We asked 11,000 people who have BFRBs, mainly Trichotillomania and Dermatillomania:
“What usually triggers a pulling or picking spree for you?”
The 20 most frequent responses were (in order of prevalence) stress (48%), boredom (34%), anxiety (13%), watching TV, reading, sitting down, thinking, nerves, being alone, worry, work, tiredness, depression, upset, using the computer, driving, being ill, itching, certain foods and looking in mirrors.
Types of Trigger
We categorised the results into the following 6 groups: Anxiety, Situational, Boredom, Physical, Emotional and Habit
Figure 1.1: Pie Chart depicting most prevalent triggers of hair pulling behaviour
The Pie Chart depicts the proportion of the 6 groups of most prevalent triggers of hair pulling behaviour compiled from a self-reported list of triggers from 11,000 people with the hair pulling condition, trichotillomania.
Below is a list of contents for the 6 groups. Each list is ordered so the most frequent trigger appears first.
Stress, anxiety, tension, thinking, nerves, worry, to relax, problems, pressure, fear, take mind off things, excitement, deadlines, socialising, restlessness, financial worry, appearance worry, to unwind, angst
Watching TV, reading, sitting down, at work, using computer, by self/on own, driving, in bed, studying, at home, on phone, concentrating, at school, during exams, looking in mirror, with family, when busy, writing, in bathroom, focussing, procrastinating, evenings, deadlines, traffic, revision, in private, travelling, tweezers
Boredom, being alone, not keeping hands busy, relaxing, being idle, waiting, traffic, day-dreaming, free time, zoning out, inactivity, procrastinating, absent-mindedness, spare time, escapism, avoidance, unwinding
Particular hairs, tiredness, feeling ill, particular lash, itch, lack of sleep, at night, long hairs, urges, eating certain foods, re-growth, period, hairs out of place, spots, pimples or bumps, pain, different hairs, irritation, sugar, roots, fatigue, thick hairs, mascara, soreness, caffeine, split ends, short hairs, prickly feeling, food, drink, white hairs, insomnia, alcohol, stubble, tingle, exhaustion, greasy hair, hormones, ingrown hairs, shaving, texture, allergies, burning, drugs.
Feeling bad, loneliness, depression, upset, anger, sadness, frustration, emotions, mind, lack of control, family, feeling low, arguments, for comfort, happy, mad, parents, fighting, hurt, overwhelm, relationships, negativity, guilt, change, mood, insecurity, bad day, feeling ugly, crying, confusion, embarrassment, distress, bullies, confrontation, father, abuse, escapism, criticism
Anything, I don’t know, habit, it’s constant, not conscious of it, it’s automatic, routine, ritual
updated 16th May 2019, review 16th May 2020