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題 名 | 成功治癒拔毛症之經驗--一例報告=A Successful Experience Treating Trichotillomania: A Case Report |
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作 者 | 劉廣齊; 黎欣怡; 姚成榮; 陳盤銘; | 書刊名 | 慈濟醫學 |
卷 期 | 15:2 2003.04[民92.04] |
頁 次 | 頁135-139 |
分類號 | 415.8754 |
關鍵詞 | 拔毛症; 衝動控制疾患; 拒學症; 心理治療; Trichotillomania; Impulse control disorder; School refusal; Psychotherapy; |
語 文 | 中文(Chinese) |
中文摘要 | Trichotillomania(拔毛症)又稱為hair pulling,trichologia,trichomania,為衝動控制疾患之一,罹患者以兒童及青少年為主。超過四分之一的兒童拔毛症患者,有明顯的壓力源為其重大導因,諸如親子關係失調,害怕獨處,及近期失落等。本文試圖從兒童的拔毛症和內在焦慮作一探討。個案為九歲國小三年級原住民女孩,由學校護士及輔導人員帶至醫院求診,原因為二個月來一直拔扯自己頭髮。經會診皮膚科後並未發現有任何皮膚病灶,多項心理評估後以認知行為治療、家族治療及支持性會談治療,緩解個案焦慮程度以改善拔毛症症狀,全程未對個案投予任何精神藥物治療。拔毛症屬於衝動控制疾患(impulse control disorder)之一,以拔扯自己毛髮之強迫行為為主要症狀,大多肇因於壓力,積極治療應將壓力源去除;將頭髮剃去並無法解決根本問題,應由所遇到之壓力種類來決定治療模式。本文個案並未投與任何藥物,而以多項心理評估與諮商、簡易行為、支持性會談及家族晤談及治療,成功地改善個案在焦慮及拔髮的行為症狀,以強調除藥物治療外,此類患者心理社會評估及介入之重要性。 |
英文摘要 | Trichotillomania, also named hair pulling, trichologia or trichomania, is an impulse control disorder that occurs mostly in children and adolescents. More than a quarter of young patients with this disorder have been found to suffer from significant psychological stress such as an instable parent-child relationship, a fear of emptiness or a recent loss. In this article we try to analyze the relationship between the hair-pulling impulse and inner anxiety. The client, a 9-year-old native girl, is in the 3rd grade of primary school and was brought to our hospital by a school nurse and a counselor because she had been pulling her hair for 2 months. An examination by a dermatologist found no skin lesion, so together with a complete psychological assessment, we performed cognitive-behavioral therapy, family counseling, family therapy and supportive psychotherapy with the aim of alleviating the hair pulling. No drugs were prescribed during the course of treatment. Trichotillomania is an impulse control disorder, with its main behavioral symptoms being hair pulling. Many victims have been under psychological stress before the behavior occurs and the approach to treatment should be one of 'understanding' rather than 'getting rid of' the behavior. Thus, the treatment modality should depend on the nature of the stress. This article describes how a psychosocial approach can play a role by integrating versatile psychological assessment, counseling, family therapy and supportive psychotherapy in the treatment of such a patient successfully without using any medication. We suggest that it is important to emphasize psychosocial intervention in the treatment of this kind of patient rather than medication. |
本系統中英文摘要資訊取自各篇刊載內容。