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Neurobiology of subtypes of trichotillomania and skin picking disorder

Published online by Cambridge University Press:  03 November 2021

Jon E. Grant Open the ORCID record for Jon E. Grant [Opens in a new window] ,
Richard A. I. Bethlehem ,
Samuel R. Chamberlain ,
Tara S. Peris ,
Emily J. Ricketts ,
Joseph O’Neill ,
Darin D. Dougherty ,
Dan Stein ,
Christine Lochner  and
Douglas W. Woods
...Show all authors
Jon E. Grant*
Affiliation:
Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois, USA
Richard A. I. Bethlehem
Affiliation:
Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom
Samuel R. Chamberlain
Affiliation:
Department of Psychiatry, Faculty of Medicine, University of Southampton, Southampton, United Kingdom Southern Health NHS Foundation Trust, Southampton, United Kingdom
Tara S. Peris
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
Emily J. Ricketts
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
Joseph O’Neill
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
Darin D. Dougherty
Affiliation:
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
Dan Stein
Affiliation:
Department of Psychiatry, University of Cape Town, Cape Town, South Africa
Christine Lochner
Affiliation:
Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
Douglas W. Woods
Affiliation:
Department of Psychology, Marquette University, Milwaukee, Wisconsin, USA
John Piacentini
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, Los Angeles, California, USA
Nancy J. Keuthen
Affiliation:
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA
*
*Author for correspondence: Jon E. Grant, JD, MD, MPH Professor Email: jongrant@uchicago.edu
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Abstract

Background

Trichotillomania (TTM) and skin picking disorder (SPD) are common and often debilitating mental health conditions, grouped under the umbrella term of body-focused repetitive behaviors (BFRBs). Recent clinical subtyping found that there were three distinct subtypes of TTM and two of SPD. Whether these clinical subtypes map on to any unique neurobiological underpinnings, however, remains unknown.

Methods

Two hundred and fifty one adults [193 with a BFRB (85.5% [n = 165] female) and 58 healthy controls (77.6% [n = 45] female)] were recruited from the community for a multicenter between-group comparison using structural neuroimaging. Differences in whole brain structure were compared across the subtypes of BFRBs, controlling for age, sex, scanning site, and intracranial volume.

Results

When the subtypes of TTM were compared, low awareness hair pullers demonstrated increased cortical volume in the lateral occipital lobe relative to controls and sensory sensitive pullers. In addition, impulsive/perfectionist hair pullers showed relative decreased volume near the lingual gyrus of the inferior occipital–parietal lobe compared with controls.

Conclusions

These data indicate that the anatomical substrates of particular forms of BFRBs are dissociable, which may have implications for understanding clinical presentations and treatment response.

Keywords

Trichotillomaniaskin picking disorderimagingsubtypesneurobiology
Type
Original Research
Information
CNS Spectrums , Volume 28 , Issue 1 , February 2023 , pp. 98 - 103
Copyright
© The Author(s), 2021. Published by Cambridge University Press

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