Diagnosis of Trichotillomania
Official DSM-IVR Diagnosis of Trichotillomania is that these 5 criteria must be present:
1. Recurrent plucking of one's hair resulting in noticeable hair loss
2. Increasing build-up of tension immediately before the plucking, which is follow by:
3. Sense of relief or reduction in tension when the hair is pulled
4. The problem is not better explained by an alternative mental or medical disorder
5. The problem results in significant distress or impairment to the individual in social, vocational or other areas of life
The diagnostic criteria of Trichotillomania is seen as contentious by some, Christenson et al (1991)and Shlosser et al 1994 (in Stein, Christenson and Hollander 1999) found that a significant number of sufferers (between 17 and 23%) taken from a clinical sample lacked either criterion 2 or 3 but still exhibited meaningful hair pulling that fulfilled the other criteria.
References:
Christenson GA, Chernoff-Clementz E, Clementz BA Personality and clinical characteristics in patients with trichotillomania. Clin Psychiatry. 1992 Nov;53(11):407-13.
Stein G, Christenson A, Hollander E (1999). Trichotillomania. Washington American Psychiatric Press.