How are OCD and hair pulling disorders the same and different for children?
Community Summary of: A Neurocognitive Comparison of Pediatric Obsessive-Compulsive Disorder and Trichotillomania (Hair Pulling Disorder)
Authors of article in the Journal of Abnormal Child Psychology: Emily P. Wilton, Christopher A. Flessner, Elle Brennan, Yolanda Murphy, Michael Walther, Abbe Garcia, Christine Conelea, Daniel P. Dickstein, Elyse Stewart, Kristen Benito, and Jennifer B. Freeman
Published online: 21 February 2020
Community summary posted: 10 September 2025
Word count: 366
Reading grade level: 10
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Why does this study matter?
Obsessive-compulsive disorder (OCD) and hair pulling disorder (HPD) are both considered obsessive-compulsive and related disorders.
HPD is when someone pulls their hair, leading to hair loss. Sometimes people are aware of the pulling (focused) and other times, pulling happens outside of someone’s awareness (automatic).
OCD and HPD are similar in some of the ways the brain functions (neurocognitive). Other studies, mostly with adults, have shown that people with OCD and HPD have similarities in their spatial working memory. There seem to be differences between the two in other brain functions like strategy, attentional flexibility, planning, visual pattern recognition, reversal learning, and cognitive flexibility.
However, there aren’t many studies that directly compare brain functioning in OCD and HPD, especially for kids. We need to know more about how they’re the same (convergent) and how they’re different (divergent).
What happened?
The research team recruited 21 children with HPD, 40 with OCD, and 29 healthy controls (HCs) without HPD or OCD. This was a large enough group (N = 90) to test the main question.
The children and their parents completed surveys and activities that tested inhibitory control, sustained attention, planning, working memory, visual memory, and cognitive flexibility.
The results of the surveys and tests were compared between the three groups. This comparison showed significant differences between groups on planning and sustained attention tasks.
Children in both the OCD and HPD groups did better than the HCs on a planning task. Children in the OCD group performed significantly worse on a sustained attention task compared to children in the HPD and HC groups.
No differences between the groups were found for reversal learning, working memory, spatial working memory, visual memory, or inhibitory control tasks.
What did this group learn?
The study suggests that children with OCD and HPD have many similar neurocognitive characteristics, except for significant differences in planning and attention tasks.
What can our research team do next?
In the future, studies could explore effects of age, length of illness, and the presence or absence of other diagnoses to investigate more hypotheses. They could also use brain scans (fMRI) to understand more about brain functioning in these disorders.
How can you find out more?
Read the full article