NIMH Trichotillomania Symptom Severity Scale In the average day, for the past week, how much time did you spend pulling hairs?Please select your answerNone15 minutes or less16-30 minutes31-60 minutes1-2 hoursMore than 2 hours Which hairs did you pull this week? Scalp / head Eyebrow Eyelash Arm / leg / body Pubic Other If other, please explain: How much time did you spend pulling hairs yesterday?Please select your answerNone15 minutes or less16-30 minutes31-60 minutes1-2 hoursMore than 2 hours What were the thoughts or feelings preceding the pulling episode? I felt anxious and this calmed me down. I felt compelled to pull and reacted to that urge. I had a troublesome thought and the ritual / habit or pulling made the thought "okay". Other If other, please explain: Did you attempt to resist the urge to pull?Please select your answerNO - too much effort to resist.NO - previously unable to resist so didn't try.NO - didn't think about resisting.NO - otherYES - successfully resisted the urge to pull.YES - moderately successful in resisting the urge to pull.YES - limited success in resisting the urge to pull.YES - unsuccessful in resisting the urge to pull. How much are you bothered by this compulsion / habit?Not at all - 012345 - Very, very much How much does hair pulling interfere with your daily life?None - 012345 - A great deal In what ways does hair pulling interfere with your daily life? Resulting appearance is embarrassing or prohibits activities. Interference because of time used pulling. Other If other, please explain: Time is Up! Time's up
