Question at position 2 Each time Harry feels anxious, he compulsively pulls hair from his scalp or eyebrows. This compulsive urge to pull his hair has made him partially bald. Harry is most likely to be diagnosed with which of the following OCD-related disorders?excoriationtrichotillomaniaBody dysmorphic disorderhoarding disorder单项选择题
A
excoriation
B
trichotillomania
C
Body dysmorphic disorder
D
hoarding disorder

Question

Question at position 2 Each time Harry feels anxious, he compulsively pulls hair from his scalp or eyebrows. This compulsive urge to pull his hair has made him partially bald. Harry is most likely to be diagnosed with which of the following OCD-related disorders?excoriationtrichotillomaniaBody dysmorphic disorderhoarding disorder单项选择题

A

excoriation

B

trichotillomania

C

Body dysmorphic disorder

D

hoarding disorder

BlackTom AI · Accepted Answer

Trichotillomania (hair-pulling disorder) is characterized by recurrent, compulsive pulling out of one's hair resulting in noticeable hair loss, repeated attempts to decrease or stop the behavior, and significant distress or impairment. It is classified among the obsessive-compulsive and related disorders in DSM-5.

1. Relevant knowledge points and concepts
- Trichotillomania: recurrent hair pulling causing hair loss (scalp, eyebrows, eyelashes), often preceded by tension and followed by relief or gratification; causes distress/functional impairment; not attributable to another medical condition.
- Excoriation (skin-picking) disorder: repetitive skin picking causing lesions, not hair pulling.
- Body dysmorphic disorder (BDD): preoccupation with perceived defects in appearance and repetitive behaviors (mirror checking, camouflaging), but the core is body-image preoccupation rather than compulsive hair pulling.
- Hoarding disorder: persistent difficulty discarding possessions leading to accumulation and clutter, unrelated to hair pulling.

2. Step-by-step reasoning
- Symptom: compulsive pulling of hair from scalp or eyebrows → direct match with the defining behavior of trichotillomania.
- Consequence: partial baldness → demonstrates clinically significant hair loss from the behavior.
- Trigger: occurs each time he feels anxious (an internal trigger and tension-reduction pattern) → consistent with the urge–tension–relief cycle described in trichotillomania.
- No description suggests skin picking, preoccupation with an imagined defect, or difficulty discarding items, so other diagnoses are less fitting.

3. Calculations
- None applicable.

4. Why the correct answer is correct
The case explicitly describes repetitive hair pulling leading to hair loss and triggered by anxiety—core diagnostic features of trichotillomania (hair-pulling disorder).

5. Why other options are incorrect
- Excoriation: involves skin picking, not hair pulling.  
- Body dysmorphic disorder: centers on preoccupation with a perceived defect, not necessarily repetitive hair pulling causing baldness.  
- Hoarding disorder: involves accumulation of items and difficulty discarding, unrelated to hair-pulling behavior.

6. Conclusion
The described behavior best fits trichotillomania; therefore the correct diagnosis is trichotillomania, matching the provided answer.

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