complete certain compulsions built around obsessive thought patterns or behaviors. Failing to give in to the compulsions can cause significant emotional distress. When hair pulling is related to obsessive-compulsive disorder, patients may create elaborate rituals around the behavior. <span class="td-sml-description"><span id="tve_leads_end_content"></span></span>
Molte persone che soffrono di tricotillomania stuzzicano anche la pelle, si mangiano le unghie o si masticano le labbra. A volte, soprattutto se in età infantile, possono strappare peli da animali, bambole o altri materiali come vestiti e coperte.
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