trichotillomania

Summary

Summary: Compulsion to pull out one's hair.

Top Publications

  1. ncbi Trichotillomania
    Giuseppe Hautmann
    Department of Dermatology, University of Florence, Italy
    J Am Acad Dermatol 46:807-21; quiz 822-6. 2002
  2. ncbi Treatment of trichotillomania with behavioral therapy or fluoxetine: a randomized, waiting-list controlled study
    Agnes van Minnen
    Department of Clinical Psychology, University of Nijmegen, The Netherlands
    Arch Gen Psychiatry 60:517-22. 2003
  3. ncbi Trichotillomania and co-morbid psychiatric disorders in a 10-year-old boy
    Lauren Kotcher
    J Child Adolesc Psychopharmacol 17:137-41. 2007
  4. ncbi Addicted to hair pulling? How an alternate model of trichotillomania may improve treatment outcome
    Jon E Grant
    Psychiatry Department, University of Minnesota Medical School, Minneapolis, MN 55454, USA
    Harv Rev Psychiatry 15:80-5. 2007
  5. pmc Sleep-isolated trichotillomania: a survey of dermatologists
    Carli Murphy
    Illinois Neurological Institute Sleep Center, Peoria, IL, USA
    J Clin Sleep Med 3:719-21. 2007
  6. ncbi Motor inhibition and cognitive flexibility in obsessive-compulsive disorder and trichotillomania
    Samuel R Chamberlain
    Department of Psychiatry, University of Cambridge School of Clinical Medicine, Addenbrooke s Hospital, Box 189, Cambridge, UK
    Am J Psychiatry 163:1282-4. 2006
  7. ncbi A neuropsychological comparison of obsessive-compulsive disorder and trichotillomania
    Samuel R Chamberlain
    Department of Psychiatry, University of Cambridge School of Clinical Medicine, Addenbrooke s Hospital, Cambridge, UK
    Neuropsychologia 45:654-62. 2007
  8. ncbi Dermoscopic clues to distinguish trichotillomania from patchy alopecia areata
    Leonardo Spagnol Abraham
    Instituto de Dermatologia e Estética do Rio de Janeiro, Brazil
    An Bras Dermatol 85:723-6. 2010
  9. ncbi Motor inhibition in trichotillomania and obsessive-compulsive disorder
    Antje Bohne
    Massachusetts General Hospital Harvard Medical School, OCD Clinic, Simches Research Building, 2nd Floor, 185 Cambridge Street, Boston, MA 02114, USA
    J Psychiatr Res 42:141-50. 2008
  10. ncbi Disordered reward processing and functional connectivity in trichotillomania: a pilot study
    Matthew P White
    Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University Medical Center, 401 Quarry Road, Stanford, CA 94305, USA
    J Psychiatr Res 47:1264-72. 2013

Detail Information

Publications202 found, 100 shown here

  1. ncbi Trichotillomania
    Giuseppe Hautmann
    Department of Dermatology, University of Florence, Italy
    J Am Acad Dermatol 46:807-21; quiz 822-6. 2002
    b>Trichotillomania is a neglected psychiatric disorder with dermatologic expression that has only recently received research attention. On the basis of clinical data, trichotillomania appears to be far more common than previously believed...
  2. ncbi Treatment of trichotillomania with behavioral therapy or fluoxetine: a randomized, waiting-list controlled study
    Agnes van Minnen
    Department of Clinical Psychology, University of Nijmegen, The Netherlands
    Arch Gen Psychiatry 60:517-22. 2003
    ..Both behavioral therapy (BT) and serotonin reuptake inhibitors have been reported effective in the treatment of trichotillomania. This study examines the efficacy of BT and fluoxetine hydrochloride compared with a waiting-list (WL) ..
  3. ncbi Trichotillomania and co-morbid psychiatric disorders in a 10-year-old boy
    Lauren Kotcher
    J Child Adolesc Psychopharmacol 17:137-41. 2007
  4. ncbi Addicted to hair pulling? How an alternate model of trichotillomania may improve treatment outcome
    Jon E Grant
    Psychiatry Department, University of Minnesota Medical School, Minneapolis, MN 55454, USA
    Harv Rev Psychiatry 15:80-5. 2007
  5. pmc Sleep-isolated trichotillomania: a survey of dermatologists
    Carli Murphy
    Illinois Neurological Institute Sleep Center, Peoria, IL, USA
    J Clin Sleep Med 3:719-21. 2007
    To determine whether sleep-isolated trichotillomania has been recognized or suspected by dermatologists.
  6. ncbi Motor inhibition and cognitive flexibility in obsessive-compulsive disorder and trichotillomania
    Samuel R Chamberlain
    Department of Psychiatry, University of Cambridge School of Clinical Medicine, Addenbrooke s Hospital, Box 189, Cambridge, UK
    Am J Psychiatry 163:1282-4. 2006
    Problems with inhibiting certain pathological behaviors are integral to obsessive-compulsive disorder (OCD), trichotillomania, and other putative obsessive-compulsive spectrum disorders...
  7. ncbi A neuropsychological comparison of obsessive-compulsive disorder and trichotillomania
    Samuel R Chamberlain
    Department of Psychiatry, University of Cambridge School of Clinical Medicine, Addenbrooke s Hospital, Cambridge, UK
    Neuropsychologia 45:654-62. 2007
    Obsessive-compulsive disorder (OCD) and trichotillomania (compulsive hair-pulling) share overlapping co-morbidity, familial transmission, and phenomenology...
  8. ncbi Dermoscopic clues to distinguish trichotillomania from patchy alopecia areata
    Leonardo Spagnol Abraham
    Instituto de Dermatologia e Estética do Rio de Janeiro, Brazil
    An Bras Dermatol 85:723-6. 2010
    b>Trichotillomania and patchy alopecia areata have similar clinical and dermoscopic features.
  9. ncbi Motor inhibition in trichotillomania and obsessive-compulsive disorder
    Antje Bohne
    Massachusetts General Hospital Harvard Medical School, OCD Clinic, Simches Research Building, 2nd Floor, 185 Cambridge Street, Boston, MA 02114, USA
    J Psychiatr Res 42:141-50. 2008
    We investigated motor inhibition abilities in trichotillomania (TTM) and obsessive-compulsive disorder (OCD), two disorders characterized by repetitive, intentionally performed behaviors...
  10. ncbi Disordered reward processing and functional connectivity in trichotillomania: a pilot study
    Matthew P White
    Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford University Medical Center, 401 Quarry Road, Stanford, CA 94305, USA
    J Psychiatr Res 47:1264-72. 2013
    The neurobiology of Trichotillomania is poorly understood, although there is increasing evidence to suggest that TTM may involve alterations of reward processing...
  11. ncbi Open-label trial of aripiprazole in the treatment of trichotillomania
    Matthew P White
    Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford, CA 94305, USA
    J Clin Psychopharmacol 31:503-6. 2011
    Serotonin reuptake inhibitors have been disappointing in the treatment of trichotillomania (TTM). Recent evidence suggests that medications that modulate dopamine may be helpful in this disorder.
  12. ncbi Trichotillomania
    Deborah E Sah
    Department of Dermatology, University of Calfornia, San Francisco, California 94143, USA
    Dermatol Ther 21:13-21. 2008
    Patients with trichotillomania often first present to dermatologists, as patients may be unaware of or deny hair pulling and seek an etiology for their hair loss...
  13. ncbi Investigating SAPAP3 variants in the etiology of obsessive-compulsive disorder and trichotillomania in the South African white population
    Leigh Boardman
    Division of Molecular Biology and Human Genetics, Department Biomedical Sciences, Faculty of Health Sciences, University of Stellenbosch, Tygerberg, South Africa
    Compr Psychiatry 52:181-7. 2011
    ..b>Trichotillomania (TTM), a psychiatric disorder characterized by repetitive hairpulling, is presently classified as an impulse ..
  14. ncbi Barbering (fur and whisker trimming) by laboratory mice as a model of human trichotillomania and obsessive-compulsive spectrum disorders
    Joseph P Garner
    Department of Animal Science, University of California, One Shields Avenue, Davis, California 95616, USA
    Comp Med 54:216-24. 2004
    ..Barbering' (abnormal whisker- and fur-plucking behavior) in mice resembles human trichotillomania (compulsive hair plucking) in that barbering mice pluck focused areas of hair, and engage in post-plucking ..
  15. ncbi Tourette's syndrome, trichotillomania, and obsessive-compulsive disorder: how closely are they related?
    Ygor Arzeno Ferrão
    Brazilian Obsessive Compulsive Research Consortium, Brazil
    Psychiatry Res 170:32-42. 2009
    The question of whether Tourette's syndrome (TS) and trichotillomania (TTM) are best conceptualized as obsessive-compulsive spectrum disorders was raised by family studies demonstrating a close relationship between TS and obsessive-..
  16. pmc Barbering in mice: a model for trichotillomania
    Biji T Kurien
    Arthritis and Immunology Program, Oklahoma Medical Research Foundation, 825 NE 13th Street, Oklahoma City, OK 73104, USA
    BMJ 331:1503-5. 2005
  17. ncbi Trichotillomania associated with the "Friar Tuck sign" and nail-biting
    L Dimino-Emme
    Department of Dermatology, Cleveland Clinic Foundation, Ohio 44195 5032
    Cutis 47:107-10. 1991
    b>Trichotillomania is a form of traction alopecia resulting from compulsive repetitive removal of one's own hair...
  18. pmc Cognitive-behavioral therapy for childhood repetitive behavior disorders: tic disorders and trichotillomania
    Christopher A Flessner
    Division of Child and Family Psychiatry, Rhode Island Hospital, Warren Alpert School of Medicine at Brown University, Providence, RI 02903, USA
    Child Adolesc Psychiatr Clin N Am 20:319-28. 2011
    ..Because tic disorders and trichotillomania are the most often studied and most debilitating of these conditions, this article focuses on the efficacy of ..
  19. ncbi DSM-5 field survey: hair-pulling disorder (trichotillomania)
    Christine Lochner
    MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, South Africa
    Depress Anxiety 29:1025-31. 2012
    ..of this multisite field survey was to examine the DSM-IV-TR criteria, proposed DSM-5 diagnostic criteria, as well as a number of possible additional diagnostic criteria, in patients with hair-pulling disorder (HPD, or trichotillomania).
  20. ncbi Understanding and treating trichotillomania: what we know and what we don't know
    Douglas W Woods
    Department of Psychology, 211 Garland Hall, University of Wisconsin Milwaukee, Milwaukee, WI 53201, USA
    Psychiatr Clin North Am 29:487-501, ix. 2006
    This article reviews current issues in the understanding and clinical management of trichotillomania (TTM)...
  21. ncbi Trichotillomania: impact on psychosocial functioning and quality of life
    Gretchen J Diefenbach
    Anxiety Disorders Center, Institute of Living, Hartford Hospital, 200 Retreat Avenue, Hartford, CT 06106, USA
    Behav Res Ther 43:869-84. 2005
    This study explored the impact of hair pulling on psychosocial functioning for patients diagnosed with trichotillomania (TTM; n = 28)...
  22. ncbi Systematic review: pharmacological and behavioral treatment for trichotillomania
    Michael H Bloch
    Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut 06520, USA
    Biol Psychiatry 62:839-46. 2007
    b>Trichotillomania is a psychiatric condition characterized by compulsive hair pulling...
  23. ncbi Resistant trichotillomania and risperidone
    Vesile Senturk
    Psychosomatics 43:429-30. 2002
  24. ncbi Lifting the veil on trichotillomania
    Samuel R Chamberlain
    Department of Psychiatry, University of Cambridge School of Clinical Medicine, Addenbrooke s Hospital, Box 189, Cambridge, CB2 2QQ UK
    Am J Psychiatry 164:568-74. 2007
  25. ncbi Is trichotillomania a stereotypic movement disorder? An analysis of body-focused repetitive behaviors in people with hair-pulling
    Dan J Stein
    University of Cape Town, Rondebosch, South Africa
    Ann Clin Psychiatry 20:194-8. 2008
    ..is typically diagnosed in people with intellectual disability, and by definition excludes people with trichotillomania (TTM)...
  26. ncbi Genetic correlates in trichotillomania--A case-control association study in the South African Caucasian population
    Sian M J Hemmings
    MRC US Centre for Molecular and Cellular Biology, University of Stellenbosch, Tygerberg, South Africa
    Isr J Psychiatry Relat Sci 43:93-101. 2006
    b>Trichotillomania (TTM), a prevalent and disabling psychiatric disorder characterized by repetitive hair-pulling, is presently classified as an impulse control disorder (ICD)...
  27. ncbi Trichotillomania (hair pulling disorder), skin picking disorder, and stereotypic movement disorder: toward DSM-V
    Dan J Stein
    Department of Psychiatry, University of Cape Town, Rondebosch, Cape Town, South Africa
    Depress Anxiety 27:611-26. 2010
    In DSM-IV-TR, trichotillomania (TTM) is classified as an impulse control disorder (not classified elsewhere), skin picking lacks its own diagnostic category (but might be diagnosed as an impulse control disorder not otherwise specified), ..
  28. ncbi Trichotillomania and skin-picking: a phenomenological comparison
    Christine Lochner
    Department of Psychiatry, MRC Unit on Stress and Anxiety Disorder, University of Stellenbosch, Tygerberg, Cape Town, South Africa
    Depress Anxiety 15:83-6. 2002
    Although trichotillomania and pathological skin-picking are both characterized by repetitive self-injurious stereotypic behaviors, the former is classified as an impulse control disorder, while the latter is not given a specific ..
  29. ncbi Reduced brain white matter integrity in trichotillomania: a diffusion tensor imaging study
    Samuel R Chamberlain
    Department of Psychiatry and Medical Research Council, Wellcome Trust Behavioural and Clinical Neurosciences Institute, University of Cambridge, England
    Arch Gen Psychiatry 67:965-71. 2010
    b>Trichotillomania is an Axis I disorder characterized by repetitive, pathological hair pulling.
  30. ncbi Use of the selective serotonin reuptake inhibitor citalopram in treatment of trichotillomania
    D J Stein
    Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa
    Eur Arch Psychiatry Clin Neurosci 247:234-6. 1997
    Previous trials of selective serotonin reuptake inhibitors (SSRIs) in the treatment of trichotillomania have provided conflicting data...
  31. pmc Obsessive-compulsive disorder and trichotillomania: a phenomenological comparison
    Christine Lochner
    MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, Cape Town, South Africa
    BMC Psychiatry 5:2. 2005
    Similarities between obsessive-compulsive disorder (OCD) and trichotillomania (TTM) have been widely recognized. Nevertheless, there is evidence of important differences between these two disorders...
  32. ncbi Trichotillomania and Pathologic Skin Picking: clinical comparison with an examination of comorbidity
    Brian L Odlaug
    Department of Psychiatry, University of Minnesota Medical Center, Minneapolis, Minnesota 55454, USA
    Ann Clin Psychiatry 20:57-63. 2008
    Pathologic Skin Picking (PSP) and trichotillomania (TTM) are repetitive behaviors presumed to share clinical characteristics...
  33. ncbi An open-label, flexible-dose study of olanzapine in the treatment of trichotillomania
    Rege S Stewart
    Department of Psychiatry, The University of Texas Southwestern Medical Center at Dallas, 75390 9101
    J Clin Psychiatry 64:49-52. 2003
    Thus far, only selective serotonin reuptake inhibitors have been systematically studied in the treatment of trichotillomania, and the results are conflicting...
  34. ncbi Acceptance-enhanced behavior therapy (AEBT) for trichotillomania and chronic skin picking: exploring the effects of component sequencing
    Christopher A Flessner
    Department of Psychology, University of Wisconsin Milwaukee, Milwaukee, WI 53211, USA
    Behav Modif 32:579-94. 2008
    This pilot study examined the utility of acceptance-enhanced behavior therapy (AEBT) for trichotillomania (TTM) and chronic skin picking (CSP) and the impact of altering treatment sequence on overall treatment efficacy...
  35. ncbi Trichotillomania +/- trichobezoar: revisited
    V N Sehgal
    Dermato Venereology Skin VD Centre, Sehgal Nursing Home, Panchwati, Azadpur, Delhi and Skin Institute and School of Dermatology, Greater Kailash, New Delhi, India
    J Eur Acad Dermatol Venereol 20:911-5. 2006
    b>Trichotillomania is an intriguing psychosomatic entity in which there is an irresistible desire to pull out the hair from the scalp, eyelashes, eyebrows and other parts of the body...
  36. ncbi A controlled evaluation of acceptance and commitment therapy plus habit reversal for trichotillomania
    Douglas W Woods
    Department of Psychology, University of Wisconsin Milwaukee, Grand Hall, P O Box 413, Milwaukee, WI 53201, USA
    Behav Res Ther 44:639-56. 2006
    ..Commitment Therapy/Habit Reversal Training (ACT/HRT) to a waitlist control in the treatment of adults with trichotillomania (TTM). Twenty-five participants (12 treatment and 13 waitlist) completed the trial...
  37. ncbi Cluster analysis of obsessive-compulsive spectrum disorders in patients with obsessive-compulsive disorder: clinical and genetic correlates
    Christine Lochner
    MRC Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, PO Box 19063, Tygerberg, 7505, Cape Town, South Africa
    Compr Psychiatry 46:14-9. 2005
    ..Comorbidity of the putative OCSDs in OCD has, however, not often been systematically investigated...
  38. ncbi Laparoscopic removal of a huge gastric trichobezoar in a patient with trichotillomania
    Samer B Shami
    Department of Surgery, Manchester Royal Infirmary, Manchester, UK
    Surg Laparosc Endosc Percutan Tech 17:197-200. 2007
    ..We present a 19-year-old girl who had trichotillomania with a symptomatic abdominal mass that represented a 17-cm gastric trichobezoar...
  39. ncbi Trichotillomania. Presentation, etiology, diagnosis and therapy
    K H Walsh
    Indiana University School of Medicine, Indianapolis, Indiana, USA
    Am J Clin Dermatol 2:327-33. 2001
    b>Trichotillomania (TTM) is an impulse disorder, in which patients chronically pull hair from the scalp and/or other sites...
  40. ncbi Styles of pulling in youths with trichotillomania: exploring differences in symptom severity, phenomenology, and comorbid psychiatric symptoms
    Christopher A Flessner
    Department of Psychology, University of Wisconsin Milwaukee, Milwaukee, WI, USA
    Behav Res Ther 46:1055-61. 2008
    ..high-automatic" or "low-automatic" based upon scores obtained on the Milwaukee Inventory for Styles of Trichotillomania-Child Version (MIST-C) using a median-split procedure...
  41. ncbi Characteristics and phenomenology of hair-pulling: an exploration of subtypes
    P L du Toit
    Medical Research Council Unit on Anxiety and Stress Disorders, Department of Psychiatry, University of Stellenbosch, Tygerberg, South Africa
    Compr Psychiatry 42:247-56. 2001
    ..differences between the following possible subtypes were investigated: hair-pullers with and without DSM-IV trichotillomania (TTM), oral habits, automatic versus focused hair-pulling, positive versus negative affective cues prior to ..
  42. ncbi Trichotillomania. An overview and guide to understanding
    S Enos
    Psychology Department, Santa Clara University, Santa Clara, California 95053-0333, USA
    J Psychosoc Nurs Ment Health Serv 39:10-8. 2001
    ..an irresistible urge to pull out one's hair, which is preceded by tension and followed by relief or pleasure, trichotillomania can cause significant impairment and distress to those who suffer from it...
  43. ncbi An open-label pilot study of naltrexone in childhood-onset trichotillomania
    Avinash De Sousa
    Get Well Clinic and Nursing Home, Mumbai, India
    J Child Adolesc Psychopharmacol 18:30-3. 2008
    This pilot open study evaluates the safety and efficacy of naltrexone in the management of patients with childhood onset trichotillomania (TTM).
  44. ncbi N-acetylcysteine, a glutamate modulator, in the treatment of trichotillomania: a double-blind, placebo-controlled study
    Jon E Grant
    Department of Psychiatry, University of Minnesota School of Medicine, Minneapolis, MN 55454, USA
    Arch Gen Psychiatry 66:756-63. 2009
    b>Trichotillomania is characterized by repetitive hair pulling that causes noticeable hair loss. Data on the pharmacologic treatment of trichotillomania are limited to conflicting studies of serotonergic medications...
  45. ncbi The Trichotillomania Impact Project (TIP): exploring phenomenology, functional impairment, and treatment utilization
    Douglas W Woods
    Department of Psychology, University of Wisconsin Milwaukee, 53211, USA
    J Clin Psychiatry 67:1877-88. 2006
    b>Trichotillomania (TTM) occurs in 0.6% to 3.4% of adults. Questions remain about phenomenological features of the disorder, its impact on functioning, and treatment utilization. The current study (i.e...
  46. ncbi Pediatric trichotillomania: descriptive psychopathology and an open trial of cognitive behavioral therapy
    David F Tolin
    Anxiety Disorders Center, The Institute of Living Hartford Hospital, Hartford, CT 06106, USA
    Cogn Behav Ther 36:129-44. 2007
    In study 1, 46 children and adolescents with trichotillomania who sought treatment at 2 specialty outpatient clinics were assessed...
  47. ncbi SLITRK1 mutations in trichotillomania
    S Zuchner
    Mol Psychiatry 11:887-9. 2006
  48. ncbi Splitting hairs: the 'hamburger sign' in trichotillomania
    Michael C Royer
    Armed Forces Institute of Pathology, Washington, DC, USA
    J Cutan Pathol 33:63-4. 2006
    A 43-year-old male presented with the clinical findings of patchy alopecia that contained persistent hair and re-growth of hairs of various lengths, consistent with trichotillomania. A biopsy was performed to confirm the diagnosis..
  49. ncbi Cognitive inhibition in trichotillomania and obsessive-compulsive disorder
    Antje Bohne
    Massachusetts General Hospital, Harvard Medical School, OCD Clinic, 9th Floor, 149 Thirteenth Street, Charlestown, MA 02129, USA
    Behav Res Ther 43:923-42. 2005
    Cognitive inhibition was investigated in 21 trichotillomania (TTM), 21 obsessive-compulsive disorder (OCD) and 26 healthy control (HC) participants using a block cued directed forgetting task...
  50. doi Practice corner: managing trichotillomania--no need to pull your hair out
    Georgios Papazisis
    Psychiatric Hospital of Thessaloniki, Thessaloniki, Greece
    Evid Based Med 13:66-7. 2008
  51. ncbi Trichotillomania: an NREM sleep parasomnia?
    Carli Murphy
    OSF Saint Francis Sleep Disorders Center, Illinois Neurological Institute, Peoria, IL 61637, USA
    Neurology 66:1276. 2006
  52. ncbi Trichotillomania (hair pulling) in toddlers
    Harry H Wright
    University of South Carolina School of Medicine, Department of Neuropsychiatry and Behavioral Sciences, Columbia 29208, USA
    Psychol Rep 92:228-30. 2003
    Although the clinical diagnosis of trichotillomania has been observed for more than a century, not until the last decade has there been a focus on this diagnosis in early childhood...
  53. ncbi A randomized, double-blind, placebo-controlled trial of olanzapine in the treatment of trichotillomania
    Michael Van Ameringen
    Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
    J Clin Psychiatry 71:1336-43. 2010
    b>Trichotillomania has been considered as part of the obsessive-compulsive disorder spectrum; however, trichotillomania treatment with obsessive-compulsive disorder medications has largely been unsuccessful.
  54. ncbi Loose anagen syndrome as a severity factor for trichotillomania
    K E Thai
    Department of Medicine Dermatology, The University of Melbourne, St Vincent s Hospital Melbourne, Fitzroy, Victoria 3065, Australia
    Br J Dermatol 147:789-92. 2002
    ..A 4-year-old girl presented with patches of hair loss and a clinical diagnosis of trichotillomania was made. A hair pull test extracted multiple hairs easily and painlessly...
  55. ncbi The relationship of violence and trichotillomania
    Susan Boughn
    School of Nursing, College of New Jersey, Ewing, NJ 08628 0718, USA
    J Nurs Scholarsh 35:165-70. 2003
    To examine the relationship between violence and the development of trichotillomania (TTM) in women.
  56. ncbi Styles of pulling in trichotillomania: exploring differences in symptom severity, phenomenology, and functional impact
    Christopher A Flessner
    Department of Psychology, University of Wisconsin Milwaukee, Milwaukee, Milwaukee, WI 53211, USA
    Behav Res Ther 46:345-57. 2008
    ..e., with a compulsive quality) and "automatic" (i.e., with decreased awareness) pulling associated with trichotillomania (TTM), but these constructs have not been assessed using psychometrically sound measures...
  57. ncbi The neuropsychology of trichotillomania
    M A Stanley
    University of Texas, Health Science Center at Houston, USA
    J Anxiety Disord 11:473-88. 1997
    The pathophysiology of trichotillomania (TM) is not well understood. Overlap with obsessive compulsive disorder (OCD) has been proposed, although extant data are inconsistent in this regard...
  58. ncbi The child and adolescent trichotillomania impact project: descriptive psychopathology, comorbidity, functional impairment, and treatment utilization
    Martin E Franklin
    University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
    J Dev Behav Pediatr 29:493-500. 2008
    b>Trichotillomania (TTM) is associated with significant morbidity, comorbidity, and functional impairment in adults...
  59. pmc Clinical characteristics of trichotillomania with trichophagia
    Jon E Grant
    Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN 55454, USA
    Compr Psychiatry 49:579-84. 2008
    Little is known about trichophagia in individuals with trichotillomania. Although studies have mentioned the behavior, no previous studies have examined clinical correlates of trichophagia.
  60. ncbi Evidence for reduced cerebellar volumes in trichotillomania
    Nancy J Keuthen
    Department of Psychiatry, Massachusetts General Hospital, Boston, Massachusetts, USA
    Biol Psychiatry 61:374-81. 2007
    Limited knowledge exists regarding the neurobiology of trichotillomania (TTM). Cerebellum (CBM) volumes were explored, given its role in complex, coordinated motor sequences.
  61. ncbi Trichotillomania and trichobezoar: a clinical practice insight with report of illustrative case
    Joel R Carr
    Department of Psychiatry, Drexel University School of Medicine, Philadelphia, PA 19125 1012, USA
    J Am Osteopath Assoc 106:647-52. 2006
    Untreated trichophagia secondary to trichotillomania is a potentially life-threatening condition...
  62. ncbi Escitalopram in trichotillomania
    M S Bhatia
    Eur Psychiatry 19:239-40. 2004
  63. ncbi Childhood trauma in obsessive-compulsive disorder, trichotillomania, and controls
    Christine Lochner
    MRC Unit on Stress and Anxiety Disorders, University of Stellenbosch, Tygerberg, Cape Town, South Africa
    Depress Anxiety 15:66-8. 2002
    ..Although various factors may play a role in the etiology of both OCD and trichotillomania (TTM), this study is consistent with some evidence from previous studies suggesting that childhood trauma may ..
  64. ncbi Cerebrospinal fluid interleukin-6 in obsessive-compulsive disorder and trichotillomania
    Linda L Carpenter
    Mood Disorders Research Program, Butler Hospital, and Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, 345 Blackstone Boulevard, Providence, RI 02906, USA
    Psychiatry Res 112:257-62. 2002
    ..fluid (CSF) concentrations of the proinflammatory cytokine interleukin (IL)-6 differ between OCD and trichotillomania patients and healthy control subjects...
  65. ncbi Comparison of clinical characteristics in trichotillomania and obsessive-compulsive disorder
    R Tükel
    Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Turkey
    J Anxiety Disord 15:433-41. 2001
    Fifteen patients with trichotillomania (TM) and 25 patients with obsessive-compulsive disorder (OCD) were studied. All patients were evaluated using the structured clinical interview for DSM-III-R (SCID-P)...
  66. ncbi Dissociative experiences in obsessive-compulsive disorder and trichotillomania: clinical and genetic findings
    Christine Lochner
    Medical Research Council Unit on Anxiety Disorders, Department of Psychiatry, University of Stellenboch, Cape Town, South Africa
    Compr Psychiatry 45:384-91. 2004
    ..Based on the relative paucity of data on dissociation and trauma in obsessive-compulsive disorder (OCD) and trichotillomania (TTM), the primary objective of this study was to examine the relationship between trauma and dissociative ..
  67. ncbi Trichotillomania: current issues in conceptualization and treatment
    N J Keuthen
    Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Mass, USA
    Psychother Psychosom 67:202-13. 1998
    b>Trichotillomania is a little-known disorder with wider prevalence and more significant consequences than previously believed...
  68. ncbi Personal toll of trichotillomania: behavioral and interpersonal sequelae
    R M Stemberger
    Loyola College, Baltimore, Maryland 21210 2699, USA
    J Anxiety Disord 14:97-104. 2000
    Patients suffering from trichotillomania are at risk for significant mood and interpersonal problems...
  69. ncbi Beneficial effects of the antiglutamatergic agent riluzole in a patient diagnosed with trichotillomania
    Vladimir Coric
    J Clin Psychiatry 68:170-1. 2007
  70. ncbi Retrospective review of treatment outcome for 63 patients with trichotillomania
    N J Keuthen
    Department of Psychiatry, Massachusetts General Hospital 02129, USA
    Am J Psychiatry 155:560-1. 1998
    The authors' goal was to assess naturalistic treatment outcome in trichotillomania.
  71. ncbi Trichotillomania: women's reports of treatment efficacy
    Susan Boughn
    School of Nursing, The College of New Jersey, Ewing, NJ 08628 0718, USA
    Res Nurs Health 25:135-44. 2002
    b>Trichotillomania (TTM) is an enigmatic disease characterized by an overwhelming compulsion to pull out one's hair, most notably scalp hair, but also eyebrows, eyelashes, and hair from the extremity, axillary, and pubic areas...
  72. ncbi Affective correlates of trichotillomania
    G J Diefenbach
    Department of Psychiatry and Behavioral Sciences, Mental Sciences Institute, University of Texas Houston Medical School, Houston, TX, USA
    Behav Res Ther 40:1305-15. 2002
    Affective correlates of hair pulling were investigated in a sample of 44 participants diagnosed with trichotillomania (TM)...
  73. ncbi Trichotillomania, stereotypic movement disorder, and related disorders
    Dan J Stein
    UCT Department of Psychiatry, Groote Schuur Hospital J 2, Observatory 7925, Cape Town, South Africa
    Curr Psychiatry Rep 9:301-2. 2007
    b>Trichotillomania is currently classified as an impulse control disorder not otherwise classified, whereas body-focused behaviors other than hair-pulling may be diagnosed as stereotypic movement disorder...
  74. ncbi [Peritonitis caused by a giant trichobezoar ventriculi--a case report]
    Marian Szpakowski
    Instytut Centrum Zdrowia Matki Polki, Klinika Chirurgii Ginekologicznej, Łódź
    Ginekol Pol 79:301-4. 2008
    ..The preoperative diagnosis was not confirmed and a giant trichobezoar was found and removed during the surgery...
  75. ncbi Impulsivity and compulsivity in patients with trichotillomania or skin picking compared with patients with obsessive-compulsive disorder
    Ygor Arzeno Ferrão
    Universidade Federal do Rio Grande do Sul Hospital Psiquiátrico São Pedro, Centro Universitário Metodista IPA, Rua Padre Chagas, 185 403 Porto Alegre, 90570 080 Brazil
    Compr Psychiatry 47:282-8. 2006
    ..group of 20 patients with obsessive-compulsive disorder with a group of 20 patients with skin picking and/or trichotillomania (SP/T)...
  76. ncbi Epigastric mass in a young girl: trichobezoar. Imaging diagnosis
    Umesh Kumar Sharma
    Department of Radiodiagnosis, Kathmandu University Teaching Hospital, Dhulikhel, Nepal
    Nepal Med Coll J 8:211-2. 2006
    ....
  77. ncbi Single modality versus dual modality treatment for trichotillomania: sertraline, behavioral therapy, or both?
    Darin D Dougherty
    Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
    J Clin Psychiatry 67:1086-92. 2006
    b>Trichotillomania is a psychiatric condition characterized by chronic hair pulling...
  78. ncbi Obsessive-compulsive disorders in the pediatric dermatology practice
    J Y Koo
    Department of Dermatology, University of California, San Francisco 94143
    Pediatr Dermatol 8:107-13. 1991
    ..When present, OCD is most frequently manifested in younger patients as trichotillomania, onychotillomania, onychophagia, and acne excoriée...
  79. ncbi Escitalopram treatment of trichotillomania
    Kishore M Gadde
    Duke University Medical Centre, Durham, NC 27710, USA
    Int Clin Psychopharmacol 22:39-42. 2007
    ..the effectiveness of escitalopram, a potent and selective serotonin uptake inhibitor, in the treatment of trichotillomania. Twenty women meeting the Diagnostic and Statistical Manual-IV-Text revision criteria for trichotillomania ..
  80. ncbi Trichotillomania
    Judith Fennessy
    Sand Lake Dermatology Center, Orlando, FL, USA
    Dermatol Nurs 20:63. 2008
  81. ncbi Brain activation during implicit sequence learning in individuals with trichotillomania
    Scott L Rauch
    Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
    Psychiatry Res 154:233-40. 2007
    b>Trichotillomania (TTM) may be related to obsessive-compulsive disorder (OCD) and other neuropsychiatric conditions characterized by cortico-striatal dysfunction...
  82. ncbi Gastric trichobezoar presenting as gastric outlet obstruction--a case report
    Binay Thakur
    Department of Surgical Oncology, BP Koirala Memorial Cancer Hospital BPKMCH, Bharatpur, Nepal
    Nepal Med Coll J 9:67-9. 2007
    ..They occur in emotionally disturbed, depressed, or mentally retarded patients who have trichotillomania and trichophagia. Removal of gastric trichobezoar by open surgery (gastrotomy) is a standard approach...
  83. ncbi Examination of gender in pathologic grooming behaviors
    Jon E Grant
    Department of Psychiatry, University of Minnesota Medical Center, 2450 Riverside Avenue, Minneapolis, MN 55454, USA
    Psychiatr Q 78:259-67. 2007
    b>Trichotillomania and pathologic skin picking are pathologic versions of grooming behaviors. Although mentioned in the psychiatric literature for decades, little is known about how gender influences clinical presentation of these behaviors...
  84. pmc Obsessive-compulsive spectrum of disorders: a defensible construct?
    David J Castle
    Mental Health Research Institute and University of Melbourne, Parkville, Victoria, Australia
    Aust N Z J Psychiatry 40:114-20. 2006
    ..To explore critically whether there is a robust basis for the concept of an obsessive-compulsive (OC) spectrum of disorders, and if so, which disorders should be included...
  85. ncbi Is it trichotillomania? Hair pulling in childhood: a developmental perspective
    Radhika Santhanam
    School of Medicine, University of Queensland, Cairns, Australia
    Clin Child Psychol Psychiatry 13:409-18. 2008
    ..Thirty-eight children were clinically assessed for a diagnosis of trichotillomania, co-morbidity, co-existing habits and other relevant factors...
  86. ncbi Basal ganglia hemorrhagic ablation causing temporary suppression of trichotillomania symptoms
    Ygor Arzeno Ferrão
    Rev Bras Psiquiatr 25:262-3, author reply 263. 2003
  87. ncbi Weathering of hair in trichoteiromania
    Jeremy P Banky
    Department of Dermatology, Oxford Radcliffe Hospitals, Headington, Oxford, UK
    Australas J Dermatol 45:186-8. 2004
    ..Education and behavioural therapy were instituted. After 4 months of reduced rubbing of the vertex scalp hairs, the hairs re-grew with no evidence of persistent hair shaft abnormality...
  88. ncbi Successful treatment of trichotillomania with olanzapine augmentation in an adolescent
    Sanjeev Pathak
    J Child Adolesc Psychopharmacol 14:153-4. 2004
  89. ncbi [Functional imaging in mental disorders]
    Katalin Borbely
    Országos Idegsebészeti Tudományos Intézet, Nukleáris Medicina Osztály, Budapest
    Orv Hetil 145:277-89. 2004
    ..Additionally, radionuclide techniques may improve medical therapy by demonstrating individual biochemical abnormalities of altered brain functions...
  90. ncbi Impact of age at onset and duration of illness on the expression of comorbidities in obsessive-compulsive disorder
    Juliana B Diniz
    Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil
    J Clin Psychiatry 65:22-7. 2004
    Obsessive-compulsive disorder (OCD) patients usually experience comorbidities including tics, trichotillomania, body dysmorphic disorder, and mood and anxiety disorders...
  91. ncbi Gastric trichobezoar: an important cause of abdominal pain presenting to the pediatric emergency department
    Kristin A Lynch
    Department of Pediatrics, University of Utah College of Medicine and Primary Children s Medical Center, Salt Lake City 84113, USA
    Pediatr Emerg Care 19:343-7. 2003
    ..Finally, we review and briefly summarize the current literature regarding the etiology, diagnosis, and management of this disorder in children...
  92. ncbi Obsessive-compulsive symptoms, obsessive-compulsive disorder, and related disorders in Parkinson's disease
    Alex F Maia
    Department of Psychiatry, University of Sao Paulo Medical School, Sao Paulo, Brazil
    J Neuropsychiatry Clin Neurosci 15:371-4. 2003
    ..g., tic disorders, trichotillomania, and body dysmorphic disorder) in 100 patients with Parkinson's disease (PD) and 100 individually matched ..
  93. ncbi The relationship of obsessive-compulsive disorder to putative spectrum disorders: results from an Indian study
    T S Jaisoorya
    Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
    Compr Psychiatry 44:317-23. 2003
    ..g., Tourette's syndrome [TS]), and impulse control disorders (e.g., trichotillomania). Only those disorders that are commonly noted to be possibly related to OCD are studied...
  94. ncbi Trichotillomania
    Anthony J Papadopoulos
    Dermatology and Pediatrics, New Jersey Medical School, Newark, New Jersey 07103 2714, USA
    Int J Dermatol 42:330-4. 2003
  95. ncbi [Obsessive-compulsive disorders in children. Subtypes of OCD and their relation to infection with group A streptococci]
    Per Hove Thomsen
    Børne og Ungdomspsykiatrisk Hospital, Arhus Universitetshospital, Harald Selmers Vej 66, DK 8240 Risskov
    Ugeskr Laeger 164:3763-7. 2002
    ..This spectrum includes such disorders as trichotillomania, eating disorders, body dysmorphic disorder, and possibly pervasive developmental disorders...
  96. ncbi Acceptability of treatments for trichotillomania. Effects of age and severity
    Amy J Elliott
    Western Michigan University, USA
    Behav Modif 26:378-99. 2002
    Based on the literature, trichotillomania (TTM, chronic hair pulling) in children and adults appears to be responsive to behavioral interventions such as habit reversal...
  97. pmc Further evaluation of the role of protective equipment in the functional analysis of self-injurious behavior
    John C Borrero
    University of Florida, Gainesville 32611, USA
    J Appl Behav Anal 35:69-72. 2002
    ..Results of our analyses revealed that the use of protective equipment during functional analyses of SIB suppressed levels of responding such that a behavioral function could not be identified...
  98. ncbi Early- versus late-onset obsessive-compulsive disorder: investigating genetic and clinical correlates
    Sian M J Hemmings
    MRC Unit on Anxiety and Stress Disorders, University of Stellenbosch, Medical School, PO Box 19063, Tygerberg 7505, South Africa
    Psychiatry Res 128:175-82. 2004
    ..an association between early age of onset and an increased frequency of tics, Tourette's disorder, and trichotillomania (TTM)...
  99. ncbi [Trichotillomania. Its course and psychosocial consequences]
    Katarzyna Prochwicz
    Instytutu Psychologii UJ
    Psychiatr Pol 38:639-49. 2004
    The article contains the definition and characteristics of trichotillomania, its prevalence, main syndromes and factors which intensify the pressure of uncontrolled hair pulling...
  100. pmc Strategy implementation in obsessive-compulsive disorder and trichotillomania
    Samuel R Chamberlain
    Department of Psychiatry, University of Cambridge School of Clinical Medicine, Addenbrooke s Hospital, Cambridge, UK
    Psychol Med 36:91-7. 2006
    ..However, studies to date have not examined the effects of strategy training on task performance in OCD or in trichotillomania (compulsive hair-pulling, a condition that has been argued to share overlap with OCD in terms of ..
  101. ncbi Diagnosis and management of trichotillomania in children and adolescents
    Travis O Bruce
    Department of Neuropsychiatry and Behavioral Science, University of South Carolina School of Medicine, Columbia, South Carolina, USA
    Paediatr Drugs 7:365-76. 2005
    b>Trichotillomania (TTM), a disorder characterized by the repeated non-cosmetic pulling out of hair from any part of the body, was first described in 1889...

Research Grants29

  1. Trichotillomania Referral Education Awareness and Treatment (TREAT)
    SALVATORE LIBRETTO; Fiscal Year: 2007
    unreadable] DESCRIPTION (provided by applicant): Trichotillomania (compulsive hair pulling), or TTM, is characterized by the recurrent pulling out of one's own hair resulting in noticeable hair loss...
  2. From Defective Microglia to Cortical Activity and Pathological Behavior
    Mario R Capecchi; Fiscal Year: 2013
    ..behavior manifested by compulsive grooming and hair removal, similar to human with the OCD-spectrum disorder, trichotillomania. These mice first exhibit compulsive grooming, which turns pathological, resulting in hair removal and ..
  3. Awareness Enhancement and Monitoring Device for Treatment of Trichotillomania
    Joseph A Himle; Fiscal Year: 2012
    ..an inconspicuous, awareness- enhancement and monitoring device (AEMD) which will assist the treatment of trichotillomania (TTM)...
  4. Behavior Therapy for Pediatric Trichtillomania
    Martin E Franklin; Fiscal Year: 2012
    DESCRIPTION (provided by applicant): Trichotillomania (TTM) is a chronic impulse control disorder characterized by pulling out one's own hair, resulting in noticeable hair loss...
  5. Acceptance Enhanced Behavior Therapy for Trichotillomania
    Douglas W Woods; Fiscal Year: 2013
    DESCRIPTION (provided by applicant): Trichotillomania (TTM) is a chronic impulse-control disorder involving the repetitive pulling and removal of one's hair that results in notable hair loss...
  6. Stepped Care in the Treatment of Trichotillomania
    DAVID A HAAGA; Fiscal Year: 2010
    DESCRIPTION (provided by applicant): Trichotillomania (TTM), repetitive pulling out of one's own hair to the extent that noticeable hair loss occurs, is a distressing condition interfering substantially with functioning and quality ..
  7. Genetic and Functional Analysis of the Obsessive-Compulsive Spectrum
    Uzoezi Ozomaro; Fiscal Year: 2012
    Obsessive-compulsive disorder (OCD) and the spectrum of associated conditions, such as trichotillomania (TTM), Tourette's syndrome, and body dysmorphic disorder, affect about 2-4% of the population worldwide...
  8. Clinical and Research Training Curriculum in Behavioral Treatments
    Douglas W Woods; Fiscal Year: 2012
    ..as existing faculty clinical-research strengths in habit reversal training (HRT) for tic disorders (TD) and trichotillomania (TTM) and behavioral activation (BA) for depression. Two curricular modifications will be implemented...
  9. Error-related brain activity and pediatric anxiety
    Greg Hajcak; Fiscal Year: 2005
    ..by investigating error-related brain activity in pediatric obsessive-compulsive disorder (OCD) and trichotillomania (TTM) both before and after cognitive-behavioral intervention...
  10. Cognitive-Behavioral Therapy for Pathological Gambling
    Jon Grant; Fiscal Year: 2008
    ..This award would provide me with the necessary background for further studies in the treatment of pathological gambling and the training for an independent patient-oriented research career. ..
  11. TREATMENT OF PEDIATRIC OBSESSIVE COMPULSIVE DISORDER
    Martin Franklin; Fiscal Year: 2007
    ..Health professionals then will be better able to advise their pediatric OCD patients regarding the management of partial response to SRls. ..
  12. Screening for GAD among Frail Elderly
    Gretchen Diefenbach; Fiscal Year: 2006
    ..The R03 will provide pilot data to support a subsequent R34 to develop and pilot test a cognitive behavioral treatment for use within the community-based program. ..
  13. COGNITIVE-BEHAVIORAL TREATMENT OF PED TRICHOTILLOMANIA
    Martin Franklin; Fiscal Year: 2003
    ..involves the development and empirical testing of a manual-driven cognitive-behavioral therapy for pediatric trichotillomania (TTM), a chronic impulse control disorder in which the individual acts on urges to pull out his/her own hair...
  14. Neural Mechanisms of Compulsive Hoarding
    David Tolin; Fiscal Year: 2009
    ..We will use cutting-edge data analytic procedures to examine patterns of interrelated neural activation as well as the time course of activation across the decision making process. ..
  15. Stepped Care for Obsessive-Compulsive Disorder
    David Tolin; Fiscal Year: 2008
    ..However, because of the novelty of this approach extensive protocol development and pilot research via this R34 application is needed before the program can be truly operational. [unreadable] [unreadable]..
  16. A Family-Genetic Study of Pathological Gambling
    Donald Black; Fiscal Year: 2009
    ..abstract_text> ..
  17. Personality, anxiety, and depression in community adults
    O Bienvenu; Fiscal Year: 2007
    ..He will be guided by exceptionally talented mentors, including Drs. Gerald Nestadt, Kenneth Kendler, William Eaton, Kung-Yee Liang, Paul Costa, Murray Stein, Patrick Sullivan, and Lindon Eaves. ..
  18. MOLECULAR GENETICS OF SCHIZOPHRENIA
    Donald Black; Fiscal Year: 2006
    ..The goal of the study is to identify one or more SZ susceptibility genes whose subsequent characterization inmolecular and functional studies will elucidate the pathophysiology and treatment of SZ. ..
  19. A Cognitive Group Treatment for Borderline Outpatients
    Donald Black; Fiscal Year: 2005
    ..abstract_text> ..
  20. BASAL GANGLIA FUNCTION IN OBSESSIVE COMPULSIVE DISORDER
    Scott Rauch; Fiscal Year: 2003
    ..abstract_text> ..
  21. Bupropion VS Placebo to Treat Pathological Gambling
    Donald Black; Fiscal Year: 2004
    ..abstract_text> ..
  22. Pharmacogenetics in Tourette Syndrom
    Harvey Singer; Fiscal Year: 2004
    ..The identification of genetic polymorphisms that are associated with clinical disease or treatment success, has obvious benefits. ..
  23. Prefrontal Mechanisms in Retention of Fear Extinction
    Scott Rauch; Fiscal Year: 2006
    ..In humans, such knowledge may be critical for elucidating the pathophysiology of anxiety disorders and developing improved extinction-based treatments. ..
  24. Improving Outcomes in Pharmacotherapy of Social Phobia
    Michael Van Ameringen; Fiscal Year: 2009
    ..It thus directly addresses a critical public health issue that adversely affects a substantial proportion of the population. ..
  25. Probing Amygdalo-Cortical Circuitry in Anxiety Disorders
    Scott L Rauch; Fiscal Year: 2010
    ..4) study psychiatric comparison groups, in addition to normal comparison and trauma-exposed normal comparison subjects, in order to determine the specificity (vs. generalizability) of findings among these anxiety disorders. ..
  26. Awareness Enhancement and Monitoring Device for Treatment of Trichotillomania
    Joseph Himle; Fiscal Year: 2007
    ..will develop a wearable awareness enhancement and monitoring device (AEMD) which will assist the treatment of trichotillomania, a repetitive hair pulling disorder that leads to noticeable hair loss...
  27. PHYSIOLOGIC STUDIES OF ANGER IN DEPRESSED PATIENTS
    Darin Dougherty; Fiscal Year: 2002
    ..abstract_text> ..
  28. Zonisamide for Weight Reduction in Obese Adults
    Kishore Gadde; Fiscal Year: 2009
    ..We will also systematically assess whether weight loss achieved with zonisamide treatment can reduce metabolic and cardiovascular risk factors. ..
  29. PULSE LOADED IV CLOMIPRAMINE IN UNRESPONSIVE OCD
    Lorrin Koran; Fiscal Year: 2001
    ..outcome can be predicted from baseline clinical information. (Throughout this revised grant application, revisions are indicated by bold type face, except that the new Introduction is in ordinary typeface). ..