Compulsive exercise in adults with trichotillomania and skin picking disorder

Boutouis, Sophie and Grant, Jon E. (2026) Compulsive exercise in adults with trichotillomania and skin picking disorder. JOURNAL OF BEHAVIORAL ADDICTIONS, 15 (1). pp. 488-496. ISSN 2062-5871

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Abstract

Background and aims Compulsive exercise (CE) has significant theoretical overlap with obsessive-compulsive disorder. No research has examined the relationship between CE and trichotillomania and skin picking disorder, common conditions on the obsessive-compulsive spectrum. Methods A total of 382 adults (mean age = 29.2, 78.0% female) with trichotillomania (n = 203) and/or skin picking disorder (n = 276) completed an online survey. Participants who met criteria for CE on the Minnesota Impulse Disorders Interview were compared to those who did not meet these criteria on demographics, a clinical measure of hair pulling/skin picking severity and impairment, and various personality traits. Results The prevalence of CE in the sample was 10.2% (n = 39). Subjects who screened positive for CE were more likely to be male (p = .003), were less likely to engage in hair pulling/skin picking daily (p < .001), had more hair pulling/skin picking-related impairment (p < .001), reported more physical/verbal aggression, anger, and hostility (p < .001), and reported being less open to experience than those who screened negative (p < .001). In a binary logistic regression model, hair pulling/skin picking-related impairment was not significantly associated with CE after accounting for personality traits. Discussion and conclusions CE appears to be common in adults with trichotillomania and skin picking disorder, and CE is associated with lower openness to experience and higher trait aggression, anger, and hostility. Mental health providers should screen for CE in these patients and consider how these dimensional traits may influence treatment outcomes.

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