Nouvelles normalités Nouvelles pathologies Nouvelles ... - Psynem

6° 6éme Congresso Congrès Européen Europeo de di Psicopatologia Psychopathologie dell’Infanzia de l’Enfance e et dell’Adolescenza
de l’Adolescence
Nuove Nouvelles normalità normalités Nuove Nouvelles patologie pathologies Nuove pratiche Nouvelles pratiques
SATURDAY, May 7 SYMPOSIUMS
SYMPOSIUM 8 WAIMH. Multiple facets of infant psichopathology
TRICHOTILLOMANIA IN INFANCY IS NOT ALWAYS A BENIGN HABIT
Sam Tyano, Miri Keren Tel Aviv University medical school, Geha mental health unit, Israel
Whether infancy-onset trichotillomania is best
regarded as a habit, an early sign of obsessive
compulsive disorder, a symptom of anxiety, or a
sign of severe deprivation has been a topic of
continuous debate. In this paper, we describe our
clinical experience. A distinct psychosocial stressor
can be identified in most cases, and loss in
the parents’ histories is common. Most of the children
have no transitional object.
Length of treatment varies from 4 to 21 sessions
and outcome seems to be unrelated to treatment
duration. Mother-child interactions tend to be
characterized by a lack of maternal physical contact
and warmth, sharp maternal transitions
between under-involvement and intrusiveness,
lack of mutual engagement, and no elaboration of
symbolic play.
461
The overall family functioning tends to be instrumental.
We tentatively suggested that early-onset
trichotillomania represents an end-point symptom
of several factors, such as a disturbed parentinfant
relationship, a low pain threshold in the
infant, and a parental hypersensitivity to overt
expressions of aggressive impulses and negative
affects. Issues related to treatment modalities are
also addressed.
Discussion focuses on our experience that
early-onset cases of trichotillomania are often not
benign or homogenous in terms of etiology,
course, or response to treatment and require
much further study.