intermediatetrichotillomaniahair-pulling disorderOCD spectrumbody-focused repetitive behaviorBDD differentialDSM-5 criteria
A 31-year-old female reports spending 2-3 hours daily pulling hair from her scalp, resulting in noticeable bald patches. She has tried repeatedly to stop but cannot. She describes a building tension before pulling and a sense of relief afterward. She wears hats to conceal the hair loss and has stopped socializing due to embarrassment. What is the MOST likely diagnosis?