Clinical Characteristics, Sleep, and Temperament in Infants and Young Children with Problematic Hair Pulling and Skin Picking.

Autor: Pendo K; Herbert Wertheim College of Medicine, Florida International University., Swisher VS; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles., Leman TY; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles., Rissman AJ; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles.; Department of Psychology, Adelphi University., Peris TS; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles., Piacentini J; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles., Snorrason I; Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School., Ricketts EJ; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles.
Jazyk: angličtina
Zdroj: Cognitive therapy and research [Cognit Ther Res] 2024 Feb; Vol. 48 (1), pp. 119-136. Date of Electronic Publication: 2023 Oct 25.
DOI: 10.1007/s10608-023-10435-z
Abstrakt: Background: This study examined clinical characteristics of problematic hair pulling (HP) and skin picking (SP) in infants and young children and their association with self-soothing, sleep, and temperament.
Methods: An internet survey of parents/caregivers of 0-5-year-olds ( n = 384 with data analyzed, of whom 26 experienced HP, 62 experienced SP, and 302 were controls free of HP and SP) assessed demographics and medical history, HP and SP characteristics, contextual factors, self-soothing, sleep patterns, and temperament. Participants were recruited through both HP and SP advocacy and support webpages and general webpages (e.g., parenting groups). Descriptive statistics, chi-square tests of independence, independent samples t-test clinically characterized HP, SP, and control groups. Logistic regression and one-way analysis of covariance controlled for sex and age in analyses.
Results: HP and SP rates were 6.1% ( n = 26) and 14.5% ( n = 62), respectively. SP presented in 23.1% of children with HP, and HP presented in 9.7% of children with SP. Mean HP and SP onset occurred at 12.2 ( SD = 11.2) and 24.1 ( SD = 15.8) months, respectively. Contextual factors, including boredom, upset, and awake-in-bed were common in HP and SP. Common caregiver responses included distracting the child, moving the hand away, and telling the child to stop. Few caregivers sought professional help for the child. Children with HP engaged in more hair twirling than controls, and children with SP engaged in more nail biting than controls. Children with HP, but not SP, had more sleep disturbance than controls. In terms of temperament, children with HP displayed sensitivity to stimuli, children with SP exhibited low persistence, and both HP and SP groups displayed serious, observant mood relative to controls.
Conclusions: Findings expand clinical understanding of HP and SP in children aged 0-5 and provide targets (contextual factors, sleep, sensory sensitivity, persistence, and mood) for behavioral interventions. Low rates of treatment seeking highlight the need for expansion of clinical guidelines for HP and SP in this age range.
Competing Interests: Dr. Ricketts has received research funding from the TLC Foundation for Body-Focused Repetitive Behaviors, National Institute of Mental Health (NIMH), American Academy of Sleep Medicine, and Brain and Behavior Research Foundation. She has received honoraria and research funding from the Tourette Association of America (TAA). She has received honoraria from the Centers for Disease Control and Prevention, Springer Nature, and Wink Sleep. Dr. Peris has received funding from the NIMH and the TLC Foundation for Body Focused Repetitive Behaviors and royalties from Oxford University Press. Dr. Piacentini has received research funding from NIMH, and the TLC Foundation for Body Focused Repetitive Behaviors. He has received travel support and honoraria from the TAA and the International OCD Foundation and book royalties from Guilford Publications and Oxford University Press. He serves as an advisor to Lumate Health. Dr. Snorrason, Mr. Pendo, Miss Swisher, Miss Leman, and Miss Rissman declare that they have no conflicts of interest.
Databáze: MEDLINE
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